Feasibility and acceptability of a brief suicide intervention for youth involved with the family court

As efforts to develop models for suicide prevention and intervention in the juvenile justice (JJ) system continue to grow, research to understand the feasibility and acceptability of implementing these models is critical. Examining organizational readiness for implementation, ensuring leadership and staff buy‐in for delivering the intervention, and planning for sustainability of staff participation in implementation efforts is essential. The current study involved semi‐structured formative evaluation interviews with key JJ stakeholders (n = 10) to determine perspectives on the acceptability (perceived need and fit of the intervention) and feasibility (organizational readiness for change) of a proposed brief safety planning intervention for youth with suicidal ideation delivered by nonclinical staff and integrated into the existing system. Qualitative data revealed stakeholders' perceived need for the intervention in the family court context and their agreement that the aims of the intervention were congruent with the goals of the family court. Some barriers to successful implementation were noted, which, addressed through selection of appropriate implementation strategies, can be overcome in a future test of the safety intervention.     

Individual and contextual predictors of involvement in twelve-step self-help groups after substance abuse treatment

Drawing on ecological and narrative theories of self-help groups, this study tests a multilevel model predicting self-help group involvement among male veterans who received inpatient substance abuse treatment. Following K. Maton (1993), the study moves beyond the individual-level of analysis to encompass variables in the treatment and post-treatment social ecology. Surveys administered to patients (N = 3,018) and treatment staff (N = 329) assessed these predictor domains and self-help group involvement 1 year after discharge. A hierarchical linear model fit to the data indicates that greater involvement in 12-step groups after discharge is predicted by the compatibility between personal and treatment belief systems. The implications of these findings for efforts to facilitate transitions between inpatient professional treatment and community-based self-help groups are discussed.     

Readiness, Functioning, and Perceived Effectiveness in Community Prevention Coalitions: A Study of Communities That Care

This paper examined whether community readiness, prevention knowledge, coalition functioning, and barriers are linked to perceived effectiveness of community prevention coalitions. Interviews were conducted with 203 key leaders in Communities That Care (CTC) prevention boards in 21 Pennsylvania communities. Community-level means for the reliable self-report measures were utilized separately and in combination with research staff ratings, state technical assistant staff ratings, and other data. The results indicated that the strong link between readiness and perceived effectiveness was mediated by internal coalition functioning. The extent of CTC linkage with outside community entities was not linked to perceived effectiveness. The study concludes that community readiness is an important condition for success of a prevention coalition, and exerts effects mainly through the quality of the coalition's internal functioning. Member turnover and infighting appear to be important factors related to internal functioning. Linkage with outside entities may be more important for coalition models where the coalition is more dependent on local institutions for resources.     

Situation Awareness and Transformational Leadership in Senior Military Leaders: An Exploratory Study

This study explored the relationship between leadership style and operational readiness in a sample of senior Norwegian military officers (N = 43), who participated in a 1-week joint staff exercise. Leadership style was measured by the Multifactor Leadership Questionnaire (MLQ-45), and indicators of operational readiness included situation awareness and interpersonal influence. Transformational leadership emerged as a predictor of situation awareness (R² = .33) and interpersonal influence (R² = .25), with intellectual stimulation as the only significant predictor among the facet subscales. Some possible theoretical and methodological implications for future research are also pointed out.     

Suicidal Ideation among Inmate‐Patients in State Prison: Prevalence,Reluctance to Report,and Treatment Preferences

This study examined the prevalence, willingness to report, and treatment preferences for suicidal ideation among state prison inmates. The Beck Scale for Suicide Ideation (BSS) and a novel questionnaire were completed by 67 inmate‐patients. The BSS score was in the high range for 15% of general population (GP) and 40% of Intermediate Care Program (ICP) patients, with 19% of ICP inmates reporting a “moderate to strong” desire to commit suicide. A majority (64% GP, 86% ICP) had prior suicide attempt(s). Forty‐two percent of GP and 31% of ICP inmate‐patients were unlikely to tell mental health staff about suicidal thoughts. Family contact and talking with mental health staff were preferred interventions. ICP inmates preferred staff visits and observation in their own cells, but GP inmates did not. Only a small minority (14% GP, 21% ICP) favored transfer to a crisis observation cell, but the least desired option was talking to a corrections officer. While many inmate‐patients reported experiencing suicidal thoughts, they preferred not to inform staff. Almost 80% did not favor the current primary intervention: the observation cell. Alternative or supplementary options should be considered. Copyright © 2013 John Wiley & Sons, Ltd.     

The effects of self-monitoring on the procedural integrity of a behavioral intervention for young children with developmental disabilities

The effects of self-monitoring on the procedural integrity of token economy implementation by 3 staff in a special education classroom were evaluated. The subsequent changes in academic readiness behaviors of 2 students with low-incidence disabilities were measured. Multiple baselines across staff and students showed that procedural integrity increased when staff used monitoring checklists, and students' academic readiness behavior also increased. Results are discussed with respect to the use of self-monitoring and the importance of procedural integrity in public school settings.     

Selecting nonprofessional counselor trainees with the Group Assessment of Interpersonal Traits (GAIT)

The GAIT is a procedure for sampling and measuring communication behavior. Candidates for a counselor-training program (136 Ss; 86% women; average age 44 yr.) took the GAIT in 18 groups and completed written forms for staff screening. Data included pre-GAIT first impression peer ratings and GAIT Empathy. Acceptance, and Openness ratings by peers and by trained audiotape judges. After nine months of training, 26 remaining Ss were judged on a counseling readiness criterion. First impression and peer GAIT ratings were positively intercorrelated, but none predicted counseling readiness. The criterion was correlated with both trained GAIT Empathy (Kendall tau = .40) and staff ratings (.41. both ps less than .01). Suggestions were made for using the GAIT as a counselor selection instrument.     

T-Group Theory and Laboratory Method: Innovation in Re-Education Edited by Leland P. Bradford,Jack R. Gibb,and Kenneth D. Benne

The authors conducted a quantitative examination of parallels between milieu and therapy group dynamics on a short-term inpatient unit. The Ward Atmosphere Scale was used to assess the milieu, and the Group Climate Questionnaire-S to measure processes in key groups. Assessments were made by patients and staff once each week for 10 months. The authors found clear parallels between ward and therapy group processes. The parallels reflected the impact of patterns utilization of the unit, its treatment philosophy, and the emotional dynamics of its constituents. Examination of these associations also revealed limitations of the treatment setting, clarified the potential impact of particular staff interventions, and demonstrated biases in the rating methods. Study of parallel process on the psychiatric unit is a rich source of information on the nature of inpatient treatment.     

Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa

Although group therapy is often recommended for the treatment of bulimia nervosa, relatively little is known about predictors of short-term outcome. This pilot study examined whether a standardized measure of readiness for change might be related to changes in binge frequency. Sixteen bulimic patients participated in short-term cognitive behavioral group therapy for twelve weeks. Each patient completed the Change Assessment Scale prior to treatment, along with a battery of symptom measures which were readministered at the conclusion of therapy. Bulimic patients with positive outcome in binge frequency were at a higher stage of readiness for change at pretreatment than were patients with negative outcome. Results indicated that there may be methods of determining who would be most likely to benefit from cognitive behavioral group therapy, and tentatively suggest that interventions may be more successful when readiness for change is taken into consideration.     

Individual Determinants of Behavioral Intentions: What tells us that practitioners really want to change hiring strategies?

The current study investigated hiring managers' intentional readiness to change hiring procedures as a function of individual determinants, such as their self‐efficacy beliefs, causal attributions, and past behaviors. Hiring managers from three large organizations were recruited to participate and provide information about their current hiring processes and personal experiences. Results showed that self‐efficacy beliefs had a strong negative relationship with intentional readiness to change. Managers' past behavior, in terms of use of unstructured interviews and external attributions of failure, were negatively associated with intentional readiness to change, while use of unstructured interviews and external attribution of success were positively associated with intentional readiness to change. Furthermore, the interactive effect of causal attribution and use of selection methods played a significant role in explaining intentional readiness for change. The results indicated that recruiting managers who preferred using unstructured interviews and attributed failures to external causes were less willing to change hiring practices than those who made less use of unstructured interviews and explained their failure externally. Implications and limitations are discussed.     

The Emergence of Suicidal Ideation During the Post‐Hospital Treatment of Depressed Patients

There is a paucity of research on the emergence of suicidal ideation in recently hospitalized patients undergoing treatment for depression. As part of a larger clinical trial, patients (N = 103) with major depression without suicidal ideation at hospital discharge were followed for up to 6 months while receiving study‐related outpatient treatments. Fifty‐five percent reported the emergence of suicidal ideation during the outpatient period, with the vast majority (79%) exhibiting this problem within the first 2 months post‐discharge. Seventy percent of those reporting severe suicidality prior to hospitalization exhibited a reemergence of suicidal ideation post‐discharge. However, 29% without significant suicidality at the index hospitalization later developed suicidal ideation during the outpatient treatment period. A faster time to the emergence of suicidal ideation was predicted by both higher prehospitalization levels of suicidal ideation as well as greater depression severity at hospital discharge. Overall, rates of emergent suicidal ideation found in the current sample of recently hospitalized patients were higher than those reported in previous outpatient samples.     

Spirituality and Substance Abuse Recovery

Researchers explored patient and staff perceptions of spiritual well-being and the spiritual needs of patients enrolled in a residential substance abuse treatment program. The Spiritual Well-Being Scale was used to gather quantitative data. Additionally, a brief questionnaire containing one qualitative and two quantitative questions was completed by both clients and staff. A statistically significant difference was found, indicating a more positive sense of spiritual well-being among patients upon discharge. Although the staff and clients of the residential program have similar perceptions regarding the concept of spiritual well-being, their definitions do not appear identical.     

Correlates of Readiness to Change in Victims of Intimate Partner Violence

Intimate partner violence (IPV) is a social problem associated with significant morbidity; however, victims do not always utilize treatment and resources. One's readiness to change might be one variable impacting his or her pursuit of treatment and other resources. This study investigated correlates of readiness to change, and readiness to change's impact on treatment utilization. Data were collected from 223 women residing in battered women's shelters. Correlational analyses find that generally victims with more psychopathology and distress, as well as more social support, were more ready to change. Posttraumatic stress disorder symptoms, overall distress, and social support were the strongest predictors of readiness to change. Finally, victims higher in readiness to change were more likely to seek mental health treatment and other IPV-related services.     

Shifting probation culture and advancing juvenile probation reform through a community‐based,participatory action research‐informed training

Many jurisdictions are currently transforming their juvenile probation systems to reflect research‐informed, developmentally based case management approaches. Training, developed through a community‐based, participatory action research (CBPAR) framework and guided by a community–academic partnership, may promote probation staff's readiness for such change. This paper examined whether such training could serve as an effective method to impact organizational culture by exploring shifts in probation staff's knowledge, attitudes, and beliefs about graduated response – a structured juvenile probation case management system that aligns with research on adolescent development and youth behavior change. Data came from 559 juvenile probation staff trained in graduated response theory and practice between 2016 and 2019. Results demonstrated that at the end of a 1‐day, CBPAR‐grounded training program, participating staff reported significantly more buy‐in to graduated response, greater knowledge of this new system, and attitudes more strongly in favor of graduated response and intended behaviors. Study findings revealed important shifts indicative of readiness for change within juvenile probation departments. Additional implementation strategies are needed to extend training gains and overcome organizational‐ and system‐level barriers to change.     

Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to singificantly delay relapse, reduce symptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.     

Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV‐hepatitis C co‐infected gay men

Background: Increasing numbers of HIV‐infected gay men acquire hepatitis C virus (HCV) co‐infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV‐infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV‐infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk‐taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co‐infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self‐awareness, and level of risk‐taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV‐co‐infected gay men.     

Contributions of Cognitions,Psychological Flexibility,and Therapeutic Alliance to Suicidal Ideation in Psychiatric Inpatients

Although suicide treatment is an expanding area of research, there is relatively less in the literature with respect to how specific vulnerabilities to suicide are addressed by treatment. Utilizing measures of suicide cognitions, therapeutic alliance, and psychological flexibility, we compared their relative contributions to suicidal ideation during and posttreatment among a group of adult psychiatric inpatients (N  = 434). Results revealed that cognitions contributed considerably more unique variance to suicidal ideation than alliance and flexibility at discharge and at 2 weeks postdischarge, and to change in suicidal ideation over the course of treatment. Psychological flexibility explained a small amount of variance at the 6‐month time point. Factor level analyses also were conducted, with the unsolvability factor within suicide cognitions accounting for the largest portion of variance at both discharge and 2 weeks postdischarge. Study limitations, implications, and future directions are discussed.     

组织变革准备研究回顾与整合

作为组织实施变革的前奏,组织变革准备包括：（1）组织本身处于变革就绪待发状态,和（2）组织成员在情感及认知上能够接受和容忍组织即将实施变革的程度。文章通过对组织变革准备相关概念、内容结构和测量、前因和后果的梳理,整合出一个新的分析框架。研究指出：未来在深化现有研究的同时,宜多采用跨层次的视角探讨相关构念在不同层面上的影响机制,结合具体变革情境开发有针对性的测量工具,弥补现有研究不足、指导企业实践。     

An Analysis of Expressions Used by Adolescents at Varying Economic Levels to Describe Accepted and Rejected Peers

Conservation has been found to be positively and moderately correlated with reading readiness, and only slightly less correlated with reading readiness than intelligence as measured by the Primary Mental Abilities Test. A moderate correlation also existed between conservation and intelligence. It was suggested that conservation would be worthy of attention by primary teachers as a predictor of the child's readiness for learning to read.     

Implementation of the Wolverine Mental Health Program,Part 1: Adoption Phase

Residential treatment facilities (RTFs) are a first-line treatment option for juvenile justice-involved youth. However, RTFs rarely offer evidence-based interventions for youth with internalizing or externalizing mental health problems. Wolverine Human Services (WHS) is one of the first RTFs in the nation to implement cognitive-behavioral therapy (CBT) to enhance mental health care for their youth. This study outlines the preimplementation phase of a 5-year collaborative CBT implementation effort among WHS, the Beck Institute, and an implementation science research team. The preimplementation phase included a needs assessment across two sites of WHS to identify and prioritize barriers to CBT implementation. Of the 76 unique barriers, 23 were prioritized as important and feasible to address. Implementation teams, consisting of clinician and staff champions and opinion leaders, worked across 8 months to deploy 10 strategies from a collaboratively designed blueprint. Upon reevaluation of the needs assessment domains, all prioritized barriers to CBT implementation were removed and WHS’s readiness for CBT implementation was enhanced. This study serves as a model of a preimplementation process that can be employed to enhance the potential for successful evidence-based practice implementation in youth RTFs.