关于严重突发事件危机干预的研究评述

对国外关于严重突发事件危机干预的研究作了概览与评述。认为有两点值得关注：其一,危机干预中的评估的重要性。在干预中,评估是进行干预的前提条件,更贯穿干预过程的始终。干预者必须通过不断评估确定危机的严重程度,不断确定当事人的心理状态,才能确定采用相应的应付策略和支持系统等。其二,国外许多不同的干预模式具有3个特征：一是阶段划分技术,将干预过程划分为不同的阶段,针对不同阶段的特点采取不同的措施与策略。二是整合倾向,将不同的干预模式、支持资源加以整合,使干预的效果达到最佳水平。三是特异性发展,即针对不同人群、不同应激情境作深度拓展,发挥干预的特异性效果。“非典”流行对我国的危机干预体系是一个严峻的考验,我国面对严重突发事件的危机干预体系还有待于健全。虽然不能照搬外国的干预模式,但是其思路与技术、经验与教训还是值得我们借鉴的。     

An Exercise in Cost-Effectiveness Analysis: Treating Emotional Distress in Melanoma Patients

This study presents a retrospective assessment of a psychological intervention examined for its potential cost-effectiveness if implemented into standard care. It discusses (1) the cost of instituting a psychological intervention for distressed melanoma patients, (2) the effectiveness of that intervention for reducing distress when compared with a standard care group, and (3) the costs of providing the treatment as compared to costs of physician time to answer distress-driven questions as part of standard care. Although the per-minute cost of providing the psychological intervention was marginally greater than standard care, providing the intervention was significantly cheaper in terms of distress reduction. Inclusion of 60% payer reimbursement rates for the intervention further suggested that incorporating a psychological intervention into standard medical care for melanoma patients would potentially generate revenue.     

Perfectionism and Psychological Distress: A Modeling Approach to Understanding their Therapeutic Relationship

The present study assessed the effectiveness of a web-based psycho-educational intervention protocol for decreasing levels of perfectionism and psychological distress. Different levels of therapeutic intervention (no treatment, general stress management intervention, general stress management intervention plus cognitive behavioral intervention) were provided to perfectionistic participants over a 10-week period. It was found via a longitudinal structural equation model that higher levels of therapeutic intervention predicted greater improvements in perfectionism and psychological distress. Further, amount of improvement in trait perfectionism and perfectionistic automatic thoughts was highly related to amount of improvement in psychological distress. The findings attest to the potential usefulness of a web-based intervention that combines a general stress management intervention with a cognitive behavioral intervention.     

Development and Evaluation of an Online Intervention for Reducing Hostile Interpretation Bias: A Randomized Controlled Trial

Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility.Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.     

A Brief Parenting Intervention to Enhance the Parent–Child Relationship in Hong Kong: Harmony@Home

There is a dearth of high-level evidence for brief programs designed to promote positive parent–child relationships in nonwestern cultures. We present a pilot randomized controlled trial of a four-session intervention to enhance the parenting skills that promote a positive relationship with pre-adolescent children in Hong Kong. Our intervention, Harmony@Home, utilized Cunningham’s culturally appropriate coping modeling, problem-solving approach to change parental behavior. Our objective was to evaluate the feasibility, acceptability and initial evidence of benefit of the intervention. We blindly randomized 150 Hong Kong parents of children 10–13 years of age to (a) a Harmony@Home intervention group, (b) a waitlist control group, or (c) a third active intervention which shared the control group. Immediately following the intervention, we report increases in satisfaction with the parent–child relationship, one of the targeted parenting behaviors and family harmony, for the Harmony@Home group versus control group. However, only the results from satisfaction with the parent–child relationship were significant at 3-months post intervention. Most respondents reported high levels of program satisfaction. The results provide preliminary evidence that this parenting intervention is culturally acceptable for a nonwestern general population, is feasible for implementation in a community setting and shows evidence of benefit. This intervention is concordant with public health priorities because of the global importance of the parent–child relationship as a protective factor for adolescent outcomes, the need for culturally-appropriate interventions for nonwestern populations, and design characteristics that promote dissemination.     

Early Parenting Intervention: Family Risk and First-time Parenting Related to Intervention Effectiveness

The effects of cumulative risk and parity on the effectiveness of a home based parenting intervention were tested in a randomized controlled trial with 237 families with 1- to 3-year-old children screened for high levels of externalizing behavior. The intervention was aimed at enhancing positive parenting and decreasing externalizing behaviors. The results showed that cumulative risk was not associated with either change in child externalizing behaviors or change in positive parenting. When intervention effectiveness was compared for primiparas (i.e., first-time mothers) versus multiparas (i.e., mothers with more than one child), we found that intervention mothers of first-born children displayed an increase in their use of positive discipline strategies as compared to first-time mothers in the control group, whereas a similar effect for multiparas was absent. Among multiparas we found an intervention effect on sensitivity, with control group mothers showing an increase in sensitivity, whereas the intervention group showed a constant level of sensitivity over time. These results suggest that parity may be a moderator of intervention effectiveness. Implications for investigating moderators of intervention effectiveness are discussed.     

Increasing intervention implementation in general education following consultation: a comparison of two follow-up strategies

This study examined two strategies for increasing the accuracy with which general education teachers implemented a peer tutoring intervention for reading comprehension. The intervention was implemented for 5 elementary school students who had been referred for consultation services. Initial implementation of the intervention by the teachers was variable, and the data exhibited a downward trend. When consultants held brief daily meetings with the teachers to discuss the intervention, implementation improved for 2 of 5 participants. Four of the teachers implemented the intervention at levels substantially above baseline during the performance feedback condition, whereas implementation for 1 teacher increased following discussion of an upcoming follow-up meeting with the principal. Student reading comprehension scores improved markedly during the peer tutoring intervention. Three students maintained these gains 4 weeks after the intervention ended. The implications of these findings for the maintenance of accurate treatment implementation in applied settings are discussed.     

Can Math-Gender Stereotypes Be Reduced? A Theory-Based Intervention Program with Adolescent Girls

Math-gender stereotypes have been prevalent with adolescent girls and negatively affect their developmental outcome. The discrepancy between these negative stereotypes and early adolescent girls’ pronounced mathematical performance provides a good opportunity for intervention on negative math-gender stereotypes. This study designed a three-month intervention program based on Identity Threat Model to reduce math-gender stereotypes for middle school girls. Nine intervention sessions were held in classrooms and targeted at changing adolescent girls’ collective representations, situational cues and personal characteristics. Three-wave measures were collected before the intervention (pre-test), immediately after the intervention (post-test), and three months after the end of the intervention (follow-up test). Intervention effect indicators included math-gender stereotypes, self-esteem, math scores and language-gender stereotypes. The results immediately after the intervention showed that math-gender stereotypes were significantly reduced, math scores were improved, and self-esteem and language-gender stereotypes were not significantly affected among girls in the intervention group compared with control group. Follow-up test showed no significant differences between the intervention group and the control group except that math-gender stereotypes in intervention group were still lower than control group, indicating that the intervention activities were effective to reduce adolescent girls’ math-gender stereotypes. The intervention program provided theoretical and educational implications for effective intervention on adolescent girls’ math-gender stereotypes in school or classroom settings.     

Energizing respites from work: a randomized controlled study on respite interventions

Increasing and new work demands drain employees’ energy resources at work. This 4-week longitudinal field experiment investigated the energizing potential of a respite intervention conducted at the workplace (either a simulated savouring nature intervention or a progressive muscle relaxation intervention). First, growth modelling analyses confirmed a linear trend for the growth of vigour and decline in fatigue across the days of the intervention group, indicating a typical upward resource trajectory. No changes appeared in the control group. Mediation analyses indicated that repeatedly engaging in a daily respite intervention influenced more stable energy levels after the intervention period indirectly through the immediate changes in daily energy levels during the intervention period. Findings suggest that, in some cases, respite interventions may present a useful tool to replenish and build energy resources at work. Implications for using respite intervention in organizational research and practice are discussed.     

A Situational Model of Sexual Assault Prevention through Bystander Intervention

Bystander intervention is a potentially potent tool in the primary prevention of sexual assault but more information is needed to guide prevention programs (Banyard 2008). Undergraduates (378 women and 210 men, primarily White) at a central coast California university completed an anonymous questionnaire measuring five barriers identified by the situational model of bystander intervention (Latane and Darley 1970) and bystander intervention behavior. As expected, the barriers were negatively correlated with intervention, were greater for men than for women, and intervention likelihood was affected by perceptions of victim worthiness, especially for men. Hypotheses predicting a positive relationship between having a relationship with the potential victim or perpetrator and intervention were supported. Implications for sexual assault bystander intervention programming are provided.     

Effects of a brief media intervention on expectations, attitudes, and intentions of mental health help seeking

This study examined the effects of a mass-media video intervention on expectations, attitudes, and intentions to seek help from professional mental health care services. A public service announcement-style, mass-media video intervention was developed, with prior empirical research on help-seeking behaviors organized according to the theory of reasoned action/planned behavior. In total, 228 participants were randomly assigned to 1 of 2 conditions: (a) the media-exposed intervention group, who watched programming in which the media intervention was inserted, and (b) the control group, who watched the same programming without the media intervention. The media intervention was not influential on expectation and belief-based barrier variables. However, the media intervention was effective at increasing positive attitudes toward help seeking. Findings regarding the intervention's ability to increase help-seeking intentions for interpersonal problems were complex. Implications of these findings for future research are discussed.     

Multiple outcome measures and mixed methods for evaluating the effectiveness of theory-based behaviour-change interventions: a case study targeting health professionals' adoption of a national suicide prevention guideline

Interest in behaviour-change interventions targeting health professionals' adoption of clinical guidelines is growing. Recommendations have been made for interventions to have a theoretical base, explore the local context and to use mixed and multiple methods of evaluation to establish intervention effectiveness. This article presents a case study of a behaviour-change intervention delivered to community mental health professionals in one Primary Care Trust, aimed at raising adherence to a national suicide prevention guideline. A discussion of how the theory-base was selected, the local context explored, and how the intervention was developed and delivered is provided. Time series analysis, mediational analysis and qualitative process evaluation were used to evaluate and explore intervention effectiveness. The time series analysis revealed that the intervention was not effective at increasing adherence to the guideline. The mediational analysis indicates that the intervention failed to successfully target the key barrier to adoption of the guidance, and the qualitative process evaluation identified certain intervention components that were well received by the health professionals, and also identified weaknesses in the delivery of the intervention. It is recommended that future research should seek to further develop the evidence-base for linking specific intervention strategies to specific behavioural barriers, explore the potential of theories that take into account broader social and organisational factors that influence health professionals' practice and focus on the process of data synthesis for identifying key factors to target with tailored interventions. Multiple and mixed evaluation techniques are recommended not only to explore whether an intervention is effective or not but also why it is effective or not.     

Going Home Again: Transitioning Youth to Families After Group Care Placement

This paper presents results from the transitioning youth to families intervention, which aimed to promote family care for youth served in group care programs in the child welfare system. The intervention was conducted in two counties in a Mid-Atlantic state. The effort encompassed administrative case review and family involvement meetings. We assessed the effect of the intervention in promoting placement in family settings within 12 months. We also explored other effects of the intervention identified by participants. Using propensity score matching with administrative data to compare one-year placement settings for the intervention counties and non-intervention counties, a higher rate of family reunification was identified for youth in the treatment counties. To provide a richer contextual understanding of the effects of the intervention, thematic analysis of open-ended comments from youth and caregiver participants was conducted. These resulting themes provided further understanding of the value of the intervention especially in the areas of planning for the transition, improving youth insight about placement options, and the importance of family involvement. Participants also made recommendations for how to enhance the intervention and promote the transition of youth from group care to family settings. Overall, the effect of the intervention in transitioning youth to family settings was nominal; however unanticipated benefits of engaging youth and family in the transition process were noted. From this evaluation, we provide suggestions for future research and the development of effort to transition youth from group care settings.     

Methods Used to Document Procedural Fidelity in School-Based Intervention Research

There has been a paucity of guidance on the methodological details needed for measuring and sampling the independent variable or actual intervention occurrences in research and practice. Furthermore, the planning and support necessary to document the independent variable in both circumstances may be considerable. The current study extends prior research by reviewing the methods used to document procedural fidelity in school-based intervention research with student participants published between 2005 and 2012 in journals known for publishing school-related intervention studies. Two hundred sixty-six articles met the inclusion criteria and the majority (70 %) used fidelity data in the analysis of intervention effectiveness. By systematically examining contributions of school-based intervention researchers across targeted variables as well as qualities of interventions and settings, suggestions can be made for (a) planning measurement of fidelity across phases of the intervention, (b) sampling fidelity occurrences, (c) preventing intervention failure by providing needed supports, and (d) responding to patterns of fidelity required for intervention and outcome measurement in both research and practice.     

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention

We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.     

Effect of Client Sense of Humor and Paradoxical Interventions on Test Anxiety

This study investigated the effectiveness of paradoxical and non-paradoxical interventions with clients [henceforth known as participants] possessing a high or low sense of humor. Fifty-three test-anxious participants were divided into a low sense of humor group and a high sense of humor group and were assigned to a paradoxical intervention condition, a nonparadoxical intervention condition, or a no-treatment control group. Participants in all groups improved over time but, contrary to the hypothesis, low sense of humor participants improved significantly more with a paradoxical intervention than high sense of humor participants with a paradoxical intervention. There were no differences in improvement due to treatment condition for the high sense of humor group. Low sense of humor participants perceived the counselor as more able to help than did high sense of humor participants. The paradoxical intervention was seen as more surprising than the nonparadoxical intervention. Implications for the use of paradoxical interventions are discussed.     

Pilot Evaluation of a University-Based Training in Trauma-Informed Services for Gang Intervention Workers

The purpose of this pilot study was to investigate the feasibility and efficacy of a course designed to bring trauma-informed practices into community-based intervention programming for gang-involved youth and families. There have been no formally evaluated trauma trainings for gang intervention workers to date. Thirty gang intervention workers completed a University-based course on trauma, which aimed to raise the level of knowledge regarding trauma exposure and its effects on youth, increase intervention workers’ confidence in their ability to identify and respond to posttraumatic stress reactions among clients, and build resilience among staff. Pre-post results revealed that participants significantly improved in their knowledge related to trauma and confidence in their ability to respond to trauma among clients. Participants also rated themselves significantly higher on these domains compared to gang intervention workers who did not take the course. Participants rated the course positively on dimensions that are associated with staff members’ willingness to implement evidence-based interventions following training. The findings indicate a number of important recommendations for supporting gang intervention workers and integrating trauma-informed practices into gang intervention services.     

Supporting teacher use of interventions: effects of response dependent performance feedback on teacher implementation of a math intervention

This study examined general education teachers’ implementation of a peer tutoring intervention for five elementary students referred for consultation and intervention due to academic concerns. Treatment integrity was assessed via permanent products produced by the intervention. Following verbal instructions, intervention implementation by four teachers was consistently low or exhibited a downward trend whereas one teacher’s moderate implementation co-occurred with student gains. When classroom training was conducted with four teachers exhibiting low integrity, all teachers improved implementation. After accurately implementing the intervention for three training sessions with classroom training, response dependent performance feedback was provided when teachers independently used the intervention below 100% integrity, as determined by review of permanent products. With response dependent performance feedback, three of the four teachers implemented the intervention at levels above the verbal training performance, whereas implementation for one teacher increased following discussion of an upcoming school team meeting. Student math scores improved during intervention.     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.