A translational application of music for preschool cognitive development: RCT evidence for improved executive function,self-regulation,and school readiness

The benefits of active music participation and training for cognitive development have been evidenced in multiple studies, with this link leveraged in music therapy approaches with clinical populations. Although music, rhythm, and movement activities are widely integrated into children's play and early education, few studies have systematically translated music therapy-based approaches to a nonclinical population to support early cognitive development. This study reports the follow-up effects of the Rhythm and Movement for Self Regulation (RAMSR) program delivered by generalist preschool teachers in low socioeconomic communities. This randomized control trial (RCT) involved 213 children across eight preschools in disadvantaged communities in Queensland, Australia. The intervention group received 16–20 sessions of RAMSR over 8 weeks, while the control group undertook usual preschool programs. Primary outcome measures included executive function (child assessment of shifting, working memory, and inhibition) and self-regulation (teacher report), with secondary outcomes of school readiness and visual-motor integration. Data were collected pre- and post-intervention, and again 6 months later once children had transitioned into school. Results demonstrated significant intervention effects across the three time points for school readiness (p = 0.038, η_p² = 0.09), self-regulation (p < 0.001, η_p² = 0.08), and inhibition (p = 0.002 η_p² = 0.23). Additionally, the feasibility of building capacity in teachers without any music background to successfully deliver the program was evidenced. These findings are important given that children from low socioeconomic backgrounds are more likely to need support for cognitive development yet have inequitable access to quality music and movement programs.

Research Highlights

• Initial effects of self-regulation from a rhythm and movement program were sustained following transition into school for children from disadvantaged backgrounds.
• Delayed effects of inhibition and school readiness from a rhythm and movement program appeared 6 months post-intervention as children entered school.
• Generalist teachers can successfully implement a rhythm and movement program, which boosts critical developmental cognitive skills.

     

Improving the Emotional Adjustment and Communication Patterns of Incarcerated Mothers: Effectiveness of a Prison Parenting Intervention

Incarcerated mothers at a state prison participated in an eight-session parenting class designed to help them manage the stress of separation from children and to improve communication patterns with children and home-caregivers. In comparison to a waitlist control group (n = 46), inmates who received immediate intervention (n = 60) experienced less parenting distress regarding upcoming visitation experiences; however, waitlist and immediate treatment groups did not differ on other intervention measures. Additional analyses contrasted pre- and post-intervention differences on adjustment measures for inmates from either treatment condition who completed the parenting program (N = 90). After intervention, mothers reported reduced parenting stress, improved alliance with home caregivers, increased letter-writing, and reduction of mental distress symptoms. Large drop-out rates in both subgroups may have reduced the benefits of the random assignment used to form groups. Results support the value of interventions for incarcerated mothers that focus on ways to manage the emotional distress and poor communication patterns associated with being a parent in prison.     

iCOPE With COVID-19: A Brief Telemental Health Intervention for Children and Adolescents During the COVID-19 Pandemic

The COVID-19 pandemic has prompted extensive disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase in anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care was initially reduced, causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.     

Piloting ‘Clever Kids’: A randomized-controlled trial assessing feasibility,efficacy, and acceptability of a socioemotional well-being programme for children with dyslexia

Children with dyslexia are at elevated risk of internalizing (emotional) and externalizing (behavioural) problems. Clever Kids is a nine-week socioemotional well-being programme developed specifically for upper primary school children with dyslexia. In a small randomized-controlled trial, we tested the feasibility, efficacy, and acceptability of the Clever Kids programme. ‘Forty children (M_age = 10.45 years, 65% male) with clinically diagnosed dyslexia too part in the study. Children were randomized to either attend Clever Kids (n = 20) or to a wait-list control condition (n = 20). Coping skills, self-esteem, resilience, emotion regulation, and internalizing and externalizing symptoms were measured at pre-programme, post-programme, and at three-month follow-up. Recruitment and retention rates indicate high feasibility for further evaluation of the programme. There was a significant interaction between intervention condition and time for non-productive coping [F(2, 76) = 4.29, p = 0.017, f² = 0.11]. Children who attended Clever Kids significantly reduced their use of non-productive coping strategies, and this was maintained at three-month follow-up assessment. For all other outcomes, the interactions between intervention condition and time were non-significant. The programme appears acceptable to children with dyslexia and their families, but may be improved by further reducing the number of activities involving reading and writing. Clever Kids improved the coping skills of children with dyslexia; however, a larger trial is needed to replicate this finding and investigate whether programme attendance is associated with additional improvements in children’s socioemotional well-being.     

Children’s Perspectives of an Enhanced Cognitive-Behavioral Treatment for Child–Parent Dyads With Anxiety Disorders

Prior research has extensively evaluated the efficacy of cognitive-behavioral therapy (CBT) for child anxiety disorders—however, few studies have investigated anxious children’s perspectives and experiences of participating in CBT. This qualitative study explored children’s acceptability of a newly developed enhanced CBT intervention, designed specifically for the treatment of anxiety disorders in children with a clinically anxious parent. The study also explored children’s perceptions and experiences of individual (child only) and joint observational (child–parent) exposure activities that were key to the intervention. Ten children (age range 6–11, M = 8.5 years) and their mothers (age range 34–45, M = 39.5 years) completed in-depth semistructured interviews to investigate child participants’ anticipated and experiential acceptability of the enhanced CBT intervention. Thematic analysis revealed seven major themes broadly reflecting the acceptability, appropriateness, and perceived benefit of the intervention elements, with particular value credited to exposure tasks and the dyadic nature of the intervention. Findings suggest that future experimental evaluation of the enhanced intervention is warranted. Further, the study highlights that CBT for child anxiety disorders, where exposure work is a feature, is acceptable and perceived to be effective by its intended treatment recipients. Trial prospectively registered, preresults, ANZCTR1261900033410.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

A growth mindset intervention to improve mental health in adolescents during COVID-19

COVID-19 poses a considerable threat to adolescent mental health. We investigated depression rates in teens from pre to post-COVID. We also explored if leveraging a growth mindset intervention (“Healthy Minds”) could improve adolescent mental health outcomes during the pandemic, especially for adolescents experiencing the most distress. In Study 1, we recruited youth from schools in a rural southern community (N = 239) and used a pre-post design. In Study 2, we recruited an online sample (N = 833) and used a longitudinal randomized control trial design to test the effectiveness of Healthy Minds. Across both studies, there is evidence of higher rates of depression in youth during COVID-19, relative to pre-pandemic numbers. In Study 1, the intervention effectively changed psychological and behavioral processes related to mental health, especially for adolescents experiencing greater COVID-19 stress. However, in Study 2, the intervention failed to impact depression rates or symptoms at follow-up.     

Effects of an indicated cognitive-behavioral depression prevention program are similar for Asian American, Latino, and European American adolescents

The authors tested whether a brief indicated cognitive-behavioral depression prevention program produced similar effects for Asian American, Latino, and European American adolescents (M age = 17.3, SD = 1.6) with elevated depressive symptoms using data from two randomized trials. The first trial involved 37 Asian-American/Pacific Islanders, 32 Latinos, and 98 European Americans and the second trial involved 61 Latinos and 72 European Americans. Reductions in depressive symptoms from pre- to post-intervention and from pre to 6-month follow-up for intervention participants versus assessment-only controls did not differ significantly for the various ethnic groups in either trial, despite sufficient power to detect clinically meaningful differences. These findings suggest that this indicated depression prevention intervention is similarly efficacious for Asian American, Latino and European American adolescents.     

Randomized Control Trial of Teaching Recovery Techniques in Rural Occupied Palestine: Effect on Adolescent Dissociation

This study assessed the effect of a cognitive behavioral group intervention, Teaching Recovery Techniques (TRT), for adolescents with high levels of posttraumatic stress (n = 154), from villages in occupied Palestine. A randomized control trial involved standardized measures to assess war stressors, posttraumatic stress, depression, and dissociation. Program fidelity was measured by presenter and observer ratings and program delivery cost was calculated per adolescent. High levels of traumatic exposure, dissociation, and posttraumatic stress were found. In comparison to a wait list group (n = 75), TRT adolescents reported significantly fewer posttraumatic stress symptoms postintervention. Depression and dissociation remained stable for TRT adolescents, but worsened for those on the wait list. Given the high returns and low costs, this cost–benefit analysis makes a clear case for TRT to be delivered throughout the West Bank. Longitudinal evaluation is needed to assess adolescent traumatization and the impact of TRT within a context of ongoing violence.     

The effects of the Newborn Behavioral Observations (NBO) system in early intervention: A multisite randomized controlled trial

The purpose of this pilot study was to evaluate the effect of an infant mental health intervention, the Newborn Behavioral Observations system (NBO), versus usual care (UC) on infant neurodevelopment and maternal depressive symptoms in early intervention (EI). This multisite randomized trial enrolled newborns into the NBO (n = 16) or UC group (n = 22) and followed them for 6 months. Outcome measures included the Battelle Developmental Inventory (BDI-2), Bayley Scales of Infants Development (BSID-III), and Center for Epidemiologic Studies Depression Scale (CES-D). The CES-D and BSID-III were collected at 3- and 6-months post EI entry and the BDI-2 was collected at EI entry and 6-months post-EI entry. We estimated group differences [95% CI], adjusting for program characteristics. At 6 months, the NBO group had greater gains in Communication (b = 1.0 [0.2, 1.8]), Self-Care (b = 2.0 [0.1, 3.9]), Perception and Concepts (b = 2.0 [0.4, 3.6]), and Attention and Memory (b = 3.0 [0.4, 6.0]) than the UC group. The NBO group also had greater decline in maternal postnatal depressive symptoms (b = −2.0 [−3.7, −0.3]) than the UC group. Infants receiving the NBO infant mental health intervention had greater gains in cognitive and adaptive functions at 6 months than infants receiving UC. Caregivers receiving NBO care had greater improvements in maternal depressive symptoms than caregivers receiving UC.     

Effectiveness of cognitive behavioral therapy on health‐related quality of life: An evaluation of therapies provided by trainee therapists

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health‐related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.     

An Open Trial of Telephone-Delivered Mindfulness-Based Cognitive Therapy: Feasibility,Acceptability, and Preliminary Efficacy for Reducing Depressive Symptoms

Mindfulness-based cognitive therapy (MBCT) is a promising intervention for reducing depressive symptoms in individuals with comorbid chronic disease, but the program’s attendance demands make it inaccessible to many who might benefit. We tested the feasibility, acceptability, safety, and preliminary efficacy of an abbreviated, telephone-delivered adaptation of the in-person mindfulness-based cognitive therapy (MBCT-T) program in a sample of patients with depressive symptoms and hypertension.Participants (n = 14; 78.6% female, mean age = 60.6) with mild to moderate depressive symptoms and hypertension participated in the 8-week MBCT-T program. Feasibility was indexed via session attendance and home-based practice completion. Acceptability was indexed via self-reported satisfaction scores. Safety was assessed via reports of symptomatic decline or need for additional mental health treatment. Depressive symptoms (Quick Inventory of Depressive Symptomatology–Self-Report [QIDS-SR]) and anxiety (Hospital Anxiety and Depression Scale—Anxiety subscale; HADS-A) were assessed at baseline and immediately following the intervention.Sixty-four percent of participants (n = 9) attended ≥4 intervention sessions. Seventy-one percent (n = 6) of participants reported completing all assigned formal home practice and 89.2% (n = 8) reported completing all assigned informal practice. Participants were either very satisfied (75%; n = 6) or mostly satisfied (25%; n = 2) with the intervention. There were no adverse events or additional need for mental health treatment. Depressive symptom scores were 4.09 points lower postintervention (p = .004). Anxiety scores were 3.18 points lower postintervention (p = .039).Results support the feasibility, acceptability, safety, and preliminary efficacy of an abbreviated, telephone-delivered version of MBCT for reducing depressive and anxiety symptoms in individuals with co-occurring chronic disease.     

Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling

Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27–0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.     

A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children

Interpretation bias is a transdiagnostic mechanism underlying anxiety. Theoretical models highlight the role of parental interpretation bias in predicting and maintaining child anxiety. However, very few studies have examined parent interpretation bias as a treatment target. The current pilot study tested the feasibility and acceptability of an interpretation bias intervention delivered by a smartphone app, called HabitWorks, in parents of anxious children who self-reported at least mild symptoms of anxiety and negative interpretation bias.Parents of anxious youth (ages 8 to 16) were recruited from the waitlists of three child anxiety clinics. They were asked to complete interpretation modification exercises via the HabitWorks app 3 times per week for 1 month. Participants completed assessments at pre- and post-intervention and 1-month follow-up to assess changes in interpretation bias, anxiety symptoms, and overall perceptions of HabitWorks.Participants (N = 14) (M_age = 44.36; 14.29% men, 85.71% women) completed an average of 13.29 exercises out of the 12 prescribed. Acceptability ratings were high. Interpretation bias, as measured by an assessment version of the intervention exercise, significantly improved from pre- to posttreatment, and these improvements were maintained at the 1-month follow-up. Anxiety symptoms significantly improved from the “mild” severity range to the “none to minimal” range.In this pilot feasibility study in parents of anxious youth, HabitWorks was a feasible and acceptable low-intensity intervention. These preliminary results support a future controlled trial of HabitWorks for parents. Future studies are also needed to test whether targeting interpretation bias in parents has downstream effects on maladaptive parent behaviors and ultimately, child interpretation bias and anxiety.     

Effects of three training types on vitality among older adults: A self-determination theory perspective

ObjectivesTo investigate effects of endurance, functional and strength training on subjective vitality in older adults. Using the self-determination theory (SDT) framework we tested the moderating effects of autonomy support and mediating effects of need satisfaction on participants’ changes in vitality.DesignParallel-groups randomized controlled trial.Methods138 older adults (M = 74.2 years, SD = 4.5) were randomized to a training group or wait-list control, with assessments at baseline, at 7 weeks (short term), and 16 weeks (long term). Mixed models provided estimates of treatment effects, with covariates for moderating effects of autonomy support and mediating effects of need satisfaction (autonomy, competence, relatedness). Inferences were based on uncertainty in standardized effect-sizes (ES) in relation to a smallest important ES of 0.20.ResultsAt short term, effects on vitality were moderate for endurance training (ES = .70, ±.44), and small for functional (ES = .54, ±.36) and strength training (ES = .21, ±.47). At long term only endurance training had a clear effect on vitality (ES = .27, ±.38). Perceived autonomy support moderated the effect of endurance training at short term (ES = .66, ±.66), and functional training at long term (ES = .23, ±.40). Change in competence mediated the effect of functional and strength training at long term, while in endurance training high perceptions of autonomy support moderated the mediation effect of competence on vitality.ConclusionsEndurance training is recommended for increasing subjective vitality in older adults. Moderating effects of autonomy support and mediating effects of need satisfaction are partially consistent with self-determination theory.     

Feasibility and Acceptability of Cognitive Bias Modification for Interpretation as an Adjunctive Treatment for OCD and Related Disorders: A Pilot Randomized Controlled Trial

Cognitive models implicate interpretation bias in the development and maintenance of obsessive compulsive and related disorders (OCRDs), and research supports Cognitive Bias Modification for Interpretation (CBM-I) in targeting this mechanism. However, prior studies in OCRDs have been limited to nonclinical populations, adolescents, and adults in a laboratory setting. This study evaluated the feasibility and acceptability of CBM-I as an adjunctive intervention during intensive/residential treatment (IRT) for adults with OCRDs. We modified a lab-based CBM-I training for adults seeking IRT for OCRDs, and conducted a feasibility trial (N = 4) and subsequent pilot RCT; participants (N = 31) were randomized to receive CBM-I or psychoeducation. Benchmarks were met for feasibility, acceptability, and target engagement. From pre- to post-intervention, the CBM-I group showed a large effect for change in interpretation bias (d = .90), whereas this effect was trivial (d = .06) for psychoeducation. This was the first study to evaluate CBM-I in naturalistic treatment for adults seeking IRT for OCRDs. Findings support the feasibility and acceptability of CBM-I in this novel sample and setting. A larger scale RCT is needed to determine whether CBM-I can enhance OCRD treatment response.     

Improving Experience in Personal Social Systems through Family Constellation Seminars: Results of a Randomized Controlled Trial

This study examined the efficacy of family constellation seminars (FCSs) on individuals' experience in their personal social systems, especially the experience of belonging, autonomy, accord, and confidence. We conducted a single‐blind, stratified and balanced, randomized controlled trial. Participants were 208 adults (M = 48 years, SD = 10, 79% women) who were randomly allocated either to the intervention group (3‐day FCSs; 64 active participants, 40 observing participants) or to the wait‐list group (64 active participants, 40 observing participants). Change was measured short‐term (2‐week and 4‐month follow‐up) using the Experience In Social Systems Questionnaire, personal domain (EXIS.pers). EXIS.pers is a new outcome measure being applied for the first time in evaluation research. In addition, we used interpersonal scales derived from established measures (Outcome Questionnaire, OQ‐45; Tool for the Evaluation of the Psychotherapeutic Progress, FEP). The average person in the intervention group showed improved experience in personal social systems, as compared with approximately 73% of the wait‐list group after 2 weeks (total score: Cohen's d = .61, p = .000) and 69% of the wait‐list group after 4 months (total score: d = .53, p = .000). The results were confirmed in per‐protocol analyses (n = 191) by the results of the EXIS.pers dimensions (Belonging, Autonomy, Accord, and Confidence) and the interpersonal scales derived from the OQ‐45 and FEP. No adverse events were reported. This RCT provides first evidence that FCSs tend to positively influence participants' experience in their social systems.     

Reducing the Biological and Psychological Toxicity of Poverty-related Stress: Initial Efficacy of the BaSICS Intervention for Early Adolescents

This proof-of-concept study tests the initial efficacy of the Building a Strong Identity and Coping Skills (BaSICS) intervention, a selective prevention of internalizing problems program for early adolescents exposed to high levels of poverty-related stress. Eighty-four early adolescents (M_age = 11.36 years) residing in very low-income neighborhoods were randomized to receive the 16-session intervention (n = 44) or to an assessment-only control condition (n = 40). BaSICS teaches coping skills, social identity development, and collective social action to empower youth with the ability to connect with members of their communities and cope with poverty-related stress in positive and collaborative ways. Pretest–posttest analyses showed that intervention adolescents acquired problem-solving and cognitive-restructuring skills and reduced their reliance on avoidant coping. In addition, HPA reactivity was significantly reduced in the intervention youth, but not controls. Finally, intervention youth's internalizing and somatic symptoms as reported by both youth and their parents, showed significant reductions over time, whereas control youth had no such changes. Results provide strong support for this approach to strength-building and symptom reduction in a population of early adolescents exposed to poverty-related stress.     

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, ‘acceptance’ training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n = 63) reported significant reductions in depression (p = .047), stress (p = .01), and composite depression/anxiety symptoms (p = .02) with medium to strong effect sizes (Cohen's d = 0.53, 0.74, and 0.57, respectively). Increased wellbeing (p = .03) in the total sample and decreased anxiety scores (p = .048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d = 0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted.