Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

语言转换影响双语认知优势的发展进程

本研究包括两部分,第一部分对双语转换问卷进行修订,用于客观测量双语者的语言转换能力;第二部分采用数字命名任务考察语言转换对双语认知优势发展进程的影响。结果发现,在低水平阶段,语言转换频率与转换消耗存在显著负相关;在高水平阶段,语言转换频率与转换消耗、混用消耗均存在显著负相关。结果说明,语言转换首先影响瞬时转换能力,积累一定的经验之后,才会对持续监控能力与抑制控制能力产生积极影响。本研究结果表明,双语认知优势效应的发展具有一定的顺序性。     

Evaluating the Effectiveness of an Abduction Prevention Program for Young Adults With Intellectual Disabilities

The purpose of this study was to evaluate the effectiveness of behavioral skills training (BST) and in situ training (IST) for teaching abduction prevention skills to young adults with intellectual disabilities. Four individuals, ages 18–24, participated. Five BST sessions were conducted for each participant. Following BST, in situ assessments took place at the participants’ school to assess acquisition of the skills. The data show that none of the participants reached criterion level following BST although some of the participants improved their score from baseline. IST was then implemented with two of the participants achieving criterion level and two participants exhibiting two of the three safety skills.     

Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.     

The BUFFET Program: Development of a Cognitive Behavioral Treatment for Selective Eating in Youth with Autism Spectrum Disorder

Selective eating (often referred to as “picky” eating) is common in individuals with autism spectrum disorder (ASD) across the lifespan. Behavioral interventions are widely used to treat selective eating; however, most of these programs are time intensive, have not been evaluated for use in outpatient settings, and do not typically include youth beyond early childhood. Despite the functional impact and risk for negative outcomes associated with selective eating, there are no empirically supported treatments available for older children, adolescents, or adults, either with or without ASD. To address this treatment gap, we developed BUFFET: the Building Up Food Flexibility and Exposure Treatment program. BUFFET is a 14-week, multi-family group cognitive behavioral treatment for selective eating in children (8–12 years) with ASD. In this paper, we will (1) discuss the theoretical conceptualization of BUFFET, (2) describe the treatment content and structure, (3) present feasibility data from the initial pilot trial, and (4) consider next steps in treatment development.     

Integrating Theory and Research: The Development of a Research‐Based Treatment Program for Juvenile Male Sex Offenders

A research‐based treatment model designed to effectively address identified factors related to juvenile sexual offending behaviors is presented. Current research, theory, and national standards related to juvenile sexual offending are each explored with the treatment model reflecting an integration of these 3 components. The use of counseling skills is included throughout the model to further illustrate the application of theory and the role of the counselor in the treatment of this special population     

Developing a Commitment to Blood Donation: The Impact of One's First Experience1

The increasing demand for voluntarily donated blood has generated research concerned with the development of commitment to regular blood donation. Taking a developmental perspective, this paper explores the longitudinal impact of background, situational, and dispositional factors measured at one's first donation. Questionnaire responses from a sample of first-time donors are analyzed and logistic regression analysis is employed to predict successive “continuation decisions” (the decisions to donate twice, three times, and four times). Results suggest that factors may change in their magnitude and direction of impact across the donor's career. Externally focused social pressures and rewards are dominant at the early stages and self-originating factors at the later stages. Theoretical and practical implications of the findings are discussed.     

Telehealth for Dialectical Behavioral Therapy: A Commentary on the Experience of a Rapid Transition to Virtual Delivery of DBT

Telehealth has been rapidly adopted to provide continuity of delivery of mental health services in light of COVID-19. However, the remote implementation of intensive treatments like dialectical behavioral therapy (DBT) has been vastly understudied. The aim of the current commentary is to describe potential obstacles, propose solutions, and discuss advantages of transitioning from traditional in-person to a virtual delivery format for full model DBT. We speak to these points at multiple levels of relevance to clinical scientists and practitioners: (1) considerations about the virtual delivery format, (2) considerations for the virtual delivery of DBT specifically, and (3) person-level considerations (e.g., client, clinician). We illustrate the commentary using examples of obstacles encountered and solutions identified during our DBT team’s rapid transition to telehealth in response to COVID-19-related shut-downs and discuss considerations for the extension of telehealth delivery of DBT going forward. We are hopeful that the rapid transition to telehealth delivery of mental health services in response to COVID-19 serves as a call to action for clinicians to adapt and leverage technology to deliver DBT on a broader scale to improve patient health outcomes.     

Enhancing Family Communication: Examining the Impact of a Therapeutic Wilderness Program for Struggling Teens and Parents

Every year approximately 130 families participate in Intercept, a program for struggling teens and their families at the Voyageur Outward Bound School, because they are concerned about the loss of trust, poor communication, and/or other high-risk behaviors they are experiencing with their children. Though families hope for improvements in family functioning, little research has been done on the impact of this type of program on the parent/child relationship or how families function once they leave the program. This phenomenological study collected qualitative data from nine families to determine what positive relationship outcomes emerged between parent(s) and their adolescent child post-program, as well as what aspects of the program curriculum were helpful in improving the parent/child relationship. Results showed that communication among family members improved as a result of participation in the Outward Bound program, and families reported utilizing new skills they had learned, including the use of time-outs, improved listening, and other assertive communication tools. Families reported that the parent/child conference at the end of the program was the most helpful aspect of the Intercept curriculum for improving the parent/child relationship. Implications for family therapy include support for therapeutic wilderness programs as a viable intervention for families of high-risk teens struggling with communication.     

The Working for Wellness Program: RCT of an Employee Well-Being Intervention

This paper details the design and evaluation of a positive psychology-based employee well-being program. The effect of the program on well-being was evaluated using a mixed method design comprising of an RCT to assess outcome effectiveness, and participant feedback and facilitator field notes to assess process and impact effectiveness. Fifty government employees were randomly allocated to either an intervention or a control group (reduced to n = 23 for complete case analysis). The intervention group participated in the 6-week Working for Wellness Program and completed measures of subjective, psychological, affective and work-related well-being (SWB, PWB, AWB and WWB) at pre-intervention, post-intervention, and three and 6 month follow-ups. The control group completed the questionnaires only. As predicted, mixed ANOVAs revealed improvements in SWB and PWB for intervention group participants over time relative to control participants but these effects had reduced by time 4. There was a main effect of group on AWB in the predicted direction but no effect on WWB. Participant feedback indicated that the focus on strengths and group delivery were the most effective components of the program. Key issues were sample attrition and a lack of on-the-job support for change. Findings suggest employees can learn effective strategies for sustainably increasing their subjective and psychological well-being.     

In the Field: The Evaluation of an Employee Assistance Program

This article presents the results of an evaluative study of an employee assistance program sponsored by the Russell Corporation, an apparel manufacturing firm. Its results suggest that the program is beneficial in terms of both productivity enhancement and humanitarianism.     

Integrating Humor Into Psychotherapy: Research,Theory, and the Necessary Conditions for the Presence of Therapeutic Humor in Helping Relationships

Although humor is a key element of all social interactions and is frequently present in the psychotherapy process, rarely do therapists consciously and purposely use humor with therapeutic intent. Each theoretical orientation helps clients change emotions, behaviors, and/or cognitions. Humorous interventions can activate change in each of these central areas of human experience.

A key unanswered question is how therapeutic humor is generated. This question has been virtually ignored. Unless people specify the elements that facilitate the creation of therapeutic humor, they cannot train practitioners to be therapeutic in their use of humor. Using Carl Rogers' (1957 Rogers , C. ( 1957 ). The necessary and sufficient conditions of therapeutic personality change . Journal of Consulting Psychology , 21 ( 2 ), 95 – 103 .[Crossref], [PubMed] , [Google Scholar]) “necessary and sufficient conditions” as a central theme, this article addresses the nature of the practitioner that is necessary for therapeutic humor to be communicated to the client. It further describes the qualities of the client/receiver of the humor that are necessary for therapeutic humor to be experienced, and, finally, it specifies the nature of the interactive relationship that influences the potential for humor to be therapeutic. It is the interaction of the skills and qualities of the therapist, the qualities of the client, and the nature of the bond of the relationship between them that accounts for the client's experience of therapeutic humor.     

The Impact of the Accreditation Movement on One Counselor Education Program: Idaho State University

This article covers a 30-year-long relationship between the accreditation standards and the development of the counselor education program at Idaho State University. Specifically, accreditation's impact on the faculty members as they pursued doctoral study, the years following the approval of the Association for Counselor Education and Supervision (ACES) Standards, and the current impact of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation on the program are addressed.