Two-year follow-up of an interdisciplinary cognitive-behavioral intervention program for obese adults

Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.     

Parent education in the public school: The parent and preschooler's program

The public school is discussed as a milieu in which to provide parent education for parents of preschool children. Primary prevention within the public school setting is designated as a means by which many children and families can be reached while the mental health of infants and young children is addressed as an integral concern of the community. The Parent and Preschooler's Program is described as an example of the implementation of a preschool parent education program in a public school which was initiated by community members and is eagerly supported by the school system.     

The growth and development of an infant mental health program: An integrated perspective

This article details the development of the Infant Mental Health Clinical and Training Program at the University of Colorado School of Medicine from 1976 to the present. The article discusses the clinical sites where the program takes place, which include the Neonatal Intensive Care Unit, outpatient child psychiatry clinic, and day treatment programs. Trainees from several mental health disciplines participate in the program, including predoctoral psychology externs, interns from the Clinical Psychology Internship, residents from the Child Psychiatry Training Program, and postdoctoral research fellows in developmental psychopathology. Recently, the Infant Mental Health Program has also been able to offer its own training positions. The philosophical models of clinical service and training are outlined. The article concludes by looking at future directions and challenges for the Infant Mental Health Program. © 1997 Michigan Association for Infant Mental Health     

Increasing adolescent mothers' knowledge of child development: an intervention program

This study focused upon an intervention program that allowed adolescent mothers to have major input in identifying knowledge they needed concerning their children's growth and their own parenting skills. Seventy-six females participated in the 4-month program. A pretest-posttest design was used to measure changes in self-esteem, knowledge of child development, and tendencies toward inappropriate interactions with children. Analysis of effectiveness of this program indicated that it had been effective. Results revealed significant differences between pre- and posttest measures of child development knowledge in the areas of infant and toddler development. Further analysis indicated a significant change in the subjects' child abuse potential at the end of the program. No significant difference could be found in measures of self-esteem between the beginning and end of the program. A 10-month follow-up study coordinated between two public agencies found that none of the adolescent parents who had completed the program had been reported for child abuse or neglect. The results support the importance of short-term intervention programs for adolescent parents.     

Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being.     

The changing practices of an infant psychiatry program: The McGill experience

The present paper describes the development of a university-based infant psychiatry program. The paper initially highlights the organizational structure of the program that involves some 20 professionals, then reports on 57 infants who presented with disruptive behavior disorders and ends by describing an innovative treatment program for fathers and an attempt to help teenage mothers in caring for their infants. © 1997 Michigan Association for Infant Mental Health     

The family empowerment program: an interdisciplinary approach to working with multi-stressed urban families

The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.     

The evaluation of an intervention program for young schoolchildren with acting-out problems

The rationale and nature of a program to train nonprofessional child-aides for helping interactions with young acting-out school children are described. Pre/ post teacher measures of children's problems and competencies, aide measures of problem behavior, and school mental health professionals' change in behavior estimates were used to evaluate the program's effectiveness. Children seen by trained aides showed significantly greater reductions both in acting-out problems and in overall maladjustment than did similar children seen by comparable aides who did not have additional training, or by themselves before training. Implications were considered for optimizing outcomes both in the specific school intervention project in question and in other, broader types of clinical interventions.This study was supported by a grant from the NIMH Experimental and Special Training Branch (MH 14547-02), which the authors acknowledge with gratitude. Our thanks also go to Bruce Rapkin and Mary Boike, who assisted in the data analyses.     

The development and evaluation of a community mental health education program for seminarians

American Journal of Community Psychology -     

Pretend play: an application of an intervention program in autism

Methodologically and theoretically based on metarrepresentational deficit hypothesis, we design an intervention to teach the mental state of pretense to an autistic boy. The production and comprehension of symbolic play by means of the use of two specific strategies founded on pictorial analogy of the mental representation and process, was the focus of the learning. The efficiency and efectiveness of the program is reflected in the results that indicated the subject's competence to generate and comprehend the pretense as well as to generalize the acquired knowledge into other areas of mentalistic functioning. We discuss the possibility to develop a metarrepresentational knowledge based on the internalizing of the strategies of conceptual support.     

Quantitative evaluation of infant behaviour and mother–infant interaction: An overview of a japanese interdisciplinary programme of research

This paper provides an overview of an interdisciplinary programme of research started more than 20 years ago at the University of Tokyo. A major aim of this programme was (and still is) to develop methods and related forms of quantitative analysis that provide rigorous evaluations of infant behaviour from a particular theoretical perspective. In one part of the programme telethermography is used to measure emotional changes in young infants. Contrary to the accepted view in attachment theory, infants as young as 2–3 months showed evidence of stress following separation from the mother (as indexed by a drop in the skin temperature of the infant's forehead). In another part, we established the presence of interpersonal synchrony between arm movements of the newborn and the speech of the mother and other adults, using computer assisted pattern recognition techniques. On the basis of this finding, we have proposed a simulation model of mother-infant interaction from the perspective of system information theory. In general, our programme of research provides a theoretically driven set of techniques and analytical approaches that may provide deeper insights into early development and parenting.     

Effects of parent and child characteristics on participation and outcome of an individualized booster parent intervention for children with externalizing behaviour

In this study, we examined whether a booster parent training, offered after a cognitive behavioural child intervention, is effective in reduction of aggressive behaviour and changes in parenting. A second aim was to identify parent and child characteristics that influence parental participation. Children (73% boys, 40% immigrants, mean age = 10.1 (.53)) were randomly assigned to the child (n = 97 children) or child and parent intervention (n = 94 children) condition. Results of both intention-to-treat and completers only analyses indicated no extra effects of the parent intervention for the total group. Parents who participated (47%) did not differ from non-participants in demographic characteristics. However, mother's perceived level of child's aggression at the end of the child intervention was of significant meaning for the decision to participate in the parent intervention. Participation seemed to interrupt the development of more aggressive behaviour and less appropriate parenting skills for those children in highest need and resulted in increased maternal involvement.     

Affect regulation and synchrony in mother—infant play as precursors to the development of symbolic competence

This study examines relationships between organizing processes of affective communication in infancy and the development of symbolic competence. Thirty six mother—infant dyads were observed at 3 and 9 months, and 32 dyads were reassessed at 24 months. Mother's and infant affective states during face-to-face play at 3 and 9 months were coded in .25-second frames. The underlying structure of infant affect and the time-lag synchrony between mother and infant affective states were assessed with time-series analyses. In addition, interactions at 3 and 9 months were assessed for the global level of infant positive affect and maternal affect attunement. At 2 years, three dimensions of symbolic competence were evaluated: symbolic play, verbal IQ, and the child's use of internal states words. Infant affect regulation at 3 months, defined by the existence of a non-random, stochastic-cyclic organization of affective states, predicted all three domains of symbolic competence at 2 years. Maternal synchrony and attunement each had an independent contribution to the prediction of symbolic play and internal state talk. The microanalytic and global indices of affect each added meaningfully to the prediction of symbolic functioning. The organization of behavioral sequences into coherent affective configurations is discussed as a possible precursor to the general capacity to develop symbols. © 1997 Michigan Association for Infant Mental Health     

The effect of a twelve-week dropout intervention program

The problem of the high school dropout has been of serious concern to educators, service agencies, and society for many years. The problem has reached epidemic proportions in large urban communities with high concentrations of minority youngsters from low-income families. Given the magnitude of this problem from both the economic and humanistic perspective, the purpose of the study was to determine the effect of a twelve-week intervention program on potential dropouts. It was initiated in the Spring of the 1981-82 school year with a follow-up on the retention and absence rates in the fall of the same year. The results of the intervention revealed that the experimental intervention did impact significantly upon both variables of primary concern in the study, the retention and absence rates; the four affective measures of student attitude were not significantly affected by the program. These results pose serious questions concerning the generalizations of the self-concept to academic achievement.