Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Efforts to improve the implementation of evidence-based treatments (EBT) have recently made important strides. One such example is understanding the vital role that weekly consultation plays as therapists learn to deliver an EBT. Because mechanism-based research can further support EBT implementation, the present study sought to examine the potential relationship between therapist self-efficacy in relation to treatment fidelity and outcomes.We examined therapist self-efficacy ratings from 80 therapists working with 188 patients. These data were collected as part of a randomized controlled implementation trial testing cognitive processing therapy (CPT). Across post-workshop training conditions, we ran multilevel models to assess (1) changes in therapist self-efficacy, (2) therapist self-efficacy in relation to treatment fidelity, and (3) therapist-self-efficacy in relation to patient PTSD symptom outcomes.We found that therapist self-efficacy significantly improved over the course of 6 months of CPT training. Baseline therapist self-efficacy was differentially associated with client outcomes based on post-workshop training condition. Specifically, therapists with low self-efficacy that did not receive post-workshop consultation tended to have poorer outcomes than therapists with low self-efficacy that received consultation. In the present sample, therapist self-efficacy was not related to treatment fidelity.As this was the first study to examine therapist self-efficacy in the implementation of an evidence-based treatment, our findings suggest that self-efficacy may be an important implementation factor in treatment outcomes and worthy of ongoing research.     

The child's social network: Sex differences from three to six years

The social networks of 85 young children as they make the transition from a home-centered to a more school-centered existence is examined using longitudinal data. When the children were three and six years of age, their mothers completed a questionnaire of network structure; at six years both the child and mother independently reported the friends that the child would invite to a birthday party. The effects of age and sex of child on the number and daily contact with peers, adults, kin, nonkin, males, and females were found. As expected, as children reached formal school age they had increased contact with peers and decreased contact with kin, while adult contact remained fairly consistent over the three- to six-year age period. Sex differences were also apparent. As predicted, children as early as 3 years, and to an even greater extent at six years, showed more same-sex compared to opposite-sex peer contact. At six years both children and mothers reported more same- as compared to opposite-sex friends who would be invited by the child to a birthday party. The findings suggest how children's social networks, as shaped by their parents and themselves, provide a framework within which experience and interaction is structured to fit cultural norms.     

A Pilot Study of the Effects of Cognitive-Behavioral Conjoint Therapy for Posttraumatic Stress Disorder on Parenting

Parental posttraumatic stress disorder (PTSD) is associated with parenting difficulties. Cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD) improves PTSD symptoms, relationship adjustment, and partners’ mental health functioning. However, the impact of CBCT for PTSD on parenting competency is unknown. In this pilot study, the effects of CBCT for PTSD on parenting competency were investigated in 14 individuals (6 patients with PTSD and 8 partners) who had children under age 18. Results suggested that most participants perceived themselves as competent in their parenting prior to treatment, and some enhancements in competency occurred following CBCT for PTSD. Moreover, changes in parenting competency were associated with improvements in patient-rated PTSD. Adjunctive interventions targeting parenting and goals for future research are discussed.     

A Case Study of Cognitive-Behavioral Conjoint Therapy for Combat-Related PTSD in a Same-Sex Military Couple

Military deployments to Iraq and Afghanistan are associated with increased risk for posttraumatic stress disorder (PTSD), depression, and relationship impairment. Unfortunately, the perceived stigma associated with seeking deployment-related behavioral health care in military settings has been a significant barrier to care. Historically, active-duty military service members involved in same-sex intimate relationships have experienced further stressors and barriers to care related to additional stigma and lack of social support. Prior federal regulations excluded sexual minorities from openly serving in the military, thereby limiting the available behavioral health services for same-sex couples. Since this ban was lifted after the repeal of the U.S. policy known as "Don’t Ask, Don’t Tell" in 2010, gay and lesbian service members have increased opportunities to obtain behavioral health care. One therapy that is newly available to sexual minority military couples is Cognitive-Behavioral Conjoint Therapy (CBCT), which effectively addresses co-occurring PTSD and relationship dysfunction. This case study illustrates the use of CBCT for the treatment of deployment-related PTSD in a same-sex active-duty military couple. After completing all 15 CBCT sessions, the couple reported clinically meaningful changes in the service member’s PTSD symptoms, which was maintained at the 2-month follow-up. The results of this case study indicate that CBCT for PTSD can have positive treatment outcomes with military same-sex couples. Further clinical implications are discussed.     

Determining who to question, what to ask, and how much information to ask for: the development of inquiry in young children

To obtain reliable information, it is important to identify and effectively question knowledgeable informants. Two experiments examined how age and the ease of distinguishing between reliable and unreliable sources influence children’s ability to effectively question those sources to solve problems. A sample of 3- to 5-year-olds was introduced to a knowledgeable informant contrasted with an informant who always gave inaccurate answers or one who always indicated ignorance. Children were generally better at determining which informant to question when a knowledgeable informant was contrasted with an ignorant informant than when a knowledgeable informant was contrasted with an inaccurate informant. In some cases, age also influenced the ability to determine who to question and what to ask. Importantly, in both experiments, the strongest predictor of accuracy was whether children had acquired sufficient information; successful problem solving required integrating knowledge of who to question, what to ask, and how much information to ask for.     

The Effects of Instructions on Mothers’ Ratings of Child Attention-Deficit/Hyperactivity Disorder Symptoms

We examined whether instructional materials describing how to rate child ADHD symptoms would improve the accuracy of mothers’ ratings of ADHD symptoms presented in standard child behavior stimuli, and whether instructions would be equally effective across a range of maternal depressive symptoms and family incomes. A community sample of 100 mothers with 5 to 12 year old sons were randomly assigned to either receive or not receive the instructions. All mothers watched standard video recordings of boys displaying nonproblem behavior, ADHD symptoms, ADHD plus oppositional behaviors, or ADHD plus anxious behaviors, and then rated the ADHD symptoms of the boys in the videos. These ratings were compared to ratings of the boys’ ADHD symptoms made by objective coders. Results indicated an interaction such that the instructional materials improved the agreement between mothers’ and coders’ ratings, but only for mothers at lower family income levels. The instructional materials improved all mothers’ open-ended responses regarding knowledge of ADHD. All mothers rated more ADHD symptoms in boys with comorbid oppositional or anxious behaviors, and this effect was not reduced by the instructional materials. The potential utility of these instructions to improve the accuracy of ratings of child ADHD symptoms is explored.     

Adjustment following sexual abuse discovery: the role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time.     

Effects of social media use on desire for cosmetic surgery among young women

Current Psychology - A large body of research has documented the influence of traditional media formats (e.g. television programs, adverts) on young women’s consideration of cosmetic surgery....     

Daily Parent-Adolescent Digital Exchanges

Research on Child and Adolescent Psychopathology - The present study tracked adolescents via mobile phones to describe how parents and their adolescent children are using digital technologies in...