Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model

Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families’ engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.     

Testing a Moderated Mediation Model of Objectification Theory among Black Women in the United States: The Role of Protective Factors

Recent studies find that Black women experience rates of eating pathology and body dissatisfaction comparable to those of White women. Abundant research suggests that objectification theory could help explain the development and maintenance of eating disorder (ED) symptoms among diverse women. However, research on the applicability of objectification theory to ED symptoms in Black women is equivocal. Specifically, some have suggested that body surveillance might operate differently for Black women. Thus, the current study examined ethnic-racial identity (ERI) commitment and body appreciation as moderators of the mediated associations among body surveillance, body shame, and ED symptoms. Black women (n?=?175) in the United States completed measures of body image, ERI commitment, and ED symptoms. Consistent with objectification theory, body shame mediated the association between body surveillance and ED symptoms. Contrary to our hypothesis, ERI commitment did not moderate the link between body surveillance and body shame. However, body appreciation was a significant moderator, such that the strength of the relation between body surveillance and ED symptoms via body shame was weakened at high levels of body appreciation. Future work should consider interventions that foster body appreciation in Black women.

     

Changes in Mothering Ideology After Childbirth and Maternal Mental Health in French Women

Sex Roles - The prevailing dominant discourse about motherhood in western societies reflects a set of interconnected beliefs referred to as intensive mothering ideology. Little is known about how...     

Processing trauma in psychoanalysis in ‘real’ time and in dreams: the convergence of past,present and future during COVID-19

In the current collective unrest, we and our analysands are living in real time and need vantage points from which to make meaning, as subjective experience of time is collapsing. For many analysands, the past is being relived in the present, with no imaginable future. During the time of COVID-19, dreams are providing a valuable mechanism in working with atemporal emotional trauma, previously uncontextualized. Dream metaphor can provide a transitional space to move around in within the analytic framework. This paper explores a variety of dreams from individual analysands demonstrating different ways of conceptualizing personal and collective experience, bridging between the past, present, and future. Parallels between feeling states related to the current condition and unprocessed implicit memories from the past will be examined, as a vehicle for processing past trauma. Dreams expressing current states of dread for an unimaginable future, as well compensatory dreams showing a hopeful vision of the future will be considered.     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Volunteering for family strength

This paper describes the development of the volunteer component of the Perinatal Positive Parenting program—a program for parents of firstborns who deliver at the William Beaumont Hospital in Royal Oak, Michigan. Effective parenting volunteer service requires energy, interest, and an extraordinary commitment to healthy family relationships. Principles which assure a high level of commitment to the Perinatal Positive Parenting Program are discussed. Recruitment, training, supervision, and evaluation dimensions which specifically support this commitment are also examined.     

Effects of short-term interaction coaching with mothers of preterm infants

This study examined the effects of eight 40-minute interaction coaching sessions on the mother-infant interaction patterns of mother-preterm infant dyads. Thirty-five preterm infants and their mothers were matched for sex and then were assigned randomly to a treatment and a no-treatment control group. Behavior counts and ratings of maternal and infant interactive behavior (Interaction Rating Scale; Field, 1980) were obtained from naturalistic home observations, precoaching, postcoaching, and at a 2-month follow-up. It was hypothesized that coaching, which was intended to facilitate more sensitive responding by mothers, would positively influence mother-infant interaction and mothers' knowledge of infant development. The only marginally significant difference between the groups that emerged over time was in knowledge of infant development, in which the treatment group surpassed the control group.     

An examination of the effectiveness of multiple summary scoring procedures of the BNBAS in detecting group differences

The Brazelton Neonatal Behavioral Assessment Scale is the most widely used and accepted tool in the study of the behavior of the human newborn; yet there remains some controversy over the most appropriate way to score the results. The present research compares three a priori methods of scoring. The sample consisted of 43 infants: (a) 11 preterms, (b) 10 fullterms in intensive care, (c) 7 fullterms with sick mothers, and (d) 15 healthy fullterms. BNBAS exams administered to these four groups of infants were scored using the Als (1978), Lester, Als, and Brazelton (1982), and Jacobsen, Fein, Jacobsen, and Schwartz (1984) clusters. The data from these three methods were analyzed by means of one-way ANOVAs for group differences. In addition, a factor analysis on the BNBAS scores was also completed. These three approaches all detected differences between medically at-risk and healthy infants on those items assessing motor maturity and orientation. These results suggest that at this time no one scoring system can capture the richness of behavior of the newborn and address the question by researchers, clinicians, and parents.