This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting. 相似文献
Intersectionality, minority stress, and social ecological theories have all been important frameworks for understanding mechanisms that create and maintain sexual and gender minority health disparities. In this study, we integrated these frameworks to guide a grounded theory examination of identity-related experiences in specific settings among 33 Black, White, and Latino young sexual minority cisgender men who lived in Chicago. Analyses identified four key categories: Racism Manifests in Context- and Sexual Minority-Specific Ways, Sexual Orientation Can Mean Feeling Safe and Seen or Threatened and Alone, Gender is a Matter of Self-Expression, and Bodies Are Not Always Made to Fit In. Participants reported both identity-based privilege and marginalization as well as unique forms of minority stress at the intersection of specific identities. Across these categories, participants’ experiences of their intersecting identities and associated forms of minority stress were embodied in their physical appearance, situated in specific neighborhoods and contexts, and co-constructed through their interpersonal interactions with others. Further, participants’ narratives provide powerful insights about the nuanced ways in which young sexual minority men understand and negotiate their lived experiences. Findings highlight how experiences of identity and minority stress are both intersectional and located within specific social ecological contexts, which has important implications for research, clinical practice, and advocacy.
Neuropsychology Review - Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley’s working memory model includes four... 相似文献
This study was designed to examine the use of court-appointed experts as an alternative to privately retained experts in Dallas, Texas. Surprisingly, there has been little empirical study of court-appointed experts. Our findings suggest one reason for the lack of research. We found that court-appointed experts are used so infrequently that it makes empirical study difficult to conduct. We discuss the implications on this problem for future research. 相似文献
Forty-four depressed and non-depressed mothers participated in a videotaped interaction with their own infant and then rated the videotape using the Infant Stereotyping Scale and the Interaction Rating Scale. In addition, one half of the mothers rated a videotape of an unfamiliar infant who was labelled psychologically ‘depressed’ and the other half rated a videotape of the same infant with no label given. Both the depressed and non-depressed mothers rated the ‘depressed’ labelled infant more negatively than the non-labelled infant on the attributes of physical potency, cognitive competence, sociability and difficult behaviour. Physical appearance was the only rating that was not biased by the ‘depressed’ label. Mothers' ratings of their own infants were more positive than their ratings of the non-labelled stimulus infant. Depressed mothers did not see their infants more negatively except on one rating. They rated the physical appearance of their own infant more negatively than non-depressed mothers. 相似文献
Legislatures and courts have responded prematurely to the problem of prenatal drug exposure through a variety of criminal and civil legal sanctions to deter drug use and to protect fetal health. A review of the case law demonstrates that significant statutory and constitutional difficulties limit the effectiveness of these sanctions and ultimately inhibit their applicability. These constraints require that any governmental intervention through the courts be based upon individual judicial findings of imminent harm to the child and maternal unfitness in neglect proceedings. 相似文献
Violence in Syria has displaced an unprecedented number of people from their homes. While couple/family therapy (C/MFT) scholars have explored migration experiences, particularly among refugees, there is still limited research using a bioecological framework. This exploratory study examined the experiences of Syrian asylum-seekers and refugees living in the United States using a qualitative phenomenological approach. Twelve Syrians (n = 8 men, n = 4 women) between 20 and 52 years of age (M = 35.8, SD = 10.7) were interviewed about their experiences across three stages of resettlement: (1) pre-resettlement, (2) resettlement/migration, and (3) post-resettlement. Findings suggest that the effects of conflict-induced displacement and resettlement permeate across multiple ecologies. These range from the individual and his or her interpersonal relationships to their larger community and society. C/MFTs should account for contextual factors while becoming familiar with the sociopolitical impact of displacement and resettlement in their clinical work with this population. 相似文献