Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

Method

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

Results

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

Conclusions

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.     

The validity of psychotherapy 1

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which ‘keeps things moving’ is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from brainwashing sessions. Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is ‘perspective’ and ‘method’ dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of ‘discover’. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes.     

Benchmarking key service quality indicators in UK Employee Assistance Programme Counselling: A CORE System data profile

Background: Levels of psychological distress appear to be increasing in the workplace, in parallel with the growth of employee assistance programme (EAP) provision offering a range of talking treatments. However, such growth takes place in the absence of a substantive body of supporting research evidence despite a quarter of a decade of research activity. Aims: To analyse a national sample of EAP data and profile relative service quality on a set of key service indicators. Method: CORE System data profiles of over 28,000 clients were voluntarily donated by six EAP service providers. An established benchmarking methodology was used to assess the relative quality of EAP service provision compared with published CORE System benchmarks for NHS primary care and UK higher education student counselling services. Results: High quality data profiled an EAP service clientele who were quantifiably distressed, accessed treatment quickly, with the majority completing treatment and demonstrating high rates of recovery and/or improvement relative to published benchmarks from the NHS and HE comparative sectors. Limitations of the study and implications for practice and further investigation are considered.     

Evaluation of the Responding in Peaceful and Positive Ways (RIPP) Seventh Grade Violence Prevention Curriculum

We evaluated the impact of RIPP-7, a seventh grade violence prevention curriculum designed to strengthen and extend the effects of the sixth grade RIPP-6 curriculum. Classes of seventh graders at two urban middle schools serving predominantly African-American youth where RIPP-6 had been implemented the preceding school year were randomized to intervention (N = 239) and control groups (N = 237). Compared to students in the control group, students who participated in RIPP-7 had fewer disciplinary code violations for violent offenses during the following school year. A limited number of main effects were found on self-report outcome measures and measures of attitudes. Although significant main effects were not found on self-report measures of physical aggression, drug use, or anxiety, analyses of interactions with pretest scores indicated that intervention effects were significantly moderated by pretest scores for several outcome measures. Students most likely to benefit from the intervention were those who reported higher pretest rates of problem behaviors including violent behavior, nonphysical aggression, and delinquent behavior.     

Blood donation is an act of benevolence rather than altruism.

OBJECTIVES: Blood donation is described as an archetypal altruistic behavior, and recruitment/retention campaigns emphasize altruism. Here, a benevolence hypothesis for blood donation (both the donor and recipient benefit) rather than the altruism hypothesis (only the recipient gains) is proposed. DESIGN: Three United Kingdom-based studies contrasted benevolence and altruism: (a) a 6-month prospective study of blood donor behavior (Study 1: N = 957), (b) a cross-sectional study of blood donors' intentions (Study 2: N = 333), and (c) an experimental study examining the effect of benevolent and altruistic messages on willingness to help across high- and low-cost helping behaviors for committed and noncommitted blood donors (Study 3: N = 200). MAIN OUTCOME: Donor behavior and intentions-willingness. MEASURES: Beliefs in personal and societal benefit (Time 1) and actual donations (Time 2) were assessed in Study 1; beliefs in benevolence, altruism, hedonism, and kinship along with donation intentions were assessed in Study 2; and empathy, donor commitment, and willingness to donate blood, money, fund-raise, and staff a telephone helpline were assessed in Study 3. RESULTS: Beliefs in personal rather than societal benefit predicted actual future donation. A path model showed that only beliefs in benevolence were associated with intentions to donate. Committed blood donors were more willing to donate blood when exposed to a benevolent message rather than an altruistic one. This effect was not observed for other forms of helping. CONCLUSIONS: The benevolence hypothesis is supported, suggesting that blood donor motivation is partly selfish. Blood donation campaigns should focus on benevolent rather than purely altruistic messages.     

Counselling psychology in New Zealand

This article offers a brief overview of the history of counselling psychology in New Zealand. It describes current postgraduate study options and registration pathways as well as the institutions and organisations that provide legislative and professional membership and support to counselling psychologists in New Zealand. Data collected from a national survey in 2014 provide insight into the demographics of the profession in New Zealand, the theoretical frameworks that are utilised and employment opportunities that exist for counselling psychologists. The article also highlights the uniqueness of a cultural and contextual approach that aligns itself with New Zealand’s founding document, the Treaty of Waitangi/te Tiriti o Waitangi which is based on the principles of partnership, participation and protection. It concludes with the challenges the profession face as a new scope of practice. These challenges include establishing a professional identity in the mental health delivery system in New Zealand and responding to an ever increasing multicultural society.