Group CBT for Externalizing Disorders in Urban Schools: Effect of Training Strategy on Treatment Fidelity and Child Outcomes

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C +) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C +. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C + delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C + resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.     

Finding the good in the bad: age and event experience relate to the focus on positive aspects of a negative event

All lives contain negative events, but how we think about these events differs across individuals; negative events often include positive details that can be remembered alongside the negative, and the ability to maintain both representations may be beneficial. In a survey examining emotional responses to the 2013 Boston Marathon bombings, the current study investigated how this ability shifts as a function of age and individual differences in initial experience of the event. Specifically, this study examined how emotional importance (i.e. self-reported emotional arousal and personal significance), involvement (i.e. self and friend/family involvement in the 2013 Boston Marathon and self-involvement in prior marathons), and self-reported surprise upon hearing about the event related to the tendency to report focusing on the negative and positive aspects of the bombings. Structural equation models revealed that while greater emotional importance and surprise were associated with a greater focus on negative elements, involvement and age were associated with increased consideration of positive aspects. Further, emotional importance was more strongly related to an increased focus on negative aspects for young adults and an increased focus on positive aspects for older adults, highlighting a tendency for older adults to enhance positive features of an otherwise highly negative event.     

Positive Leader Behaviors and Workplace Incivility: the Mediating Role of Perceived Norms for Respect

Scholars have called for research on the antecedents of mistreatment in organizations such as workplace incivility, as well as the theoretical mechanisms that explain their linkage. To address this call, the present study draws upon social information processing and social cognitive theories to investigate the relationship between positive leader behaviors—those associated with charismatic leadership and ethical leadership—and workers’ experiences of workplace incivility through their perceptions of norms for respect. Relationships were separately examined in two field studies using multi-source data (employees and coworkers in study 1, employees and supervisors in study 2). Results suggest that charismatic leadership (study 1) and ethical leadership (study 2) are negatively related to employee experiences of workplace incivility through employee perceptions of norms for respect. Norms for respect appear to operate as a mediating mechanism through which positive forms of leadership may negatively relate to workplace incivility. The paper concludes with a discussion of implications for organizations regarding leader behaviors that foster norms for respect and curb uncivil behaviors at work.     

PREDICTORS AND EFFECTS OF SELF-OBJECTIFICATION IN LESBIANS

The majority of research on self-objectification has focused on heterosexual women's experiences. This study sought to examine experiences of self-objectification in lesbian women. A path model was developed to examine the relationships between participants' feminist self-identification, levels of internalized heterosexism, objectified body consciousness, and the clinically relevant variables of negative eating attitudes and depression. As has been found with heterosexual women, body surveillance led to shame, which led to negative clinical outcomes. A direct path was also found between levels of surveillance and negative eating attitudes, consistent with previous research on self-objectification among lesbians. Feminist self-identification was not significantly related to the other variables, in contrast to previous research with heterosexual women. Internalized heterosexism was related to negative clinical outcomes, both indirectly through objectification variables and directly to depressive symptomatology. These results provide evidence that self-objectification and internalized heterosexism have negative impacts on the mental health of lesbian women.     

Internet-delivered cognitive behavioral therapy for panic disorder with or without agoraphobia: a systematic review and meta-analysis

ABSTRACT

The current systematic review and meta-analysis examined the efficacy and effectiveness of internet-delivered cognitive behavioral therapy (iCBT) on panic disorder and agoraphobia symptom severity. Twenty-seven studies were identified. Results from nine randomised controlled trials (RCTs) showed that iCBT outperformed waiting list and information controls for panic (g = 1.22) and agoraphobia (g = .91) symptoms, but the quality of RCTs varied and heterogeneity was high. Results from three RCTs suggested iCBT may have similar outcomes to face-to-face CBT in reducing panic and agoraphobia symptoms. Within-group effect sizes between baseline and post-treatment were large for panic (n = 29, g = 1.16) and medium for agoraphobia symptom severity (n = 18, g = .73). Subgroup analyses of within-group pre/post treatment effect sizes showed larger within-group effect sizes for efficacy studies (n = 15) compared to effectiveness studies (n = 14) for panic severity (g = 1.38 vs. g = .98) but not agoraphobia severity. There was no impact of program length, inclusion or arousal reduction techniques, or degree of clinician support. Within-group effects of iCBT suggest the reduction in panic and agoraphobia symptom severity is maintained at 3–6 month follow-up (n = 12).