Staff and Resident Involvement in a Therapeutic Community: For Better or Worse?

Therapeutic communities are a commonly used context for counseling persons with drug problems or emotional problems and for other populations of clients. The group dynamics of therapeutic communities are very complex. When the staff members of a therapeutic community develop communication problems with one another or when these staff members become overly involved with residents, staff problems almost always have a negative impact on the program of the therapeutic community. This article describes how staff problems can negatively affect the program of a therapeutic community and also relates the kinds of problems encountered in a therapeutic community to the problems encountered in rehabilitation programs in other settings.     

Public transportation training: in vivo versus classroom instruction

This study evaluated a classroom program to teach public transportation usage (bus-riding skills) to retarded persons. Based on a task analysis of specific skills, five retarded male students were taught each of the components of locating, signalling, boarding and riding, and exiting a bus. These skills were taught sequentially, using training procedures consisting of role playing, manipulating the actions of a doll on a simulated model, and responding to questions about slide sequences. Before, during, and after training, subjects were tested on generalization probes in the classroom and in the natural environment. Results of a multiple-baseline design across subjects indicated that up to 12 months after termination of training, each subject exhibited appropriate bus-riding skills on actual city buses. Two other subjects were trained on each skill component in vivo, on city buses, in order to compare the relative effectiveness and efficiency of classroom versus in vivo training. Both of these subjects acquired appropriate bus-riding skills; however, the in vivo training procedure was both more time consuming and expensive than classroom training. These findings further demonstrate the effectiveness and practicality of properly designed classroom training procedures for teaching community survival skills to retarded persons.     

Linking level of care to level of need. Assessing the need for mental health care for nursing home residents

What are the mental health status and active treatment needs of nursing home residents? A stratified random sample of 828 residents in 25 facilities serving Medicaid recipients was assessed for levels of physical and psychosocial functioning. Although 91.2% had sufficiently high levels of medical and physical care needs to justify nursing home placement, 79.6% also had moderate to intense needs for mental health care. Older residents, relative to their younger counterparts, had more intense medical and mental health care needs. It was also found that psychiatric diagnosis was a poor indicator of mental health service needs, particularly among elderly individuals.     

The Working for Wellness Program: RCT of an Employee Well-Being Intervention

This paper details the design and evaluation of a positive psychology-based employee well-being program. The effect of the program on well-being was evaluated using a mixed method design comprising of an RCT to assess outcome effectiveness, and participant feedback and facilitator field notes to assess process and impact effectiveness. Fifty government employees were randomly allocated to either an intervention or a control group (reduced to n = 23 for complete case analysis). The intervention group participated in the 6-week Working for Wellness Program and completed measures of subjective, psychological, affective and work-related well-being (SWB, PWB, AWB and WWB) at pre-intervention, post-intervention, and three and 6 month follow-ups. The control group completed the questionnaires only. As predicted, mixed ANOVAs revealed improvements in SWB and PWB for intervention group participants over time relative to control participants but these effects had reduced by time 4. There was a main effect of group on AWB in the predicted direction but no effect on WWB. Participant feedback indicated that the focus on strengths and group delivery were the most effective components of the program. Key issues were sample attrition and a lack of on-the-job support for change. Findings suggest employees can learn effective strategies for sustainably increasing their subjective and psychological well-being.     

Emotional Bonds with Parents, Emotion Regulation, and School-Related Behavior Problems Among Elementary School Truants

Among juvenile status offenses, truancy represents the largest share of juvenile court caseloads. As a marker of risk, truancy is important because of its associations with school disengagement, drop-out, and developmental trajectories that include various forms of delinquency and anti-social behavior. Better understanding of the developmental circumstances and needs of truant children may point the way to more effective intervention strategies. Much accumulated research has shown strong associations between the emergence of juvenile delinquency and qualities of caregiving in parent–child relationships. Child-parent attachment in particular has been identified as an important developmental foundation of the child-parent relationship. We used a multi-informant approach to examine associations between children’s self-reported perceptions of attachment security (using the Security Scales), their emotion regulation (reported by parents on the Emotion Regulation Checklist), and school-related behavior problems (as reported by teachers with the Child Behavior Checklist), among 74 elementary school-aged truant children (mean age 9 years). Children and families were recruited through a truancy intervention program in a state in the deep South in the U.S. Data were analyzed via hierarchical multiple regression. Parents’ reports of their children’s emotion regulation predicted behavior problems as reported by teachers. Children’s own reports of their emotional bonds with parents were somewhat less predictive of emotion regulation and behavior problems. Implications for truancy intervention programs for high-risk elementary school children include more focused attention to the importance of children’s developing capacities for emotion regulation and the child-parent bond.     

Repetition learning in the immediate serial recall of visual and auditory materials

In 5 experiments, a Hebb repetition effect, that is, improved immediate serial recall of an (unannounced) repeating list, was demonstrated in the immediate serial recall of visual materials, even when use of phonological short-term memory was blocked by concurrent articulation. The learning of a repeatedly presented letter list in one modality (auditory or visual) did not transfer to give improved performance on the same list in the other modality. This result was not replicated for word lists, however, for which asymmetric transfer was observed. Inferences are made about the structure of short-term memory and about the nature of the Hebb repetition effect.     

Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying

This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL). VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world.     

Early Adversity and the Prospective Prediction of Depressive and Anxiety Disorders in Adolescents

The current study was a prospective exploration of the specificity of early childhood adversities as predictors of anxiety and depressive disorders in adolescents. Participants were 816 adolescents (414~males, 402 females) with diagnostic information collected at age 15; information on early adversities had been collected from the mothers during pregnancy, at birth, age 6 months, and age 5~years for a related study. Adolescents with pure anxiety disorders were compared with adolescents with pure depressive disorders (major depressive disorder, dysthymia), and these groups were compared to never-ill controls. Analyses controlled for gender and maternal depression and anxiety disorders. Results indicated that adolescents with anxiety disorders were more likely than depressed youth to have been exposed to various early stressors, such as maternal prenatal stress, multiple maternal partner changes, and more total adversities, whereas few early childhood variables predicted depressive disorders. Even when current family stressors at age 15 were controlled, early adversity variables again significantly predicted anxiety disorders. Results suggest that anxiety disorders may be more strongly related to early stress exposure, while depressive disorders may be related to more proximal stressors or to early stressors not assessed in the current study.     

Addictions Counseling Certification: An Emerging Counseling Specialty

This article summarizes the national standards for addictions counseling of 4 different professional groups or boards. The new addictions specialty certification standards that are being developed jointly by the National Board for Certified Counselors and the International Association of Addictions and Offender Counselors (a division of the American Counseling Association) are compared with the standards of 3 other groups.