Clinical Supervision Dilemmas Related to Child Abuse in Wraparound Treatment

We conducted two separate, exploratory studies to evaluate the differences between the supervision of wraparound (in-home) and outpatient (office) child treatment interventions. Study one (n = 96) examined the structure and norms of supervision between groups as well as rates of general disclosure to direct supervisors. Study two (n = 116) specifically examined the frequency of child abuse and neglect encountered in each intervention setting, and the level of disclosure in supervision of these mandatory reporting events. Findings from the first study suggest that wraparound clinicians received significantly less individual supervision and colleague consultation than their office-based counterparts. Additionally, wraparound clinicians were significantly more likely to withhold information about client cases from their direct supervisors. In the second study, wraparound clinicians endorsed significant increases for observed child abuse, observed child neglect, and verbally reported child neglect compared to their office-based counterparts. In regards to mandatory reporting issues with children, wraparound clinicians were found to be significantly less likely to disclose issues pertaining to child neglect to their direct supervisors than office-based clinicians. Our studies show preliminary evidence for a needed increase of individual supervision in wraparound practice, in addition to a greater focus on clinician disclosures related to incidents of child abuse and neglect.     

A collaborative effort to study mother—child interaction in three risk groups: Social risk mother,adolescent mother,preterm infant

This paper describes the collaborative efforts of three intervention projects with similar data sets on high-risk populations of mothers and their children at 13 and 20 months. The three projects collected data on a total of 190 dyads from three risk groups: adolescent mothers and their infants, high social risk mothers and their infants, and high social risk mothers and their preterm infants. The authors define the common set of measures and resulting variables used collaboratively to measure parent-child interaction and compare the three risk groups at both 13 and 20 months.     

Children's Fears: A Pre‐9/11 and Post‐9/11 Comparison Using the American Fear Survey Schedule for Children

Children are influenced by the salient events surrounding them (e.g., 9/11 terrorist attacks, Hurricane Katrina, massacre at Virginia Tech). In this study, the author examined fears of children and adolescents in Grades 2–12 in a pre‐ and post‐September 11, 2001, comparison using the American Fear Survey Schedule for Children (FSSC‐AM; J. J. Burnham, 1995, 2005). Differences across age, gender, and year were examined. Multivariate analyses of variance yielded significant effects for terror fear items on the FSSC‐AM.     

Relationship of IQ to suicide and homicide rate: an international perspective

IQs were correlated with the z score of suicide rate minus z score of homicide rate using nine regions of the world--established market economies, formerly socialized Europe, India, China, other Asian nations, Sub-Saharan Africa, Latin America/Caribbean, Middle East Crescent, and the USA. Correlations were .85 and .83 with crude rates and age-adjusted rates, respectively. The homicide findings are consistent with previous research in individual countries showing that less intelligent persons commit homicide more often. However, the present findings of a positive correlation between IQ and suicide rates are the opposite of what has been found in the more definitive studies within countries. Explanations for the apparent paradox and for the findings more generally were offered.     

Contemporary Fears of Children and Adolescents: Coping and Resiliency in the 21st Century

This study was prompted by the continual exposure of youth to disasters (e.g., 9/11, Iraq War, Hurricane Katrina, school violence) and the call for revisions in fear assessments to reflect contemporary fears. Fears of 1,033 students in Grades 2–12 were examined using the American Fear Survey Schedule for Children (J. J. Burnham, 2005). Results indicated that new fears have emerged in the 21st century, alerting counselors to consider preventative and intervention activities to address contemporary fears.     

A Recursive Frame Qualitative Analysis of MFT Progress Note Tipping Points

Medically oriented psychotherapists typically record progress notes by articulating client symptoms, diagnoses, functional status, progress, and adherence to treatment plans. This orientation can challenge marriage and family therapists working from discursive or post-modern perspectives. Although there are discursive therapy friendly treatment planning guides, no published research on such practice exists. To address this gap the researchers conducted a recursive frame qualitative analysis of 206 de-identified progress notes from 30 completed cases seen by MFT master’s students learning discursive approaches to therapy in a university-based training clinic. Researchers found students noted problem to solution-focused discourse tipping or turning points in 20 cases with positive outcomes and no comparable shifts in 10 cases with negative or unclear outcomes.     

Interactions between prefrontal cortex and cerebellum revealed by trace eyelid conditioning

Eyelid conditioning has proven useful for analysis of learning and computation in the cerebellum. Two variants, delay and trace conditioning, differ only by the relative timing of the training stimuli. Despite the subtlety of this difference, trace eyelid conditioning is prevented by lesions of the cerebellum, hippocampus, or medial prefrontal cortex (mPFC), whereas delay eyelid conditioning is prevented by cerebellar lesions and is largely unaffected by forebrain lesions. Here we test whether these lesion results can be explained by two assertions: (1) Cerebellar learning requires temporal overlap between the mossy fiber inputs activated by the tone conditioned stimulus (CS) and the climbing fiber inputs activated by the reinforcing unconditioned stimulus (US), and therefore (2) trace conditioning requires activity that outlasts the presentation of the CS in a subset of mossy fibers separate from those activated directly by the CS. By use of electrical stimulation of mossy fibers as a CS, we show that cerebellar learning during trace eyelid conditioning requires an input that persists during the stimulus-free trace interval. By use of reversible inactivation experiments, we provide evidence that this input arises from the mPFC and arrives at the cerebellum via a previously unidentified site in the pontine nuclei. In light of previous PFC recordings in various species, we suggest that trace eyelid conditioning involves an interaction between the persistent activity of delay cells in mPFC-a putative mechanism of working memory-and motor learning in the cerebellum.Eyelid conditioning is a form of associative learning that has proven useful for mechanistic studies of learning (Thompson 1986). All variants of eyelid conditioning involve pairing a conditioned stimulus (CS, typically a tone) with a reinforcing unconditioned stimulus (US, mild electrical stimulation near the eye) to promote learned eyelid closure in response to the CS (also known as a conditioned response). Delay eyelid conditioning, where the CS and US overlap in time (Fig. 1A , left), is largely unaffected by forebrain lesions (Solomon et al. 1986; Mauk and Thompson 1987; Kronforst-Collins and Disterhoft 1998; Weible et al. 2000; Powell et al. 2001; McLaughlin et al. 2002) and engages the cerebellum relatively directly (but see Halverson and Freeman 2006). Presentation of the tone and the US are conveyed to the cerebellum via activation of mossy fibers and climbing fibers, respectively (Fig. 1B; Mauk et al. 1986; Steinmetz et al. 1987, 1989; Sears and Steinmetz 1991; Hesslow 1994; Hesslow et al. 1999). In addition, output via a cerebellar deep nucleus is required for the expression of conditioned responses (McCormick and Thompson 1984). This relatively direct mapping of stimuli onto inputs and of output onto behavior makes delay eyelid conditioning a powerful tool for the analysis of cerebellar learning and computation (Mauk and Donegan 1997; Medina and Mauk 2000; Medina et al. 2000, 2002; Hansel et al. 2001; Ohyama et al. 2003).Open in a separate windowFigure 1.The procedures, neural pathways, and putative signals involved in delay and trace eyelid conditioning. (A) Stimulus timing for delay (left) and trace (right) training trials. For delay conditioning, the US overlaps in time with the tone CS. In this and subsequent figures, green is used to indicate the presentation of the CS for delay conditioning. For trace conditioning, the US is presented after CS offset, and “trace interval” refers to the period between CS offset and US onset. For convenience, we used red and maroon regions to represent the CS and trace interval, respectively. Sample conditioned eyelid responses are shown below, for which an upward deflection indicates closure of the eyelid. (B) Schematic representation of the pathways engaged by delay conditioning. The CS and US, respectively, engage mossy fibers and climbing fibers relatively directly, and forebrain input is not required for normal learning. (C) The signals hypothesized to engage the cerebellum during trace conditioning. The activity of mossy fibers directly activated by the tone CS does not significantly outlast the stimulus. Thus, a forebrain structure is thought to provide an input that overlaps in time with the US and is necessary to produce cerebellar learning.Trace eyelid conditioning, where the US is presented after tone offset (Fig. 1A, right), has attracted interest for its potential to reveal the nature of interactions between the forebrain and cerebellum as well as the learning mechanisms within these systems. This potential stems from the sensitivity of trace conditioning not only to lesions of cerebellum but also to lesions of hippocampus, medial prefrontal cortex (mPFC), or mediodorsal thalamic nucleus (Woodruff-Pak et al. 1985; Moyer Jr. et al. 1990; Kronforst-Collins and Disterhoft 1998; Weible et al. 2000; Powell et al. 2001; McLaughlin et al. 2002; Powell and Churchwell 2002; Simon et al. 2005). Given the general inability of forebrain lesions to affect delay conditioning, these results have promoted the general interpretation that the forebrain and cerebellum interact to mediate trace conditioning (Weiss and Disterhoft 1996; Clark and Squire 1998; Clark et al. 2002).Here we test the specific hypotheses that (Fig. 1C) (1) cerebellar learning requires that mossy fiber and climbing fiber inputs overlap in time (or nearly so) and (2) that cerebellar learning in trace conditioning occurs in response to a forebrain-driven mossy fiber input that outlasts the CS to overlap with the US rather than the inputs activated by the tone CS (Clark et al. 2002). The data provide direct support for both assertions and, together with recent anatomical studies (Buchanan et al. 1994; Weible et al. 2007), reveal a pathway between the mPFC and cerebellum that is necessary for the expression of trace eyelid responses. When combined with previous recordings from PFC in primates and rodents (Funahashi et al. 1989; Bodner et al. 1996; Fuster et al. 2000; Narayanan and Laubach 2006), these data support the hypothesis that trace eyelid conditioning is mediated by interactions between working memory-related persistent activity in mPFC and motor learning mechanisms in the cerebellum.     

Interpreting functional analysis outcomes using automated nonparametric statistical analysis

Current methods employed to interpret functional analysis data include visual analysis and post-hoc visual inspection (PHVI). However, these methods may be biased by dataset complexity, hand calculations, and rater experience. We examined whether an automated approach using nonparametric rank-based statistics could increase the accuracy and efficiency of functional analysis data interpretation. We applied Automated Nonparametric Statistical Analysis (ANSA) to a sample of 65 published functional analyses for which additional experimental evidence was available to verify behavior function. Results showed that exact behavior function agreement between ANSA and the publications authors was 83.1%, exact agreement between ANSA and PHVI was 75.4%, and exact agreement across all 3 methods was 64.6%. These preliminary findings suggest that ANSA has the potential to support the data interpretation process. A web application that incorporates the calculations and rules utilized by ANSA is accessible at https://ansa.shinyapps.io/ansa/