Individual and combined effects of noncontingent reinforcement and response blocking on automatically reinforced problem behavior

Noncontingent reinforcement (NCR) and response blocking are 2 common interventions for problem behavior maintained by automatic reinforcement. We implemented NCR and blocking with 1 boy and found this combined intervention to be effective at decreasing high rates of automatically reinforced pica. With another child, we compared the effects of blocking alone to the combined intervention. With the third child, we compared NCR alone and blocking alone to the combined intervention. Results showed that the combined intervention was effective at reducing automatically reinforced problem behavior while moderate to high levels of item engagement maintained. When evaluated individually, neither NCR nor blocking was sufficient to reduce problem behavior to clinically significant levels.     

Mechanisms Mediating Children’s Perceived Maternal Nonsupportive Reactions to Sadness and Children’s Social and Emotional Functioning

This study examined whether children’s perceptions of maternal nonsupportive reactions to sadness (active discouragement and non-response) influenced children’s loneliness and classroom popularity indirectly through their effects on children’s sadness inhibition and self-perception of social competence. Participants were children in grades 3–6 from a university affiliated public elementary school (N = 175; 53 % females; 37 % racial/ethnic minority). Children reported on the frequency of their mother’s active discouragement and non-response of their sadness, as well their own sadness inhibition, self-perceived social competence, and loneliness. Classroom peers reported on children’s popularity. Results indicated that perceived maternal non-response to sadness was indirectly related to classroom popularity and loneliness through the effect on children’s self-perception of social competence. In contrast, perceived maternal active discouragement of sadness was indirectly related to children’s classroom popularity through the effect on children’s sadness inhibition. These results support the consideration of active discouragement and non-response as distinct constructs and indicate the likelihood of different pathways of influence in predicting emotional and social outcomes such as loneliness and classroom popularity.     

‘… you kind of frantically go from one thing to the next and there isn’t any time for thinking any more’: a reflection on the impact of organisational change on relatedness in multidisciplinary teams

This paper reflects on the relational impact on Clinical Psychologists of NHS organisational change in the context of cuts and reorganisation. The reflections illustrate one theme drawn from a study of eight Clinical Psychologists working within adult Community Mental Health Multi-Disciplinary Teams. The paper considers the impact of competition and change in healthcare on the ability to engage in reflective practice potentially affecting client care due to reduced joint-working, consistency and creativity. The paper considers how acts of kindness (compassion) within organisational contexts at all levels can facilitate relatedness, reflection and more human care. It concludes by considering how shifting from short-term planning evaluating efficiencies based on perceived financial value, to thinking more widely and long-term about relational value may be of benefit to clinicians, clients and the system as a whole.     

Using Community Partnerships to Better Understand the Barriers to Using an Evidence‐Based,Parent‐Mediated Intervention for Autism Spectrum Disorder in a Medicaid System

Service use disparities have been noted to impede under‐resourced families' ability to access high‐quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent‐mediated interventions and may suggest a lack of fit between these interventions and the needs of under‐resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence‐based, parent‐mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid‐eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent–therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence‐based, parent‐mediated interventions for under‐resourced community settings.