One-to-one support for crisis intervention using online synchronous instant messaging: evaluating working alliance and client satisfaction

Young people are increasingly turning to online support, especially when traditional mental health services are not immediately available. Using a cross-sectional design, sociodemographic information and self-reported perceptions of the strength of the working alliance and client satisfaction were collected from a sample of participants (n = 78) who were users of a service providing free online support using synchronous instant messaging. The results reported a significant positive relationship between the strength of the working alliance and client satisfaction, suggesting that the strength of the working alliance remains a key component in counselling, even online. Participants, however, scored significantly lower on both the strength of the working alliance and client satisfaction, compared to participants in offline settings as reported in past studies.     

If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

Transformations of mathematical and stimulus functions

Following a pretest, 8 participants who were unfamiliar with algebraic and trigonometric functions received a brief presentation on the rectangular coordinate system. Next, they participated in a computer-interactive matching-to-sample procedure that trained formula-to-formula and formula-to-graph relations. Then, they were exposed to 40 novel formula-to-graph tests and 10 novel graph-to-formula tests. Seven of the 8 participants showed substantial improvement in identifying formula-to-graph relations; however, in the test of novel graph-to-formula relations, participants tended to select equations in their factored form. Next, we manipulated contextual cues in the form of rules regarding mathematical preferences. First, we informed participants that standard forms of equations were preferred over factored forms. In a subsequent test of 10 additional novel graph-to-formula relations, participants shifted their selections to favor equations in their standard form. This preference reversed during 10 more tests when financial reward was made contingent on correct identification of formulas in factored form. Formula preferences and transformation of novel mathematical and stimulus functions are discussed.     

Scope of attention, control of attention, and intelligence in children and adults

Recent experimentation has shown that cognitive aptitude measures are predicted by tests of the scope of an individual's attention or capacity in simple working memory tasks and also by the ability to control attention. However, these experiments do not indicate how separate or related the scope and control of attention are. An experiment with 52 children (10 to 11 years old) and 52 college students included measures of the scope and control of attention, as well as verbal and nonverbal aptitude measures. The children showed little evidence of using sophisticated attentional control, but the scope of attention predicted intelligence in that group. In adults, both the scope and control of attention varied among individuals and accounted for considerable individual variance in intelligence. About one third that variance was shared between scope an d control, and the rest was unique to one or the other.Scope and control of attention appear to be related but distinct contributors to intelligence.     

Deconstructing therapy outcome measurement with Rasch analysis of a measure of general clinical distress: the Symptom Checklist-90-Revised

Rasch analysis was used to illustrate the usefulness of item-level analyses for evaluating a common therapy outcome measure of general clinical distress, the Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994). Using complementary therapy research samples, the instrument's 5-point rating scale was found to exceed clients' ability to make reliable discriminations and could be improved by collapsing it into a 3-point version (combining scale points 1 with 2 and 3 with 4). This revision, in addition to removing 3 misfitting items, increased person separation from 4.90 to 5.07 and item separation from 7.76 to 8.52 (resulting in alphas of .96 and .99, respectively). Some SCL-90-R subscales had low internal consistency reliabilities; SCL-90-R items can be used to define one factor of general clinical distress that is generally stable across both samples, with two small residual factors.