Using a Theory of Change to Drive Human Resource Development for Wraparound

Achieving coherence and integration across staff professional development activities is facilitated when training, coaching and staff evaluation are guided by a clearly articulated program theory or “theory of change” that describes how skillful practice promotes desired outcomes. We focus on a theory of change for wraparound, a widely implemented approach to providing community-based care for children with high levels of mental health and related needs. Training, coaching and staff evaluation efforts within wraparound programs have typically been linked only very loosely to theory. We argue that wraparound’s unique history allowed it to evolve with limited theoretical grounding, and we then describe a theory of change for wraparound, focusing on the major causal routes that are hypothesized to lead to outcomes. Finally, we provide an extended illustration of how the theory can provide the basis for a coherent and integrated approach to developing the skills and capacities of staff members playing key roles in wraparound implementation.     

Innovative moments and poor outcome in narrative therapy

Aims: To analyse a poor outcome case of narrative therapy with a woman victim of intimate violence. Method: The Innovative Moments Coding System: version 1 was applied to all sessions to track the innovative moments (i‐moments) in the therapeutic process. I–moments are the narrative details that occur in psychotherapeutic conversations that are outside the influence of the problematic narrative. This research aims to describe the processes involved in the stability of meanings in psychotherapy through a dialogical approach to meaning making. Findings: Contrarily to what usually occurs in good outcome cases, re‐conceptualization i‐moments are absent. Moreover, two specific types of i‐moments emerged with higher duration: reflection and protest. Qualitative analysis showed that the potential meanings of these i‐moments were surpassed by a return to the problematic narrative. Conclusion: The therapeutic stability seems to be maintained by a systematic return to the problematic narrative after the emergence of novelties. This process was referred from a dialogical perspective as a mutual in‐feeding of voices, one that emerges in the i‐moment and another one that supports the problematic narrative, which is maintained by an oscillation between these two types of voices during therapy.     

Dysfunctional body investment versus body dissatisfaction: Relations with well-being and controlled motivations for obesity treatment

In this study, we investigated the associations between body image and psychological well-being, exploring the mediating role of controlled regulation for entering obesity treatment. In addition, we analyzed whether investment body image was more strongly associated with controlled regulation (and subsequent well-being) compared to evaluative body image. These analyses were performed controlling for baseline BMI effects. Participants were 139 overweight women (age: 38.0 ± 6.7 year; BMI: 32.0 ± 4.1 kg/m²) entering treatment. Evaluative and investment body image, controlled regulation, and psychological well-being were assessed. Body image investment was positively associated with controlled regulation; evaluative body image was not. Controlled regulation was negatively associated with self-esteem and psychological functioning. Controlled regulation partially mediated the effects of body image investment on self-esteem, but did not mediate its effects on psychological functioning. Results suggest that dysfunctional body image investment might undermine well-being within overweight women, partly by increasing controlled regulation for entering obesity treatment. Discussion focuses on the importance of enhancing body image and autonomy during treatment to improve well-being and weight outcomes.     

Upbeat and happy: arousal as an important factor in studying attention

The present study examined the effects of music-induced mood changes on different components of visual attention. Affective valence (positive vs. negative) and arousal (high vs. low) were manipulated by having participants listen to one of four versions of a Mozart Sonata that varied in mode (major or minor) and tempo (fast or slow). Attention was measured in three domains-alerting, orienting, and executive control. Affective valence and arousal had an effect on executive control, but not on alerting or orienting. Individuals who experienced positive valence had less efficient control over their responses than those who experienced negative valence, but only when arousal levels were high. Positive and negative valence did not influence executive control measures when arousal levels were low. These findings demonstrate that affective valence and arousal interact with one another to influence the processing of items in visual attention.     

Space-, object-, and feature-based attention interact to organize visual scenes

Biased-competition accounts of attentional processing propose that attention arises from distributed interactions within and among different types of perceptual representations (e.g., spatial, featural, and object-based). Although considerable research has examined the facilitation in processing afforded by attending selectively to spatial locations, or to features, or to objects, surprisingly little research has addressed a key prediction of the biased-competition account: that attending to any stimulus should give rise to simultaneous interactions across all the types of perceptual representations encompassed by that stimulus. Here we show that, when an object in a visual display is cued, space-, feature-, and object-based forms of attention interact to enhance processing of that object and to create a scene-wide pattern of attentional facilitation. These results provide evidence to support the biased-competition framework and suggest that attention might be thought of as a mechanism by which multiple, disparate bottom-up, and even top-down, visual perceptual representations are coordinated and preferentially enhanced.     

Telehealth for persons with severe functional disabilities and their caregivers: facilitating self-care management in the home setting

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This article highlights the findings of 3 pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.     

Effects of Internal and External Pay Comparisons on Work Attitudes1

The effects of internal and external pay comparisons on several work attitudes were assessed within an experimental design. Participants responded to hypothetical scenarios in which their pay was greater, less, or equal to an internal and external individual or group referent. As predicted, internal and external pay comparisons predicted pay satisfaction and perceived pay fairness. Also as expected, internal equity was the stronger predictor of work motivation and perceived organizational support, and external equity predicted turnover intention more strongly. Partial support was found for the hypothesis that work attitudes would be impacted more strongly when individuals made pay comparisons with a group referent than with an individual referent other. Implications for the design of compensation systems are discussed.     

PUNISHMENT OF SELF-INJURIOUS BEHAVIOR USING AROMATIC AMMONIA AS THE AVERSIVE STIMULUS

Punishment with aromatic ammonia was used to eliminate self-injurious behavior of an autistic woman during experimental sessions. The effects were reversible but were limited to experimental sessions until staff used the ammonia on the ward at all times.