Relational Diagnosis and Psychotherapy Treatment Cost Effectiveness

Despite a call by researchers for estimates of the treatment effectiveness and cost effectiveness for relational problems, very little has been done to answer this call. The present study is an examination of actual treatment costs and recidivism rates for patients treated for a relational problem (either in individual or conjoint therapy sessions) in the Cigna network. Policymakers and third-party payers may use such clinical-effectiveness and cost effectiveness data to make decisions regarding treatment of relational problems and funding allocation. The present study is also the first to compare the costs of couples therapy versus family therapy for relational problems.     

Establishing the Validity of the Spirituality in Clinical Training Scale: Measuring the Level of Integration of Spirituality and Religion in Family Therapy Training

The existing literature suggests that family therapy training programs are not adequately preparing students to address spiritual and/or religious beliefs as a resource for change in therapy. Therefore, this study sought to validate the Spirituality in Clinical Training Scale (SCTS) as a measure of the level of integration of spirituality and/or religion in family therapy training. Additionally, this study examined the latent associations among the subscales of the SCTS and measures of personal importance of spirituality, spiritual clinical competence, and spiritual self-exploration. Finally, given that the type of educational institution (i.e., religious compared to non-religious schools) may influence the extent to which spirituality is addressed in training, this study examined whether attending a religious or non-religious institution moderated the associations among the SCTS and constructs used to assess validity. A sample of 341 master’s and doctoral family therapy students completed an on-line survey for this study. The results suggest that the SCTS is a reliable and valid measure for assessing integration of spirituality into family therapy training. The establishment of this measure is important given that no previous scale measuring the integration of spirituality into therapy training exists. The results also suggest that spiritual self-exploration is associated with increased use of interventions that integrate spirituality into therapy. Implications for clinical training are discussed.     

Response inhibition in children with and without ADHD after traumatic brain injury

Children with attention‐deficit hyperactivity disorder (ADHD) and traumatic brain injury (TBI) show deficient response inhibition. ADHD itself is a common consequence of TBI, known as secondary ADHD (S‐ADHD). Similarity in inhibitory control in children with TBI, S‐ADHD, and ADHD would implicate impaired frontal‐striatal systems; however, it is first necessary to delineate similarities and differences in inhibitory control in these conditions. We compared performance of children with ADHD and those with TBI without pre‐injury ADHD on a stop signal, response inhibition task. Participants were 274 children aged 6–14 years. There were 92 children with ADHD, 103 children with TBI, and 79 typically developing children who served as controls. Among the TBI participants, injury severity ranged from mild to severe. Children with ADHD and TBI showed deficient inhibition. The deficit in children with ADHD was as great as or greater than that in children with TBI, regardless of degree of TBI severity or the presence of S‐ADHD. The finding indicates that TBI results in deficient inhibition regardless of the development of S‐ADHD.     

Costs of Treating Conduct Disordered Medicaid Youth with and without Family Therapy

This longitudinal, retrospective study investigated the healthcare costs of youth treated for conduct disorder in the Kansas Medicaid system. Along with a comprehensive range of services, youth received in-office individual therapy, in-office family therapy, or in-home family therapy. Data was available for 3753 youth. Overall, 3086 youth received care that included individual therapy (and no family therapy), 503 received in-home family therapy and 164 others received in-office family therapy. Healthcare costs for a period of two and one half years after therapy were available for analysis. The average cost of healthcare for youth receiving no family therapy was $16, 260. For those receiving in-office family therapy, the average cost was $11,116. Youth who received in-office family therapy received $5,144 (32%) less care on average than those receiving only individual therapy. Those who received in-home family therapy averaged $1,622 over the follow-up the period. Those who received in-home family therapy were least expensive of all, averaging at least 85% less than any form of in-office therapy. There does not appear to be an increase in the healthcare cost when family therapy is included in treatment.     

The Relationship Between Marital Satisfaction,Marital Stability,Nuclear Family Triangulation,and Childhood Depression

This study was to examine the effect of triangulation on depression in children. Clinical samples and nonclinical samples were taken from Utah and Illinois. Families were assessed for marital satisfaction and stability, family triangulation, and children's depression levels by the Marital Adjustment Test, Marital Status Inventory, Nuclear Family Triangulation, and Children's Depression Inventory. Results showed children's depressive symptoms to be most strongly linked to fathers' level of marital satisfaction, marital stability, and perceived family triangulation. Mothers' variables did not affect children's depressive symptoms .     

Mortality Salience and Perceptions of People with AIDS: Understanding the Role of Prejudice

Study 1 examined the perceived association of AIDS and death by showing that thinking about AIDS increased participants'; death-thought accessibility. Hypotheses about the consequences of this association for perceptions of people with AIDS were derived from terror management theory, which proposes that mortality salience increases derogation of those who threaten people's worldviews unless those worldviews oppose prejudice, in which case mortality salience can increase acceptance of people who are otherwise threatening. Consistent with these hypotheses, conservative participants had less favorable impressions (Study 2) and liberal participants had more favorable impressions (Study 3) of a target with AIDS following a death reminder. Study 4 suggested that the decrease in prejudice among liberals following mortality salience was a genuine decrease in prejudice (as indicated by responses to an unobtrusive attitude measure), not just an increase in the desire to appear nonprejudiced. Theoretical and practical implications of these findings are discussed.     

Anti-Luminosity: Four Unsuccessful Strategies

Adam Morton, Stephen de Wijze, Hillel Steiner, and Eve Garrard have defended the view that evil action is qualitatively distinct from ordinary wrongdoing. By this, they do not that mean that evil actions feel different to ordinary wrongs, but that they have motives or effects that are not possessed to any degree by ordinary wrongs. Despite their professed intentions, Morton and de Wijze both offer accounts of evil action that fail to identify a clear qualitative difference between evil and ordinary wrongdoing. In contrast, both Steiner's and Garrard's accounts of evil do point to qualitative distinctions between kinds of action, but it is implausible that either account correctly characterizes evil. The most plausible accounts maintain that evil actions have a necessary connection to extreme harms, and this suggests that evil is not qualitatively distinct from ordinary wrongdoing.     

Individual Piagetian Epistemological Development of Children from Ages 6 to 11

This long-term study of children from ages 6 to 11 was undertaken to support the patterns of cognitive development inferred from Piaget's work and its short-term statistical replications. Several Piagetian tasks were used individually with 48 first graders, some of the same and new tasks with 43 of the same children as third graders, and two new tasks with 38 of the same children as fifth graders. Pearson product-moment coefficients indicated that uses of the clinical tasks in the study agreed significantly with those in the literature. In 33 individual line graphs, the average age (as indicated in the literature) for the most difficult task performed by a child at each level was compared with the actual age for the child's performance. Although individual aberrations in rates and patterns of cognitive development were observed, the graphic data supported the main hypothesis of the study.     

Memory for Constrained and Preselected Movement Location and Distance

These experiments assessed the interrelationship between location and distance cues in the coding of movements. In separate experiments subjects recalled either the terminal location or the distance of constrained (Experiment 1) or preselected (Experiment 2) movements following a 15-sec retention interval. Changes in direction amd amplitude of starting position were used to ascertain whether recall errors were related to these changes. The findings of both experiments indicated that location and distance were recalled with similar accuracy when the starting position was identical for the criterion and recall movement. However, analysis of constant errors when the recall starting position was varied in either direction clearly indicated neither terminal location nor distance are coded independently, and memory for movement is based on an interaction between these cues.