Therapeutic Contract Program: preliminary report on a behavioral alternative to the token economy

The token economy has been the primary model for the behavioral management of inpatient populations. However, this basically operant approach seldom emphasizes the development of cognitive-coping skills to help patients more effectively manage stressors that result in hospitalization. The Therapeutic Contract Program (TCP) is described as an inpatient-treatment strategy that is designed to help foster such cognitive-coping and self-control skills. While external structure is provided by components of this program, subprograms of the TCP have as their goal the development of internally-attributed coping skills and self-perceptions of competence. This preliminary report describes the structure of the TCP, as well as planned and in-progress measures of program participation and treatment outcome.     

The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Researach

Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness of preventive interventions, is practically unknown in suicidology. The study authors discuss the application of both concepts to suicide research and prevention, and review literature on the subject. Despite several methodological and conceptual limitations, both PAR and PF are valuable instruments to inform development and evaluation of suicide prevention programs.