Defining the Assessment and Treatment Competencies to Deliver Low-Intensity Cognitive Behavior Therapy: A Multi-Center Validation Study

Despite the vastly increased dissemination of the low-intensity (LI) version of cognitive behavior therapy (CBT) for the treatment of anxiety and depression, no valid and reliable indices of the LI-CBT clinical competencies currently exist. This research therefore sought to develop and evaluate two measures: the low-intensity assessment competency scale (LIAC) and the low-intensity treatment competency scale (LITC). Inductive and deductive methods were used to construct the competency scales and detailed rating manuals were prepared. Two studies were then completed. The first study used a quantitative, fully-crossed design and the second a multi-center, quantitative longitudinal design. In study one, novice, qualified, and expert LI-CBT practitioners rated an LI-CBT assessment session (using the LIAC) and an LI-CBT treatment session (using the LITC). Study two used the LIAC and LITC across four training sites to analyze the competencies of LI-CBT practitioners over time, across raters, and in relation to the actor/patients’ feedback concerning helpfulness, the alliance, and willingness to return. Both the LIAC and LITC were found to be single factor scales with good internal, test-retest reliability and reasonable inter-rater reliability. Both measures were sensitive to measuring change in clinical competence. The LIAC had good concurrent, criterion, discriminant, and predictive validity, while the LITC had good concurrent, criterion, and predictive validity, but limited discriminant validity. A score of 18 accurately delineated a minimum level of competence in LI-CBT assessment and treatment practice, with incompetent practice associated with patient disengagement. These observational ratings scales can contribute to the clinical governance of the burgeoning use of LI-CBT interventions for anxiety and depression in routine services and also in the methods of controlled studies.     

Internal and External Validity of Self-Report and Parent-Report Measures of Sluggish Cognitive Tempo in South Korean Adolescents

This study evaluated the internal and external validity of self-report and parent-report measures of sluggish cognitive tempo (SCT) in South Korean adolescents. Adolescents (N =?469, ages 13–17 years; 50.2% boys) completed self-report measures of SCT and attention-deficit/hyperactivity disorder inattention (ADHD-IN) in addition to measures of internalizing and externalizing psychopathology, social problems, and grades. Parents rated adolescents on SCT, ADHD-IN, internalizing and externalizing psychopathology, and social problems. Using adolescent self-report, 11 of 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. Using parent-report, all 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. For within source analyses, SCT showed unique and stronger associations than ADHD-IN with internalizing psychopathology whereas ADHD-IN showed unique and stronger associations than SCT with externalizing psychopathology. SCT and ADHD-IN showed similar unique associations with social problems, whereas ADHD-IN was more strongly related than SCT to grades. Across source analyses also supported the differential unique associations of SCT and ADHD-IN with internalizing and externalizing psychopathologies. This study provides initial evidence for the internal and external validity of SCT with South Korean adolescents, extending support for the transcultural validity of SCT to the important developmental period of adolescence.

     

What is philosophy as a way of life? Why philosophy as a way of life?

Despite a recent surge of interest in philosophy as a way of life, it is not clear what it might mean for philosophy to guide one's life, or how a “philosophical” way of life might differ from a life guided by religion, tradition, or some other source. We argue against John Cooper that spiritual exercises figure crucially in the idea of philosophy as a way of life—not just in the ancient world but also today, at least if the idea is to be viable. In order to make the case we attempt to clarify the nature of spiritual exercises, and to explore a number of fundamental questions, such as “What role does reason have in helping us to live well?” Here we distinguish between the discerning and motivational powers of reason, and argue that both elements have limitations as guides to living well.     

Termination of information evaluation in auditing

A screening decision is about whether a candidate fails to meet a decision maker's criteria and must be rejected, or whether it meets the criteria and can be accepted. Image theory contends that screening decisions are based on a simple, noncompensatory process that focuses solely upon the candidate's negative attributes. This contention has received empirical support in a job screening context in which students role-played a hypothetical person seeking a job. But how robust is image theory's prediction? The present work was done in the context of professional auditors screening prospective clients. The client screening context is a particularly interesting setting to test the implications of image theory. If auditors reject clients with negative attributes, as predicted by image theory, this will indicate that some clients are being denied access to a socially useful service. Further, auditors can accept prospective clients with negative attributes and simply adjust the audit plan and fees to compensate for the client's riskiness. Thus, it is not clear that the preliminary findings obtained in a job screening context will generalize to the audit context. On the other hand, results consistent with the image theory prediction would suggest a robust theory. Even in the client screening context, where auditors used their own criteria to screen prospective clients, we found overwhelming support for image theory's view of screening. The results indicate the potential payoffs of image theory as a robust framework to address audit and other substantive problems. Implications of a noncompensatory, negative oriented, client screening strategy are discussed.