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.     

The use of strategies and messages to alter aggressive interactions

Male and female college students were instigated to aggression by a confederate's shocks during a preliminary task. The confederate informed half of the treatment subjects of the response strategy which he intended to adopt. The other half received an irrelevant message. All subjects then competed against the confederate, who employed one of the following five response consequence strategies: a) set a maximum shock on all trials; b) set a minimum shock on all trials; c) set shocks identical to the subject's response on the preceding trial; d) set shocks two settings below the subject's response; or e) set shocks two settings above the subject's. The subject's latency to setting a shock, the intensities of the shocks set, the durations of the shock settings, and the subject's reaction times were recorded. When an irrelevant message was delivered, passive responses, well below those of the opponent, resulted in the lowest level of retaliation. In the presence of a relevant message, the match-same strategy emerged as an effective deterrent to aggressive behavior. The results were found to be consistent with predictions derived from an application of the norm of reciprocity and research demonstrating the enhancing effects achieved through the communication of existing contingencies.     

The dissolution of “classical ethnoscience”

„Ethnoscience”︁ in the early 1960s provides a prototypical case of an elite specialty. With easy access to recognition, there was only a loose confederation, not at all the kind of tightly knit social network with a garrison worldview typifying revolutionary groups. Elite specialities both grow and dissolve more rapidly than revolutionary groups; they require less commitment, and concomitantly offer less resistance to competitors. Ethnoscience lacked a single leader and was never monolithic.