Expanding Treatment Options for Children With Selective Mutism: Rationale,Principles, and Procedures for an Intensive Group Behavioral Treatment

Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment methods for SM. In addition, geographic disparities in SM treatment expertise and the roughly 6-month duration of some of the supported SM treatment protocols can further restrict the accessibility and acceptability of quality SM care. Intensive group behavioral treatment (IGBT) for SM was developed to expand the portfolio of evidence-based SM treatment options by offering brief, but high-dose, expert SM intervention in a group format for youth ages 3–10 years that can be completed in 1 week. In this article, we outline IGBT for SM program, which has already received initial support in a waitlist-controlled trial. Our presentation is organized around the five main components of the treatment model: (1) individual “lead-in” sessions, (2) camp (i.e., all-day group sessions for children held in a simulated classroom setting, with an emphasis on graduated exposures and structured reinforcement), (3) parent training, (4) school outreach, and (5) booster treatment, as needed. We conclude with a discussion of clinical considerations and future directions for further IGBT refinement and evaluation.     

Research in counselling and psychotherapy Post‐COVID‐19

The COVID‐19 pandemic brings to light many areas the field of counselling and psychotherapy may need to address in future research. We outline several issues stemming from or exacerbated by the pandemic and offer suggestions for future research to address the mental health needs of those impacted. Our suggestions focus on five domains: (a) the health and well‐being of helping professionals, (b) the infodemic, (c) discrimination and minority stress, (d) spiritual and existential dynamics in mental health and (e) couple and family stress and resilience. We aim to provide a multi‐systemic perspective of mental health and well‐being in the time of COVID‐19, as well as encourage current and future studies to incorporate these suggestions to advance the health and well‐being of our communities through evidence‐based treatment approaches.     

Detecting children's true and false denials of wrongdoing: Effects of question type and base rate knowledge

One common and unfortunately overlooked obstacle to the detection of sexual abuse is non-disclosure by children. Non-disclosure in forensic interviews may be expressed via concealment in response to recall questions or via active denials in response to recognition (e.g., yes/no) questions. In two studies, we evaluated whether adults' ability to discern true and false denials of wrongdoing by children varied as a function of the types of interview question the children were asked. Results suggest that adults are not good at detecting deceptive denials of wrongdoing by children, even when the adults view children narrate their experiences in response to recall questions rather than provide one word answers to recognition questions. In Study 1, adults exhibited a consistent “truth bias,” leading them toward believing children, regardless of whether the children's denials were true or false. In Study 2, adults were given base-rate information about the occurrence of true and false denials (50% of each). The information eliminated the adults' truth bias but did not improve their overall detection accuracy, which still hovered near chance. Adults did, however, perceive children's denials as slightly more credible when they emerged in response to recall rather than recognition questions, especially when children were honestly denying wrongdoing. Results suggest the need for caution when evaluating adults' judgments of children's veracity when the children fail to disclose abuse.     

Taxonomies of aggressive behavior: A preliminary report

It has been widely and regularly suggested that aggression is not a unitary concept but rather an omnibus term concealing important and distinct subclasses of behavior. Psychologists have offered various categorical schemes highlighting motivation and form as distinguishing criteria. Many writers have also noted the social relativity of dermitions of classes of aggression and called for a consideration of lay conceptions of aggressive behavior. The present paper explores the correspondence between psychologists' and laypersons' categorizations of aggressive acts. Ten short scenarios of aggression were generated to embody systematic permutations of form and motive as suggested by the published work of social psychologists. Subjects rated every pairwise combination in terms of perceived similarity. The data were subjected to three-factor, multidimensional scaling. The resulting structure indicated that subjects' ratings were not random and reflected consideration of motive (hostile, normative, instrumental, status) and of direct versus indirect form. The data were thus in close correspondence with the classifications generated by psychologists. The desirability of refining this technique and extending it to other cultural and subcultural groups is discussed.     

An adolescent version of the Michigan Alcoholism Screening Test

Item content of the Michigan Alcoholism Screening Test (MAST) was modified to make it more appropriate for young persons. The resulting test was found to have lower internal consistency than the adult MAST, but the elimination of five items with comparatively poor psychometric properties yielded an acceptable alpha coefficient of .73. A unitary factor model for the adolescent MAST was not confirmed; indeed, the revised test appeared to be factorially complex. Recommendations for further revisions are discussed.     

A comparison of multiple reinforcer assessments to identify the function of maladaptive behavior

Functional analysis results indicated that maladaptive behaviors displayed by a 25-year-old man with profound mental retardation were maintained by attention from caregivers and possibly, to a lesser degree, by access to tangible items. A concurrent-schedules procedure was then used to study the relative reinforcing value for maladaptive behavior of attention versus tangible items. Results of the concurrent-schedules assessment and subsequent functional communication training indicated that preference for attention versus access to a tangible object varied.     

Holocaust survivors in a primary care setting: fifty years later

Past studies have not assessed the prevalence of emotional disturbances in Holocaust survivors seeking medical treatment in a family practice environment. The present study examined the prevalence of lifetime (the presence of symptomatology at any time) and current posttraumatic stress disorder (PTSD) symptoms, general anxiety, and depression in Holocaust survivors seeking medical treatment in a primary care setting. 20 of the 27 Holocaust survivors in our sample received a current diagnosis of PTSD and reported significant symptoms of depression and general anxiety. Although 74% of the survivors were currently diagnosed with PTSD, participants in this study had reported an overall decline in reexperiencing, hyperarousal, and overall PTSD symptoms but exhibited increased avoidance and numbing symptoms throughout the lifespan. These preliminary results suggest that removing avoidance as a defense mechanism during the course of psychotherapy may leave these survivors without an adequate way for coping with their trauma, subsequently increasing their vulnerability to psychopathology. Implications for psychological interventions are provided.