The Association Between Therapeutic Alliance and Treatment Outcomes in a Group Triple P Intervention

A growing literature has examined the association between therapeutic alliance and treatment outcomes in child therapy. Few studies, however, have specifically investigated the role of therapeutic alliance within evidence-based parenting programs for children with externalizing behavioural difficulties. The current study prospectively collected measures of therapeutic alliance for 117 families completing a Triple P parenting program in a community children’s mental health center. Higher levels of mother and father rated therapeutic alliance were associated with greater gains in parenting skills and parental sense of competence. Parental rated therapeutic alliance was also associated with greater improvements in child conduct problems for mothers, but not fathers. However, therapist ratings of therapeutic alliance had limited associations with treatment improvement. The implications of the findings for clinical practice are discussed.     

Feasibility of Conducting Long-Term Follow-Up of Children and Infants Treated for CNS Tumors on the Same Cooperative Group Clinical Trial Protocol

Given the barriers to conducting long-term assessment of neurocognitive and psychosocial functioning of those treated in infancy for central nervous system (CNS) tumors, a multi-site feasibility study was conducted. The primary objective was to demonstrate that it is feasible to identify, locate and assess the functioning of children treated on the same protocol 10-years post-treatment. Six sites obtained institutional approval, identified and recruited subjects, and obtained comprehensive neurocognitive and psychosocial data. All feasibility objectives were met. Barriers to participation included length of time for Institutional Review Board submission and review, clinical demands, limited eligible participants at individual institutions, difficulty locating long-term subjects and stipend/reimbursement concerns. Results indicate that long-term studies are feasible and essential given the need to address long-term issues of children treated at a young age for CNS tumors, especially as they relate to later academic and vocational planning, but require significant coordination and commitment of cooperative group and institutional resources.     

Establishing Therapeutic Dialogue with Refugee Families

The article describes an investigation into dialogues between native Swedish psychotherapists and refugee families. Dialogue is needed to establish the therapeutic alliance, which is ultimately important for healing, whether of individual sickness or family crisis. However the development of dialogue is hindered by cross-cultural and language barriers. We concentrate on one aspect of research originally presented in a Doctoral Thesis by the first author, asking how culture and power differences, together with their resettlement in a strange country, affected meetings with refugee families, and how these problems were overcome; language and the presence of an interpreter are not discussed. A multi-perspective methodology was used in the original research, combining text analysis, review of video-recordings by the participating therapists, and interviews with the families. All these forms of investigation are drawn on here, but particularly text analysis. Significant hindrances to dialogue turn out to be differences in cultural values between refugee and therapist, their different power positions, and the refugee’s weariness and distrust of meetings. Strategies to minimise power differences are an essential aspect of the Finnish open dialogue approach, which turns out to be particularly relevant to such refugee meetings.     

The Effect of Cognitive-Behavioral Therapy Versus Duloxetine on the Laboratory Indices of Inflammation in Fibromyalgia: A Randomized Controlled Trial

Journal of Rational-Emotive & Cognitive-Behavior Therapy - Proinflammatory cytokines have been introduced as surrogate markers of inflammation in fibromyalgia (FM). In this study, we aimed to...     

Aboriginal Children and Their Caregivers Living with Low Income: Outcomes from a Two-Generation Preschool Program

The development of preschool children of Aboriginal heritage is jeopardized by the inter-generational transmission of risk that has created, and continues to create, social disadvantage. Early intervention programs are intended to mitigate the impact of social disadvantage. Yet, evidence of the effectiveness of these programs for children of Aboriginal heritage is limited. The purpose of this study was to examine the effects of a two-generation, multi-cultural preschool program on 45 children of Aboriginal heritage and their caregivers. We used a single-group, pretest (program intake)/posttest (program exit) design with follow-up when the children were 7 years old. We used an observational measure of child receptive language (Peabody Picture Vocabulary Test–III) and caregiver-reported measures of child development (Nipissing District Developmental Screen), risk for child maltreatment (Adult-Adolescent Parenting Inventory; AAPI), parenting stress (Parenting Stress Index; PSI), self-esteem (Rosenberg Self-Esteem scale; RSE), and life skills (Community Life Skills scale; CLS). Using paired t-tests we found statistically significant increases in child receptive language scores between intake and exit, and repeated-measures ANOVA showed that these improvements were maintained up to age 7 years. For caregivers, Pearson’s correlations demonstrated that risk for child maltreatment, parenting stress, self-esteem, and life skills were stable over time. Results of this study suggest that children of Aboriginal heritage can benefit from participation in a two-generation, multi-cultural preschool program. Their caregivers may have received greater benefit if issues of intergenerational transmission of the negative influences of residential schools were addressed as part of programming.     

Prospective Predictors of Suicidal Ideation during Depressive Episodes among Older Adolescents and Young Adults

Suicide is a leading cause of death among older adolescents and young adults; however, few studies have prospectively examined risk for suicidal ideation. The present study in older adolescents and young adults investigated whether two personality traits previously implicated in risk for suicidal ideation, neuroticism and extraversion, as well as certain aspects of interpersonal functioning, prospectively predicted endorsement of suicidal ideation during depressive episodes. Participants (n=117) are a subset of the Northwestern-UCLA Youth Emotion Project sample, which started with a group of high school juniors oversampled for high neuroticism. Baseline interpersonal functioning was measured using the Life Stress Interview. Baseline personality trait composite scores were created from multiple inventories. Depressive disorders and suicidal ideation were assessed at the baseline and three annual follow-up interviews using the SCID. Cox regression was employed to predict suicidal ideation during depressive episodes diagnosed at any follow-up interview. Results showed that baseline extraversion inversely predicts suicidal ideation in males only, and that baseline interpersonal problems in one's social circle, regardless of gender, predict suicidal ideation during depressive episodes.     

Hypothalamic-pituitary-adrenal axis reactivity in the preschool-age offspring of depressed parents: moderation by early parenting

The hypothalamic-pituitary-adrenal axis is thought to play a role in the pathogenesis of depression. In the study reported here, we tested the hypothesis that parenting behavior moderates the relation between parents' lifetime history of depression and their offspring's cortisol reactivity to a psychosocial stressor. We exposed 160 preschool-age children to stress-inducing laboratory tasks, during which we obtained four salivary cortisol samples. Parents completed clinical interviews and an observational parent-child interaction task. The results confirmed our hypothesis: The offspring who evidenced high and increasing cortisol levels were those whose parents had a history of depression and demonstrated hostility toward their child. This moderating effect was specific to offspring who were exposed to maternal depression during the first few years of life. As do findings in animals, results of this study underscore the importance of the early rearing environment in the intergenerational transmission of stress sensitivity.     

Fast automatic translation and morphological decomposition in Chinese-English bilinguals

In this study, we investigated automatic translation from English to Chinese and subsequent morphological decomposition of translated Chinese compounds. In two lexical decision tasks, Chinese-English bilinguals responded to English target words that were preceded by masked unrelated primes presented for 59 ms. Unbeknownst to participants, the Chinese translations of the words in each critical pair consisted of a fully opaque compound word (i.e., a compound with two constituent morphemes that were semantically unrelated to the compound) and a monomorphemic word that was either the first or the second morpheme of the compound. The data revealed that bilinguals responded faster to English word pairs whose Chinese translations repeated the first morpheme than to English word pairs whose Chinese translations did not repeat the first morpheme, but no effect of hidden second-morpheme repetition was found. This effect of hidden first-morpheme repetition suggests that participants translated English words to Chinese and decomposed the translated compounds into their constituent morphemes. Because the primes were presented for only 59 ms, translation and morphological decomposition must be fast and automatic.