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.     

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.     

Some effort for some: further evidence that scalar implicatures are effortful

Under the assumption of the principle of cooperation (Grice, 1989), a statement such as "some eels are fish" is thought to be false since it contains less information than is considered sufficient. However, the statement is logically sound since the meaning of "some" is compatible with "all". Currently, the primary interpretation of such underinformative statements remains subject to debate. According to Levinson (2000), the pragmatic "some but not all" interpretation is the default interpretation, while others (e.g., Sperber & Wilson, 1995) argue that this pragmatic interpretation only comes to the fore when relevant within the context and is thus considered secondary to the logical "some and perhaps all" interpretation. In this study, three factors that may influence the answer pattern are studied: task load, working memory capacity, and repetition of the statements. In Experiment 1, we used a secondary task paradigm to manipulate the cognitive load under which a number of underinformative statements had to be judged. We observed that for participants with a rather limited working memory span it is harder to reach a pragmatic interpretation under cognitive load. In Experiment 2, we manipulated the repetition of the statements. We observed that with a higher number of filler statements, participants produced fewer consistent answer patterns. This study provides further evidence against the automaticity of the pragmatic interpretation: It shows that the pragmatic interpretation requires more cognitive effort than the logical interpretation and that increasing the number of filler statements inhibits the development of a response strategy.     

Fostering good citizenship through ethical leadership: exploring the moderating role of gender and organizational politics

Considering the implications of social exchange theory as a context for social role behavior, we tested relations between ethical leadership and both person- and task-focused organizational citizenship behavior and examined the roles played by employee gender and politics perceptions. Although social exchange theory predicts that ethical leadership is positively associated with citizenship, social role theory predicts that the nature of this relationship may vary on the basis of gender and politics perceptions. Results from data collected from 288 supervisor-subordinate dyads indicate that the pattern of male versus female employees' citizenship associated with ethical leadership depends significantly on their perceptions of politics. Implications for theory and practice are discussed.     

Identification of cognitive profiles among women considering BRCA1/2 testing through the utilisation of cluster analytic techniques

Based on the cognitive-social health information processing model, we identified cognitive profiles of women at risk for breast and ovarian cancer. Prior to genetic counselling, participants (N = 171) completed a study questionnaire concerning their cognitive and affective responses to being at genetic risk. Using cluster analysis, four cognitive profiles were generated: (a) high perceived risk/low coping; (b) low value of screening/high expectancy of cancer; (c) moderate perceived risk/moderate efficacy of prevention/low informativeness of test result; and (d) high efficacy of prevention/high coping. The majority of women in Clusters One, Two and Three had no personal history of cancer, whereas Cluster Four consisted almost entirely of women affected with cancer. Women in Cluster One had the highest number of affected relatives and experienced higher levels of distress than women in the other three clusters. These results highlight the need to consider the psychological profile of women undergoing genetic testing when designing counselling interventions and messages.