Injury control. A promising field for psychologists.

Injury is the fourth leading cause of death for all Americans and the most frequent cause of death for those from age 1 to 45. Moreover, injury is associated with higher treatment costs and with greater lost life-years than the other three leading causes of death. Traffic accidents are the leading cause of severe brain injury, including most paraplegic and quadriplegic cases. Because injury control is essentially psychological, there are many opportunities for psychologists to contribute, both to scientific research on the causes of injury and to clinical interventions for injury control.     

Redefining the science-practice relationship and professional training.

A revised conception of the relationship between psychological science and professional practice is proposed in the light of postmodern changes in perspectives on knowledge. Positivistic science, which has dominated the traditional interpretation of scientist-practitioner training, is considered from a constructivist point of view to be only one possible foundation of psychological knowledge. It is argued that the knowledge base of the profession should be derived with diverse methods and from multiple sources, including the knowledge of practice. The mutuality of science and practice is emphasized. An evolving framework for understanding the epistemology of practice, based on cognitive psychology, is presented. Emphasis on broadened choices of research methods, the development of reflective skills, and better linkage between teaching in the domains of research and practice are urged. Suggestions for research related to scientific training and the knowledge processes of practice are offered.     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. We classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns = 10 and 10) and nongeneralized social phobics without APD (n = 10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with APD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information but the additional diagnosis of APD may simply identify a severe subgroup of social phobics.     

Reciprocal peer management: Improving staff instruction in a vocational training program

To test the feasibility and utility of involving peers as sources of feedback, 6 subjects, instructors in a vocational program for adults with mental retardation, participated in a staff training and management program. Subjects' teaching interactions were assessed during baseline, in-service training (on effective teaching), return-to-baseline, peer management, and follow-up phases. Peer management was introduced in multiple baseline fashion across pairs of subjects. Members of each pair were trained to monitor peer teaching, to record and graph data, to provide feedback, and to set goals with the peer. Each pair then performed these procedures on the job for several weeks, during which time 4 of the 6 subjects increased their use of effective teaching methods (over baseline). However, inconsistencies in the magnitude and durability of these increases require that the study be viewed as inconclusive, although it has heuristic value as a promising model for involving co-workers in staff management programs.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.