Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System

The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense’s experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.     

Effects of Performance Criteria during Reading Instruction on Generalized Oral Reading Fluency

Although there is some evidence that setting performance criteria may improve oral reading fluency interventions, little is known about the generalized effects of these criteria. The present study trained two third‐grade students to three different fluency levels on instructional passages and assessed generalized performance in corresponding high word‐overlap passages within an alternating treatments design. Results indicated no discernable differences across experimental conditions. Follow‐up analyses revealed that generalized gains per trial were actually larger in lower criterion conditions, suggesting that performance criteria may not be as helpful as previously thought. The results are discussed in terms of the need to empirically investigate the number of instructional trials necessary to maximize instructional efficiency. Copyright © 2016 John Wiley & Sons, Ltd.     

Motivating the academic mind: High-level construal of academic goals enhances goal meaningfulness,motivation, and self-concordance

How one thinks about or conceptualizes a goal has important consequences for the motivational features of goal pursuit. Two experiments tested the hypothesis, inspired by work on meaning in life, action identification theory, and expectancy-value theory, that high-level construal of an academic goal should enhance motivation to pursue that goal. In each experiment, we manipulated high-level versus low-level construal of an academic goal and assessed several variables related to the goal: the perceived meaningfulness of the goal, motivation to pursue the goal, and goal self-concordance. Supporting the hypothesis, individuals who thought about their academic goal in a high-level manner viewed their goal as more meaningful, reported being more motivated to pursue the goal, and reported the goal to be more self-concordant. Implications and future directions are discussed.     

Estimating the Mental Health Effects of Social Isolation

It is frequently hypothesized that feelings of social isolation are detrimental for an individual’s mental health, however standard statistical models cannot estimate this effect due to reverse causality between the independent and dependent variables. In this paper we present endogeneity-corrected estimates of the mental health consequences of isolation (based on self-assessed loneliness scores) using Australian panel data. The central identification strategy comes from a natural source of variation where some people within our sample are required by work or study commitments to move home. This relocation may break individuals’ social ties, resulting in significantly higher reported feelings of loneliness and consequently may lower mental health scores. The method gives results that are significant, robust and pass a battery of diagnostic tests. Estimates indicate that feelings of isolation have large negative consequences for psychological well-being, and that the effects are larger for women and older people. The results suggest that at current levels, a 10 % reduction applied to all individuals would reduce annual expenditure on mental illness in Australia by approximately $3B AUD, or around $150 AUD per person.     

Tracking mouse movement in feature inference: Category labels are different from feature labels

In this article, we examine the role of category labels in inductive inference. Some leading research has suggested that information about category membership works just like any other feature in categorical inductions, whereas other research has proposed that the influence of category membership on induction goes beyond that of other features. To investigate these claims further, we developed an online measure of judgments that is akin to eyetracking. The judgment results and the mouse-tracking data jointly support the view that category labels do affect inductive inferences in a way distinct from that for feature information. When arbitrary labels conveyed category membership information, participants viewed these labels more often and earlier in a trial, in comparison with cases in which the same labels conveyed non-membership information. Our results suggest that category membership information works like a guide for inference. An ecological rationale for this induction strategy is also discussed.     

Overcoming intuition: metacognitive difficulty activates analytic reasoning

Humans appear to reason using two processing styles: System 1 processes that are quick, intuitive, and effortless and System 2 processes that are slow, analytical, and deliberate that occasionally correct the output of System 1. Four experiments suggest that System 2 processes are activated by metacognitive experiences of difficulty or disfluency during the process of reasoning. Incidental experiences of difficulty or disfluency--receiving information in a degraded font (Experiments 1 and 4), in difficult-to-read lettering (Experiment 2), or while furrowing one's brow (Experiment 3)--reduced the impact of heuristics and defaults in judgment (Experiments 1 and 3), reduced reliance on peripheral cues in persuasion (Experiment 2), and improved syllogistic reasoning (Experiment 4). Metacognitive experiences of difficulty or disfluency appear to serve as an alarm that activates analytic forms of reasoning that assess and sometimes correct the output of more intuitive forms of reasoning.