Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Examining the Potential Mental Health Costs of Defending Victims of Bullying: a Longitudinal Analysis

Research on Child and Adolescent Psychopathology - It has been speculated that defending victims of bullying is stressful for youth, and may contribute to poor mental health among those who...     

Proving quadratic reciprocity: explanation,disagreement, transparency and depth

Gauss’s quadratic reciprocity theorem is among the most important results in the history of number theory. It’s also among the most mysterious: since its discovery in the late eighteenth century, mathematicians have regarded reciprocity as a deeply surprising fact in need of explanation. Intriguingly, though, there’s little agreement on how the theorem is best explained. Two quite different kinds of proof are most often praised as explanatory: an elementary argument that gives the theorem an intuitive geometric interpretation, due to Gauss and Eisenstein, and a sophisticated proof using algebraic number theory, due to Hilbert. Philosophers have yet to look carefully at such explanatory disagreements in mathematics. I do so here. According to the view I defend, there are two important explanatory virtues—depth and transparency—which different proofs (and other potential explanations) possess to different degrees. Although not mutually exclusive in principle, the packages of features associated with the two stand in some tension with one another, so that very deep explanations are rarely transparent, and vice versa. After developing the theory of depth and transparency and applying it to the case of quadratic reciprocity, I draw some morals about the nature of mathematical explanation.

     

Active biological mechanisms: transforming energy into motion in molecular motors

Synthese - Unless one embraces activities as foundational, understanding activities in mechanisms requires an account of the means by which entities in biological mechanisms engage in their...