Consultation-based Academic Interventions for Children with ADHD: Effects on Reading and Mathematics Achievement

The purpose of this investigation was to evaluate the relative efficacy of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention-deficit/hyperactivity disorder (ADHD). Children (N=167) meeting DSM-IV criteria for ADHD were randomly assigned to one of two consultation groups: Individualized Academic Intervention (IAI; interventions designed using a data-based decision-making model that involved ongoing feedback to teachers) and Generic Academic Intervention (GAI; interventions designed based on consultant-teacher collaboration, representing "consultation as usual"). Teachers implemented academic interventions over 15 months. Academic outcomes (e.g., standardized achievement test, and teacher ratings of academic skills) were assessed on four occasions (baseline, 3 months, 12 months, 15 months). Hierarchical linear modeling analyses indicated significant positive growth for 8 of the 14 dependent variables; however, trajectories did not differ significantly across consultation groups. Interventions in the IAI group were delivered with significantly greater integrity; however, groups did not differ with respect to teacher ratings of treatment acceptability. The results of this study provide partial support for the effectiveness of consultation-based academic interventions in enhancing educational functioning in children with ADHD; however, the relative advantages of an individualized model over "consultation as usual" have yet to be established.     

Habitual Virtuous Actions and Automaticity

Dual process theorists in psychology maintain that the mind’s workings can be explained in terms of conscious or controlled processes and automatic processes. Automatic processes are largely nonconscious, that is, triggered by environmental stimuli without the agent’s conscious awareness or deliberation. Automaticity researchers contend that even higher level habitual social behaviors can be nonconsciously primed. This article brings work on automaticity to bear on our understanding of habitual virtuous actions. After examining a recent intuitive account of habitual actions and habitual virtuous actions, the author offers her own explanation in terms of goal-dependent automaticity. This form of automaticity provides an account of habitual virtuous actions that explains the sense in which these actions are rational, that is, done for reasons. Habitual virtuous actions are rational in the sense of being purposive or goal-directed and are essentially linked with the agent’s psychological states. Unlike deliberative virtuous actions, the agent’s reasons for habitual virtuous actions are not present to her conscious awareness at the time of acting.

Promotion of social change: a conceptual framework

This paper argues for the need to advance promotion efforts and proposes a conceptual framework for promotion of social change. A brief review is presented of traditional frameworks for the prevention of mental and social disorders and the promotion of wellness and social competencies, with attention to the ways in which promotion of social change extends and departs from these frameworks. In a framework for promoting social change, we advocate for promoting dynamic processes within systems, rather than outcomes within individuals. Systems are viewed as flexible and capable of facilitating multiple adaptive pathways for individuals and groups. Promoting social change also involves careful attention to critical analysis, values, language, and contextual processes. Examples are discussed throughout to illustrate how these principles have been used in the past and can be implemented in future efforts to promote social change.     

A Model for Primary Care Psychology With General Thoracic Surgical Patients

This study examined a model for brief psychological assessment for providing primary psychological care to patients within a surgical, specialty outpatient clinic to provide early and accurate detection of psychological distress in patients to increase compassionate care. Questionnaires were completed by 351 outpatients and 227 of these outpatients were provided a model of primary care (brief psychological intervention). Patients were assessed and provided coping strategies, patient education, and a brief evaluation of anxiety and depressive symptoms. Psychologists, in a brief interview (mean = 12 min) identified individuals experiencing significant psychological distress. The ratings of emotional status also predicted health quality of life and anxiety. Younger individuals presenting for medical care appear to be more vulnerable to psychological distress. Brief psychological interventions provide accurate, efficient assessment of psychological distress and can be an effective way of increasing compassionate care. The results support the use of primary care psychology and brief psychological interventions in the management of medical patient care.     

Limits to doubt

Supported by Ian Hacking’s concept of “intervention,” and Charles Taylor’s concept of “intentionality,” this article argues that doubting is acting, and that doubting is therefore subject to the same demands of responsibility as any other action. The argument is developed by using medical practice as a test-case. The central suggestion is that the demand of acting responsibly limits doubt in medicine. The article focuses on two such limitations to doubt. Firstly, the article argues that it is irresponsible to doubt that our actions can harm other people. Secondly, the article argues that it is irresponsible not to strive for coherence between our utterances of doubt and our other actions. Incoherence here can cause “cultural impoverishment.” In a larger context this article also argues that medicine can enrich our epistemology, because medical knowledge displays important traits of knowledge that are downplayed in traditional epistemology derived from mathematics and physics. In particular, medicine makes it possible to get the relation between ethics and epistemology into sharper focus. The endpoint in medical epistemology is “responsible action,” and not certainty in and of itself.     

Treatment of chronic stress in employees: subjective, cognitive and neural correlates

This study reports the effect of an affect-focused intervention program, the Affect School, on stress, psychological symptoms, cognitive functioning and neural activity. Fifty employees in social service and education, with high levels of chronic stress, were randomly divided into a treatment (N=27) and control (N=23) group. Complete sets of data were available in 20 participants in the treatment group and 17 in the control group. The Perceived Stress Questionnaire assessed stress and the Symptom Check List-90 psychological symptoms before and after treatment. Episodic-memory functioning under focused and divided attention conditions was also assessed. Prior and after the Affect School, seven participants in the treatment group were studied with functional magnetic resonance imaging (fMRI) during episodic memory processing. After the Affect School there was a reduction in stress and psychological symptoms for the treatment group but not in the control group. The controls showed a reduction in episodic memory functioning whereas the performance of the treatment group remained intact. The fMRI scanning indicated a qualitative change in the neural network subserving episodic memory. These preliminary results suggest that the Affect School is effective on individuals with high stress.     

Evaluation of the school-based smoking-prevention program "BE smokeFREE"

This article examines the impact of the school-based smoking-prevention program "BE smokeFREE" on adolescent smoking. A national representative sample of 99 schools (195 classes, 4,441 students) was used when the intervention started in November 1994. Schools were allocated to one of four groups: a comparison group (A) and three intervention groups (B, C, and D). Group B received the most comprehensive intervention. A baseline (autumn 1994) and three follow-up data collections (1995, 1996, and 1997) were conducted. There were no significant differences in smoking habits among the four groups at baseline. The smoking habits in the group that was involved in the most comprehensive intervention (group B) changed more favourably than those of students in the comparison schools over the three follow-up data collections. At the third follow-up, the proportion of students smoking weekly or more in the comparison group was 29.2%, compared with 19.6% in the model intervention group. The two less comprehensive interventions (no teacher in-service courses in group C, and no involvement of parents in group D) appeared to be less effective than the model intervention. Multilevel multiple logistic regression analyses, comparing changes in smoking habits between students in group B with those among students in the comparison schools, confirm the conclusion that the comprehensive intervention was the most effective. This school-based intervention, based on a social influence approach, proved to be effective at reducing smoking rates among participants.     

A collaborative family-systemic approach to treating chronic illness: irritable bowel syndrome as exemplar

This article describes an evolving collaborative relationship between a family therapist and a physician focused on the treatment of irritable bowel syndrome, a highly prevalent disorder which has several psychological characteristics. We began with a unique approach utilizing (1) simultaneous treatment by both specialists; (2) a focus on the relationship context of illness. This approach draws on family systemic theory and practice as well as a circular model of mind and body interaction. Because the intervention was significantly helpful to patients, the premises which informed it were then incorporated into a five session group treatment model. Results and clinical report support the efficacy of a collaborative systemic approach between a medical specialist and family psychologist in treating adult chronic illness.     

Proximal Peer-Level Effects of a Small-Group Selected Prevention on Aggression in Elementary School Children: An Investigation of the Peer Contagion Hypothesis

Examined peer contagion in small group, selected prevention programming over one school year. Participants were boys and girls in grades 3 (46 groups, 285 students) and 6 (36 groups, 219 students) attending school in low-resource, inner city communities or moderate resource urban communities. Three-level hierarchical linear modeling (observations within individuals within groups) indicated that individual change in aggression over time related to the average aggression of others in the intervention group. The individual child was pulled toward peers mean level of aggression; so the intervention appeared to reduce aggression for those high on aggression, and to make those low on aggression more aggressive. Effects appeared to be magnified in either direction when the child was more discrepant from his or her peers. From these results we derive a principle of discrepancy-proportional peer-influence for small group intervention, and discuss the implications of this for aggregating aggressive children in small group programs.