Simultaneous Prompting and Instructive Feedback When Teaching Chained Tasks

This study evaluated the effectiveness of the simultaneous prompting procedure when teaching students with moderate to severe mental retardation a chained task (i.e., hand washing). This study also evaluated if students could acquire responses to instructive feedback stimuli presented during training sessions. The effectiveness of these procedures was assessed by using a multiple probe across students design. Acquisition, maintenance, and generalization data were collected and analyzed. Results indicated that the simultaneous prompting procedure was effective in teaching 3 of the 5 students to follow a 16-step task analysis to wash their hands. All students who met criterion maintained and generalized the skills with 100% accuracy. All students acquired some of the instructive feedback stimuli. Future research issues are discussed.     

Delivering Acceptance and Commitment Therapy for Weight Self-Stigma Through Guided Self-Help: Results From an Open Pilot Trial

Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a self-help book, with a sample of 13 overweight/obese individuals high in weight self-stigma. Results indicated a high degree of program engagement (77% completed the intervention) and satisfaction. Participants improved on outcomes over time including weight self-stigma, emotional eating, weight management behaviors, health-related quality of life, and depression. Although not a directly targeted outcome, participants improved on objectively measured weight, with an average of 4.18 pounds lost over 7 weeks, but did not improve on self-reported weight at 3-month follow-up. Processes of change improved over time, including psychological inflexibility, valued action and reasons to lose weight. Coaching effects indicated greater retention and improvements over time with one coach vs. the other, suggesting characteristics of coaching can affect outcomes. Overall, these results provide preliminary support for the acceptability and efficacy of a guided self-help ACT program for weight self-stigma. Implications of these results and how to address clinical challenges with guided self-help are discussed.     

Resilience facilitates positive emotionality and integration of negative memories in need satisfying memory networks: An experimental study

Resilience has been associated with the capacity to experience positive emotions in the midst of negative life events or following the recall of such events. Apparently, resilient people are able to self-generate those positive emotions because they tend to integrate and associate such past negative life events with other positive past events in memory networks. However, study designs on resilience have remained either cross-sectional or longitudinal. The causal effect of resilience on these outcomes remains to be shown as a third variable or unknown factor could be at play. In this study, we used a resilience intervention from a self-help clinical program to induce resilience and compared this condition against Jacobson type relaxation and neutral music background. Results showed that the resilience intervention increased positive emotionality following the recall of a negative self-defining memory and facilitated the integration of that memory within more positive and need satisfying memory networks.     

Guided self-help for disordered eating: A randomised control trial

Treatment guidelines recommend evidence-based guided self-help (GSH) as the first stage of treatment for bulimia nervosa and binge eating disorder. The current randomised control trial evaluated a cognitive behavioural therapy-based GSH pack, ‘Working to Overcome Eating Difficulties,’ delivered by trained mental health professionals in 6 sessions over 3 months. It was congruent with the transdiagnostic approach and so was intended as suitable for all disordered eating, except severe anorexia nervosa. Eighty one clients were randomly allocated to either a GSH or waiting list condition. Eating disorder psychopathology (EDE-Q), key behavioural features and global distress (CORE) were measured at pre- and post-intervention, and 3- and 6-month follow-up. Results showed significant improvements in eating disorder psychopathology, laxative abuse, exercise behaviours, and global distress, with the GSH condition being superior to the waiting list on all outcomes. Treatment gains were maintained at 3 and 6 months. This study adds to the evidence supporting GSH for disordered eating, including EDNOS. However, further work is needed to establish the factors that contribute to observed therapeutic improvements and determine for whom GSH is most suitable.     

Guided Imagery and Relaxation for Women with Early Stage Breast Cancer

Abstract

Fifty-two women with Stage I and Stage II breast cancer agreed to participate in a study to determine the effectiveness of two interventions, guided imagery and relaxation, to enhance psychological well-being. Participants were randomly assigned to either a guided imagery or relaxation group. Forty women completed the study. A student's t-test was used to analyze the quantitative results. Depression, anxiety and fatigue were significantly improved for the guided imagery group. There were no changes reported by the relaxation group. Women in both groups reportedly enjoyed the experience, found it helpful, and would recommend it to others. The majority of the women in both groups perceived that the treatment helped them to relax.     

Selective search for conjunctively defined targets by children and young adults

Two experiments were conducted to investigate age-related differences in visual search for targets defined by the conjunction of two features. In the experiments, 7- and 10-year-old children and young adults searched visual displays for a black circle among distractors consisting of gray circles and black squares. In Experiment 1 (N = 60), we compared performance in the standard search task (where an equal number of each type of distractor appeared across all display sizes) with performance in a modified search task (where the number of black squares was fixed at two and the number of gray circles increased as the display size increased). In Experiment 2 (N = 60), the ratio of black stimuli to gray stimuli was varied systematically as the display size increased. Results of both experiments indicated that all participants were able to restrict search to an appropriate subset of the display rather than conduct an exhaustive search. However, the young adults were more efficient in their ability to do so than were either the 7- or 10-year-old participants. The 10-year-olds were as efficient as the young adults when the number of black stimuli in the display was relatively small. However, these children became relatively less able to restrict search effectively as the number of black stimuli increased. Discussion focused on possible preattentive and attentive processes that may change systematically with age.     

Manualized Treatment of Panic Disorder in a Medical Setting: Two Illustrative Case Studies

People who experience panic attacks (PAs) typically present to medical settings, concerned that their symptoms signify a life-threatening condition. Despite the efficacy of cognitive-behavioral therapy (CBT) for panic disorder (PD), medical practitioners seldom provide this type of treatment. Physicians may lack the time or expertise to impart such behavioral medicine interventions, while patients may find group or individual CBT too costly even when available. Researchers have begun investigating manualized CBT as a cost-effective alternative when traditional forms of this intervention are prohibited. This article describes two case studies in which women presenting to a medical clinic with PD were treated with 6 weeks of manualized CBT after pharmacotherapy was unsuccessful or unpalatable. Both patients exhibited reductions in panic and depressive symptomatology over baseline levels, along with increases in self-efficacy regarding their ability to manage future PAs. Improvements were maintained over 12 months, supporting continued use of manualized CBT as a supplement or alternative to pharmacological methods of treating PD in the medical setting.     

TEACHING A PARENT TO TRAIN A SPOUSE IN CHILD MANAGEMENT TECHNIQUES

This study analyzed several aspects of the training of a mother and father in child management techniques for use with their 6-year-old severely developmentally delayed son. The mother received clinic training in procedures for increasing her son's independent dressing skills; subsequently, she was asked to teach the same procedures to her husband with no assistance from the trainer. For both parents, procedures were introduced sequentially across two components of parent behavior in a multiple baseline design. Examinations were made of (a) the effectiveness of initial child management training on the mother's behaviors, (b) her ability to teach the same techniques to her husband independently, (c) the generalization of both parents' skills from the training setting (a dressing task) to two untrained activities (eating and toy use), and (d) the impact of training on the child's behavior. Results showed that the mother learned to implement the trained procedures and successfully communicated them to her husband, as evidenced by substantial positive changes in both parents' behaviors after being introduced to the child management skills. Both parents showed some generalization to the untrained activities, and their written comments following training indicated they understood the procedures. Clear-cut improvements were observed in the child's attending and independent performance of dressing and toy use skills concurrent with parent training. A 2-year follow-up report indicated that both parents retained their knowledge of skills taught, continued to use the procedures, and rated the training as very helpful in teaching the child self-help skills.     

Reduced Contact Cognitive-Behavioral Interventions for Adult Depression: A Review

Depression is a highly prevalent and debilitating mental health condition. Evidence suggests that there is a widening gap between the demand for and availability of effective treatments. As such, there is a vast need for the development and dissemination of accessible and affordable treatments for depression. In the past decade, there has been a proliferation of reduced client-therapist contact protocols for depression. In this article, the authors review and compare the efficacy of reduced contact cognitive-behavioral interventions for adult depression across two degrees of therapist-client contact (i.e., no therapist-client contact versus minimal therapist-client contact interventions). The authors also discuss the methodological and theoretical limitations of this research base. The present review suggests that a) reduced contact interventions for depression can be effective in remediating the symptoms of depression; b) the effect sizes of some reduced contact protocols may approximate those reported in traditional protocols involving significantly greater client-therapist contact; and c) protocols which employ some form of client-therapist contact, on average, generate higher effect sizes than those that are purely self-help in nature. A discussion of the theoretical and applied implications of such findings, as well as areas in need of further research, is provided.