Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

Positivity is an up‐to‐date predictor of well‐functioning instead of a eudaemon

Summing up the process of conceptualization of positive orientation theory (POT), the results of empirical studies which confirmed its validity, the operationalization of the positive orientation as a personality disposition in the Positivity Scale (PS), and the verification of the scale responsibility and empirical validity, it can be established that POT is a very promising, empirically validated theory. The dissemination of the POT and the PS in high‐impact scientific journals is an important contribution to the research on well‐being and in the domains of health psychology and positive psychology as well.     

Functions of Identity in the Context of Being a Student: Development and Validation of the Functions of Student Identity Scale

A promising approach to the understanding of identity is the identity functions framework. However, its developmental specificities associated with adolescence remain unexplored. The aim of this study was to develop and test a new measure of the functions of identity as they relate to being a student. Consistent with the theoretical framework, an exploratory analysis with a subsample of high school students revealed five identity functions. A confirmatory analysis with a second subsample found that a higher-order model incorporating these five subscales demonstrated good fit to the data. A bifactor model and statistical indices indicated that it is appropriate to interpret a total student identity score using this instrument. The five subscales, and total scale, demonstrated good convergent validity with a measure of academic behavioral change. These preliminary results suggest that this new instrument presents good psychometric properties and that it is a suitable assessment instrument for the measurement of students’ processes and outcomes. For example, its associations with academic performance stages of changes suggest that this instrument will be useful for identifying students at risk for poor academic trajectories.     

Factorial invariance,differential item functioning,and norms of the Orgasm Rating Scale

Background/Objective: Orgasm Rating Scale (ORS) assess the subjective orgasm experience in context of sexual relationship. It is composed of four dimensions attributed to the orgasm (Affective, Sensory, Intimacy, and Rewards). The purpose is to analyse the factorial invariance of the ORS across groups, to examine the metric equivalence across sex, and to present the standard scores. Method: A total of 1,472 Spanish adults (715 men and 757 women) were evaluated. They were distributed across age groups (18-34, 35-49 and 50 years old and older). Factorial invariance across different groups and the differential functioning of the items across sex were analyzed, internal consistency was examined, and the standard scores were developed. Results: The structure of the ORS showed strict measurement invariance across sex, relationship status, sexual orientation and education level. It also reached a scalar measurement invariance across age range and duration of the relationship. Some items showed a differential functioning between sexes. Conclusions: The Spanish version of the ORS is invariant across different groups at a factorial level, and it shows equivalence across sex in most of its items at a metric level. The standard scores allow a more accurate assessment of the subjective orgasm experience in context of sexual relationship.     

The Primacy of Discourse in the Study of Gender in Family Therapy

Family therapists and scholars increasingly adopt poststructural and postmodern conceptions of social reality, challenging the notion of stable, universal dynamics within family members and families and favoring a view of reality as produced through social interaction. In the study of gender and diversity, many envision differences as social constructed rather than as “residing” in people or groups. There is a growing interest in discourse or people's everyday use of language and how it may reflect and advance interests of dominant groups in a society. Despite this shift from structures to discourse, therapists struggle to locate the dynamics of power in concrete actions and interactions. By leaving undisturbed the social processes through which gendered and other subjectivities and relations of power are produced, therapists may inadvertently become complicit in the very dynamics of power they seek to undermine. In this article, we argue that discourse analysis can help family therapy scholars and practitioners clarify the link between language and power. We present published examples of discourse analytic studies of gender and sexism and examine the relevance of these ideas for family therapy practice and research.     

The Experience in Personal Social Systems Questionnaire (EXIS.pers): Development and Psychometric Properties

This study presents the theoretical background, development, and psychometric properties of the German and English versions of the Experience in Personal Social Systems Questionnaire (EXIS.pers). It assesses how the members of a personal social system experience their situation within that system. It is designed as a research tool for interventions in which only one member of the system participates (e.g., Family Constellation Seminars). The EXIS.pers was created to measure change on the individual level relating to one's own important personal social system. In Study 1, we used exploratory factor analysis (EFA) for latent variable identification of the original German EXIS.pers (n = 179). In Studies 2 and 3, we used confirmatory factor analysis (CFA) to examine the dimensionality of the German (n = 634) and English (n = 310) EXIS.pers. Internal consistencies and cross‐cultural structural equivalence were assessed. EFA indicated that a four‐factor model provided best fit for the German EXIS.pers. For both the German and English EXIS.pers, CFA provided the best fit for a five‐factor bi‐level model that included a general factor (Experience In Personal Social Systems) and four dimensions (Belonging, Autonomy, Accord, Confidence). Good internal consistencies, external associations, and cross‐cultural structural equivalence were demonstrated. This study provides first evidence for the German and English EXIS.pers as an economical and reliable measure of an individual's experience within his or her personal social systems.     

Effects of Group Functional Behavior-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Behavior in a Youth With Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) often present with comorbid Obsessive Compulsive Behaviors (OCBs), but little research exists on effective intervention for OCBs. Using a single-case experimental design, this study highlights the efficacy of a Group Functional Behavior-based Cognitive-Behavior Therapy (Fb-CBT) to reduce OCBs in an 11-year-old youth with ASD. Tailored to the individual needs of this youth, Fb-CBT included traditional CBT components (e.g., psychoeducation, cognitive-behavioral skills training, and exposure and response prevention) coupled with functional behavior assessment and intervention. Time-series parent report data and standardized measures showed clinically significant decreases in OCBs, an increase in psychosocial functioning, and high consumer satisfaction.