Elaborate reflections on a simple manifesto

In an earlier article (^{McFall, 1991}), I urged clinical psychologists to work toward the goal of integrating science and practice and proposed the adoption of a principle and two corollaries aimed at achieving this goal. In general, I argued that all aspects of clinical psychology must be guided by the highest scientific and ethical standards, that clinical practice be limited to empirically supported procedures, and that clinical training be devoted to producing clinical scientists. In the present article, I elaborate and defend these points by offering reflections on a number of submitted questions provoked by the earlier article. I address four major issues: the philosophical foundations for a scientific epistemology, the implications of this epistemology for clinical practice, the implications for clinical training, and the likely impact of adopting this epistemology on the field of clinical psychology.     

The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change—higher utilizers’ use of services decreased substantially, whereas lower utilizers’ slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions.     

Subscales of the Barratt Impulsiveness Scale differentially relate to the Big Five factors of personality

The place of impulsiveness in multidimensional personality frameworks is still unclear. In particular, no consensus has yet been reached with regard to the relation of impulsiveness to Neuroticism and Extraversion. We aim to contribute to a clearer understanding of these relationships by accounting for the multidimensional structure of impulsiveness. In three independent studies, we related the subscales of the Barratt Impulsiveness Scale (BIS) to the Big Five factors of personality. Study 1 investigated the associations between the BIS subscales and the Big Five factors as measured by the NEO Five‐Factor Inventory (NEO‐FFI) in a student sample (N = 113). Selective positive correlations emerged between motor impulsiveness and Extraversion and between attentional impulsiveness and Neuroticism. This pattern of results was replicated in Study 2 (N = 132) using a 10‐item short version of the Big Five Inventory. In Study 3, we analyzed BIS and NEO‐FFI data obtained from a sample of patients with pathological buying (N = 68). In these patients, the relationship between motor impulsiveness and Extraversion was significantly weakened when compared to the non‐clinical samples. At the same time, the relationship between attentional impulsiveness and Neuroticism was substantially stronger in the clinical sample. Our studies highlight the utility of the BIS subscales for clarifying the relationship between impulsiveness and the Big Five personality factors. We conclude that impulsiveness might occupy multiple places in multidimensional personality frameworks, which need to be specified to improve the interpretability of impulsiveness scales.     

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale‐up for the child welfare system. In child welfare, scale‐up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale‐up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system.     

Decreased attention to object size information in scale errors performers

Young children sometimes make serious attempts to perform impossible actions on miniature objects as if they were full-size objects. The existing explanations of these curious action errors assume (but never explicitly tested) children's decreased attention to object size information. This study investigated the attention to object size information in scale errors performers. Two groups of children aged 18–25 months (N = 52) and 48–60 months (N = 23) were tested in two consecutive tasks: an action task that replicated the original scale errors elicitation situation, and a looking task that involved watching on a computer screen actions performed with adequate to inadequate size object. Our key finding – that children performing scale errors in the action task subsequently pay less attention to size changes than non-scale errors performers in the looking task – suggests that the origins of scale errors in childhood operate already at the perceptual level, and not at the action level.     

Efficacy of Parent-Child Interaction Therapy with Parents with Intellectual Disability

Parents with intellectual disability (ID) face many parenting challenges that may affect their ability to parent effectively, and such deficits are often associated with various poor child outcomes. Research findings are inconsistent for interventions targeting systematic skills for parents with ID. Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment that incorporates performance-based training to enhance parenting ability. This study evaluated implementation of PCIT with parents with ID using a multiple baseline design across behaviors. Results suggest increases in positive parenting behaviors and consistent discipline. However, limitations related to poor maintenance and generalization warrant the need for future research.     

The effects of mindful learning on pro-environmental behavior: A self-expansion perspective

This current article explores the differential effects of mindful learning on pro-environmental behavior from the perspective of self-expansion. A total of 253 participants were recruited for four experiments. In Study 1, the mindful-learning group reported greater levels of pro-environmental behavioral intentions compared to a randomized control. In Study 2, we utilized different learning materials focusing on self, humans, or the biosphere in three sub-experiments. Study 2a manipulated mindsets by a self-related focus and revealed participants in a mindfulness condition had lower pro-environmental behavioral intentions than those in the mindlessness group. Study 2b centered on “humans” and results showed that participants in a mindfulness group reported higher levels of pro-environmental behavioral intentions. Finally, Study 2c induced mindsets with a biospheric focus, showing participants in the mindful-learning condition had greater pro-environmental behavioral intentions. Combined, the studies provide empirical evidence that mindful learning could influence self-reported pro-environmental behavioral intentions both positively and negatively.