Treating Childhood Social Anxiety Disorder With Virtual Environments and Serious Games: A Randomized Trial

Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.     

Exploring the mediating role of integrative self-knowledge in the relationship between mindfulness and well-being in the context of a mindfulness-based stress reduction program

Mindfulness-based stress reduction (MBSR) is an effective program for improving well-being. A growing body of studies is exploring the mechanisms mediating its beneficial effects. Integrative self-knowledge (ISK) is the construct of focus in this study. The primary goal of the current study was to investigate the mediating role of ISK in the relationship between improved mindful observing (MO), non-judging inner experience (NJ), and well-being following an MBSR program with an Iranian sample. Participants (n = 118) enrolled in MBSR and completed depression, anxiety, stress (DASS), Bartone Symptoms Checklist (BSC), Five-Facet Mindfulness Questionnaire, and ISK scale before and after the program. Results showed significant reductions in BSC, DASS, and improvements in MO, NJ, and ISK at the end of the program. Mediation analyses revealed that changes in ISK significantly mediated the relationship between changes in MO and NJ and symptoms (MO indirect effect on DASS: β = 0.11, confidence interval [CI] [0.003, 0.29]; NJ indirect effect on DASS: β = 0.12, CI [−0.16, 0.45]; MO indirect effect on BSC: β = 0.08, CI [0.001, 0.27]; NJ indirect effect on BSC: β = 0.09, CI [0.01, 0.22]). Improvements in MO and NJ may provide a pathway to cultivating ISK in MBSR, which may lead to enhanced well-being.     

An update on the search for symmetry in nonhumans

Sidman et al.'s (1982) failure to find evidence for symmetry (bidirectional associations between stimuli) in monkeys and baboons set the stage for decades of work on emergent relations in nonhumans. They attributed the failure to the use of procedures that did not (1) promote stimulus control based on the relation between the sample and correct comparison and (2) reduce control by irrelevant stimulus features. Previous reviews of symmetry in nonhumans indicated that multiple exemplar training and successive matching might encourage appropriate stimulus control. This review examined 16 studies that investigated symmetry in 94 subjects, including pigeons, rats, capuchin monkeys, and baboons. Several studies used alternative training procedures to minimize sources of irrelevant stimulus control, and many combined multiple exemplar training with other procedural modifications. Symmetry was observed in approximately 30% of subjects. Studies that reported the strongest evidence for symmetry used successive matching-to-sample procedures that included training on both symbolic and identity relations, and studies finding mixed evidence employed alternative methods. These studies highlight the challenge in creating training procedures that promote symmetry and the need to assess the underlying sources of control on positive demonstrations.     

Computer‐based training to teach observers to accurately score problem behavior using fast forwarding at 5x normal speed

The current study evaluated whether a computer‐based training program could improve observers' accuracy in scoring discrete instances of problem behavior at 5x normal speed using a multiple‐baseline design across subjects. During pretraining and posttraining, observers attempted to score multiple examples of problem behavior at 5.0x without feedback. During training, participants scored multiple examples of problem behavior at 5.0x with automated feedback. Researchers measured omission (missing problem behavior) and commission (scoring other behavior as problem behavior) errors and the total duration of scoring time to determine the observers' accuracy and efficiency, respectively. After training, all participants scored instances of problem behavior with less than 11% error using 5.0x. The time required to score the videos across 90‐min observations was reduced by 66%. Results extend previous evaluations of fast forwarding by demonstrating that the training program could be used to teach observers to accurately score problem behavior using a speed faster than 3.5x.     

Functional communication training: From efficacy to effectiveness

Functional communication training (FCT; Carr & Durand, 1985) is a common function‐based treatment in which an alternative form of communication is taught to reduce problem behavior. FCT has been shown to result in substantial reductions of a variety of topographically and functionally different types of problem behavior in children and adults (efficacy). The extent to which these reductions maintain in relevant contexts and result in meaningful changes in the lives of those impacted (effectiveness) is the focus of this paper. This review evaluates the degree to which FCT has been established as an evidence‐based practice in psychology (EBPP) according to the definition set out by the American Psychological Association's 2005 Presidential Task Force on Evidence‐Based Practice. Our review finds overwhelming evidence in support of FCT as an efficacious treatment but highlights significant limitations in support of its effectiveness. In order to also be recognized as an EBPP, future research on FCT will need to focus more closely on issues related to home, school, and community application, feasibility, consumer satisfaction, and more general and global changes for the individual.     

Sitting with it: An investigation of the relationship between trait mindfulness and sustained attention

BackgroundSustaining attention for extended periods of time is associated with negative affect and this increase in negative affect is related to poorer task performance. Trait mindfulness has been shown to be associated with better sustained attention performance. This may be because trait mindfulness is associated with better attention ability or better emotion regulation ability.AimsThe present research aims to replicate previous findings and better understand why trait mindfulness is associated with better sustained attention performance.MethodParticipants responded to self-report questionnaires assessing their trait mindfulness, attentional control, and experiential avoidance. Next, participants performed a sustained attention task, during which they also reported their subjective feelings of discomfort and boredom. Finally, participants reported their retrospective discomfort and boredom after the task.ResultsWe replicated and extended previous findings by showing that the relationship between trait mindfulness and sustained attention performance was mediated by negative affect experienced during the task. Moreover, the correlation between trait mindfulness and sustained attention disappeared when controlling for experiential avoidance, but remined when controlling for attention control.ConclusionOur results suggest that trait mindfulness is associated with sustained attention because of enhanced emotion regulation and that enhancing affective regulation would be an effective strategy for improving sustained attention performance.     

COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions

The SARS-COV-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.     

Using the teaching interaction procedure to train interventionists to implement the Cool versus Not CoolTM procedure

The teaching interaction procedure is a behavior analytic procedure that has been used to target the development of social skills. The teaching interaction procedure consists of labeling the target skill, providing a meaningful rationale, describing the steps of the target skill, modeling the skill, role‐play, and providing feedback throughout the interaction. Although the teaching interaction procedure has been used to teach a variety of social skills for individuals diagnosed with autism spectrum disorder (ASD), it has only been used to train staff in two studies. The purpose of this study was to evaluate the use of the teaching interaction procedure to teach three interventionists to implement the Cool versus Not Cool? procedure to target the development of social skills for children diagnosed with ASD. The results of a multiple baseline design demonstrated that the teaching interaction procedure was effective for all three interventionists. Results of the child participants' skill acquisition are also provided.     

Comparing computer‐based training and lecture formats to teach visual analysis of baseline‐treatment graphs

Accurate analysis of data is vital to the validation of interventions. As such, there has been a recent increase in studies evaluating visual analysis training procedures. However, past investigations have not evaluated direct and indirect visual analysis training methods with matched instructional content that was systematically designed. Furthermore, training has rarely included assessment of generalization and maintenance of visual analysis skills. The purpose of the current dissertation study was to compare the effectiveness and efficiency of (a) computer‐based training, (b) lecture formats with and (c) without the opportunity to pause, and (d) a no‐training group to teach visual analysis of AB graphs to university students. To make these formats directly comparable, the instructional content was equated by ensuring information and examples were identical across the three training procedures. Eighty‐three students were randomly assigned to one of the four groups. Results showed that all three training formats produced increases in accurate responding compared to the no‐training group. Visual analysis skills generalized to novel graphs and maintained approximately 2 weeks following all trainings. These results suggest that structured approaches that are carefully designed to train visual analysis are effective and lead to gains that generalize and maintain in the absence of training.     

Mindfulness-based programs,perceived stress and well-being at work: The preferential use of informal practices

IntroductionOrganizations which engage in the promotion of well-being are likely to prevent mental health issues in workers. Mindfulness-based interventions offer new perspectives to increase well-being at work. However, the issue of finding time and framework to practice at work is important. Recent studies suggested that informal mindfulness practices could be useful in reducing stress and increasing well-being.ObjectiveThe present study aimed to study how the duration and type of mindfulness practice may enhance employees’ well-being.MethodA multi-method (qualitative and quantitative), controlled pre/post design study (N = 72) was conducted to collect data about the type of preferred mindfulness practices used during an 8-week MBSR program, and to analyse the effects of the program on employees’ well-being. Number of sessions, number of days of practice, and practice time per day were used as moderators.ResultsParticipants reported a preferential use of brief, informal practices. Employees who followed the MBSR program reported higher levels of well-being compared to the wait-list control group (η² = .194). Those who preferentially used informal practices showed the same increase in well-being as those who reported preferentially using formal practices. The number of days of practice did not moderate the effect of the intervention on well-being.ConclusionBrief and informal mindfulness practices appear to be a promising means of increasing well-being in everyday life. Further research is needed to compare an 8-week mainly informal mindfulness-based program to a classical MBSR program to identify whether informal practices may be sufficient to increasing employees’ well-being.