Individualized services and supports through the wraparound process: Philosophy and procedures

The wraparound process is emerging as an alternative to the traditional treatment planning processes inherent in categorical services for children and adolescents with emotional and behavioral disorders. We describe the current practices which have been developed in the field. Key elements of the value and philosophical base for the wraparound process are discussed. Proposed procedural steps are described to aid communities in the implementation of the wraparound process. Due to social and policy pressures, it is likely that wraparound process implementations will continue to develop.     

VARIANT AND INVARIANT HIGH-PROBABILITY REQUESTS: INCREASING APPROPRIATE BEHAVIORS IN CHILDREN WITH EMOTIONAL-BEHAVIORAL DISORDERS

This study examined the effects of variant versus invariant high-probability (high-p) request sequences on the performance of requests to initiate a social bid by young children with emotional-behavioral disorders. In the initial phases of the investigation, a multiple baseline design showed that the delivery of invariant sequences (i.e., high-p requests delivered in the same sequence) produced initial increases in compliance to requests to initiate a social bid to a peer. However, increases were not maintained across the invariant condition. The delivery of variant high-p sequences produced increases in compliance to requests to initiate social bids that were maintained across the variant condition. In a follow-up condition, the number of requests within the pool of the variant and invariant high-p requests were controlled. Results of the follow-up condition replicated those found in the initial condition. Implications for applied use and future research are discussed.     

ARE PERSONS WITH NERVOUS HABITS NERVOUS? A PRELIMINARY EXAMINATION OF HABIT FUNCTION IN A NONREFERRED POPULATION

In this study, 44 individuals were exposed to three conditions (anxiety, bored, and neutral) while being covertly videotaped. The videotapes were then scored for the occurrence of five classes of habits including hair, face, and object manipulation; object mouthing; and repetitive movement of the limbs. Results showed that hair and face manipulation increased during the anxiety condition, whereas object manipulation increased in the bored condition. The implications of this research are discussed.     

The effects of different adults as therapists during functional analyses

The differential effects of caregivers and inpatient staff members as therapists on behavior were evaluated within a reversal design. Results indicated that problem behaviors were higher in the presence of caregivers relative to inpatient staff. These results are discussed in terms of how antecedent stimuli can affect functional analysis outcomes.     

School-Based Mental Health Services: A Research Review

This paper provides a synthetic review of research on school-based mental health services. Schools play an increasingly important role in providing mental health services to children, yet most school-based programs being provided have no evidence to support their impact. A computerized search of references published between 1985 and 1999 was used to identify studies of school-based mental health services for children. Study inclusion was determined by (i) use of randomized, quasi-experimental, or multiple baseline research design; (ii) inclusion of a control group; (iii) use of standardized outcome measures; and (iv) baseline and postintervention outcome assessment. The application of these criteria yielded a final sample of 47 studies on which this review is based. Results suggest that there are a strong group of school-based mental health programs that have evidence of impact across a range of emotional and behavioral problems. However, there were no programs that specifically targeted particular clinical syndromes. Important features of the implementation process that increase the probability of service sustainability and maintenance were identified. These include (i) consistent program implementation; (ii) inclusion of parents, teachers, or peers; (iii) use of multiple modalities; (iv) integration of program content into general classroom curriculum; and (v) developmentally appropriate program components. Implications of these findings and directions for future research are discussed.     

Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills

BackgroundExercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects.MethodsPhysically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling.ResultsFrom T1 to T3, the intervention group significantly improved on global symptom severity (d = −0.43, p = .031), depression among a depressed subsample (d = −0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = −0.28, p = .037) and clinically significant changes (ß = −0.24, p = .042).ConclusionsThe exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.     

Mediation of the stigma in the influence of negative symptomatology over recovery in psychosis

Background/Objective: The interest in recovery processes in psychotic disorders has boosted the necessity of knowledge about the factors that could influence in such recovery. Negative symptomatology and the stigma have been negatively linked to the recovery process in psychosis. The aim of this investigation is to improve the understanding of how the recovery process is affected by negative symptomatology based on the analysis of the mediating effects of the internalized stigma. Method: The sample was composed of 114 people that had experienced, at some point in their life, at least one clinically relevant psychotic episode. CAPE-42, STORI and ISMI were used for the evaluation. The macro PROCESS for SPSS was used. The indirect effect was calculated using 10.000 samples of bootstrap for the bootstrap confidence intervals (IC) corrected for bias. Results: The results show that the influence of negative symptomatology predicts the stigmatization of the person regarding his disorder. This predicts a negative influence in the recovery process of the psychosis. Conclusions: These results back the importance of adding the reduction of the stigma as a specific strategy to improve the recovery process in psychotic disorders.     

Benefits of recreational dance and behavior analysis for individuals with neurodevelopmental disorders: A literature review

Dance can be an entertaining experience that offers multiple benefits for those who participate. Unlike typically developing populations, studies examining benefits of recreational dance for individuals with neurodevelopmental disorders are limited. In this review, we conducted a literature search, where “dance” was cross‐listed with all neurodevelopmental disorders across five databases, yielding 19 articles. Twelve studies involved children and youth with neurodevelopmental disorders aged 3–19 years, two studies included both adolescents and adults aged 14–22 years, and five studies included adults aged 20–65 years. Given the effectiveness of applied behavior analysis in enhancing skill development, it is encouraging that eight studies explicitly identified behavioral components. Results suggest potential benefits of recreational dance across studies using self‐report and objective measures, but limited research with sound methodology exists. There is a need for controlled research with measurable outcomes to evaluate programs tailored to these populations to improve core challenges and secondary outcomes such as quality of life.     

Changing Polish university students’ attitudes toward cluttering

PurposeThis quasi-experimental design study in Poland explored the extent to which attitudes toward cluttering of university students could be changed or improved after a series of activities dedicated to attaining deeper recognition of problems associated with fluency disorders.MethodUniversity students were assigned to either an Experimental or a Control group, with 39 in each (total = 78). They all completed the Polish version of the Public Opinion Survey of Human Attributes–Cluttering (POSHA–Cl) on two occasions up to eight weeks apart.Participants in the Experimental group attended the following intervention activities: watching and discussing an educational video on cluttering, participating in a workshop on the nature of cluttering, and watching and discussing a documentary on the life experiences of people struggling with fluency disorders. The Experimental group also filled out an open-ended questionnaire at the end of the study.ResultsPre-intervention comparisons indicated that participants assigned to either of the Experimental or Control groups differed significantly on 2 of the 15 summary ratings (13 %) of their pre-POSHA–Cl attitudes toward cluttering. For the Experimental group, the intervention resulted in significant positive changes in cluttering attitudes on 8 of the 15 summary ratings (53 %). In contrast, pre- and post- POSHA–Cl scores for the Control group were essentially unchanged (0 of 15 ratings).ConclusionsThis quasi-experimental study demonstrated that it is possible to positively modify the cluttering attitudes of university students. This has implications for the length, content, and experiential components of interventions designed to improve public attitudes toward fluency disorders.     

A comprehensive model of women’s social cognition and responsiveness to infant crying: Integrating personality,emotion, executive function,and sleep

Disparate lines of research suggest that women’s (a) emotion regulation and personality, (b) executive function and (c) sleep may be important predictors of mothers’ cry responding in part through their effects on social cognition. However, the extent to which each contributes to cry responding independently remains unknown. We examined this question in a convenience sample of 109 nulliparous undergraduate women. Women completed online surveys to assess personality and emotion dysregulation traits, then visited the lab for a testing session during which they reported on sleep the night before and reactions to videotapes of crying infants and completed computerized working memory and inhibitory control tasks under challenging noise conditions (exposure to traffic and cry sounds). Results indicate that women’s positive personality and higher working memory were associated with higher levels of infant-oriented cry processing (i.e., accurate distress detection, empathy and situational/emotional attributions about distress), which in turn was associated with higher intended responsiveness to infant crying. Emotion dysregulation and deficits in inhibitory control were associated with higher levels of self-oriented cry processing (i.e., anger, anxiety, negative and emotion minimizing attributions in response to infant distress), which in turn was associated with lower cry responsiveness. Short-term sleep deprivation was associated with lower intended responsiveness via the above path from poorer inhibitory control to heightened self-oriented cry processing. Findings suggest that sleep, emotional and cognitive factors are associated with cry processing and subsequent responsiveness independent of one another.