Patient preference as a predictor of outcomes in a pilot trial of person-centred counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression

The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face).     

Positive psychotherapy: A strength-based approach

Positive psychotherapy (PPT) is a therapeutic approach broadly based on the principles of positive psychology. Rooted in Chris Peterson’s groundbreaking work on character strengths, PPT integrates symptoms with strengths, resources with risks, weaknesses with values, and hopes with regrets in order to understand the inherent complexities of human experiences in a way that is more balanced than the traditional deficit-oriented approach to psychotherapy. This paper makes the case of an alternative approach to psychotherapy that pays equal attention and effort to negatives and positives. It discusses PPT’s assumptions and describes in detail how PPT exercises work in clinical settings. The paper summarizes results of pilot studies using this approach, discusses caveats in conducting PPT, and suggests potential directions.     

Effectiveness of a Universal,Interdependent Group Contingency Program on Children's Academic Achievement: A Countywide Evaluation

The Good Behavior Game (GBG) is a universal prevention program designed to increase academic engagement and to decrease disruptive behavior in elementary school-age children. Teachers and other school personnel use interdependent group contingencies to improve students’ behavior in the classroom. Previous research indicates the GBG is efficacious in reducing behavior problems; however, little research has examined its effects on academic achievement in real-world settings. In this study, the authors evaluated the PAX GBG, a commercially available version of the GBG, as it is typically administered in elementary schools. The authors examined standardized reading and mathematics scores across one academic year for 949 students enrolled in the GBG or comparison classrooms. Results showed significant but small effects of the GBG on reading and mathematics. Results were greatest for boys, children with lower achievement scores at baseline, and students from more economically disadvantaged school districts. School personnel may find the PAX GBG useful in improving children's behavior and academic skills.     

Introducing Reality Play Therapy: Reactions and Perceptions From Elementary School Counselors

Many elementary school students lack school relationships required for positive personal, social, and academic interactions. Reality therapy and play therapy both seek to address these relationships through developmentally appropriate and effective interventions. Integrating these 2 approaches has the potential for elementary school counselors to provide students with opportunities to create positive relationships and develop problem-solving skills. In this study, 8 school counselors participated in a series of trainings introducing reality play-therapy techniques to assess this potential. A thematic analysis conducted on feedback sessions following the trainings yielded themes related to the participants’ positive perceptions to the training and possible application.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

The perceived helpfulness of rendering emotional first aid via email

The present research examined the perceived helpfulness of an increasingly widespread mode of psychological assistance, namely, emotional first aid via email. The sample comprised 62 naturally occurring email interactions between distressful clients and trained volunteers operating within the framework of the Israeli Association for Emotional First Aid. Data were gathered by means of a structured questionnaire and open-ended questions so as to examine the clients' motivation to seek help via email and evaluate their satisfaction with the responses obtained. The results revealed a preference for written communication and the accessibility of assistance to be the most frequent reasons for clients to choose the medium of email. Most clients found the responses to be helpful in providing emotional support, enhancing cognitive change and suggesting practical ways of coping. Women perceived the assistance to be more helpful than men did. The results are discussed in terms of the unique value of email as an agent of mental health assistance.     

Single session email consultation for parents: an evaluation of its effect on empowerment

This study evaluated the effect of single session email consultation (SSEC) on empowerment of parents. Practitioners in a control group (n = 19) received no training and practitioners in an experimental group (n = 21) were trained to use empowerment-oriented techniques in online consultation. Parental empowerment was measured (n = 96) through a questionnaire based on the Family Empowerment Scale before and after receiving advice from a trained or a non-trained practitioner. Parents showed a significant increase in the subscale of self-confidence (Cohen's d = 0.33). Study findings lend support to the feasibility of SSEC as a brief intervention to improve self-confidence of parents. A training for practitioners did not influence the outcomes.     

Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder

IntroductionDelivering psychotherapy by videoconference could considerably extend the accessibility of empirically validated treatments.ObjectiveThe aim of this study was to evaluate the efficacy of a cognitive-behavioural therapy (CBT) for generalized anxiety disorder (GAD), administered via videoconference.MethodFive participants with a primary diagnosis of GAD took part in an experimental multiple baseline case study protocol. The efficacy of the treatment was evaluated using a semi-structured interview, self-report questionnaires, and daily self-monitoring diaries.ResultsThe results demonstrate that overall, participants’ conditions were improved following treatment and they no longer met the diagnostic criteria for GAD in the short-term. Participants’ conditions improved clinically and statistically at each follow-up point, achieving a greater global level of functioning at post-test, as well as at 3-month and 12-month follow-up.ConclusionClinical implications of this new treatment modality and directions for future research are discussed.     

Psychometric Properties and Responsiveness to Change of 15‐ and 28‐Item Versions of the SCORE: A Family Assessment Questionnaire

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 centers from 701 families at baseline and from 433 of these 3–5 months later. Results confirmed the three‐factor structure (strengths, difficulties, and communication) of the 15‐ and 28‐item versions of the SCORE. Both instruments had good internal consistency and test–retest reliability. They also showed construct and criterion validity, correlating with measures of parent, child, and family adjustment, and discriminating between clinical and nonclinical cases. Total and factor scales of the SCORE‐15 and ‐28 were responsive to change over 3–5 months of therapy. The SCORE‐15 and SCORE‐28 are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy.