An evaluation of parent preference for prompting procedures

Parent participation in intervention can enhance intervention efficacy and promote generalization of skills across settings. Thus, parents should be trained to implement behavioral interventions. The purpose of the current investigation was to evaluate parent preference for and acceptability of 3 commonly used prompting procedures. We trained parents of children with disabilities to use 3 empirically validated prompting strategies (i.e., least-to-most, most-to-least, and a progressive-prompt delay). Once the parent reached the mastery criteria with each prompting procedure, we evaluated his/her preference for each of the procedures using a concurrent-chains arrangement. We also measured treatment acceptability of all procedures throughout the study. All participants met the mastery criteria for each of the prompting procedures and showed a preference for least-to-most prompting. Results suggest parents' acceptability of procedures prior to training were different than posttraining/post-child practice. In addition, acceptability rating scores obtained at the end of the investigation corresponded to preference of intervention during the concurrent-chains arrangement. The results demonstrate the benefits of objective measures for studying preference for behavioral, skill-acquisition procedures.     

Autistic traits in mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: Secondary analyses of a randomized controlled feasibility study

Autism is suggested to be a dimensional construct and often represents a comorbid state. However, research on the clinical implications of the presence of autistic traits is scarce. This study aimed to investigate the impact of subclinical autistic traits in mentalization-based treatment (MBT) for concurrent borderline personality disorder (BPD) and substance use disorder (SUD). Based on the data of a randomized controlled feasibility study by Philips, Wennberg, Konradsson, and Franck (2018), secondary analyses were conducted. It was tested, if patients’ (N = 46) levels of autistic traits were associated with treatment outcome measured in the course of and after treatment using interviews and self-report measures. Participants’ autistic traits were not associated with the change in the severity of BPD throughout and at the end of the treatment. However, results showed associations between autistic traits and the change in patients’ consumption of alcohol in the course of MBT. Furthermore, there was an association between autistic traits and the change in mentalizing capacity at the end of MBT, indicating that elevated autistic traits were associated with an improvement in mentalizing capacity. Autistic traits on a subclinical level do not appear to be a complicating factor in MBT for concurrent BPD and SUD. On the contrary, in terms of mentalizing capacity autistic traits might be associated with a larger potential for improvement or facilitate treatment outcome. Further research is needed to explore the role of higher autistic traits in treatment of this special patient group.     

The Effectiveness of Substance Abuse Treatment in Reducing Violent Behavior

The use of alcohol and other drugs has long been associated with violence. Yet relatively little is known about the effect of treatment on specific violent behaviors. This study examines violent behaviors in the National TreatmentImprovement Evaluation Study (NTIES), and assesses the extent to which treatment appears to reduce violence for each measured behavior. It also examines these reductions by gender, treatment modality, and whether the client wasa victim of violence in addition to being a perpetrator. The results indicate large reductions in violence among clients actively violent during the pretreatment period, with virtually no increase in violence among clients not actively violent during that same period, irrespective of gender, modality, or victimization status. On their face, the results strongly suggest that substance abuse treatment is effective in reducing violent behavior. Alternative explanations areproposed and assessed, followed by implications for policy, practice, and future research.     

Characteristics, Services, and Outcomes of Treatment for Women

This paper analyzes the demographic and pretreatment characteristics of maleand female participants in the National Treatment Improvement Evaluation Study,including the women's treatment experiences and the outcomes of various types of substance abuse treatment. Follow-up of a multisite sample of 1,374 women and 3,037 men indicates minimal differences exist between menand women in the outcomes of five modalities of substance abuse treatment. Treatment appears to reduce women's drug and alcohol use and illegal activities and increase their levels of employment. Demographic and pretreatment characteristics are only modestly associated with differences in treatment outcomes, and differential service receipt has inconsistent effects on outcomes.     

Augmentation: Synergistic Conditioning in Taste-Aversion Learning

Recent work in taste-aversion learning has revealed a new phenomenon in classical conditioning. When a preconditioned gustatory cue (taste or odor) is conditioned in compound with a second gustatory cue, conditioning to the second cue is augmented. This enhanced conditioning of the second cue is noteworthy because studies with other forms of classical conditioning have shown blocked conditioning to the second cue. This new phenomenon has been termed augmentation , and it has implications for the study of taste and odor interactions, formal models of learning, and clinical interventions with cancer patients.     

The Iatrogenic Effects of Group Intervention for Antisocial Youth: Premature Extrapolations?

Group intervention for antisocial youth has received harsh criticism in recent years. This paper reviews relevant research focused on the influence of contact with delinquent peers on the development of antisocial activity. Also reviewed are studies reporting outcomes of group intervention for antisocial youth. Although a few studies have found iatrogenic effects for group intervention with antisocial youth, the majority have not. Well-developed models of group intervention have produced substantial reductions in youth antisocial activity. We describe one such program, a family-style residential program based on behavioral learning principles, and review outcomes of this program. We conclude that treatment of antisocial youth in groups is feasible and can be effective in reducing delinquent behavior.     

Breast Cancer in Men: Emasculation by Association?

The occurrence of breast cancer in men is rare in comparison to women. Public knowledge that men can get breast cancer and of male breast self-examination are lacking. Research in the course and treatment of breast cancer in men is needed. Men generally present in more advanced stages of breast cancer than women, and have a poorer prognosis. In this article, the epidemiology, common symptoms, diagnostic methods, and current treatment of breast cancer in men are described. Gender differences in presentation and course of illness are discussed. Additionally, the psychological implications of breast cancer for male gender roles and masculine identity are explored. Directions for further investigation are given. Treatment providers are encouraged to educate themselves and their male patients on breast cancer in men and male breast examination techniques so that this disease may be identified earlier in its course and survival rates improved.     

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d = 1.38), the sum of all anxiety and depressive disorder severity ratings (d = 1.07), and child-reported anxiety (d = 0.47) and parent-reported depressive symptoms (d = 0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.     

Motivation as a predictor of outcomes in school‐based humanistic counselling

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects.     

心理治疗与普通医疗的平等性

心理治疗与普通医疗的平等性是美国心理健康服务系统面临的一个主要政策问题,强调健康保险应为心理健康和物质滥用障碍提供与普通医疗相同的承保范围。近20年来,平等性立法在美国得到了较快发展,并取得了一定效果。但由于立法本身存在的局限性及心理健康服务需求与提供双方的多重因素影响,平等性立法的实施及对其效果的评估仍存在一定困难。借鉴平等性立法的经验,得出了一些关于我国心理健康服务发展的启示。