Fulfilling the Promise of School-Based Mental Health: Moving Toward a <Emphasis Type="Italic">Public Mental Health Promotion</Emphasis> Approach

School-based mental health (SBMH) programs and services are growing progressively in the United States for many reasons. However, the SBMH field is young and tenuously supported, and challenges are being confronted on many levels. There are major needs to continue to bring research-supported interventions into schools, and to better equip educators and mental health programs and staff in schools to function effectively. Articles in this special issue present the many challenges well and point to important directions for advancing SBMH. To truly advance the field a Public Mental Health Promotion approach is needed. Elements of this approach, in advancing training, quality assessment and improvement (including empirically supported practice), and advocacy and policy influence are discussed, as are strategic connections to the Community Science perspective and to the development of a growing Community of Practice in SBMH.     

Enhancing Quality of Practice Through Theory of Change‐Based Evaluation: Science or Practice?

This paper describes the evaluation component of Partnerships for Success (PfS), a comprehensive community effort designed to address youth development issues. The evaluation component is referred to as theory of change-based evaluation. The author considers the implications of applying community practice tools such as theory of change-based evaluation to the current conceptualization of community science. More specifically, the author argues that the current conceptualization of community science pays scant attention to community practice. This paper concludes by suggesting that the current conceptualization of community science be modified to recognize the importance of community practice as an equal aspiration for community psychologists.     

The Practice of Argumentative Discussion

I propose some changes to the conceptions of argument and of argumentative discussion in Ralph Johnson's Manifest Rationality (2000). An argument is a discourse whose author seeks to persuade an audience to accept a thesis by producing reasons in support of it and discharging his dialectical obligations. An argumentative discussion (what Johnson calls argumentation) is a sociocultural activity of constructing, presenting, interpreting, criticizing, and revising arguments for the purpose of reaching a shared rationally supported position on some issue. Johnson's theory of argumentative discussion, with occasional modifications, is derived from this definition as a sequence of 17 theorems. Argumentative discussion is a valuable cultural practice; it is the most secure route to correct views and wise policies.     

Le psychologue face au Covid-19 : enquête exploratoire sur les pratiques en distanciel

The context of the health crisis has led psychologists working in institutions or in private practice to adapt their working methods to the constraints of confinement, in particular by resorting to distance learning. This exploratory survey aims at documenting this evolution of practices, in collaboration with COVID 19. An online survey was conducted among practitioners, resulting in 397 responses. The questions concerned the use of telepsychology (time, activity), before, during and after the crisis period. While the use of telepsychology was infrequent before the crisis, almost three-quarters of the psychologists used it during the crisis, and slightly less than half thought they would use it afterwards. The amount of time devoted to these practices depends on the tasks and the status of the psychologist. It is more important for administrative tasks and meetings than for treatment, and more often envisaged by freelance psychologists than by employees. Beyond the general findings, taking into account the status and the field of activity allows a picture of the evolutions in progress.     

Brief Imaginal Exposure for PTSD: Trajectories of Change in Distress

Preliminary evidence shows that brief, condensed imaginal exposure only interventions can be effective in the treatment of PTSD, but we need to understand its mechanisms of action. Consistent with extinction learning and retrieval processes, the present study examined whether a pattern of between-session distress reduction observed during standard prolonged exposure (PE) therapy would be observed and predict outcome. Sixty-three patients with PTSD were enrolled in two clinical trials using our treatment protocol consisting of six daily 50-min sessions focusing on imaginal exposure and processing only. Individual patient trajectories of distress reduction were examined over the course of the five imaginal exposure sessions (Sessions 2-6). Overall, significant linear distress reduction was observed for anticipatory (d = 1.18), peak (d = 1.83), and ending imaginal exposure distress (d = 1.21). Consistent with extinction learning, the steeper slope of peak distress (d = 1.03) and end distress (d = 0.68) across imaginal exposure sessions strongly predicted decreases in PTSD symptoms. Distress reduction across sessions was predicted by higher baseline avoidance and hyperarousal but not reexperiencing symptoms. This condensed format of daily 50-min sessions without in vivo exposure may be operating via similar extinction learning processes as longer protocols. Our clinical observations suggest that the brief daily format may offer the advantage of allowing each session to build on the previous one to promote meaningful shifts in the retrieval of the trauma memory. Brief imaginal exposure and processing may be a viable option for PTSD patients in settings where brief interventions are needed. Understanding potential change processes and baseline predictors of change brings us closer toward precision medicine in treating PTSD.     

How to Conduct Research in Your Private Practice

Mental health professionals who work in private practice and other clinical settings have huge opportunities to contribute to the science of our field. But they rarely do so. This article describes ways that practitioners who have research training can capitalize on recent developments in practice, science, and technology to conduct research in their private practice. I describe a model for conducting research as a practitioner that entails tightly integrating the research into clinical practice, and I point out why conducting research in your private practice is worth doing. The remainder of the paper provides a primer, describing strategies for implementing in a clinical setting all the elements of the research enterprise: addressing ethical and legal issues, keeping up to date with the scientific literature, selecting a good research question, conducting a single-case experimental design, finding collaborators and assistants, collecting the data, analyzing the data, writing the paper and getting it published, and handling time and money. Although this paper focuses on research in a solo or group private practice setting, many of the strategies described here can also prove useful in the conduct of research in hospital or community settings.     

Partners' internal stress and well-being: The role of dyadic coping and problem resolution

Couples' experiences of daily stress can be detrimental for partners' individual and relational well-being, specifically their identity as a couple, their relational satisfaction, and their life satisfaction. Grounded in the Systemic Transactional Model, this study aimed at analyzing factors that may safeguard partners and their relationship from detrimental effects of internal stress (i.e., stress that originates inside the relationship). We examined the buffering effect of partners' positive dyadic coping and internal problem resolution. Daily diary data were collected across 7 days from 82 heterosexual couples. Multilevel dyadic analyses showed that internal stress was negatively associated with partners' individual and relational well-being. Positive dyadic coping moderated the association between partners' internal stress and couple satisfaction for both partners, but not life satisfaction and couple identity. Moreover, for partners who reported a resolution to the internal problem, the negative associations of internal stress with life satisfaction, couple satisfaction, and couple identity were significantly lower than for those who did not resolve the internal problem. This study confirms the negative role of internal stress on well-being, shows the associations between internal stress and couple identity, and highlights the protective role of dyadic coping and internal problem resolution in couples' daily lives.     

Pediatric Health-Related Quality-of-Life Measurement Technology: Intersections between Science, Managed Care, and Clinical Care

The demand for health care outcomes assessment is increasing, driven by the proliferation of managed care as a form of health care financing. Providers, consumers, and payers can use health care outcomes to improve the efficiency and quality of care, spur performance improvement, and demonstrate accountability. This review introduces health outcomes and focuses on one particular outcome—pediatric health-related quality of life (HRQOL), exemplified by the PedsQL, a brief, practical, reliable, valid, and responsive measure of pediatric HRQOL. HRQOL measurement has the potential, in pediatric clinical practice, to improve assessment, clinical management, and treatment evaluation if practical, conceptual, and empirical challenges are addressed. These issues are discussed and directions for future research are described that would demonstrate the value of HRQOL measurement in pediatric clinical settings.     

Learning from within: Therapists' actions in daily clinical practice

The integration of theories and techniques is part of family therapists' daily practice, raising the need to understand which resources are used in this professional's clinical actions. Our aim is to reflect on the use of theoretical and technical resources by family therapists in their daily practice. We developed an inquiry process inspired by collaborative action research and social constructionism. Couple and family therapy sessions were conducted by two family therapists, and we developed subsequent dialogs with them focused on describing theoretical and technical inspirations for their actions. Next, we named four categories of actions in this process: exploratory actions, actions for the construction of relational visions, actions for the construction of communication, and actions for family orientation. The therapists-participants referred to many theoretical and technical resources that inspired their practice. For them, the choice of using one or another resource was based on the demands of the interactive moment, which involves their relational and embodied responses to what was experienced in the sessions. We argue that epistemological coherence is not something that guides the therapist's practice a priori, but something that can be achieved by talking about and reflecting on their actions. This article can contribute to clinical practice and training in family therapy by presenting an interesting reflexive process that can be useful to enhance practice in couple and family therapy (FAPESP, Process n. 2015/21316–1).     

Exploring Daily Religious/Spiritual Activities Among Older Couples: Religious/Spiritual Influence Moderating the Effects of Health Symptoms on Marital Interactions

Using data from 191 later-life couples across 14 days, patterns of husband and wife religious/spiritual activities were explored, as well as how those activities predicted daily marital processes and how they moderated the links between daily physical symptoms and marital interactions. Husband and wife reports of religious/spiritual influence were linked with their own positive and negative marital interactions (“actor” effects). However, only husband religious/spiritual influence was linked with wife marital interactions (“partner” effects). Religious/spiritual influence moderated the link between symptoms and marital interactions for wives. Findings suggest a buffering effect of religious/spiritual activities on daily symptoms for older married wives.