Reasons for sequence preferences

Much research shows that when it comes to preferences over sequences of money, such as a monthly paycheck, people do not always maximize present value. Rather, they often choose the lower‐valued of a pair of sequences, especially when it has attractive properties such as an increasing trend. To unearth the reasons for sequence preferences we conducted a verbal‐protocol analysis of choices between money sequences, including lifetime and one‐year earnings and one‐year lottery winnings, as well as lifetime health sequences. Participants thought aloud while choosing between visual representations of sequences. Their verbalizations contained reference to a wide range of previously hypothesized, as well as new, reasons for choice. These reasons were also correlated in sensible ways with the choices made. There was some evidence of solid economic reasoning (which we called maximization), although this was largely restricted to choices for one‐year earnings. More commonly, respondents did not distinguish between earnings and consumption, and thought about money as if they would automatically spend it at the rate it was received. This meant the most frequently given reason was what we called appropriateness—how well the money received at a given point matched the desired consumption at that point. Other common explanations include the expectedness of a sequence (we argue this is mediated by appropriateness), the way that parts of the sequence constitute reference points for other parts, and the ease with which incoming money can be managed (convenience). Copyright © 2002 John Wiley & Sons, Ltd.     

Integrating Advocacy for Marginalized Children and Families Into Evidence-Based Care During COVID-19: Clinical Vignettes

The novel coronavirus (COVID-19) has disproportionately impacted the health and socioeconomic outcomes for low-income populations, people of color, and immigrant children and families in the United States. As inequities in resources (i.e., food, internet, housing), health care, and education increased for marginalized families as a result of COVID-19, child-focused clinicians had to broaden their professional scope and implement new advocacy efforts. The current paper uses clinical vignettes taken from a New York State Office of Mental Health–licensed child and adolescent outpatient clinic in the Bronx, New York. The vignettes highlight the social inequities that impacted marginalized children and families during the pandemic, as well as the clinical team’s response through the integration of evidence-base practice and advocacy. Implications for practice with vulnerable populations as the COVID-19 pandemic persists are discussed.     

Economic Impact of the Statewide Implementation of an Evidence-Based Treatment: Multisystemic Therapy in New Mexico

Several states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs), yet little is known about key success indicators for these implementation efforts such as cost and sustainability. To that end, the present study examined the economic impact of statewide implementation of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cuningham, 2009), a family- and community-based behavioral EBT for serious juvenile offenders in New Mexico. Participants were 1,869 youth who received MST across 23 teams during the study period. We conducted a cost-benefit analysis using metrics from state data sources that compared the cost of MST to its benefits (i.e., avoided expenses from pre- to posttreatment) in two domains: (a) behavioral health services (i.e., Medicaid claims) and (b) juvenile crime (i.e., taxpayer expenses, tangible and intangible expenses to crime victims). MST costs were based on Medicaid claims, which were reimbursed at an enhanced billing rate that was intended to cover expenses for both clinical and implementation (e.g., training, quality assurance) activities. Results suggest that implementation of MST in New Mexico over the 7-year study period may have produced net benefits, through 2 years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $15,019 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST appeared to have returned $3.34 for a total benefit of $64.2 million over the course of the study. We discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the sustainability of complex EBTs in community settings.     

A Mixed Methods Study of the Stages of Implementation for an Evidence-Based Trauma Intervention in Schools

A mixed methods study was conducted to examine the implementation process of 26 urban school-based mental health clinics that took part in a training and implementation support program for an evidence-based school trauma intervention. Implementation process was observed using the Stages of Implementation Completion (SIC) measure. Qualitative interviews were conducted with clinic leaders in order to gain insight into clinic processes related to the SIC. Results showed that almost all of the clinics engaged in some activities related to pre-implementation (engagement, feasibility, and readiness), but only 31% of the sites formally started delivering the program to youth. Completing more pre-implementation activities, particularly those related to readiness, predicted program start-up. Qualitative analysis comparing those that implemented the program to those that did not revealed critical differences in decision-making processes, leadership strategies, and the presence of local champions for the program. This study documented the patterns of clinic behavior that occurs as part of large-scale training efforts, suggests some unique challenges that occur in schools, and highlights the importance of engaging in particular implementation activities (i.e., readiness planning, stakeholder consensus and planning meetings) as part of program start-up. Findings indicate that pre-implementation and readiness-related consultation should be employed as part of broad-scale implementation and training efforts.     

Compatibility and the use of information processing strategies

When a prominent attribute looms larger in one response procedure than in another, a violation of procedure invariance occurs. A hypothesis based on compatibility between the structure of the input information and the required output was tested as an explanation of this phenomenon. It was also compared with other existing hypotheses in the field. The study had two aims: (1) to illustrate the prominence effect in a selection of preference tasks (choice, acceptance decisions, and preference ratings); (2) to demonstrate the processing differences in a matching procedure versus the selected preference tasks. Hence, verbal protocols were collected in both a matching task and in subsequent preference tasks. Silent control conditions were also employed. The structure compatibility hypothesis was confirmed in that a prominence effect obtained in the preference tasks was accompanied by a lower degree of attention to the attribute levels in these tasks. Furthermore, as predicted from the structure compatibility hypothesis, it was found that fewer comparisons between attribute levels were performed in the preference tasks than in the matching task. It was therefore concluded that both these processing differences may explain the occurrence of the prominence effects. © 1998 John Wiley & Sons, Ltd.     

美国临床心理学培养模式的演进及展望

受到社会、组织及自身发展因素的影响, 美国临床心理学在不同时期存在着不同的培养模式。文章选取“科学家－实践者”模式、“实践者－学者”模式、“临床心理科学家”模式、“当下的临床科学家”模式及“循证实践者”模式等五种最具代表性的经典模式, 介绍了1949年以来美国临床心理学培养模式的特点及发展规律。认为“循证实践者”模式修正了前面四种培养模式的个体主义倾向, 将单个的“科学家－实践者”, 分化成“科学家”与“实践者”两个集团, 强调实践者遵循科学家提供的最佳证据, 考虑病人的特征、文化与价值观, 在管理者协调下开展实践。这种模式代表着当代临床心理学培养模式的发展方向。     

Evidence‐based practice: Accounting for the importance of the therapeutic relationship in UK National Health Service therapy provision

It is argued that different models of therapy result in broadly similar outcomes and that the therapeutic relationship is the most important factor in relation to outcome. This paper presents some of the main findings from over 30 years of psychotherapy research. We discuss these findings in relation to current provision of therapy within the UK National Health Service (NHS) and express our fears that despite a culture of evidence‐based practice, this evidence is in danger of being ignored. We conclude by discussing some of the implications and challenges that this evidence presents to therapy researchers, policy makers, trainers and practitioners.     

循证医学思维方法在骨科中的应用

循证医学(evidence-based medicine,EBM)是遵循证据的医学,这一新型边缘学科的出现使传统经验医学面临巨大的挑战。为提高骨科医疗质量,我们必须克服经验医学中存在的问题,科学地应用循证医学的思维方法来指导骨科临床实践。这将是21世纪骨科学发展的必然趋势。