Social referencing in infants of mothers with symptoms of depression

The present study examined the acquisition of social referencing skills in infants of mothers with symptoms of depression (n = 44). We aimed to determine if a short discrimination training could facilitate infants’ social referencing. Mothers were instructed to pose either joyful or fearful facial expressions to cue infants’ approach/avoidance responses toward an ambiguous object. Maternal expressions were correlated with pleasant or unpleasant events occurring after the infant's response. The results showed that after the intervention, infants looked at their mothers more frequently and reached or avoided the ambiguous object based on the preceding maternal expression. The results suggest that discrimination training procedures can establish social referencing in infants of mothers with symptoms of depression.     

Educational Reforms in the Former Soviet Union

With the dissolution of the Soviet Union, there have been movements toward a range of education reforms. In this article, an historical account is presented of education from communist roots to current times.     

Memphis City Schools Mental Health Center

Summary

This article describes a nationally recognized integrated service program in operation since 1969 within the Memphis (TN) City Schools. Memphis City Schools Mental Health Center represents a comprehensive model for the delivery of integrated mental health and substance abuse services to children and youth with a wide range of problems. Notably, the model incorporates elements of primary and secondary prevention and community outreach into service delivery, components that may be under-emphasized in programs that are oriented toward specific clinical populations (e.g., SED). Program components are discussed in detail to demonstrate both unique and inter-related program features, reflecting the complex needs of the children and families being served. Future directions and challenges are also considered.     

Task-shifting to improve the reach of mental health interventions for trauma patients: findings from a pilot study of trauma nurse training in patient-centered activity scheduling for PTSD and depression

ABSTRACT

Despite high rates of posttraumatic stress disorder (PTSD) and depression among traumatically injured patients, engagement in session-based psychotherapy early after trauma is limited due to various service utilization and readiness barriers. Task-shifting brief mental health interventions to routine trauma center providers is an understudied but potentially critical part of the continuum of care. This pilot study assessed the feasibility of training trauma nurses to engage patients in patient-centered activity scheduling based on a Behavioral Activation paradigm, which is designed to counteract dysfunctional avoidance/withdrawal behavior common among patients after injury. Nurses (N = 4) and patients (N = 40) were recruited from two level II trauma centers. A portion of a one day in-person workshop included didactics, demonstrations, and experiential activities to teach brief intervention delivery. Nurses completed pre- and posttraining standardized patient role-plays prior to and two months after training, which were coded for adherence to the intervention. Nurses also completed exit interviews to assess their perspectives on the training and addressing patient mental health concerns. Findings support the feasibility of training trauma nurses in a brief mental health intervention. Task-shifting brief interventions holds promise for reaching more of the population in need of posttrauma mental health care.     

Mixed-Design Training Outcomes for Fellows Serving At-Risk Youth Within Integrated Care Settings

We used an exploratory mixed-methods design with single-case comparative analysis and analysis of covariance to evaluate the potential effectiveness of an interprofessional clinical training in a mental health counseling program. Initial findings indicate those engaging in specialized learning experiences that attended to critical aspects of youth behavioral health care experienced benefits with regard to their professional development, interprofessional socialization and valuing, and counseling self-efficacy. Implications for the usefulness of trainings focused on interprofessional experiences are framed in relation to professional trends concerning integrated health care.     

Psychologists in Academic Health Centers: Reflections on Traditions and Innovations in Education,Science, and Practice

In 2007, the Association of Psychologists in Academic Health Centers (APAHC), formerly known as Association of Medical School Psychologists (AMSP), held its first national conference since 1997. At the latter conference, the author of this article [Sheridan (1999) Journal of Clinical Psychology in Medical Settings, 6, 211–218] was asked to present some of the issues that would be important to health care psychologists in the next decade. These issues included the role of psychology in academic health centers, interventions psychologists offer, reimbursements for such treatments, education and training models, and research. This article examines those observations, offers new data, and explores the current challenges and opportunities for psychologists in academic health centers. The presentation also addresses aspirations of psychologists as well as resistances within the profession. Parts of this paper were delivered at the 3rd Conference of the Association of Academic Health Center Psychologists in Minneapolis, Minnesota in 2007.     

Training the Parents of Juvenile Offenders: State of the Art and Recommendations for Service Delivery

Parent training is consistently highlighted as one of the most effective means of preventing delinquency and treating young children with conduct problems, and it has proven to be one of the most cost-effective interventions for doing so. There is, however, far less evidence supporting the efficacy of parent-training programs with adolescents and juvenile offenders. Nonetheless, it still seems to be one of the more promising methods for treating the behavior problems of adolescent delinquents, especially when used in conjunction with other carefully selected program components. We begin with an overview of parent training, highlighting the key components of successful programs. Research on the efficacy of parent training in the treatment of behavior problems among children and adolescents is discussed, particularly the differential impact of parental-training programs with specific groups of youths and families. We then discuss the ways in which parent training has been combined with other interventions in the treatment of delinquency. We conclude with a discussion of the problems encountered in implementing parent training, including recommendations for meeting the unique challenges of effective program implementation. The findings and conclusions of the research reported here are those of the authors and do not reflect the official positions or policies of the National Institute of Justice, The Office of Justice Programs, or the U.S. Department of Justice.     

Implementation of Effective Treatments of Preschool Behavior Problems in a Clinic Setting

Epidemiological data indicate that nearly 20% of preschool aged children have significant behavioral problems. Parents typically consult their child’s primary care provider, who frequently refers to child psychologists for treatment regarding these difficulties. Psychologists skilled in providing effective services for young children are in short supply, limiting accessibility, and parents often are reluctant to follow up with a mental health specialist, suggesting low acceptability. The Behavior Consultation Clinic is a structured clinic for preschool children designed to address these issues of effectiveness, accessibility and acceptability. A retrospective review of 550 patients seen over a 5-year period found that half were seen for one therapy session. Review of the remaining patients found that slightly more than half showed improvement (32% successful discharge with improvement, 24% premature discharge with improvement) with a typical range of two to seven half-hour sessions, about a quarter did not improve, and the remaining patients were referred to a higher level of service. These data indicate that a structured, brief clinic that focuses on the needs of preschool children utilizing evidence-based approaches can be effective, acceptable, and accessible. The Behavior Consultation Clinic also serves as a training clinic for psychology interns and pediatric medical residents.     

Emotion-regulation skills as a treatment target in psychotherapy

Background

Deficits in emotion-regulation skills have been shown to be integral to the development and maintenance of a wide range of mental disorders.

Aim

To evaluate the importance of these skills as a treatment target in psychotherapeutic interventions.

Method

Nine specific emotion-regulation skills were assessed in a sample of 289 inpatients before and after cognitive-behavioural treatment. Self-reports of success in pretreatment skills application were first compared to those of 246 non-clinical controls. Pretreatment skills application and change in skills application during therapy were then related to a variety of outcome measures. Finally, the effects of integrating a brief training of general emotion-regulation skills into the CBT-based treatment were evaluated in a controlled trial.

Results

Uni- and multivariate analyses identified the skills of acceptance, tolerance, and active modification of negative emotions as particularly important for current mental health and treatment outcome. Replacing parts of the standard CBT treatment with the emotion-regulation training enhanced the effects of the CBT treatment on skills application and on other measures of mental health.

Conclusion

Incorporating interventions that directly target general emotion-regulation skills may improve the effectiveness of psychotherapeutic interventions.