A Multilevel Approach for Reducing Mental Health and Substance Use Disparities Affecting Bisexual Individuals

Despite bisexual individuals being at increased risk for mental health and substance use problems, clinicians’ ability to provide affirmative and competent care to bisexual clients is limited by their lack of bisexual-specific training. To address this common gap in training, this article provides a brief review of bisexual health disparities and the factors that influence them. Then, we describe a multi-level approach for improving the health and well-being of bisexual individuals. This approach addresses factors that influence health at the micro-level (e.g., strategies that clinicians can use to help bisexual clients cope with stigma-related stressors), mezzo-level (e.g., adaptations to clinical environments and training programs that promote bisexual-affirmative care), and macro-level (e.g., advocating for political change and implementing strategies to reduce prejudice against bisexual individuals at the population-level). Specifically, we describe how clinicians can adapt evidence-based interventions to tailor them to the needs of their bisexual clients. Additionally, we discuss the need for bisexual-affirmative clinical training and provide recommendations for how clinical training can be adapted to prepare clinicians to work effectively with bisexual clients. Finally, we describe how population-level interventions can be used to reduce prejudice against bisexual individuals in order to reduce bisexual health disparities. Given the striking health disparities affecting bisexual individuals, there is a critical need to develop, test, and disseminate interventions to improve the health of this population and to prepare clinicians to provide bisexual-affirmative care.     

Comparing in-the-moment skill coaching effects from tailored versus non-tailored acceptance and commitment therapy mobile apps in a non-clinical sample

Mobile apps are promising for teaching how to practice psychological skills in high-risk and in vivo momentary situations, but there has been minimal research on the immediate effects of app-based skill coaching on mental health in-the-moment. This study analyzed the mobile app data in a non-clinical sample of 39 adults participating in a larger randomized controlled trial, with participants randomized to an acceptance and commitment therapy (ACT) mobile app that tailors skill coaching based on in-the-moment variables (n = 17) or an app that provides randomly selected skill coaching (n = 22). Data were collected before and after each ACT skill coaching session on proximal outcome (depression, anxiety, and engagement in meaningful activity) and ACT process variables. Multilevel models indicated significant immediate improvements on average following ACT skill coaching sessions on all proximal outcome and ACT process variables, although with relatively small effects ranging between 0.17 and 0.27 SD units change. Larger immediate pre-to-post effects from ACT coaching sessions were found for anxiety, experiential avoidance, and cognitive fusion in the tailored app versus random app condition. Overall, results suggest that an ACT app can have immediate, in-the-moment effects on psychological functioning, which may be enhanced by tailoring skills to current context.     

Effects of Humor on Intergroup Communication in Intractable Conflicts: Using Humor in an Intergroup Appeal Facilitates Stronger Agreement Between Groups and a Greater Willingness to Compromise

Overcoming sociopsychological barriers within intergroup communications may bring forth new, practical methods for conflict resolution, particularly crucial for groups engulfed by intractable conflict. This article examines the use of humor—an extremely effective technique of persuasive communication—as one potential route whose potency in resolving intractable conflicts has thus far been neglected. In Study 1, Palestinians who read a message from an “Israeli representative” (conveying the Israeli narrative of the conflict) agreed more with the Israeli perspective once three short humorous asides were added to the original statement. When these humorous asides targeted Jewish‐Israelis, Palestinian‐Israeli participants were more willing to compromise on various aspects of the conflict. In Study 2, Jewish‐Israelis who read a message from a “Palestinian representative” were more agreeable to the Palestinian message (portraying the Palestinian narrative) once three short humorous asides were added to the original statement. When these humorous asides were general in nature (but not when they targeted Palestinian‐Israelis), Jewish‐Israeli participants were more willing to compromise on various aspects of this intractable conflict. These findings further demonstrate the power of psychological barriers in intractable conflicts and the potential of humor to overcome them. Implications and limitations of the current research are discussed.     

Supporting Out‐of‐School Time Staff in Low Resource Communities: A Professional Development Approach

Federally funded out‐of‐school time (OST) programs provide academic support, enrichment, and safety for students and families in low‐resource communities. However, programs struggle to meet these aims, in part because of the lack of program structure and limited training and support for staff. This observational case study documents the training and technical assistance (TA) delivered to OST frontline staff and program leadership to implement Positive Behavior in Out‐of‐School Time (Positive BOOST), an adaptation of positive behavior interventions and supports conducted in multiple settings. Findings across three programs indicate that varied levels of TA (i.e., business as usual, performance feedback, coaching) are associated with different levels of staff‐ and program‐level implementation. Taken together with previous research, these findings suggest that targeted investment in developing the skills of OST staff and improving program‐wide outcomes is critical for supporting youth in low‐resource communities.     

Improving metacognition: A comparison of interventions

Accurate knowledge monitoring is critical to the learning process, as it allows one to regulate studying and test preparation. Thus, a number of investigations have attempted to improve metacognition in the classroom, with the ultimate goal of improving student exam performance. However, such interventions have had inconsistent success using varying paradigms. We compared the effectiveness of five interventions aimed at improving prediction accuracy in a laboratory environment: review, salient feedback, motivation warning lecture, incentives, and reflection. Only the salient feedback and the motivation warning lecture interventions significantly improved participants' prediction accuracy from test 1 to test 2. Review, incentives, and reflection did not improve predictive or postdictive calibration. Well‐timed salient feedback and a lecture warning students not to be biased by desired grades were effective methods of improving calibration accuracy. Results offer effective interventions to improve metacognition that could be used in a classroom setting.     

Outcomes and Findings of Program Evaluation for the Intensive Mental Health Program

We describe changes in adaptive functioning for children enrolled in the Intensive Mental Health Program (IMHP), an innovative model for serving children with the most severe forms of SED. Most children show marked improvements in multiple indicators of role performance and symptomatology. Although a high risk, high need group, most children attended school regularly and lived with a stable caregiver at discharge.     

Constructive conversations: Revisiting selected developments with clients and counsellors

Aim: to examine client and counsellor experiences in using and responding to social constructionist (e.g. solution‐focused, narrative and collaborative approaches) questions and other conversational interventions. Method: retrospective comments were elicited from 32 clients and 12 counsellors (trained in social constructionist counselling approaches) in reviewing their videotaped use of (or response to) questions and interventions from the social constructionist approaches in single session lifestyle consultations. These comments were transcribed then analysed using the constant comparison method of grounded theory. Results: five common themes (but with different emphases for clients and counsellors) were identified: exploring and adopting the client's perspective; identifying alternative perspectives; identifying strengths, possibilities, and solutions; developing a shared understanding; struggling to talk in a different way. Conclusions: the findings will be useful to counsellors interested in improving their responsive use of questions and interventions in dialogues with clients.     

VERB™ Summer Scorecard: Findings from a Multi-level Community-based Physical Activity Intervention for Tweens

The benefits of physical activity for adolescents are well established. Multi-level interventions may be especially effective in establishing and sustaining health-enhancing behaviors. This study explored the influences of a multi-level community intervention aimed at increasing physical activity among tweens (youth 9–13). Two Florida school districts far apart served as intervention and comparison sites in a quasi-experimental post-test design. Youth in grades 5 through 8 in the intervention community (n = 1,253) and comparison community (n = 866) completed an anonymous post-intervention survey. An intent-to-treat analysis did not show any statistically significant group differences for the physical activity outcomes examined. However, a subset analysis revealed that students who reported participating in the intervention were more likely to be physically active than youth in the comparison group, as well as youth in the intervention community who reported not participating. Participating in the intervention was significantly related to meeting recommendations for vigorous physical activity (OR = 2.08, P = 0.0259), being physically active on weekends (OR = 1.84, P = 0.0017), and reporting more days of trying a new game or sport (OR = 1.49, P = 0.046) after controlling for grade, gender, race/ethnicity, and SES. These findings support the efficacy of multi-level interventions to create effective health behavior change, especially when linkages among community, media, schools, and the home are present.     

Promoting child and family wellness: priorities for psychological and social interventions

In order to foster the well‐being of children and families we propose a shift in the priorities of psychological and social interventions. Following a brief discussion of the concept of wellness, we present a framework for interventions to promote child and family wellness. Psychological and social intervention strategies to promote child and family wellness are then reviewed and interpreted in terms of the framework. Recommendations for changing priorities for programmes and policies are based on the framework and a review of the effectiveness of existing interventions. Copyright © 2000 John Wiley & Sons, Ltd.     

Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.