Brief Behavioral Activation Treatment for Depressed Adolescents Delivered by Nonspecialist Clinicians: A Case Illustration

Behavioral activation (BA) can be as effective as cognitive-behavioral therapy for the treatment of depression in adults, but to date there is little research with adolescents. This is problematic given the recognized need to increase access to evidence-based interventions for depression in young people. We have developed a new adaptation of brief Behavioral Activation (Lejuez, Hopko, Acierno, Daughters, & Pagoto, 2011) specifically for young people: Brief BA for depressed adolescents. In this paper, we use a case example with session-by-session measurement to show how a nonspecialist clinician can deliver this intervention successfully. We discuss the key themes arising from this training case, challenges the clinician faced, and how these were managed through training and supervision.     

The effect of driver improvement interventions on crash involvement; has it been under-estimated?

The available evidence suggests that driver improvement interventions (with the aim to increase driver safety, most often by education or training) do not work. The average effect calculated in several meta-analyses is close to, and not always possible to distinguish from, zero, despite total samples sizes of several hundred thousand drivers. However, it is possible that all studies included in these meta-analyses have under-estimated the effect, due to a methodological error; all crashes have been used as dependent variable, instead of only those that the targeted drivers have caused. This error is expected to have considerably deflated the effect sizes, but it is not known how large this effect could be.Using crash data for bus drivers in which culpability had been reliably established, a simple simulation was performed to determine the difference between using culpable and all crashes as an estimator of a safety effect. Using data for six years, calculations were made on single years. About ten percent of culpable crashes in each year were deleted to simulate a safety effect, where after the difference between the original and the simulated variable were calculated, using culpable only and all crashes in parallel. The effects using these two different kinds of datasets could then be compared and the under-estimation effect estimated.Culpable crashes, as compared to all crashes, yielded larger differences in means between time periods, and smaller standard deviations. In between-subjects comparisons resulted in 15–30 percent larger effects for culpable crashes. Within-subjects calculations yielded larger but not as systematic effects.The effect of driver improvement on crash involvement has been systematically under-estimated, as extremely few evaluation studies seem to have taken culpability for crashes into account. Therefore, new evaluations need to be undertaken, and/or old data re-analysed, to calculate a better estimate of the true effect of training and education in driving safety.     

The supervisory alliance: Comparison of measures and implications for a supervision toolkit

Background Clinical supervision lies at the core of the professional development of clinicians providing services within a range of service settings. The supervisory alliance is regarded as the most important construct in effective supervision which underlies the importance of metrics to assess this construct. Aims materials and Method A cross‐sectional self‐report questionnaire design was used to examine clinical supervision constructs. The study used two scales measuring the supervisory alliance (SRQ and SWAI‐T), a scale measuring supervision satisfaction (SSQ) and a scale measuring disclosure (TDS). The questionnaires were administered to 127 clinical psychology trainees who were undertaking a practicum placement. Results Both scales measuring the alliance were positively correlated with satisfaction with supervision and disclosure, with similar sizes of correlation for each alliance scale. There was also a large, positive correlation between the two scales of measuring the alliance. Discussion Both scales were designed for use in supervision and are related to supervision outcome measures in the expected directions. Conclusion The SRQ has some distinct advantages over the SWAI‐T that lend the SRQ to be potentially more useful in clinical and research settings.     

Do Subtle Linguistic Interventions Priming a Social Identity as a Voter Have Outsized Effects on Voter Turnout? Evidence From a New Replication Experiment

An ongoing debate in political psychology is about whether small wording differences have outsized behavioral effects. A leading example is whether subtle linguistic cues embedded in voter mobilization messages dramatically increase turnout. An initial study analyzing two small‐scale field experiments argued that describing someone as a voter (noun) instead of one who votes (verb) increases turnout rates 11 to 14 points because the noun activates a person's social identity as a voter. A subsequent study analyzing a large‐scale field experiment challenged this claim and found no effect. But questions about the initial claim's domain of applicability persist. The subsequent study may not have reproduced the conditions necessary for the psychological phenomenon to occur, specifically the electoral contexts were not competitive or important enough for the social identity to matter. To address the first of these critiques, as well as other potential explanations for different results between the first two studies, we conduct a large‐scale replication field experiment. We find no evidence that this minor wording change increases turnout levels. This research provides new evidence that the strategy of invoking the self does not appear to consistently increase turnout and calls into question whether subtle linguistic cues have outsized behavioral effects.     

Memory rehabilitation for older adults: preserving independent living / Rehabilitación de la memoria para adultos mayores: preservación de la autonomía de vida

Abstract

Episodic memory problems are the hallmark of cognitive ageing in normal elderly people. Learning of new material is worse in pathological cognitive ageing, such as dementia and its preliminary states (mild cognitive impairment). Because episodic learning is crucial to preserve independent living in the elderly, rehabilitation programmes for everyday memory problems are welcomed. The scope of scientific interest has switched from treatment to prevention. We claim that lifestyle interventions are the most direct way to preserve cognition. We summarize evidence for changes in nutrition and exercise. In addition, psychological interventions for elderly people with normal or pathological cognitive ageing are available. Recent meta-analyses found lacking evidence of transfer to everyday life and long-term effects. We critically assess these meta-analyses. We propose theoretically derived experimental interventions relying on spared learning mechanisms. As an example we report visual-imagery training showing positive effects in a randomized control trial, using individual memory diaries on memory improvement.     

Impulsive choice and pre‐exposure to delays: iv. effects of delay‐ and immediacy‐exposure training relative to maturational changes in impulsivity

Impulsive choice describes preference for smaller, sooner rewards over larger, later rewards. Excessive delay discounting (i.e., rapid devaluation of delayed rewards) underlies some impulsive choices, and is observed in many maladaptive behaviors (e.g., substance abuse, gambling). Interventions designed to reduce delay discounting may provide therapeutic gains. One such intervention provides rats with extended training with delayed reinforcers. When compared to a group given extended training with immediate reinforcers, delay‐exposed rats make significantly fewer impulsive choices. To what extent is this difference due to delay‐exposure training shifting preference toward self‐control or immediacy‐exposure training (the putative control group) shifting preference toward impulsivity? The current study compared the effects of delay‐ and immediacy‐exposure training to a no‐training control group and evaluated within‐subject changes in impulsive choice across 51 male Wistar rats. Delay‐exposed rats made significantly fewer impulsive choices than immediacy‐exposed and control rats. Between‐group differences in impulsive choice were not observed in the latter two groups. While delay‐exposed rats showed large, significant pre‐ to posttraining reductions in impulsive choice, immediacy‐exposed and control rats showed small reductions in impulsive choice. These results suggest that extended training with delayed reinforcers reduces impulsive choice, and that extended training with immediate reinforcers does not increase impulsive choice.