The Effect of Competitive Outcome and Task-Involving,Ego-Involving,and Cooperative Structures on the Psychological Well-Being of Individuals Engaged in a Co-Ordination Task: A Self-Determination Approach

Differing task and motivational characteristics of the competitive setting (viz., task-involving/ego-involving climates, cooperative/individual, and win/loss competitive outcome) were explored in relation to need satisfaction and subjective well-being (SWB). Participants, one-on-one or in pairs, were required to participate in a physical co-ordination task. Results revealed participants exposed to a task-involving condition and those who worked in cooperation to report higher levels of need satisfaction and SWB. Conversely, individuals exposed to ego-involving conditions and those who competed individually experienced higher levels of negative affect. Winning resulted in higher levels of need satisfaction and SWB, whereas losing led to higher levels of negative affect. Losing individually in an ego-involving condition led to the highest levels of negative affect responses and attenuated levels of reported need satisfaction and SWB. Via structural equation modeling, a model of motivational processes grounded in self-determination theory was supported in which elements of the competitive situation that facilitated need satisfaction led to increments in reported indices of SWB.     

Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.     

Review of studies evaluating psychotherapy in bulimia nervosa: the influence of research methods

The purpose of the study was to test if design and research methods of studies predict outcome results of bulimia nervosa. Fifty-seven articles on outcome of bulimia nervosa were found through MEDLINE and PSYCHINFO databases and 25 were included in the statistical analysis. Percentages of patients with a good outcome ranged from 24% to 74% with a mean of 51.1%. The variables best predicting outcome were time to follow-up and number of symptoms evaluated in definition of good outcome whereas dropout, design of studies, treatments, and sample characteristics did not predict significantly. The implications of these findings are discussed.     

Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)

The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.     

An outcome management program for extending advances in choice research into choice opportunities for supported workers with severe multiple disabilities

We evaluated an outcome management program for increasing choice opportunities provided by 2 job coaches for 5 supported workers with severe multiple disabilities in a community job. The program involved specifying and monitoring behavioral outcomes among workers and staff, training staff, and supportive and corrective feedback. Increased choice provision occurred for both job coaches across a 1-year period. Results indicate how outcome management can help translate advances in choice research into routine practice.     

Underemployment in America: Measurement and Evidence

An important way in which employment hardship has come to be conceptualized and measured is as underemployment. Underemployment goes beyond mere unemployment (being out of a job and looking for work), to include those who have given up looking for work, part-time workers whose employer(s) cannot give them full-time work, and the working poor. To provide needed background for the other articles in this special issue, we trace the history of the concept of underemployment, review existing empirical literature, offer a critique of the measurement of underemployment as conventionally operationalized, and provide up-to-date evidence on the trends and correlates of underemployment in the United States.     

The Role of Schools in Outcomes for Youth: Implications for Children's Mental Health Services Research

We explore the role of schools in children's mental health services research. Recent literature has suggested that schools play an important role in delivering services to children and adolescents with emotional and behavioral problems. Research in services research, though, has taken a fairly narrow view of which dimensions of school environments are relevant for inclusion in studies. We suggest that a broader view of school environments is appropriate and potentially beneficial to the field. Using Bronfenbrenner's ecological model as a guide, we conceptualize schools as microsystems. Such an approach suggests that all aspects of school environments (treatment as well as non-treatment) are likely to influence many of the outcomes that children's mental health services research frequently targets (e.g., behavioral problems, problematic peer relationships, academic achievement, school attendance). We review literature from a variety of disciplines to suggest relevant features of schools, with particular attention to the role of peer dynamics within schools. We conclude with implications of this expanded conceptualization of schools for children's mental health services research.     

The Strengths and Limitations of Case Record Reviews in Examining Family Preservation Outcome Formulation and Treatment Planning

Much debate has centered on what are reasonable outcomes of the short-term intensive family preservation services (IFPS). However, little attention has been given to how therapists actually formulate outcomes in their practices. The files of 98 families who used IFPS were reviewed to determine how therapists formulated outcomes and whether formulated outcomes varied by service sector (child welfare or mental health) and child age. It was found that formulated outcomes in mental health were more likely than those in child welfare to have a child focus and an interpersonal locus. Variation in outcome formulation in child welfare by child age was found, with outcomes of younger children more likely to be parent-focused than were outcomes of older children. The issues pointed out by these findings are discussed. Since case records are a potential data source for researchers, the paper concludes with a discussion of the strengths and limitations of case record reviews for research purposes.     

An Examination of the Effectiveness of Dialectical Behavior Therapy Skills Groups

This study implemented a multiple‐phase, contrast, single‐case research design to examine the effectiveness of the 4 core dialectical behavior therapy skills group modules in reducing emotion dysregulation. Three participants completed four 6‐week skills modules over 9 months. Examination of calculated estimates of treatment effect indicated that 2 out of the 3 participants experienced meaningful changes in their degree of emotion dysregulation over the course of treatment. Implications for counseling practice are discussed.     

The Counseling Center Assessment of Psychological Symptoms Distress Index: A pragmatic exploration of general factors to enhance a multidimensional scale

Objective: The authors attempted to develop and validate a general distress index for a multidimensional psychological symptom/outcome measure used in over 300 college counseling centers with more than 100,000 cases annually: the Counseling Center Assessment of Psychological Symptoms (CCAPS). Method: Four models were compared for fit indices (n = 19,247): the existing first-order factor model (without a general factor), a second-order factor model, a bifactor model, and a single factor or “total score” model. In separate clinical and non-clinical samples, concurrent and divergent validity were examined using several well-established measures of psychological symptoms, as well as two-week test–retest and treatment utilization data. Results: Second-order and bifactor models which captured a single “distress” factor both exhibited good fit to the data relative to the baseline and “total score” model. Validity data indicated that factors adequately measured meaningful clinical onstructs. Conclusion: Both the bifactor and second-order models indicated the presence of a “distress index” comprised items across many of the CCAPS subscales. This distress scale has strong applicability for benchmarking the overall severity and complexity of patients at different centers, and can be used to help identify colleges and universities with areas of clinical strength, which can be studied to improve the field. Clinically, the distress index offers a parsimonious and efficient method for clinicians to monitor patients’ progress through treatment.