Interpersonal Skills Training to Reduce Aggressive and Delinquent Behavior: Limited Evidence and the Need for an Evidence-Based System of Care

The prevention of aggressive and delinquent behavior during childhood and adolescence is one of the highest priorities for public health and crime prevention. The most common approach to preventing or treating these conduct problems has been to provide interpersonal skills training to the affected youth. This paper reviews all randomized controlled trials evaluating interpersonal skills training programs as an intervention to reduce conduct problems. Research shows that such programs have weak empirical support as isolated interventions. An alternative evidence-based system of care is described. Such a system would include behavioral parent training and behavioral classroom-based interventions for young children at risk of developing problems, as well as multisystemic family therapy or multidimensional treatment foster care for chronic delinquents. Within such a network of services, interpersonal skills training could play an important supportive role. Such a system holds the greatest promise for reducing the prevalence of aggressive and delinquent behavior in communities.     

Occupational Stressors, Stress Responses, and Alcohol Consumption Among Professional Firefighters: A Prospective, Longitudinal Analysis

This dual-site longitudinal prospective study monitored and measured change in self-reported occupational stressors, emotional trauma, symptoms of stress, and alcohol consumption in urban firefighters. Study participants were 188 firefighters employed by two urban fire departments. The results showed that of 19 occupational stressors examined, only 5 (26%) changed significantly over time, and of those 5, only two—job skill concerns and concerns regarding reduction in force and benefits—decreased, reflecting less bothersome subjective ratings. Of the 12 measures of posttraumatic and other symptoms of stress, 9 (75%) increased significantly over time and none decreased significantly, whereas alcohol consumption was stable over time. Job stressors, trauma caseness, and stress response symptoms at baseline were strongly and significantly associated with the same measures at the two-year follow-up. The implications of the findings for prevention and remediation of stress disorders in fire service personnel are considered. It can be concluded that the stressful nature of urban firefighting is significantly associated with negative health outcomes, including the potential overreliance on alcohol use.     

A comparison of peer verbal responding directed toward adolescents with behavioral disorders and nonhandicapped peers

One of the primary intents of inclusion is the maximization of interaction between persons with and without disabilities. The purpose of this study was to analyze the verbal responding that peers directed toward adolescents with behavioral disorders and, to this effect, several comparisons were made: verbal responding of peers directed toward adolescents with behavioral disorders was compared to verbal responding of peers directed toward regular class adolescents; verbal responding of peers directed toward the same adolescents with behavioral disorders was compared across their self-contained and integrated settings; and verbal responding of peers directed toward adolescents with behavioral disorders in integrated settings was compared to verbal responding of peers directed toward regular class adolescents. Data, collected in real time using portable microcomputers, focused on positive, negative, and neutral social responding and positive, negative, and neutral academic responding. All verbal responding of peers directed toward 14 adolescents with behavioral disorders and 14 regular class peers was recorded. Data were analyzed by group and setting, as well as by social or academic content. Results of the study support inclusion, with high levels of peer responding directed toward adolescents with behavioral disorders in integrated classrooms. Almost all peer responding was positive or neutral in content. Results were discussed as they related to placement of students, social skills training, and previous research.     

Differential patterns of post-shelter placement as a function of problem type and severity

Changes in placement restrictiveness, as a function of problem type and severity, were examined in a sample of 154 children departing a shelter for runaway and homeless youth. Six problem types were identified using a principal components analysis of youth-reported personal and family problems. Four of the six factors obtained represented youth problem types interpreted as reflecting antisocial/conduct problems, victimization by abuse, risk of suicide, and rebellious youth behaviors. The two remaining problem types were interpreted as a chaotic/aggressive family type and a mixed pattern of youth aggression and parental skill deficiency. An analysis of the problem types indicated that youth at higher risk for suicide, and those who came from more dysfunctional families, departed to living environments that were more restrictive than their placements at entry.     

Adaptation of the Alcohol Expectancy Questionnaire (AEQ-A): A short version for use among 13-year-olds in Norway

An adaptation of a Norwegian modified short version of Christiansen & Goldman's Alcohol Expectancy Questionnaire for Adolescents (AEQ-A) was examined in this survey. Subjects were 924 Norwegian seventh graders, with an average age of 13.3 years. From the original 90 items, 27 items representing all seven original scales were used in this study. Factor analysis did not create any preferred new factor solution compared to Christiansen & Goldman's original factors. Internal consistency of the seven AEQ-A scales ranged from 0.37 to 0.72 on Cronbach's alpha. All seven AEQ-A scales correlated significantly with self-reported alcohol use as was expected, and this study also replicated the relative importance of the social enhancement scale. This was the first study using AEQ-A in a non-English-speaking culture. The generalizability of alcohol outcome expectancies was strongly supported.
The present study indicates that the Norwegian version of AEQ-A possesses a level of concurrent validity and internal reliability that is acceptable compared to the original scales, and can serve as a useful instrument in behavioral research on alcohol use among Norwegian adolescents in the years to come.     

Community-referenced leisure skill clusters for adolescents with multiple disabilities

We evaluated the effectiveness of a training package used to teach student-selected community-referenced leisure skill clusters — ordering a pizza-to-go and renting a video from a local vendor — to two adolescents with multiple disabilities. The adolescents were taught the leisure skills (e.g., ordering the pizza) as well as related behaviors necessary to perform those leisure skills (e.g., using a phone, interacting with the delivery person, cutting and serving pizza, cleaning up). The students were taught functional skill clusters, problem-solving skills, and assistance-seeking skills. Training consisted of didactic instruction, feedback, a least intrusive prompting procedure for incorrect responses, and verbal praise and natural consequences for correct responses. Simulation training was conducted at school and in vivotraining was conducted in the local community. A multiple baseline design demonstrated the controlling effects of treatment. Also, follow-up probes conducted up to five months after treatment showed these students maintained treatment gains. Applied issues related to the efficiency of the training package, general and specific skills training, and factors influencing skill maintenance are discussed.     

IN-HOME GENERALIZATION OF SOCIAL INTERACTIONS IN FAMILIES OF ADOLESCENTS WITH BEHAVIOR PROBLEMS

The effects of a three-phase family communication program were evaluated. In the skill-teaching phase, family members were taught reciprocal social communication skills in a clinic setting. During the skill-review phase, each family member practiced the skills in their homes with the teacher. During the home-based family conference phase, each family was taught to use a structured format to resolve current family issues using their newly acquired skills. In-home parent-youth interactions were observed during a series of 1-hr sessions that involved directed and nondirected situations. Evaluation included a multiple baseline design across skills during the skill-teaching phase and a multiple baseline design across families for the family conference phase. Although the procedures of the skill-teaching phase resulted in parent-adolescent dyads learning to use the skills in the teaching setting, competent use of the skills in the home was not observed until the family conference phase was implemented. These results suggest the importance of home-based intervention if changes are to be obtained at home.     

A journey through languages: A systematic literature review on the multilingual experience in counselling and psychotherapy with children and adolescents

The purpose of this research was to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents. This research aimed at interpreting possible meanings for clients of being multilingual in the therapeutic process as well as reflect on the influence of clients’ multilingualism in the therapeutic relationship. The researcher used a systematic literature review (PRISMA guidelines, 2009) to select articles based on empirical qualitative/mixed studies with participants up to 25 years old or adults referring to childhood/adolescence. The researcher used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-etnography documents self-reflections on personal experience of being multilingual contributing to deeper contextualised knowledge. The findings confirm previous research on the existence of a link between multilingualism and “identity” (Costa, 2020, p. 5). This research suggests that the meaning a client gives to bilingualism can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world. The main limitation of this research relates to the fact that there are not many studies with children/young people. This led the researcher to also include studies based on a mixed sample and with adults referring to childhood/adolescence, which might have influenced the interpretation of findings.     

Difficulties,uncertainty, and opportunity: The experience of the COVID-19 pandemic by early to late adolescence in the Czech Republic

The pandemic created an unfamiliar situation for adolescents, especially within the school context. Drawing on the theory of cognitive appraisal, according to which people evaluate the benefit, harm, and threat of a certain event, this study explored Czech adolescents' experiences of the COVID-19 pandemic. We conducted six focus groups with early (11–12 years), middle (14–15 years), and late (18–19 years) adolescents. Using thematic analysis, we identified three themes—pandemic as difficulties, uncertainty, and a (un)seized opportunity. While some younger participants initially perceived the pandemic as exciting, others struggled immediately with isolation, online learning, and disrupted daily activities. The feelings of distressing uncertainty, but also the appraisal of the pandemic as an opportunity to utilize free time differently, which in some cases faded over time, prevailed among late adolescents. This study captured the effects of the pandemic and its appraisals on adolescents' subjective well-being and the shift in the thinking of early and late adolescents.     

Attention Training as a Low-Intensity Treatment for Concerning Anxiety in Clinic-Referred Youth

Although youth anxiety treatment research has focused largely on severe and impairing anxiety levels, even milder anxiety levels, including levels that do not meet full criteria for a diagnosis, can be impairing and cause for concern. There is a need to develop and test viable treatments for these concerning anxiety levels to improve functioning and reduce distress. We present findings from a randomized controlled efficacy trial of attention bias modification treatment (ABMT) and attention control training (ACT) for youths with concerning anxiety levels. Fifty-three clinic-referred youths (29 boys, M age = 9.3 years, SD age = 2.6) were randomized to either ABMT or ACT. ABMT and ACT consisted of attention-training trials in a dot-probe task presenting angry and neutral faces; probes appeared in the location of neutral faces in 100% of ABMT trials and 50% of ACT trials. Independent evaluators provided youth anxiety severity ratings; youths and parents provided youth anxiety severity and global impairment ratings; and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and 2-month follow-up. In both arms, anxiety severity and global impairment were significantly reduced at posttreatment and follow-up. At follow-up, anxiety severity and global impairment were significantly lower in ACT compared with ABMT. Attention control, but not attention bias to threat, was significantly improved at follow-up in both arms. Changes in attention control and attention focusing were significantly associated with changes in anxiety severity. Findings support the viability of attention training as a low-intensity treatment for youths with concerning anxiety levels, including levels that do not meet full criteria for a diagnosis. Superior anxiety reduction effects in ACT highlight the critical need for mechanistic research on attention training in this population.