Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Prologue: Introduction and Overview to Special Volume

Abstract

The editors provide an overview of the obstacles that prevent us from ending child abuse in the United States and briefly summarize the various articles in this volume that address these obstacles from multiple points of view.     

Do Geographic Regions with Higher Suicide Rates also have Higher Rates of Nonfatal Intentional Self‐Harm?

Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.     

Effects of Interspersing Additional Brief Math Problems on Student Performance and Perception of Math Assignments: Getting Students to Prefer to Do More Work

Three experiments were conducted to assess the effects of the interspersing procedure on students' mathematics performance, perceptions of mathematics assignments, and preference for mathematics assignments when more work was added. In Experiment I, college students worked computation problems from two assignments. The control assignment contained 15 three-digit by two-digit problems (3 × 2) and the experimental assignments contained 18 3 × 2 problems and 6 additional interspersed one-digit by one-digit problems (1 × 1). Students then rated the assignments and chose one for homework. Results showed significantly more students preferred (i.e., chose it for homework) the experimental assignment with the additional target (i.e., 3 × 2) and interspersed problems. Furthermore, significantly more students rated this experiment as requiring less effort and being less difficult. Moreover, students' mathematics performance was not affected by the procedure. Experiment II strengthened the internal validity by showing that students did not prefer the experimental assignment because it contained more target problems. Experiment III showed that the interspersing procedure was not powerful enough to extend findings beyond the 20% level (i.e., 40 and 60% more conditions). Results showed how the interspersing procedure could be used to encourage students to choose to do more target computation tasks. Discussion focuses on the applied value of the interspersing procedure and plausible causal mechanisms that may account for current and past findings related to student choice and interspersing brief tasks.     

Improving reading outcomes for children with learning disabilities: using brief experimental analysis to develop parent-tutoring interventions

The present study assessed the effects of summer parent tutoring on 3 children with learning disabilities using empirically derived reading interventions. Brief experimental analyses were used to identify customized reading fluency interventions. Parents were trained to use the intervention strategies with their children. Parents implemented the procedures during parent-tutoring sessions at home and results were measured continuously in high-word-overlap and low-word-overlap passages to determine whether generalization occurred. Parent and child satisfaction with the procedures was assessed. Results demonstrated generalized increases in reading fluency in both high-word-overlap and low-word-overlap passages as a function of parent tutoring. Also, acceptability ratings by children and their parents indicated that they viewed the interventions as acceptable and effective. Results are discussed in terms of structuring reading fluency interventions that promote generalization and maintenance of treatment effects.     

Nichtspezifische,funktionelle und somatoforme Körperbeschwerden

In the S3 guidelines on non-specific, functional and somatoform bodily complaints, a broad group of medical and psychological societies as well as patient representatives have for the first time achieved an evidence-based consensus on terminology and care of these patients. This paper summarizes the main background information and recommendations for psychotherapists. For mild courses treatment by the general practitioner with establishment of a biopsychosocial explanatory model and physical as well as social activation is usually sufficient. More severe courses call for cooperative, coordinated management, including regular appointments with the general practitioner, graded activation and psychotherapy, especially cognitive behavioral, in addition to psychodynamic interpersonal or hypnotherapeutic imaginative psychotherapy. In particularly severe courses multimodal and if necessary day clinic or inpatient treatment is needed. Additionally the patient guidelines for affected people and their relatives are presented.