The Viability of Structural Family Therapy in the Twenty-first Century: An Analysis of Key Indicators

This paper examines the degree to which structural family therapy has adapted effectively to client families and professional demands of the twenty-first century. A review of the current professional literature was conducted to assess the structural model’s continued clinical relevance, how the model has changed in adapting to contemporary social and professional contexts, and whether or not the integrity of the model’s core proposition has been eroded or confounded as a result of adaptive changes.     

HabitWorks: Development of a CBM-I Smartphone App to Augment and Extend Acute Treatment

The month following discharge from acute psychiatric care is associated with increased risk of relapse, rehospitalization, and suicide. Effective and accessible interventions tailored to this critical transition are urgently needed. Cognitive bias modification for interpretation (CBM-I) is a low-intensity intervention that targets interpretation bias, a transdiagnostic process implicated in the development and maintenance of emotional disorders. We describe the development of a CBM-I smartphone app called HabitWorks as an augmentation to acute care that extends through the high-risk month postdischarge. We first obtained input from various stakeholders, including adults who had completed partial hospital treatment (patient advisory board), providers, CBM experts, and clinic program directors. We then iteratively tested versions of the app, incorporating feedback over three waves of users. Participants were recruited from a partial hospital program and completed CBM-I sessions via the HabitWorks app while attending the hospital program and during the month postdischarge. In this Stage 1A treatment development work, we obtained preliminary data regarding feasibility and acceptability, adherence during acute care, and target engagement. Pilot data met our a priori benchmarks. While adherence during acute treatment was good, it decreased during the postacute period. Qualitative feedback was generally positive and revealed themes of usability and helpfulness of app features. Participants varied in their perception of skill generalization to real-life situations. The feasibility and acceptability data suggest that a controlled trial of HabitWorks is warranted.     

Career decidedness as a predictor of subjective well-being

Forming, pursing, and achieving life tasks constitute important determinants of subjective well-being (SWB). A principal life task for emerging adults involves deciding about career goals. Prior research indicates that depression predicts SWB and may be linked to lower levels of career decidedness. We tested whether or not career decidedness predicts SWB above and beyond the influence of depression and other personality traits. We also examined whether or not career decidedness partially mediates depression's influence on SWB when controlled for personality effects. Undergraduate students (N = 181; 65% female, 52% Asian) responded to measures of career decidedness, SWB, and personality. Results largely confirmed predictions. A partial mediator model indicated a direct relationship between decidedness and SWB not moderated by grade level, and an inverse relationship between the depression facet of neuroticism and both career decidedness and SWB. Findings further support career interventions to increase decidedness during the first year of college.     

Suicide on Railroad Rights‐of‐Way: A Psychological Autopsy Study

Findings from 55 psychological autopsies of decedents who perished on U.S. railroad rights‐of‐way between October 1, 2007, and September 30, 2010 are reported. Described are distal, proximal, and contextual factors of risk; understandings of why these suicides occurred on railroad rights‐of‐way; and opportunities for prevention of similar suicides. International comparisons of suicides on railroad rights‐of‐way are made to highlight distinct findings regarding U.S. cases. Decedents studied exhibited considerable predisposing risk for suicide, with a high prevalence of severe mental disorders and substance abuse. In addition, a number of acute risk factors were commonly observed, notably suicide ideation, hopelessness, anxiety, and anger. In the context of that acute risk, associated situational variables and a relative absence of protective factors are described.