COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

繁殖群中婴幼川金丝猴社会关系发展的个案研究

使用瞬时取样法,对繁殖笼内出生的两只婴幼川金丝猴进行连续22个月的行为记录。结果表明,川金丝猴婴猴断乳大约在19—20月龄;断乳表现为母婴之间矛盾冲突的过程;群内其他雌性对初生婴儿表现出明显的抢婴、护婴和育婴行为;父亲对婴幼猴表现出接纳和容忍的态度;婴儿在断乳前是群内全体成员保护和爱护的对象,以后开始进入社会关系网,受到成年个体的责备,但很轻微;雌性幼猴在32月龄时尚未被记录到对群内成员表现威胁、蜷缩和匍伏等行为模式。     

Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

Empirical tests of scientific realism: A quantitative framework

The scientific realism debate in philosophy of science raises some intriguing methodological issues. Scientific realism posits a link between a scientific theory's observational and referential success. This opens the possibility of testing the thesis empirically, by searching for evidence of such a link in the record of theories put forward in the history of science. Many realist philosophers working today propose case study methodology as a way of carrying out such a test. This article argues that a qualitative method such as case study methodology is not adequate for this purpose, for two reasons: to test scientific realism is to pose an effects-of-causes question, and observational and referential success are quantities that theories possess to a greater or lesser degree. The article concludes that an empirical test of scientific realism requires a quantitative method.     

Systematic review of interruption and redirection procedures for autistic individuals

Interruption and redirection (IR) procedures involve systematically disrupting an undesirable behavior and prompting an individual to engage in an alternative behavior. These procedures have been frequently assessed for reducing repetitive behaviors for autistic individuals. The primary purpose of this review was to assess IR interventions to determine whether outcomes vary according to intervention characteristics, dependent variable types, design quality, or publication status. A secondary purpose was to assess the extent to which generalization and maintenance outcomes were measured and whether characteristics of these conditions were related to outcomes. IR interventions were moderately successful for reducing repetitive behaviors but less effective for improving corollary variables such as appropriate vocalizations and functional engagement. Generalization and maintenance outcomes, when measured, were poor. Results indicate the need for alternative or augmentative procedures that focus on engagement in meaningful interactions and activities.     

“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.     

Family mental health during the COVID-19 pandemic: Changes in parent-adolescent internalizing symptoms in the United States

The current paper examined the temporal linkage of internalizing symptoms among parent-adolescent dyads during the beginning of the COVID-19 pandemic, and whether COVID-19-related concerns were associated with parent-adolescent linkage of symptoms. Using a 5-week survey-based study, parent-adolescent dyads filled out weekly surveys measuring COVID-19 concerns and internalizing symptoms. Parent and adolescent depressive symptoms did not change over time; however, adolescents experienced decreases in anxiety. Parent-adolescent dyads exhibited linkage in depressive symptoms but not anxiety symptoms. However, linkage in anxiety symptoms varied by parent's COVID-related stress. Study findings provide insight into how COVID-19 disruptions impacted family well-being during adolescence.     

IN VIVO VERSUS SIMULATION TRAINING: AN INTERACTIONAL ANALYSIS OF RANGE AND TYPE OF TRAINING EXEMPLARS

We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives.     

Social integration and social support in a life crisis: Effects of macrosocial change in east Germany

This process evaluation study examined what variables moderate and mediate treatment effects on days in stable housing and client satisfaction for homeless mentally ill clients. In general, demographic characteristics did not moderate either outcome variable. Housing contacts, entitlement contacts, mental health contacts, and supportive services were significant mediators of the treatment effect on days in stable housing. Program contacts, mental health contacts, and supportive services were significant mediators of client satisfaction. The authors thank the National Institute of Mental Health for their financial support (MH43248, MH42357) for this project, Dorothy Gano for word processing and editorial assistance, and Gitry Heydebrand, Melissa Dannelet, Betty Tempelhoff, Ruth Smith, and Laeeq Ahmad for assisting in the interviews of clients. We are also appreciative of the cooperation given to us by the staffs of Malcolm Bliss Mental Health Center, St. Patrick's Center, the Community Advocacy and Support Alliance Program, and the St. Louisemergency shelters. Finally, we thank all of the participants in this study; we hope that their homelessness has now ended. (The conclusions presented in this paper are the sole responsibility of the authors and do not necessarily reflect official National Institute for Mental Health policy.)     

When More is Better than Less; Three Theories of Psychosis—Projection, Double Bind, and Possession

Three psychological theories of psychosis are described, each of which has standing in psychiatry. Defined by the terms projection, double bind, and possession, they initially appear to have little or nothing in common to explain psychosis, but converge at four points: (1) A high degree of anxiety precipitated by a dilemma or conflict perceived to be unsolvable by the person; (2) the anxiety triggers a shift from one thought or motive in the direction of its opposite, because the original was believed too antagonistic to the wishes of significant others; (3) the opposite, in order to remain opposite, requires that the original thought or motive be forgotten, (4) a singular means to produce and reinforce forgetting is the interposition of psychiatric symptoms. In psychiatry today treatment would fit more consistently with the three theories taken as a whole rather than any one, and a rationale for this viewpoint is elaborated.