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Ramarushton B, Blumenthal H, Slavish DC, Kaminski PL, Ramadan T, Lewis S. Perceived psychological control relates to coping-related drinking motives via social anxiety among adolescents: A cross-sectional mediation analysis. Alcohol 2024; 118:17-24. [PMID: 37944869 DOI: 10.1016/j.alcohol.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Accumulating evidence suggests that particular parenting behaviors (e.g., elevated psychological control) may increase risk for both problematic social anxiety and alcohol use among youth; however, no work has yet examined these factors together in a single model. Building developmentally sensitive models of problematic alcohol use trajectories is key to developing effective prevention and intervention strategies. The present study includes 94 adolescents (ages 14-17 years; 53.3% girls; 89.2% White) entering a treatment facility for a variety of internalizing and externalizing forms of psychological distress. Levels of perceived parental psychological control, social anxiety, and coping-related drinking motives were assessed. Higher levels of perceived psychological control were associated with a greater endorsement of coping-related drinking motives; however, a significant proportion of that association was accounted for by elevated social anxiety symptoms. These data extend the existing literature and lay groundwork for more sophisticated experimental and longitudinal designs to corroborate the findings. Moreover, personality-targeted drinking interventions for adolescents may benefit from identifying elevated perceived psychological control as a developmentally relevant risk factor for social anxiety and problematic drinking motives and administering relevant interventions (e.g., personality-targeted coping skills training, parent-involved care) before drinking patterns are established.
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Affiliation(s)
- Banan Ramarushton
- University of North Texas, Department of Psychology, Denton, TX, United States.
| | | | - Danica C Slavish
- University of North Texas, Department of Psychology, Denton, TX, United States
| | - Patricia L Kaminski
- University of North Texas, Department of Psychology, Denton, TX, United States
| | - Taqwa Ramadan
- University at Albany, Department of Psychology, Albany, NY, United States
| | - Sarah Lewis
- Center for Research, Assessment, and Treatment Efficacy (CReATE), Asheville, NC, United States
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2
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McAleavey AA, de Jong K, Nissen-Lie HA, Boswell JF, Moltu C, Lutz W. Routine Outcome Monitoring and Clinical Feedback in Psychotherapy: Recent Advances and Future Directions. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:291-305. [PMID: 38329643 PMCID: PMC11076375 DOI: 10.1007/s10488-024-01351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
In the past decade, there has been an increase in research related to the routine collection and active use of standardized patient data in psychotherapy. Research has increasingly focused on personalization of care to patients, clinical skills and interventions that modulate treatment outcomes, and implementation strategies, all of which appear to enhance the beneficial effects of ROM and feedback. In this article, we summarize trends and recent advances in the research on this topic and identify several essential directions for the field in the short to medium term. We anticipate a broadening of research from the focus on average effects to greater specificity around what kinds of feedback, provided at what time, to which individuals, in what settings, are most beneficial. We also propose that the field needs to focus on issues of health equity, ensuring that ROM can be a vehicle for increased wellbeing for those who need it most. The complexity of mental healthcare systems means that there may be multiple viable measurement solutions with varying costs and benefits to diverse stakeholders in different treatment contexts, and research is needed to identify the most influential components in each of these contexts.
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Affiliation(s)
- Andrew A McAleavey
- Helse Førde Hospital Trust, Svanehaugvegen 2, Førde, 6812, Norway.
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway.
- Department of Psychiatry, Weill Cornell Medical Center, New York, NY, USA.
| | - Kim de Jong
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
| | | | - James F Boswell
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Christian Moltu
- Helse Førde Hospital Trust, Svanehaugvegen 2, Førde, 6812, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
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3
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Coyne AE, Constantino MJ, Boswell JF, Gaines AN, Kraus DR. Therapist-Level Moderators of Patient-Therapist Match Effectiveness in Community Psychotherapy. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01360-8. [PMID: 38565810 DOI: 10.1007/s10488-024-01360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 04/04/2024]
Abstract
Based on patient-reported outcomes data analyzed at the provider level, there is evidence that psychotherapists can possess effectiveness strengths and weaknesses when treating patients with different presenting concerns. These within-therapist differences hold promise for personalizing care by prospectively matching patients to therapists' historical effectiveness strengths. In a double-masked randomized controlled trial (RCT; NCT02990000), such matching outperformed pragmatically determined usual case assignment-which leaves personalized, measurement-based matching to chance-in naturalistic outpatient psychotherapy (Constantino et al., JAMA Psychiatry 78:960-969, 2021). Demonstrating that personalization can be even more precise, some research has demonstrated that the strength of this positive match effect was moderated by certain patient characteristics. Notably, though, it could also be that matching is especially important for some therapists to achieve more effective outcomes. Examining this novel question, the present study drew on the Constantino et al. (JAMA Psychiatry 78:960-969, 2021) trial data to explore three therapist-level moderators of matching: (a) effectiveness "spread" (i.e., greater performance variability across patients' presenting problem domains), (b) overestimation of their measurement-based and problem-specific effectiveness, and (c) the frequency with which they use patient-reported routine outcomes monitoring in their practice. Patients were 206 adults, randomized to the match or control condition, treated by 40 therapists who were crossed over conditions. The therapist variables were assessed at the trial's baseline and patients' symptomatic/functional impairment and global distress were assessed regularly up to 16 weeks of treatment. Hierarchical linear models revealed that only therapist effectiveness spread significantly moderated the match effect for the global distress outcome; for therapists with more spread, the match effect was more pronounced, whereas the match effect was minimal for therapists with less effectiveness spread. Notably, two therapist-level covariates unexpectedly emerged as significant moderators for the symptomatic/functional impairment outcome; for clinicians who consistently treated patients with higher versus lower average severity levels and who relatedly treated a higher proportion of patients with primary presenting problems of substance misuse or violence, the beneficial match effect was even stronger. Thus, measurement-based matching may be especially potent for therapists with more variable effectiveness across problem domains, and who consistently treat patients with more severe presenting concerns or with particular primary problems, which provides further precision in conceptualizing personalized care.
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Affiliation(s)
- Alice E Coyne
- Department of Psychology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Michael J Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - James F Boswell
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Averi N Gaines
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
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Klein DN. Assessment of Depression in Adults and Youth. Assessment 2024; 31:110-125. [PMID: 37081793 DOI: 10.1177/10731911231167446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
This article selectively reviews the key issues and measures for the assessment of depressive disorders and symptoms in youth and adults. The first portion of the article addresses the nature and conceptualization of depression and some key issues that must be considered in its assessment. Next, the diagnostic interview and clinician- and self-administered rating scales that are most widely used to diagnose, screen for, and assess the severity of depression in adults and youth are selectively reviewed. In addition, the assessment of three transdiagnostic clinical features (anhedonia, irritability, and suicidality) that are frequently associated with both depression and other forms of psychopathology is discussed. The article concludes with some broad recommendations for assessing depression in research and clinical practice and suggestions for future research.
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Trudeau KJ, Yang J, Di J, Lu Y, Kraus DR. Predicting Successful Placements for Youth in Child Welfare with Machine Learning. CHILDREN AND YOUTH SERVICES REVIEW 2023; 153:107117. [PMID: 37841819 PMCID: PMC10569152 DOI: 10.1016/j.childyouth.2023.107117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Out-of-home placement decisions have extremely high stakes for the present and future well-being of children in care because some placement types, and multiple placements, are associated with poor outcomes. We propose that a clinical decision support system (CDSS) using existing data about children and their previous placement success could inform future placement decision-making for their peers. The objective of this study was to test the feasibility of developing machine learning models to predict the best level of care placement (i.e., the placement with the highest likelihood of doing well in treatment) based on each youth's behavioral health needs and characteristics. We developed machine learning models to predict the probability of each youth's treatment success in psychiatric residential care (i.e., Psychiatric Residential Treatment Facility [PRTF]) versus any other placement (AUROCs > 0.70) using data collected in standard care at a behavioral health organization. Placement recommendations based on these machine learning models distinguished between youth who did well in residential care versus non-residential care (e.g., 80% of those who received care in the recommended setting with the highest predicted likelihood of success had above average risk-adjusted outcomes). Then we developed and validated machine learning models to predict the probability of each youth's treatment success across specific placement types in a state-wide system, achieving an average AUROC score of greater than 0.75. Machine learning models based on risk-adjusted behavioral health and functional data show promise in predicting positive placement outcomes and informing future placement decisions for youth in care. Related ethical considerations are discussed.
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Affiliation(s)
| | - Jichen Yang
- Outcome Referrals, Inc., Framingham, MA, USA
| | - Jiaming Di
- Outcome Referrals, Inc., Framingham, MA, USA
| | - Yi Lu
- Outcome Referrals, Inc., Framingham, MA, USA
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Boswell JF, Schwartzman CM, Constantino MJ, Scharff A, Muir HJ, Gaines AN, King BR, Kraus DR. A Qualitative Analysis of Stakeholder Attitudes Regarding Personalized Provider Selection and Patient-Therapist Matching. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01302-w. [PMID: 37740813 DOI: 10.1007/s10488-023-01302-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
This study explored mental health care patients and therapists' perspectives on using therapists' measurement-based and problem-specific effectiveness data to inform case assignments - a type of treatment personalization that has been shown to outperform non-measurement-based case assignment as usual (Constantino et al., 2021). We conducted semi-structured qualitative interviews with 8 patients (75% women; M age = 33.75 years) and 8 therapists (75% women; M age = 47.50 years). The interview protocols were unique to stakeholder group. Recorded responses were transcribed and qualitatively analyzed by four judges using a blend of consensual qualitative research and grounded theory methods. Derived patient domains included preferred characteristics of a provider, and experiences and suggestions regarding provider selection. Within the domains, most patients expressed an interest in accessing more specific provider information online. Additionally, most patients indicated that both provider outcome track records and personal preference information (e.g., therapist characteristics) should be considered in the therapist selection process. All patients endorsed being comfortable with having the ability to select a provider based on a list of empirically well-matched recommendations. Derived therapist domains included using routine outcomes monitoring for patient-provider matching, referral source and direct patient use of preferred provider lists, and improvements to the provider selection process. Within the domains, all therapists remarked that outcome data would be useful for matching patients to providers; however, most also indicated that outcome data should not be the only factor used in provider selection. All therapists expressed a willingness to be included in preferred provider lists that incorporate track record data. Overall, both patients and therapists held generally positive views toward using therapist effectiveness data to help personalize mental health care. Yet, both stakeholder groups acknowledged that other personalization factors should be considered alongside these data. Based on these results, our team is in the process of implementing patient-therapist match strategies in larger and more diverse mental health care contexts.
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Affiliation(s)
- James F Boswell
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | - Carly M Schwartzman
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Michael J Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Adela Scharff
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Heather J Muir
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Averi N Gaines
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Brittany R King
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
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7
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Constantino MJ, Gaines AN, Coyne AE, Boswell JF, Kraus DR. Existential Isolation as a Correlate of Mental Health Problems, Predictor of Treatment Outcome, and Moderator of a Patient-Therapist Match Effect. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2023. [DOI: 10.1521/jscp.2023.42.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Introduction: Ample research has established that interpersonal isolation—the objective separateness from others—is a correlate of maladaptive psychological outcomes. However, existential isolation (EI)—the feeling of aloneness in one's subjective experience—has received less empirical attention. From the limited existing research, higher EI has been associated with greater severity of mental health concerns and more negative beliefs about treatment. Yet, these investigations have largely been conducted with non-clinical samples. Further, virtually no studies have examined EI as a predictor of current psychotherapy outcomes. Moreover, given their risk of holding negative treatment beliefs, it is plausible that therapy would be most effective if more existentially isolated individuals experienced being well matched to their therapist. This study extended EI research to a clinical sample and provided a novel test of EI as a direct predictor of outcome and moderator of a patient-therapist match system in naturalistic psychotherapy. Method: Data derived from a randomized trial comparing the effectiveness of prospectively matching patients (N = 218) to therapists (N = 48) with empirical strengths in treating the patient's specific presenting problem(s) versus case assignment as usual (Constantino et al., 2021). Patients rated EI at baseline and mental health outcomes repeatedly through treatment. We conducted correlations to examine baseline EI-symptom associations and multilevel modeling to test EI as a predictor of symptom change and moderator of the known beneficial match effect on outcome. Results: As predicted, higher EI was associated with greater depression, anxiety, and distress at baseline, as well as poorer therapy outcome across and at the end of treatment. In the expected direction, though not to a statistically significant level, the positive match effect was stronger for patients with higher versus lower EI. Discussion: We discuss research and practice implications at the intersection of social and clinical psychology.
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8
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Alessandri G, Tavolucci S, Perinelli E, Eisenberg N, Golfieri F, Caprara GV, Crocetti E. Regulatory emotional self-efficacy beliefs matter for (mal)adjustment: A meta-analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04099-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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9
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Ko H, Shin J, Cooper LD. Brief Adjustment Scale-6 for Measurement-Based Care: Psychometric Properties, Measurement Invariance, and Clinical Utility. Assessment 2022:10731911221115144. [PMID: 35923134 DOI: 10.1177/10731911221115144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Brief Adjustment Scale-6 (BASE-6) was recently developed for measuring general psychological functioning within measurement-based care (MBC). The present study further evaluated psychometric properties, generalizability to race/ethnic populations, and clinical utility of the BASE-6. Three adult samples, Sample 1: online community participants (n = 394); Sample 2: college students (n = 249); Sample 3: outpatient clinic clients (n = 80), were included. The results demonstrated a high level of internal consistency, good test-retest reliability, and convergent validity in all samples. The unidimensional structure of BASE-6 was confirmed and factorial invariance was established across groups. Finally, the BASE-6 captured change over time by demonstrating a large effect size of pre-post treatment changes and significant linear change in multilevel growth modeling. These results support the BASE-6 as a reliable and valid measure regardless of race/ethnicity and can sensitively detect clinical change over the course of the treatment. Thus, the BASE-6 appears to accurately monitor overall psychological adjustment.
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Affiliation(s)
- Hayoung Ko
- Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Jaehyun Shin
- Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Lee D Cooper
- Virginia Polytechnic Institute and State University, Blacksburg, USA
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10
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O'Shea M, Capon H, Evans S, Agrawal J, Melvin G, O'Brien J, McIver S. Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map. J Clin Psychol 2022; 78:1671-1711. [PMID: 35315071 PMCID: PMC9546402 DOI: 10.1002/jclp.23338] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/19/2021] [Accepted: 02/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking. MATERIALS AND METHODS This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence-based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders. RESULTS Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi-experimental research designs. DISCUSSION Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD. CONCLUSIONS Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence-based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice.
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Affiliation(s)
- Melissa O'Shea
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Hannah Capon
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Subhadra Evans
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Jyotsna Agrawal
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Glenn Melvin
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Jennifer O'Brien
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Shane McIver
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Australia
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11
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Jankowski PJ, Hall E, Crabtree SA, Sandage SJ, Bronstein M, Sandage D. Risk, Symptoms, and Well‐Being: Emerging Adult Latent Profiles During Treatment. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Peter J. Jankowski
- Albert and Jessie Danielsen Institute Boston University, and Counseling Program, Bethel University
| | - Eugene Hall
- Albert and Jessie Danielsen Institute Boston University
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12
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Overview of Ten Child Mental Health Clinical Outcome Measures: Testing of Psychometric Properties with Diverse Client Populations in the U.S. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:197-225. [PMID: 34482501 PMCID: PMC8850232 DOI: 10.1007/s10488-021-01157-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 11/11/2022]
Abstract
While many standardized assessment measures exist to track child mental health treatment outcomes, the degree to which such tools have been adequately tested for reliability and validity across race, ethnicity, and class is uneven. This paper examines the corpus of published tests of psychometric properties for the ten standardized measures used in U.S. child outpatient care, with focus on breadth of testing across these domains. Our goal is to assist care providers, researchers, and legislators in understanding how cultural mismatch impacts measurement accuracy and how to select tools appropriate to the characteristics of their client populations. We also highlight avenues of needed research for measures that are in common use. The list of measures was compiled from (1) U.S. state Department of Mental Health websites; (2) a survey of California county behavioral health agency directors; and (3) exploratory literature scans of published research. Ten measures met inclusion criteria; for each one a systematic review of psychometrics literature was conducted. Diversity of participant research samples was examined as well as differences in reliability and validity by gender, race or ethnicity, and socio-economic class. All measures showed adequate reliability and validity, however half lacked diverse testing across all three domains and all lacked testing with Asian American/Pacific Islander and Native American children. ASEBA, PSC, and SDQ had the broadest testing.
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13
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Depression Anxiety Stress Scale-10: A Brief Measure for Routine Psychotherapy Outcome and Progress Assessment. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractRoutine outcome measurement and progress monitoring is well established to enhance quality assurance in clinical psychology service delivery but is not widely used in routine care. A major barrier to more widespread implementation is the lack of public domain, brief, psychometrically sound outcome measures that easily integrate into clinical information systems. The current study assessed a brief 10-item version of the widely used Depression Anxiety Stress (DASS)-42 scale, which we called the Depression Anxiety Stress-10 (DASS-10) scale. In two clinical samples of adults (n = 1036, 445 men, 591 women; and n = 1084, 493 men, 591 women), the DASS-10 had a replicable two-level factor structure, which at the lower level had two factors assessing stress-anxiety and depression, which each loaded onto a superordinate psychological distress scale. The items in the distress score discriminated between a clinical sample (n = 376) and a community sample (n = 379) and were sensitive to clinical change. The measure has the potential to make routine outcome measurement and progress monitoring more cost-effective to implement than existing measures, particularly when integrated with practice management software to make administration, scoring, and use easy.
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14
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Jankowski PJ, Captari LE, Sandage SJ. Exploring virtue ethics in psychodynamic psychotherapy: latent changes in humility, affect regulation, symptoms and well‐being. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Peter J. Jankowski
- Albert and Jessie Danielsen Institute Boston University Boston MassachusettsUSA
- Bethel University St. Paul MinnesotaUSA
| | - Laura E. Captari
- Albert and Jessie Danielsen Institute Boston University Boston MassachusettsUSA
| | - Steven J. Sandage
- Albert and Jessie Danielsen Institute Boston University Boston MassachusettsUSA
- Department of Psychology of Religion MF Norwegian School of Theology, Religion, and Society Oslo Norway
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15
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Lin T, Farber BA. Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement. J Clin Psychol 2021; 77:1354-1370. [PMID: 33538344 DOI: 10.1002/jclp.23119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/18/2020] [Accepted: 01/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current study aims to ascertain the trajectories of psychotherapy clients' symptom change and identify client factors that predict treatment outcome. METHOD We conducted a latent growth mixture model (LGMM) to identify the change trajectories of 44 clients' depression scores during psychotherapy. Client characteristics were then explored to determine whether any were associated with change trajectories. We examined whether the number of physician visits and/or client self-concealment scores predict 63 clients' improvement after controlling for initial symptom severity. RESULTS Two trajectories of clients' symptom change were identified: nonimprovers (52.3%) and improvers (47.7%). Nonimprovers had higher levels of self-concealment and baseline depression than improvers. The number of physician visits was associated with higher depression scores at baseline and greater clinical improvement during psychotherapy. CONCLUSION Clients showed distinct trajectories of symptom change in psychotherapy. Early identification of clients at risk for treatment failure may increase the probability of therapeutic success.
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Affiliation(s)
- Tao Lin
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Barry A Farber
- Teachers College, Columbia University, New York, New York, USA
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16
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Youn SJ, Castonguay LG, McAleavey AA, Nordberg SS, Hayes JA, Locke BD. Sensitivity to Change of the Counseling Center Assessment of Psychological Symptoms-34. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1080/07481756.2019.1691459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Soo Jeong Youn
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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17
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Boswell JF. Monitoring processes and outcomes in routine clinical practice: A promising approach to plugging the holes of the practice-based evidence colander. Psychother Res 2019; 30:829-842. [DOI: 10.1080/10503307.2019.1686192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- James F. Boswell
- Department of Psychology, University at Albany, SUNY, Albany, NY, USA
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18
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Black J, Bond MA, Hawkins R, Black E. Test of a clinical model of poor physical health and suicide: The role of depression, psychosocial stress, interpersonal conflict, and panic. J Affect Disord 2019; 257:404-411. [PMID: 31306991 DOI: 10.1016/j.jad.2019.05.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/08/2019] [Accepted: 05/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study employed a structural equation model to examine the relationships between poor physical health, suicide, depression, psychosocial stress, interpersonal conflict, and panic. METHODS The sample consisted of a large, archived set of mental health treatment-seeking adults who completed a behavioral outcome questionnaire prior to beginning treatment. RESULTS Results supported the extant literature indicating that poor physical health, depression, psychosocial stress, interpersonal conflict, and panic impose increased risk for suicidal ideation, with depression demonstrating the highest risk for increased suicidal ideation. The results also supported the hypotheses that depression, psychosocial stress, interpersonal conflict, and panic would mediate the association between poor physical health and suicidal ideation. Although no a priori hypotheses were made regarding relationships among the 15 physical illnesses examined, results indicated that HIV/AIDS had the strongest correlation with depression and the weakest correlation with interpersonal conflict. LIMITATIONS Firstly, the study sample was primarily Caucasian, limiting its generalizability. Secondly, causal inferences should be interpreted with caution, due to the quasi-experimental design. Thirdly, these data were self-reported, which create response biases since suicidal ideation is stigmatized. CONCLUSIONS These findings highlight the importance of considering interpersonal factors as potential mediators in the relationship between poor physical health, mental illness, and suicide. Clinically, the impact of an active major depressive episode on an individual who is struggling with a serious physical illness may be strongly predictive of suicidal ideation.
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Affiliation(s)
- Janie Black
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND).
| | - Mark A Bond
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND)
| | - Raymond Hawkins
- Department of Psychology, the University of Texas at Austin, United States
| | - Elizabeth Black
- Elizabeth A. Black: MSN Candidate, School of Nursing, University of Texas at Austin, United States
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19
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Donahue JM, Hormes JM, Gordis EB, Anderson DA. Attending to the Alliance in the Application of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A Case Study. Clin Case Stud 2019. [DOI: 10.1177/1534650119845503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As conceptualizations of mood and anxiety disorders shift toward a dimensional approach, transdiagnostic treatments have gained recognition and support. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is an evidence-based cognitive behavioral therapy that targets the core processes that underlie common and comorbid mental disorders. It is designed to help clients learn how to confront, experience, and respond to their emotions in adaptive ways through the modification of their emotion regulation strategies. The current case study describes the flexible application of the UP with a treatment-naïve 25-year-old female who presented to outpatient therapy with symptoms of anxiety and depression. Additions to the UP were made to address issues related to the therapeutic alliance and information discovered over the course of treatment. Outcome measures administered to the client reflect significant symptom improvement and add to a growing body of literature that supports the usefulness of transdiagnostic approaches to treating a range of disorders. Moreover, quantitative and qualitative data point to the necessity for clinicians to attend to the therapeutic alliance and consider cultural factors when delivering manualized treatment approaches to individuals from diverse backgrounds.
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20
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Bell CA, Jankowski PJ, Sandage SJ. Early treatment narcissism associated with later social and sexual functioning among psychotherapy clients. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Peter J. Jankowski
- Boston University; Boston Massachusetts
- Bethel University; Saint Paul Minnesota
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21
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Jankowski PJ, Sandage SJ, Bell CA, Rupert D, Bronstein M, Stavros GS. Latent trajectories of change for clients at a psychodynamic training clinic. J Clin Psychol 2019; 75:1147-1168. [PMID: 30817007 DOI: 10.1002/jclp.22769] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Employing practice-based research methods, we addressed the need to examine the effectiveness of psychodynamic treatment as a supplement to the efficacy evidence offered by randomized clinical trials. METHOD We used person-centered analyses to generate latent subgroups of clients (N = 118; M age = 40.92; 53.4% female; 81.4% Caucasian; 80.5% heterosexual) receiving contemporary relational psychotherapy (CRP) at a psychodynamic community mental health training clinic. RESULTS Subgroups of clients reported a change in depression, social conflict, and anxiety symptomatology, and overall life satisfaction, depicted by significant quadratic growth curves. Findings also offered exploratory support for a theoretical proposition from CRP that improved relational functioning would correspond to improved affect dysregulation and overall life satisfaction. CONCLUSION Clinical and training implications highlight the need to distinguish subgroups of "responders" and "nonresponders" to inform treatment.
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Affiliation(s)
- Peter J Jankowski
- Counseling Program, Bethel University, St. Paul, Minnesota.,Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
| | - Steven J Sandage
- Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
| | - Chance A Bell
- Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
| | - David Rupert
- Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
| | - Miriam Bronstein
- Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
| | - George S Stavros
- Albert and Jessie Danielsen Institute, Boston University, Boston, Massachusetts
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22
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Paine DR, Bell CA, Sandage SJ, Rupert D, Bronstein M, O’Rourke CG, Stavros GS, Moon SH, Kehoe LE. Trainee psychotherapy effectiveness at a psychodynamic training clinic: a practice-based study. PSYCHOANALYTIC PSYCHOTHERAPY 2019. [DOI: 10.1080/02668734.2019.1582084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- David R. Paine
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - Chance A. Bell
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - Steven J. Sandage
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - David Rupert
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - Miriam Bronstein
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | | | - George S. Stavros
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - Sarah H. Moon
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
| | - Lauren E. Kehoe
- Albert and Jessie Danielsen Institute, Boston University, Boston, MA, USA
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23
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Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis. J Anxiety Disord 2019; 61:3-17. [PMID: 30057346 DOI: 10.1016/j.janxdis.2018.06.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/23/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022]
Abstract
Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31-1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.
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24
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Stanley IH, Boffa JW, Rogers ML, Hom MA, Albanese BJ, Chu C, Capron DW, Schmidt NB, Joiner TE. Anxiety sensitivity and suicidal ideation/suicide risk: A meta-analysis. J Consult Clin Psychol 2018; 86:946-960. [PMID: 30335426 PMCID: PMC6469498 DOI: 10.1037/ccp0000342] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized. METHOD This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk. RESULTS Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32). CONCLUSIONS AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi
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25
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Johns RG, Barkham M, Kellett S, Saxon D. A systematic review of therapist effects: A critical narrative update and refinement to review. Clin Psychol Rev 2018; 67:78-93. [PMID: 30442478 DOI: 10.1016/j.cpr.2018.08.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 08/14/2018] [Accepted: 08/16/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review the therapist effects literature since Baldwin and Imel's (2013) review. METHOD Systematic literature review of three databases (PsycINFO, PubMed and Web of Science) replicating Baldwin and Imel (2013) search terms. Weighted averages of therapist effects (TEs) were calculated, and a critical narrative review of included studies conducted. RESULTS Twenty studies met inclusion criteria (3 RCTs; 17 practice-based) with 19 studies using multilevel modeling. TEs were found in 19 studies. The TE range for all studies was 0.2% to 29% (weighted average = 5%). For RCTs, 1%-29% (weighted average = 8.2%). For practice-based studies, 0.2-21% (weighted average = 5%). The university counseling subsample yielded a lower TE (2.4%) than in other groupings (i.e., primary care, mixed clinical settings, and specialist/focused settings). Therapist sample sizes remained lower than recommended, and few studies appeared to be designed specifically as TE studies, with too few examples of maximising the research potential of large routine patient datasets. CONCLUSIONS Therapist effects are a robust phenomenon although considerable heterogeneity exists across studies. Patient severity appeared related to TE size. TEs from RCTs were highly variable. Using an overall therapist effects statistic may lack precision, and TEs might be better reported separately for specific clinical settings.
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Affiliation(s)
- Robert G Johns
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK
| | - Michael Barkham
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK.
| | - Stephen Kellett
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK
| | - David Saxon
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK
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26
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Boswell JF, Constantino MJ, Kraus DR. Harnessing the Therapist Effect in Patient-Centered Mental Health Care Decision Making. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 44:724-728. [PMID: 28064399 DOI: 10.1007/s10488-016-0789-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this commentary, we address the critical importance of the research literature documenting therapist differences in skill and outcomes. In particular, we focus on the implications of therapist differences for patient-centered decision making, including the matching of patients to specific psychotherapists who have empirically-based track records of positive performance. In addition, we present preliminary results from a grant supported study of patients' values and preferences regarding the use of provider performance track records in routine mental health care decision making.
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Affiliation(s)
- James F Boswell
- Department of Psychology, University at Albany, SUNY, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | - Michael J Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts, 612 Tobin Hall - 135 Hicks Way, Amherst, MA, 01003-9271, USA
| | - David R Kraus
- Outcome Referrals, Inc., 1 Speen St., Framingham, MA, 01701, USA
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27
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de Jong K, Segaar J, Ingenhoven T, van Busschbach J, Timman R. Adverse Effects of Outcome Monitoring Feedback in Patients With Personality Disorders: A Randomized Controlled Trial in Day Treatment and Inpatient Settings. J Pers Disord 2018; 32:393-413. [PMID: 28594629 DOI: 10.1521/pedi_2017_31_297] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study aimed to evaluate the differential effect of outcome monitoring feedback to therapists and to patients on outcomes in cluster B, cluster C, and personality disorder not otherwise specified (PD-NOS) patients. Day treatment patients (n = 112) and inpatients (n = 94) were randomly assigned to a feedback to therapist (FbT), feedback to therapist and patient (FbTP), or no feedback (NFb) condition. Feedback was based on weekly administrations of the Outcome Questionnaire-45 (OQ-45). In cluster B and PD-NOS patients FbTP resulted in increased OQ-45 scores during the first 6 months of therapy for not on track (NOT) patients. In cluster C patients, no adverse effects of feedback were found. These results suggest that for certain personality disorder patient groups, providing feedback during treatment may not always be beneficial, although more research is needed to further assess these effects.
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Affiliation(s)
- Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jaap Segaar
- GGZ Centraal, Expertise Centre for Personality Disorders
| | - Theo Ingenhoven
- Pro Persona, Center for Psychotherapy, Amersfoort, The Netherlands
| | - Jan van Busschbach
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.,De Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
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28
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Solstad SM, Castonguay LG, Moltu C. Patients' experiences with routine outcome monitoring and clinical feedback systems: A systematic review and synthesis of qualitative empirical literature. Psychother Res 2017; 29:157-170. [PMID: 28523962 DOI: 10.1080/10503307.2017.1326645] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Routine outcome monitoring (ROM) and clinical feedback (CF) systems have become important tools for psychological therapies, but there are challenges for their successful implementation. OBJECTIVE To overcome these challenges, a greater understanding is needed about how patients experience the use of ROM/CF. METHOD We conducted a systematic literature search of qualitative studies on patient experiences with the use of ROM/CF in mental health services. RESULTS The findings from 16 studies were synthesized, resulting in four meta-themes: (1) Suspicion towards service providers, (2) Flexibility and support to capture complexity, (3) Empowering patients, and (4) Developing collaborative practice. CONCLUSIONS We discuss the implications of these meta-themes for further development and implementation of ROM/CF into clinical practice, acknowledging the limitations of our review and suggesting avenues for further research. Clinical or methodological significance of this article: This article provides useful and actionable knowledge about the patient perspective on ROM/CF, an important discussion on the current state of research in this area, and useful and concrete suggestions for further avenues of research.
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Affiliation(s)
- Stig Magne Solstad
- a Department of Psychiatry , District General Hospital of Førde , Førde , Norway
| | | | - Christian Moltu
- a Department of Psychiatry , District General Hospital of Førde , Førde , Norway
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29
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Locke BD, McAleavey AA, Zhao Y, Lei PW, Hayes JA, Castonguay LG, Li H, Tate R, Lin YC. Development and Initial Validation of the Counseling Center Assessment of Psychological Symptoms–34. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1177/0748175611432642] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Pui-Wa Lei
- The Pennsylvania State University, University Park, PA, USA
| | | | | | - Hongli Li
- Georgia State University, Atlanta, GA, USA
| | - Robin Tate
- The Pennsylvania State University, University Park, PA, USA
| | - Yu-Chu Lin
- The Pennsylvania State University, University Park, PA, USA
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30
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Mellor-Clark J, Cross S, Macdonald J, Skjulsvik T. Leading Horses to Water: Lessons from a Decade of Helping Psychological Therapy Services Use Routine Outcome Measurement to Improve Practice. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 43:279-85. [PMID: 25179755 DOI: 10.1007/s10488-014-0587-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We summarise the recent reflections of five thought leaders in the field of routine outcome measurement (ROM) for psychological therapy, and then add our own experience of introducing a national ROM system in the UK. We highlight, in particular, the post-implementation challenge of securing data of sufficient reliability to help inform service quality improvements. We ground our conclusions and recommendations in the rapidly evolving discipline of implementation science, and offer a best practice model for applying research recommendations in practice settings. In this context we portray ROM implementation as significant organizational change that benefits from rigorous process and clearly defined, well-communicated targets.
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Affiliation(s)
- John Mellor-Clark
- CORE Information Systems Ltd. (IMS), Valiant Office Suites, Lumonics House, Valley Drive, Swift Valley, Rugby, CV21 1TQ, UK.
| | - Simone Cross
- CORE Information Systems Ltd. (IMS), Valiant Office Suites, Lumonics House, Valley Drive, Swift Valley, Rugby, CV21 1TQ, UK
| | - James Macdonald
- CORE Information Systems Ltd. (IMS), Valiant Office Suites, Lumonics House, Valley Drive, Swift Valley, Rugby, CV21 1TQ, UK
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31
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Sanders PW, Richards PS, McBride JA. Development of the clinically adaptive multidimensional outcome survey. Psychother Res 2017; 28:925-939. [PMID: 28100133 DOI: 10.1080/10503307.2016.1277039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Routine outcome monitoring (ROM) has been strongly endorsed by psychotherapy researchers, but has yet to achieve widespread implementation in clinical settings. This article describes the development of the Clinically Adaptive Multidimensional Outcome Survey (CAMOS), an innovative ROM system that allows for local adaptation while providing high quality data. METHOD Three-hundred and four clients at a university counseling center and 211 female patients at an eating disorder treatment facility were administered the CAMOS at intake, and 118 took the CAMOS at both intake and discharge. Two models were developed and compared. Both models were developed using exploratory and confirmatory factor analysis. RESULTS A five-factor model was found to have the best model fit, internal consistency, convergent validity, and discriminant validity. CONCLUSIONS The CAMOS has evidence to support its reliability and validity as a measure of various dimensions of distress. Distinctive tailoring features of the CAMOS compared to other ROM measures are described.
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Affiliation(s)
- Peter W Sanders
- a Department of Counseling Psychology , Brigham Young University , Provo , UT , USA
| | - P Scott Richards
- a Department of Counseling Psychology , Brigham Young University , Provo , UT , USA
| | - Jason A McBride
- a Department of Counseling Psychology , Brigham Young University , Provo , UT , USA
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32
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Bujarski SJ, McDaniel CE, Lewis SF, Leen-Feldner EW, Feldner MT. Past-Month Marijuana Use Is Associated with Self-Reported Violence Among Trauma-Exposed Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1222980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Rogers ES, Maru M, Kash-MacDonald M, Archer-Williams M, Hashemi L, Boardman J. A Randomized Clinical Trial Investigating the Effect of a Healthcare Access Model for Individuals with Severe Psychiatric Disabilities. Community Ment Health J 2016; 52:667-74. [PMID: 27137507 DOI: 10.1007/s10597-016-0009-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/07/2016] [Indexed: 11/24/2022]
Abstract
We conducted a randomized trial to examine a model for integrating primary care into a community mental health setting. Two hundred individuals were recruited and randomly assigned to receive primary care delivered by a nurse practitioner (n = 94) or services-as-usual (n = 106), assessed on health and mental health outcomes, and followed for 12 months. Intent-to-Treat and exposure analyses were conducted and suggest that participants who engaged with the nurse practitioner experienced gains in perceptions of primary care quality. Health benefits accrued for individuals having receiving nurse practitioner services in a mental health setting to address primary care needs.
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Affiliation(s)
- E Sally Rogers
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.
| | - Mihoko Maru
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.,Boston University School of Social Work, Boston, MA, USA
| | - Megan Kash-MacDonald
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.,Institute of Child Health, University College London (UCL), London, England
| | - Mariah Archer-Williams
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.,Sharp HealthCare, San Diego, CA, USA
| | - Lobat Hashemi
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.,Genzyme, Sanofi, Boston, MA, USA
| | - Judith Boardman
- Northeast Health Systems/Health and Education Services, Inc., Beverly, MA, USA.,Salem State University, Salem, MA, USA
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34
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Semcho S, Bilsky SA, Lewis SF, Leen-Feldner EW. Distress tolerance predicts coping motives for marijuana use among treatment seeking young adults. Addict Behav 2016; 58:85-9. [PMID: 26921722 DOI: 10.1016/j.addbeh.2016.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 02/05/2016] [Accepted: 02/09/2016] [Indexed: 10/22/2022]
Abstract
Given increasing marijuana use and abuse among young adults in the United States and the associated physical and mental health consequences, it is important to improve our understanding of factors that may contribute to problematic marijuana use. A convergence of theory and research underscores the relevance of particular marijuana use motives generally, and coping-related motives specifically, in enhancing risk for marijuana use problems. Distress tolerance is a transdiagnostic emotion vulnerability factor that may relate to coping-related motives for marijuana use. The current study was designed to further explore this relationship within a treatment-seeking sample of young adults (Mage=24.40; SD=2.06 years). Results were consistent with hypotheses, suggesting distress tolerance is related to coping motives for marijuana use within this treatment-seeking sample, even after accounting for a number of theoretically relevant covariates. Theoretical and applied implications of distress tolerance as it relates to coping motives for marijuana use as treatment targets are discussed.
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35
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Schiepek G, Aichhorn W, Gruber M, Strunk G, Bachler E, Aas B. Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance. Front Psychol 2016; 7:604. [PMID: 27199837 PMCID: PMC4853656 DOI: 10.3389/fpsyg.2016.00604] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/11/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients' compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific) surveys. Methods: The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic. Results: We found high compliance rates (mean: 78.3%, median: 89.4%) amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders. Conclusion: The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for the assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities).
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Affiliation(s)
- Günter Schiepek
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical UniversitySalzburg, Austria; Faculty of Psychology and Educational Sciences, Ludwig Maximilians UniversityMunich, Germany
| | - Wolfgang Aichhorn
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical UniversitySalzburg, Austria
| | - Martin Gruber
- Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical University Salzburg, Austria
| | | | - Egon Bachler
- Institute of Psychoanalysis and Family Therapy Salzburg, Austria
| | - Benjamin Aas
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Faculty of Psychology and Educational Sciences, Ludwig Maximilians UniversityMunich, Germany
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de Jong K. Challenges in the Implementation of Measurement Feedback Systems. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 43:467-70. [PMID: 26518779 PMCID: PMC4831990 DOI: 10.1007/s10488-015-0697-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This commentary on the articles published in the special section on the development and implementation of measurement feedback systems (MFSs) discusses three challenging themes in the process of MFS implementation: design and planning, organizational context, and sustainability and unintended consequences. It is argued that the implementation of MFSs is complex, but is an important step in improving outcomes in routine care for children and young persons.
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Affiliation(s)
- Kim de Jong
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
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Dawood S, Pincus AL. Multisurface Interpersonal Assessment in a Cognitive-Behavioral Therapy Context. J Pers Assess 2016; 98:449-60. [DOI: 10.1080/00223891.2016.1159215] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nordberg SS, Moltu C, Råbu M. Norwegian translation and validation of a routine outcomes monitoring measure: The treatment outcome package. NORDIC PSYCHOLOGY 2015. [DOI: 10.1080/19012276.2015.1071204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rojas SM, Leen-Feldner EW, Blumenthal H, Lewis SF, Feldner MT. Risk for Suicide Among Treatment Seeking Adolescents: The Role of Positive and Negative Affect Intensity. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9650-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bystedt S, Rozental A, Andersson G, Boettcher J, Carlbring P. Clinicians' perspectives on negative effects of psychological treatments. Cogn Behav Ther 2014; 43:319-31. [PMID: 25204370 PMCID: PMC4260663 DOI: 10.1080/16506073.2014.939593] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Negative effects of psychological treatments is a fairly unexplored area of clinical research. Previous investigations have indicated that a portion of all patients experience negative effects in terms of deterioration and various adverse events. Meanwhile, evidence suggests that many clinicians are untrained in identifying negative effects and unaware of the current research findings. The objective of the current study is thus to investigate clinicians' own perspectives and experiences of possible negative effects of psychological treatments. An invitation to participate in an anonymous online survey consisting of 14 open-ended questions was distributed via three mailing lists used by clinicians that primarily identify themselves as cognitive behavior therapists. The responses were analyzed using a qualitative method based on thematic analysis. In total, 74 participants completed the survey. A majority agreed that negative effects of psychological treatments exist and pose a problem, and many reported having experienced both deterioration and adverse events among patients in their own practice. The thematic analysis resulted in three core themes: characteristics of negative effects, causal factors, as well as methods and criteria for evaluating negative effects. The clinicians recognize that negative effects exist, but many are unaware of the current research findings and are unfamiliar with methods and criteria for identifying and preventing deterioration and adverse events. The results provide evidence for further dissemination of the present knowledge regarding negative effects, particularly during basic clinical training, as well as the need for raising awareness of the available methods for identifying and preventing negative effects.
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Affiliation(s)
- Samuel Bystedt
- a Division of Clinical Psychology, Department of Psychology , Stockholm University , Stockholm , Sweden
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Koerner K, Castonguay LG. Practice-oriented research: What it takes to do collaborative research in private practice. Psychother Res 2014; 25:67-83. [DOI: 10.1080/10503307.2014.939119] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Khalsa MK, Greiner-Ferris JM, Hofmann SG, Khalsa SBS. Yoga-enhanced cognitive behavioural therapy (Y-CBT) for anxiety management: a pilot study. Clin Psychol Psychother 2014; 22:364-71. [PMID: 24804619 DOI: 10.1002/cpp.1902] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 03/27/2014] [Accepted: 03/29/2014] [Indexed: 11/09/2022]
Abstract
UNLABELLED Cognitive behavioural therapy (CBT) is an effective treatment for generalized anxiety disorder, but there is still room for improvement. The aim of the present study was to examine the potential benefit of enriching CBT with kundalini yoga (Y-CBT). Participants consisted of treatment resistant clients at a community mental health clinic. A total of 32 participants enrolled in the study and 22 completed the programme. After the Y-CBT intervention, pre-post comparisons showed statistically significant improvements in state and trait anxiety, depression, panic, sleep and quality of life. Results from this preliminary study suggest that Y-CBT may have potential as a promising treatment for those suffering from generalized anxiety disorder. KEY PRACTITIONER MESSAGES Yoga-enhanced cognitive behavioural therapy (Y-CBT) may be a promising new treatment for those suffering from generalized anxiety disorder. Y-CBT may also reduce depression in those suffering from generalized anxiety. Y-CBT may reduce depression and anxiety in a clinic population where clients suffer from multiple diagnoses including generalized anxiety disorder.
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Affiliation(s)
- Manjit K Khalsa
- Outpatient Center at Upton, Riverside Community Care, Upton, MA, USA
| | | | | | - Sat Bir S Khalsa
- Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Nordberg SS, Castonguay LG, Fisher AJ, Boswell JF, Kraus D. Validating the Rapid Responder Construct Within a Practice Research Network. J Clin Psychol 2014; 70:886-903. [DOI: 10.1002/jclp.22077] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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De Jong K, Timman R, Hakkaart-Van Roijen L, Vermeulen P, Kooiman K, Passchier J, Busschbach JV. The effect of outcome monitoring feedback to clinicians and patients in short and long-term psychotherapy: A randomized controlled trial. Psychother Res 2014; 24:629-39. [DOI: 10.1080/10503307.2013.871079] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Castonguay LG, Pincus AL, McAleavey AA. Practice research network in a psychology training clinic: Building an infrastructure to foster early attachment to the scientific-practitioner model. Psychother Res 2013; 25:52-66. [DOI: 10.1080/10503307.2013.856045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Boswell JF, Kraus DR, Miller SD, Lambert MJ. Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychother Res 2013; 25:6-19. [DOI: 10.1080/10503307.2013.817696] [Citation(s) in RCA: 207] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Ellison WD, Levy KN, Cain NM, Ansell EB, Pincus AL. The Impact of Pathological Narcissism on Psychotherapy Utilization, Initial Symptom Severity, and Early-Treatment Symptom Change: A Naturalistic Investigation. J Pers Assess 2013. [DOI: 10.1080/00223891.2012.742904] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lewis SF. Examining changes in substance use and conduct problems among treatment-seeking adolescents. Child Adolesc Ment Health 2013; 18:33-38. [PMID: 32847262 DOI: 10.1111/j.1475-3588.2012.00657.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Outdoor behavioral healthcare (OBH) treatment offers an alternative to parents of youth who are treatment-resistant or avoidant. METHOD The current study evaluated OBH therapeutic outcomes. The sample was 190 adolescents (Mage = 15.69) presenting for treatment between 2006 and 2008. To be eligible, participants had to be between the ages of 13 and 17 years and be admitted to one of the three OBH programs for mental health intervention. Primary study hypotheses were that OBH treatment would be associated with a reduction in psychiatric symptomatology from baseline to post-treatment and second, that the OBH intervention would be associated with the maintenance of the hypothesized treatment gains. RESULTS AND CONCLUSIONS Findings were consistent with hypotheses, suggesting that youth demonstrated significant symptomatic reductions and maintained these improvements over a 12-month follow-up period.
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Affiliation(s)
- Sarah F Lewis
- Center for Research, Assessment, and Treatment Efficacy (CReATE), P.O. Box 2062, Asheville, NC, 28802-2062, USA
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Bridgett DJ, Valentino K, Hayden LC. The contribution of children's temperamental fear and effortful control to restraint and seclusion during inpatient treatment in a psychiatric hospital. Child Psychiatry Hum Dev 2012; 43:821-36. [PMID: 22418945 DOI: 10.1007/s10578-012-0298-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The current study examined temperament characteristics as risk factors for restraint and seclusion (R/S) events in psychiatrically hospitalized youth, extending work that has sought to identify R/S risk factors and research examining temperament-behavior problem associations that has largely relied upon community samples. It was anticipated that children with poor effortful control (EC) and greater frustration would have more instances of R/S during psychiatric hospitalization. The contribution of children's fearfulness to R/S was also examined. A measure of temperament was completed by youths' clinicians and youths (n = 52) completed objective measures of EC. The frequency of R/S events for each participant was obtained from hospital records. After controlling for R/S risk factors, lower EC and higher fearfulness predicted increased R/S occurrences during the first 2 weeks of hospitalization and over the course of children's entire hospitalization. These findings indicate that temperament should potentially be considered in individualized treatment plans targeting the prevention and/or reduction of R/S. Additional implications of the findings are also discussed.
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Affiliation(s)
- David J Bridgett
- Department of Psychology, Emotion Regulation and Temperament Laboratory, Northern Illinois University, Psychology-Computer Science Building Rm. 400, DeKalb, IL 60115, USA.
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