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Hare M, Conroy K, Georgiadis C, Shaw AM. Abbreviated Dialectical Behavior Therapy Virtual Skills Group for Caregivers of Adolescents: An Exploratory Study of Service User and Clinical Outcomes. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01681-7. [PMID: 38530589 DOI: 10.1007/s10578-024-01681-7] [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] [Accepted: 02/10/2024] [Indexed: 03/28/2024]
Abstract
Prior work emphasizes involving caregivers in youth mental health services. To support youth with emotion dysregulation, dialectical behavior therapy for adolescents (DBT-A) includes a multi-family skills group, wherein adolescents and caregivers learn skills together. However, limited work has examined the impact of caregiver involvement within DBT-A. The current study examines outcomes of two caregiver-only DBT-A skills groups adapted for abbreviated telehealth delivery. We report on caregivers' (N = 11, 100% mothers, 55% Hispanic) service user outcomes (e.g. self-efficacy at skill usage, group cohesion, therapeutic alliance) and clinical outcomes (i.e. their own emotion functioning, criticism, responses to their adolescent's negative emotions). Results indicate caregiver-only groups were feasible and acceptable, and suggest preliminary efficacy, including improvements in caregiver emotion functioning, distress during interactions with their adolescents, and adolescent-reported criticism. Caregivers also reported reductions in unsupportive responses with their adolescents. Overall, while we caution interpretation due to a small sample size, findings support the preliminary feasibility and efficacy of modifying caregiver participation in DBT-A to be less time-consuming and administered via telehealth.
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Affiliation(s)
- Megan Hare
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA
| | - Christopher Georgiadis
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA
| | - Ashley M Shaw
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA.
- School of Social and Behavioral Sciences, University of New England, Biddeford, ME, 04005, USA.
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Staffini A, Fujita K, Svensson AK, Chung UI, Svensson T. Statistical Methods for Item Reduction in a Representative Lifestyle Questionnaire: Pilot Questionnaire Study. Interact J Med Res 2022; 11:e28692. [PMID: 35302507 PMCID: PMC8976253 DOI: 10.2196/28692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/18/2021] [Accepted: 02/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background Reducing the number of items in a questionnaire while maintaining relevant information is important as it is associated with advantages such as higher respondent engagement and reduced response error. However, in health care, after the original design, an a posteriori check of the included items in a questionnaire is often overlooked or considered to be of minor importance. When conducted, this is often based on a single selected method. We argue that before finalizing any lifestyle questionnaire, a posteriori validation should always be conducted using multiple approaches to ensure the robustness of the results. Objective The objectives of this study are to compare the results of two statistical methods for item reduction (variance inflation factor [VIF] and factor analysis [FA]) in a lifestyle questionnaire constructed by combining items from different sources and analyze the different results obtained from the 2 methods and the conclusions that can be made about the original items. Methods Data were collected from 79 participants (heterogeneous in age and sex) with a high risk of metabolic syndrome working in a financial company based in Tokyo. The lifestyle questionnaire was constructed by combining items (asked with daily, weekly, and monthly frequency) from multiple validated questionnaires and other selected questions. Item reduction was conducted using VIF and exploratory FA. Adequacy tests were used to check the data distribution and sampling adequacy. Results Among the daily and weekly questions, both VIF and FA identified redundancies in sleep-related items. Among the monthly questions, both approaches identified redundancies in stress-related items. However, the number of items suggested for reduction often differed: VIF suggested larger reductions than FA for daily questions but fewer reductions for weekly questions. Adequacy tests always confirmed that the structural detection was adequate for the considered items. Conclusions As expected, our analyses showed that VIF and FA produced both similar and different findings, suggesting that questionnaire designers should consider using multiple methods for item reduction. Our findings using both methods indicate that many questions, especially those related to sleep, are redundant, indicating that the considered lifestyle questionnaire can be shortened.
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Affiliation(s)
- Alessio Staffini
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Economics and Finance, Catholic University of Milan, Milan, Italy.,Data Solutions Division, Project Promotion Department, Albert Inc, Tokyo, Japan
| | - Kento Fujita
- Data Service Infrastructure Development Department, Service Infrastructure Division, IT-OT Innovation Division, Mobile Technology Unit, SoftBank Corp, Tokyo, Japan
| | - Akiko Kishi Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Diabetes and Metabolic Diseases, The University of Tokyo, Tokyo, Japan
| | - Ung-Il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan.,Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
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Burlingame GM, Alldredge CT, Arnold RA. Alliance Rupture Detection and Repair in Group Therapy: Using the Group Questionnaire--GQ. Int J Group Psychother 2021; 71:338-370. [PMID: 38449232 DOI: 10.1080/00207284.2020.1844010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The identification of relationship ruptures in group therapy coupled with repair efforts by the group leader are addressed from a measurement-based care (MBC) perspective. Several MBC systems are now recognized as evidence-based treatments, and these systems typically use self-report assessment of both outcome and relationship measures. After laying a brief foundation of alliance rupture and repair from an individual therapy perspective, the complexity of applying alliance and repair across the multiple therapeutic relationships and constructs found in the group treatment literature is considered. The Group Questionnaire (GQ) is an empirically derived measure designed to capture the multiple relationship structures (member-member, member-leader, and member-group) and constructs (alliance, cohesion, climate, and empathy) in group therapy. Similarities and differences between the GQ and alliance rupture and repair measures are considered, followed by algorithms used to identify rupture and repair in group therapy on the three GQ subscales-positive bond, positive work, and negative relationship. MBC clinical reports are used to illustrate how rupture is identified at both a group and individual member perspective along with information to support repair interventions. Finally, both clinical and empirical reasons for using the MBC approach are considered along with clinical observations.
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Giannone F, Guarnaccia C, Gullo S, Di Blasi M, Giordano C, Lo Coco G, Burlingame G. Italian adaptation of the Group Questionnaire: validity and factorial structure. RESEARCH IN PSYCHOTHERAPY (MILANO) 2020; 23:443. [PMID: 33024720 PMCID: PMC7513611 DOI: 10.4081/ripppo.2020.443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/21/2020] [Indexed: 11/22/2022]
Abstract
The Group Questionnaire (GQ) is a measure recently developed by Krogel et al. (2013) for the evaluation of the therapeutic relationship in group. The GQ identifies a three-factor model of the relationship that allows to measure quality (Positive Bonding, Positive Working and Negative Relationship) and structure (member-member, member-leader and member-group), dimensions in group. This work shows the results of a first study on the Italian validation of the GQ. In this study the GQ was administered to 536 subjects from 32 non-clinical groups of undergraduate students. The cross-cultural validity of the GQ in the Italian population has been examined by comparing the psychometric properties and equivalence in factor structure and scores of the Italian GQ with the original American version. Multilevel confirmatory factor analysis was used to examine both the between- and within-group structures. Data concerning reliability and validity of GQ and the results for different SEM in Multilevel CFA confirm the three factors structure of the GQ. Data from the Italian population have a good fit with the original proposed model. Finally, we discuss the importance of an instrument like GQ, short but consistent, for the evaluation of the therapeutic relationship in clinical and training group.
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Affiliation(s)
- Francesca Giannone
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Cinzia Guarnaccia
- Université Rennes 2, LP3C, Laboratoire de Psychologie: Cognition, Comportement, Communication, Rennes, France
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Maria Di Blasi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Cecilia Giordano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Gary Burlingame
- Department of Psychology, Brigham Young University, Provo, USA
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Coco GL, Tasca GA, Hewitt PL, Mikail SF, Kivlighan DM. Ruptures and repairs of group therapy alliance. An untold story in psychotherapy research. RESEARCH IN PSYCHOTHERAPY (MILANO) 2019; 22:352. [PMID: 32913782 PMCID: PMC7451388 DOI: 10.4081/ripppo.2019.352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/02/2019] [Indexed: 11/23/2022]
Abstract
Although previous studies investigated the characteristics of therapeutic alliance in group treatments, there is still a dearth of research on group alliance ruptures and repairs. The model by Safran and Muran was originally developed to address therapeutic alliance in individual therapies, and the usefulness of this approach to group intervention needs to be demonstrated. Alliance ruptures are possible at member to therapist, member to member, member to group levels. Moreover, repairs of ruptures in group are quite complex, i.e., because other group members have to process the rupture even if not directly involved. The aim of the current study is to review the empirical research on group alliance, and to examine whether the rupture repair model can be a suitable framework for clinical understanding and research of the complexity of therapeutic alliance in group treatments. We provide clinical vignettes and commentary to illustrate theoretical and research aspects of therapeutic alliance rupture and repair in groups. Our colleague Jeremy Safran made a substantial contribution to research on therapeutic alliance, and the current paper illustrates the enduring legacy of this work and its potential application to the group therapy context.
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Affiliation(s)
- Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy
| | | | - Paul L. Hewitt
- Department of Psychology, University of British Columbia, Canada
| | | | - Dennis M. Kivlighan
- Department of Counseling, Higher Education and Special Education, University of Maryland, USA
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