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Quigley KM, Kwon R, Nelson CA, Bosquet Enlow M. Caregiving stress and maternal mental health during the COVID-19 pandemic. FAMILY PROCESS 2024. [PMID: 38978327 DOI: 10.1111/famp.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 04/17/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
It has now been extensively documented that parental mental health has deteriorated since the beginning of the COVID-19 pandemic. Although pandemic-related stress has been widespread, parents faced the unique challenge of navigating remote schooling. Parental oversight of children's education, loss of access to school supportive resources, and the challenges of remote learning may have been most problematic for parents of children with or at elevated risk for mental health difficulties. In the current study, we examined interactive effects of parent-reported pandemic-related caregiving stress and child internalizing and externalizing problems on parental depressive symptoms in a community-based cohort (N = 115) in the Northeast of the United States. Results indicated that parents experiencing higher levels of pandemic-related caregiving stress whose children exhibited elevated externalizing behaviors reported heightened levels of depressive symptoms. Greater child internalizing problems were associated with higher parental depressive symptoms independent of caregiving stress. These findings point to conditions that might heighten risk for parent mental health challenges in the context of ongoing remote or hybrid learning and pandemic-associated restrictions. Further, the findings point to conditions and characteristics that may be screened to identify and intervene with vulnerable families to mitigate mental health problems.
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Affiliation(s)
- Kelsey M Quigley
- Harvard University, Cambridge, Massachusetts, USA
- Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel Kwon
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - Charles A Nelson
- Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Michelle Bosquet Enlow
- Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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2
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Sprik PJ, Vanderstelt H, Valenti-Hein C, Denton J, Ashton D. Chaplain interventions and outcomes in outpatient settings: a scoping review. J Health Care Chaplain 2024:1-23. [PMID: 38836429 DOI: 10.1080/08854726.2024.2357042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
As chaplaincy is increasingly practiced in outpatient settings, further understanding is needed of what it entails and is accomplishing within this unique context. This scoping review summarizes 42 articles that describe the types of spiritual care interventions and programs offered by chaplains in outpatient settings, and their outcomes. Findings support that chaplaincy is practiced in outpatient settings, especially in palliative care, oncology, and primary care. Interventions are delivered by chaplains as the sole interventionist, and by interdisciplinary teams with chaplain participants. Results show that outpatient chaplain interventions are feasible and acceptable, with positive psychological and spiritual outcomes. More studies with consistent outcome measurements, and structured chaplain interventions are needed to draw further conclusions about the effectiveness of outpatient chaplain interventions.
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Affiliation(s)
- Petra J Sprik
- Department of Health Services Administration, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Heather Vanderstelt
- Department of Spiritual Care, St. Joseph's Health Care London, London, Canada
| | | | - Joseph Denton
- Spiritual Health Department, Bon Secours Mercy Health, Cincinnati, OH, USA
| | - Deadra Ashton
- Department of Spiritual Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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3
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Holtrop K, Piehler TF, Miller D, Young D, Tseng CF, Gray LJ. The Effectiveness of GenerationPMTO During Sustained Implementation in the Public Mental Health System: A Single-Arm Open Trial Evaluation. Behav Ther 2024; 55:248-262. [PMID: 38418038 DOI: 10.1016/j.beth.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/05/2023] [Accepted: 06/27/2023] [Indexed: 03/01/2024]
Abstract
To support families and reduce the burden of child mental, emotional, and behavioral problems, evidence-based parenting interventions must remain effective in real-world service delivery contexts. The purpose of the current study was to evaluate the effectiveness of the GenerationPMTO (GenPMTO) intervention during sustained implementation in the Michigan public mental health system using a single-arm open trial (pre-post) design. We also examined potential predictors of treatment response. A multilevel analysis framework was utilized to evaluate data from 365 caregivers who completed GenPMTO treatment. Results revealed significant positive improvements from pretest to posttest in all four outcome domains (i.e., parenting confidence, parenting practices, caregiver depressive symptoms, child behavior problems). When compared to group-based GenPMTO delivery, the individual delivery format was associated with significantly greater improvements in overall effective parenting practices, as well as in the subdomain of skill encouragement. Caregiver gender, caregiver educational level, and child age were all implicated as predictors of GenPMTO outcomes. These findings add to the literature by supporting the effectiveness of the GenPMTO intervention when fully integrated into mental health care practice and can inform continued efforts to provide families with evidence-based services in community settings.
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4
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Gee DG, Shackman AJ. Reforming clinical psychological science training: The importance of collaborative decision-making with trainees. Clin Psychol Sci 2024; 12:175-179. [PMID: 38550306 PMCID: PMC10977727 DOI: 10.1177/21677026221129820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
To effectively address the staggering burden of mental illness, clinical psychological science will need to face some uncomfortable truths about current training practices. In a commentary authored by 23 current or recent trainees, Palitsky and colleagues highlight a number of urgent challenges facing today's clinical interns. They provide a thoughtful framework for reform, with specific recommendations and guiding questions for a broad spectrum of stakeholders. Key suggestions are applicable to the entire sequence of clinical training. While there is cause for cautious optimism, overcoming these systemic barriers will require a coordinated, all-hands approach and a more collaborative approach to policy-making.
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Affiliation(s)
| | - Alexander J Shackman
- Department of Psychology, Neuroscience and Cognitive Science Program, and Maryland Neuroimaging Center, University of Maryland
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5
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Buckner JD, Morris PE, Threeton EM, Zvolensky MJ. Cannabis and Nicotine Dual Use among Sexual Minority Individuals: Relations to Cannabis Use and Negative Affect. Subst Use Misuse 2023; 58:1813-1817. [PMID: 37622481 PMCID: PMC10786340 DOI: 10.1080/10826084.2023.2250427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Background: Sexual minority individuals report significantly more cannabis use and use-related problems than their heterosexual peers, and emerging data indicate sexual minority individuals who use cannabis are at greater risk for dual use of nicotine products (combustible smoking, e-cigarette use) than heterosexual individuals. Although cannabis-nicotine dual use is related to worse cannabis outcomes and negative affect, little work has identified factors related to dual use among sexual minority individuals or tested if sexual orientation-based discrimination (microaggressions, overt discrimination) is related to dual use. Objectives: The current study tested if cannabis-nicotine dual use is related to more frequent cannabis use, more cannabis-related problems, negative affect, and discrimination among sexual minority undergraduate students who endorsed current (past three-month) cannabis use (N = 328), 43.6% of whom endorsed dual nicotine use. Cannabis-nicotine dual use was related to more frequent cannabis use, more cannabis-related problems, more anxiety (but not depression), and more sexual orientation-based microaggressions and microaggressions-related negative affect (but not overt discrimination or non-sexual orientation-based daily stressors). Conclusions/Importance: Overall, this is the first known study to identify that sexual orientation-based discrimination is related to cannabis-nicotine dual use and that dual use is related to more frequent cannabis use, use-related problems, and negative affect (especially anxiety) among this underrepresented group.
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Affiliation(s)
- Julia D. Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E. Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Evan M. Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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6
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Almeida J. Underfunding Basic Psychological Science Because of the Primacy of the Here and Now: A Scientific Conundrum. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:527-530. [PMID: 36068007 PMCID: PMC10018049 DOI: 10.1177/17456916221105213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The psychological sciences are suffering from the primacy of the "here and now" and from a radical utilitarian view of science-this is certainly true in less affluent countries around the world. Portugal is a particular case study, as both psychology departments and funding agencies are largely biased toward applied psychology-but this is a more global trend. The field needs to find a balance between applied and basic psychology to better respond to the challenges of tomorrow.
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Affiliation(s)
- Jorge Almeida
- Proaction Lab, Faculty of Psychology
and Educational Sciences, University of Coimbra
- CINEICC, Faculty of Psychology and
Educational Sciences, University of Coimbra
- Jorge Almeida, Proaction Lab, Faculty of
Psychology and Educational Sciences, University of Coimbra
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7
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Kwon N, Stewart RE, Wang X, Marzalik JS, Bufka LF, Halfond RW, Purtle J. Where do psychologists turn to inform clinical decisions? Audience segmentation to guide dissemination strategies. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231185376. [PMID: 37790187 PMCID: PMC10331216 DOI: 10.1177/26334895231185376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background Audience segmentation is an analysis technique that can identify meaningful subgroups within a population to inform the tailoring of dissemination strategies. We have conducted an empirical clustering audience segmentation study of licensed psychologists using survey data about the sources of knowledge they report most often consulting to guide their clinical decision-making. We identify meaningful subgroups within the population and inform the tailoring of dissemination strategies for evidence-based practice (EBP) materials. Method Data come from a 2018-2019 web-based survey of licensed psychologists who were members of the American Psychological Association (APA; N = 518, response rate = 29.8%). Ten dichotomous variables assessed sources that psychologists regularly consult to inform clinical decision-making (e.g., colleagues, academic literature, and practice guidelines). We used latent class analysis to identify segments of psychologists who turn to similar sources and named each segment based on the segment's most salient characteristics. Results Four audience segments were identified: the No-guidelines (45% of psychologists), Research-driven (16%), Thirsty-for-knowledge (9%), and No-reviews (30%). The four segments differed not only in their preferred sources of knowledge, but also in the types of evidence-based posttraumatic stress disorder (PTSD) treatments they provide, their awareness and usage intention of the APA PTSD clinical practice guideline, and attitudes toward clinical practice guidelines. Conclusion The results demonstrate that licensed psychologists are heterogeneous in terms of their knowledge-seeking behaviors and preferences for knowledge sources. The distinctive characteristics of these segments could guide the tailoring of dissemination materials and strategies to subsequently enhance the implementation of EBP among psychologists.
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Affiliation(s)
- Nayoung Kwon
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Rebecca E. Stewart
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Xi Wang
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jacob S. Marzalik
- Office of Practice Transformation and Quality, Practice Directorate, American Psychological Association, Washington, DC, USA
| | - Lynn F. Bufka
- Office of Practice Transformation and Quality, Practice Directorate, American Psychological Association, Washington, DC, USA
| | - Raquel W. Halfond
- Office of Practice Transformation and Quality, Practice Directorate, American Psychological Association, Washington, DC, USA
| | - Jonathan Purtle
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA
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8
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Associations of decayed teeth and localized periodontitis with mental stress in young adults: CHIEF oral health study. Sci Rep 2022; 12:19139. [PMID: 36352004 PMCID: PMC9646768 DOI: 10.1038/s41598-022-23958-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022] Open
Abstract
The associations of mental stress with decayed teeth in children and periodontitis in old-aged adults have been described. However, the associations for young adults were not clear. This study aimed to examine the associations of decayed teeth and localized periodontitis with mental stress in young adults. This study included 334 military recruiters, aged 19-45 years in Taiwan. Mental stress was assessed by the brief symptom rating scale-5 (BSRS-5), including five domains: anxiety, depression, hostility, interpersonal sensitivity and insomnia (maximum score of 20). Those with symptomatic mental stress were defined as having BSRS-5 > 5 (n = 34). Multiple linear and logistic regression models were used to determine the associations of decayed tooth numbers and periodontitis with BSRS-5, with adjustments for age, sex, education level, physical activity, body weight category and smoking status. The BSRS-5 was positively correlated with decayed tooth numbers [β: 0.26 (95% confidence interval: 0.01-0.52)]. Those who had more than two decayed teeth [odds ratio: 3.59 (1.52-8.46)] had a higher risk of symptomatic mental stress. In contrast, the correlation between BSRS-5 and localized severer periodontitis was null. Our study recommended that decayed teeth instead of localized periodontitis, was a risk factor for mental stress in young adults.
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9
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Goldberg SB. A common factors perspective on mindfulness-based interventions. NATURE REVIEWS PSYCHOLOGY 2022; 1:605-619. [PMID: 36339348 PMCID: PMC9635456 DOI: 10.1038/s44159-022-00090-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 05/25/2023]
Abstract
Mindfulness-based interventions (MBIs) have entered mainstream Western culture in the past four decades. There are now dozens of MBIs with varying degrees of empirical support and a variety of mindfulness-specific psychological mechanisms have been proposed to account for the beneficial effects of MBIs. Although it has long been acknowledged that non-specific or common factors might contribute to MBI efficacy, relatively little empirical work has directly investigated these aspects. In this Perspective, I suggest that situating MBIs within the broader psychotherapy research literature and emphasizing the commonalities rather than differences between MBIs and other treatments might help guide future MBI research. To that end, I summarize the evidence for MBI efficacy and several MBI-specific psychological mechanisms, contextualize MBI findings within the broader psychotherapy literature from a common factors perspective, and propose suggestions for future research based on innovations and challenges occurring within psychotherapy research.
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Affiliation(s)
- Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
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10
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Li QKW, Wollny K, Twilt M, Walsh CM, Bright K, Dimitropoulos G, Pires L, Pritchard L, Samuel S, Tomfohr-Madsen L. Curricula, Teaching Methods, and Success Metrics of Clinician-Scientist Training Programs: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1403-1412. [PMID: 36098782 DOI: 10.1097/acm.0000000000004764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To describe the literature on clinician-scientist training programs to inform the development of contemporary and inclusive training models. METHOD The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician-scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics. RESULTS From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician-scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment). CONCLUSIONS Although programs are providing clinician-scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician-scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.
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Affiliation(s)
- Queenie K W Li
- Q.K.W. Li is a clinical research coordinator, Department of Psychology, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-7318-1701
| | - Krista Wollny
- K. Wollny is instructor, Faculty of Nursing, University of Calgary, and at the time of writing was a PhD candidate, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, and trainee, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Marinka Twilt
- M. Twilt is a pediatric rheumatologist and associate professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Catharine M Walsh
- C.M. Walsh is staff gastroenterologist, Division of Gastroenterology, Hepatology, and Nutrition, an educational researcher, SickKids Learning Institute, a scientist, Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children (SickKids), a cross-appointed scientist, Wilson Centre for Research in Education, and associate professor of paediatrics, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-3928-703X
| | - Katherine Bright
- K. Bright is Health System Impact Postdoctoral Fellow, Canadian Institutes for Health Research, Addictions and Mental Health Strategic Clinical Network, Alberta Health Services and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Gina Dimitropoulos
- G. Dimitropoulos is a social worker and associate professor, Faculty of Social Work and Department of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-9487-0290
| | - Linda Pires
- L. Pires is research operations manager, Canadian Child Health Clinician Scientist Program, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Lesley Pritchard
- L. Pritchard is pediatric physical therapist and associate professor, Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada; ORCID: https://orcid.org/0000-0002-6684-376X
| | - Susan Samuel
- S. Samuel is pediatric nephrologist and professor, Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- L. Tomfohr-Madsen is a clinical psychologist and associate professor, Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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11
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López-Pinar C, Vicente-Gispert A. Online Cognitive Behavior Therapy for Two College Students With Attention-Deficit/Hyperactivity Disorder. Clin Case Stud 2022. [DOI: 10.1177/15346501221090267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder among college students. Although there is growing literature supporting the effectiveness of cognitive behavioral therapy (CBT) for this population, no previous study has investigated the feasibility of it being delivered online. In addition, recent evidence suggests that online therapy could be possible for other diagnoses such as depression, anxiety, or health-related disorders. Therefore, research in this area could be critical, as online settings could also improve accessibility to evidence-based interventions for college students with ADHD. This study describes the implementation of CBT for ADHD intervention delivered online for two college students with this diagnosis. We found improvements in both self-reported and clinician-assessed outcomes, in measuring ADHD-related behaviors, executive functioning, emotional comorbidities, and quality of life. These changes were more evident in the case that was more severe at pre-treatment, and were maintained at a 6-month follow-up; even further improvements in self-reported quality of life were observed. These findings support the potential feasibility and clinical utility of online CBT in this population.
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Affiliation(s)
- Carlos López-Pinar
- School of Psychology, University of Valencia, Valencia, Spain
- European University of Valencia, Valencia, Spain
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12
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Gee DG, DeYoung KA, McLaughlin KA, Tillman RM, Barch DM, Forbes EE, Krueger RF, Strauman TJ, Weierich MR, Shackman AJ. Training the Next Generation of Clinical Psychological Scientists: A Data-Driven Call to Action. Annu Rev Clin Psychol 2022; 18:43-70. [PMID: 35216523 PMCID: PMC9086080 DOI: 10.1146/annurev-clinpsy-081219-092500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The central goal of clinical psychology is to reduce the suffering caused by mental health conditions. Anxiety, mood, psychosis, substance use, personality, and other mental disorders impose an immense burden on global public health and the economy. Tackling this burden will require the development and dissemination of intervention strategies that are more effective, sustainable, and equitable. Clinical psychology is uniquely poised to serve as a transdisciplinary hub for this work. But rising to this challengerequires an honest reckoning with the strengths and weaknesses of current training practices. Building on new data, we identify the most important challenges to training the next generation of clinical scientists. We provide specific recommendations for the full spectrum of stakeholders-from funders, accreditors, and universities to program directors, faculty, and students-with an emphasis on sustainable solutions that promote scientific rigor and discovery and enhance the mental health of clinical scientists and the public alike.
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Affiliation(s)
- Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA;
| | - Kathryn A DeYoung
- Department of Psychology, Neuroscience and Cognitive Science Program, and Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Rachael M Tillman
- Department of Psychology, Neuroscience and Cognitive Science Program, and Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Erika E Forbes
- Departments of Psychiatry, Psychology, and Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Timothy J Strauman
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | | | - Alexander J Shackman
- Department of Psychology, Neuroscience and Cognitive Science Program, and Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, USA
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13
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Hartmann WE, Saint Arnault DM, Gone JP. Conceptualizing culture in (global) mental health: Lessons from an urban American Indian behavioral health clinic. Soc Sci Med 2022; 301:114899. [PMID: 35313219 DOI: 10.1016/j.socscimed.2022.114899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/24/2022] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
The movement for global mental health (GMH) has brought perennial questions about human diversity in mental health to the fore through heightened debates over if and how established knowledge, institutions, and practices should be altered for ethical and effective interventions with diverse peoples around the world. Kirmayer and Pedersen (2014) encouraged dialogue between GMH scholars and communities considered for intervention to address differences and concerns about colonialism. American Indian mental health offers an instructive site for global mental health inquiry to understand frameworks that might facilitate this desired dialogue. Here, we draw from a clinical ethnography in urban American Indian behavioral health conducted between September 2014 and February 2015 to glean insights into a popular response to these differences: Incorporating Indigenous cultural forms into clinical practice. Our findings highlight a predicament this response presents to mental health professionals. They can either eschew their clinical training and its cultural assumptions to take up new lives enabling their representation of Indigenous cultural forms, or they can hold onto their professional training and modify what is clinically familiar to appear culturally different. Rather than a purposeful decision, in the clinic contextual factors-tacit assumptions, clinic structures, and popular culture concepts-powerfully shaped clinical practice and reconfigured Indigenous cultural forms to support familiar clinical processes (e.g., treatment-planning). Although potentially therapeutic, culturally repackaged mental health practices are not the therapeutic alternatives called for by many Indigenous communities, and when advertised as such, risk harmful appropriations and misleading reticent people into participating in culturally prescriptive interventions. Lessons for global mental health point away from incorporating Indigenous cultural forms into clinical practice, which is likely to result in cultural repackaging, toward ethnographically-informed dialogue of differences to inform models for medical and epistemic pluralism providing interested communities more culturally commensurate mental health services alongside well-supported Indigenous therapeutic alternatives.
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Affiliation(s)
- William E Hartmann
- School of Interdisciplinary Arts and Sciences, University of Washington, Bothell, WA, USA.
| | | | - Joseph P Gone
- Department of Anthropology, Harvard University, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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14
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Haeffel GJ, Jeronimus BF, Fisher AJ, Kaiser BN, Weaver LJ, Vargas I, Goodson JT, Soyster PD, Lu W. The Hierarchical Taxonomy of Psychopathology (HiTOP) Is Not an Improvement Over the DSM. Clin Psychol Sci 2022; 10:285-290. [PMID: 36299281 PMCID: PMC9596130 DOI: 10.1177/21677026211068873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
In their response to our article (both in this issue), DeYoung and colleagues did not sufficiently address three fundamental flaws with the Hierarchical Taxonomy of Psychopathology (HiTOP). First, HiTOP was created using a simple-structure factor-analytic approach, which does not adequately represent the dimensional space of the symptoms of psychopathology. Consequently, HiTOP is not the empirical structure of psychopathology. Second, factor analysis and dimensional ratings do not fix the problems inherent to descriptive (folk) classification; self-reported symptoms are still the basis on which clinical judgments about people are made. Finally, HiTOP is not ready to use in real-world clinical settings. There is currently no empirical evidence demonstrating that clinicians who use HiTOP have better clinical outcomes than those who use the Diagnostic and Statistical Manual of Mental Disorders (DSM). In sum, HiTOP is a factor-analytic variation of the DSM that does not get the field closer to a more valid and useful taxonomy.
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Affiliation(s)
| | | | - Aaron J. Fisher
- Department of Psychology, University of California, Berkeley
| | - Bonnie N. Kaiser
- Department of Anthropology and Global Health Program, University of California, San Diego
| | | | - Ivan Vargas
- Department of Psychology, University of Arkansas
| | - Jason T. Goodson
- PTSD Clinical Team, VA Salt Lake City Health Care Systems, Salt Lake City, Utah
| | | | - Wei Lu
- Carver School of Medicine, University of Iowa Hospitals and Clinics
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16
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Simon N, Ploszajski M, Lewis C, Smallman K, Roberts NP, Kitchiner NJ, Brookes-Howell L, Bisson JI. Internet-based psychological therapies: A qualitative study of National Health Service commissioners and managers views. Psychol Psychother 2021; 94:994-1014. [PMID: 33788999 DOI: 10.1111/papt.12341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/11/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To explore in-depth the views on Internet-based psychological therapies and their implementation from the perspective of National Health Service (NHS) commissioners and managers. DESIGN Qualitative interview study. METHOD Ten NHS commissioners and managers participated in a semi-structured, co-produced interview. Each transcribed interview was double-coded and thematically analysed using The Framework Method. RESULTS Interviews generated three main themes. (1) Capacity issues across psychological therapy services create barriers to face-to-face therapies, and Internet-based interventions offer a solution. (2) Despite reservations, there is growing acceptance of Internet-based therapies. Different ways of connecting with patients are required, and Internet-based treatments are accessible and empowering treatment options, with guided self-help (GSH) preferred. Internet-based interventions may however exclude some individuals and be a threat to the therapeutic relationship between patient and practitioner. (3) Successful roll-out of Internet-based interventions would be facilitated by a strong empirical- or practice-based evidence, a national coordinated approach and timely training and supervision. Barriers to the roll-out include digital intervention set-up costs and delays due to NHS inflexibility. CONCLUSIONS The study highlights factors influencing access to Internet-based therapies, important given the rapid evolution of e-therapies, and particularly timely given increasing use of remote therapies due to COVID-19 restrictions. Interviewees were open to Internet-based approaches, particularly GSH interventions, so long as they do not compromise on therapy quality. Interviewees acknowledged implementation may be challenging, and recommendations were offered. PRACTITIONER POINTS There is a shift in practice and increasingly positive views from NHS staff around remote psychological therapies and different ways of connecting with patients, particularly since the COVID-19 pandemic. There is a strong preference for Internet-based psychological interventions that are guided and that include built-in outcome measures co-produced with service users. There is a need to raise awareness of the growing evidence base for Internet-based psychological therapies, including research examining therapeutic alliance across Internet-based and face-to-face therapies. Challenges implementing Internet-based psychological therapies include therapist resistance to changing working practices in general, and inflexibility of the NHS, and national, coordinated implementation efforts are encouraged.
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Affiliation(s)
- Natalie Simon
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK
| | - Matt Ploszajski
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK
| | - Catrin Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK
| | - Kim Smallman
- Centre for Trials Research, Cardiff University School of Medicine, Wales, UK
| | - Neil P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK.,Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Wales, UK
| | - Neil J Kitchiner
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK.,Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Wales, UK
| | - Lucy Brookes-Howell
- Centre for Trials Research, Cardiff University School of Medicine, Wales, UK
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Wales, UK
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Stewart RE, Mandell DS, Beidas RS. Lessons From Maslow: Prioritizing Funding to Improve the Quality of Community Mental Health and Substance Use Services. Psychiatr Serv 2021; 72:1219-1221. [PMID: 33853379 PMCID: PMC8928566 DOI: 10.1176/appi.ps.202000209] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Evidence-based practices (EBPs) are frequently proposed as an approach to close the quality chasm in behavioral health treatment, and many U.S. municipalities are investing in EBPs as a primary way to improve the quality of care delivered to individuals most in need. In this Open Forum, the authors argue that EBPs often cannot be successfully implemented because basic organizational needs are not met in the current fiscal environment. The authors summarize research that supports why EBPs, along with other approaches to improve quality, are likely to fail until there is adequate financing. They also propose a policy and research agenda to ameliorate and address the fiscal challenges inherent in community mental health and substance use services.
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Affiliation(s)
- Rebecca E Stewart
- Department of Psychiatry, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (all authors); Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - David S Mandell
- Department of Psychiatry, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (all authors); Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Rinad S Beidas
- Department of Psychiatry, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (all authors); Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
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18
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Bakker GM. Psychotherapy outcome research: Implications of a new clinical taxonomy. Clin Psychol Psychother 2021; 29:178-199. [PMID: 34180112 DOI: 10.1002/cpp.2638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/11/2022]
Abstract
Since the publication of DSM-III in 1980, the scientist-practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis-testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory-derived conception or operational definition of 'CPPs', standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation-based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self-sustaining problem-maintaining circles (PMCs) of psychological-level causal elements-that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence-based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment-worthy CPPs, not just diagnosable mental disorders; to assess theory-derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented "evidence supported therapies."
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Affiliation(s)
- Gary M Bakker
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
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19
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Wakefield S, Kellett S, Simmonds‐Buckley M, Stockton D, Bradbury A, Delgadillo J. Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta‐analysis of 10‐years of practice‐based evidence. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 60:1-37. [DOI: 10.1111/bjc.12259] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 05/14/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Sarah Wakefield
- Clinical Psychology Unit Department of Psychology University of Sheffield UK
| | - Stephen Kellett
- University of Sheffield and Sheffield Health and Social Care NHS Foundation Trust UK
| | | | | | - Abigail Bradbury
- Clinical Psychology Unit Department of Psychology University of Sheffield UK
| | - Jaime Delgadillo
- Clinical Psychology Unit Department of Psychology University of Sheffield UK
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20
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Krishnamurthy R, Golriz F, Toole BJ, Qureshi AM, Crystal MA. Comparison of computed tomography angiography versus cardiac catheterization for preoperative evaluation of major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect. Ann Pediatr Cardiol 2020; 13:117-122. [PMID: 32641882 PMCID: PMC7331845 DOI: 10.4103/apc.apc_94_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/05/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Pulmonary atresia with the ventricular septal defect is a rare congenital heart defect with high anatomic variability. The most important management question relates to the sources of pulmonary blood flow. The ability to differentiate between ductal dependence and major aortopulmonary collateral arteries is critical to achieving good outcomes and avoiding life-threatening hypoxia in the postneonatal period. Having accurate information about pulmonary arteries, major aortopulmonary collateral arteries, and sources of blood supply to each pulmonary segment is crucial for choosing the optimal surgical strategy. The purpose of this study is to compare computed tomography angiography (CTA) with cardiac catheterization for anatomic delineation of surgically relevant anatomy in pulmonary atresia with ventricular septal defect with major aortopulmonary collateral arteries. Materials and Methods: Retrospective review of all children with pulmonary atresia with ventricular septal defect with major aortopulmonary collateral arteries cared for at a large tertiary children's hospital who underwent cardiac catheterization with angiography and CTA close to each other without interval therapy. All studies were performed between 2007 and 2011. Results: There were 9 patients who met the inclusion criteria. Pulmonary artery anatomy (confluent vs. nonconfluent) was correctly identified in 9 patients by CTA and 8 patients by catheterization. There were no significant differences between CTA and catheterization in the identification of major aortopulmonary collateral arteries (mean = 3.4 collaterals/study via catheterization; mean = 3.1 collaterals/study via CTA; P = 0.67). CTA was superior to catheterization in the delineation of segmental pulmonary blood flow (P = 0.006). Conclusion: CTA and catheterization are equivalent in their ability to delineate pulmonary artery anatomy and major aortopulmonary collateral arteries.
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Affiliation(s)
| | - Farahnaz Golriz
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | | | - Athar M Qureshi
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Matthew A Crystal
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
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21
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McAndrew LM, Friedlander ML, Litke D, Phillips LA, Kimber J, Helmer DA. Medically Unexplained Physical Symptoms: What They Are and Why Counseling Psychologists Should Care about Them. COUNSELING PSYCHOLOGIST 2019; 47:741-769. [PMID: 32015568 PMCID: PMC6996203 DOI: 10.1177/0011000019888874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Medically unexplained symptoms and syndromes (MUS) affect the health of 20%-30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. By developing an expertise in MUS, counseling psychologists can improve the care of patients with MUS who are already in their practice, expand the number of patients they help, and enhance the integration of counseling psychology into the broader medical community. Additionally, counseling psychologists' expertise in culture, attunement to therapeutic processes, and our focus on prioritizing patients' perspectives and quality of life can fill the gap in research on MUS and bringing increased attention to counseling psychologists' unique contributions to health service delivery.
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Affiliation(s)
- Lisa M McAndrew
- Veterans Affairs New Jersey Health Care System University at Albany
| | | | - David Litke
- Veterans Affairs New Jersey Health Care System
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22
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Dubovská E, Furstová J, Růžička J, Tavel P. Validity of the Czech Version of the Therapeutic Factors Inventory - Short Form (TFI-S). Int J Group Psychother 2019; 69:308-327. [PMID: 38449202 DOI: 10.1080/00207284.2019.1584527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study's aim was to assess validity of the Czech translation of the Therapeutic Factors Inventory (TFI-S), which includes four factors: Instillation of Hope, Secure Emotional Expression, Awareness of Emotional Impact, and Social Learning. We assessed data from 220 patients who attended a daily three-month treatment program that used integrative group psychotherapy. TFI-S's reliability was satisfactory: at week 12, Cronbach's α was .93 and McDonald's ω was .95. Confirmatory factor analysis showed acceptable fit to our data: at week 12, χ2(146) = 262.5, p < 0.001, CFI = .994, TLI = .992, RMSEA = .071 (90% CI = .057-.084), and SRMR = .063. Predictive validity showed significant correlations between TFI-S factors and pre/post-treatment change. In the conclusion, we discuss possible future potential of cross-cultural research.
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23
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Asnaani A, Gallagher T, Foa EB. Evidence‐based protocols: Merits, drawbacks, and potential solutions. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Dodier O, Tomas F. When psychological science fails to be heard: the lack of evidence-based arguments in a ministerial report on child sexual abuse. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2018; 26:385-395. [PMID: 31984084 PMCID: PMC6763119 DOI: 10.1080/13218719.2018.1506716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
One of the most debated issues in relation to child sexual abuse (CSA) is whether there should be a limitation period for prosecutions. In 2017 a French ministerial report was released proposing extension of the limitation period in part because of the sometimes long delay between the alleged events and the disclosure of the abuse. For this, the report relied on dissociative amnesia. It also advocated for the development of child victim interview protocols by victim associations. We show that dissociative amnesia is not consensual within the scientific community. Instead, we recommend scientifically reliable cognitive principles to explain the lack of memory. Moreover, interviewing techniques for children have already been designed by memory researchers to enhance recall and report of CSA, from which any uncontrolled deviation might put the child's testimony at risk. We conclude by advocating for the use of evidence-based psychology, and for co-operation between practitioners, judges and researchers.
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Affiliation(s)
- Olivier Dodier
- Department of Psychology, Université Clermont
Auvergne, Clermont-Ferrand, France
- CLLE-LTC Laboratory, Université Toulouse Jean
Jaurès, Toulouse, France
| | - Frédéric Tomas
- Department of Psychology, Université Paris
8, Saint-Denis, France
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26
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Gnaulati E. Overlooked Ethical Problems Associated With the Research and Practice of Evidence-Based Treatments. JOURNAL OF HUMANISTIC PSYCHOLOGY 2018. [DOI: 10.1177/0022167818800219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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McLeod BD, Cox JR, Jensen-Doss A, Herschell A, Ehrenreich-May J, Wood JJ. Proposing a Mechanistic Model of Clinician Training and Consultation. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018; 25:e12260. [PMID: 30713369 PMCID: PMC6353552 DOI: 10.1111/cpsp.12260] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To make evidence-based treatments deliverable, effective, and scalable in community settings, it is critical to develop a workforce that can deliver evidence-based treatments as designed with skill. However, the science and practice of clinician training and consultation lags behind other areas of implementation science. In this paper, we present the Longitudinal Education for Advancing Practice (LEAP) model designed to help span this gap. The LEAP model is a mechanistic model of clinician training and consultation that details how training inputs, training and consultation strategies, and mechanisms of learning influence training outcomes. We first describe the LEAP model and then discuss how key implications of the model can be used to develop effective training and consultation strategies.
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Affiliation(s)
- Bryce D McLeod
- Virginia Commonwealth University, Department of Psychology
| | - Julia R Cox
- Virginia Commonwealth University, Department of Psychology
| | | | | | | | - Jeffrey J Wood
- Departments of Education and Psychiatry, University of California
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28
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Shedler J. Dove sono le evidenze della terapia "basata sulle evidenze"? PSICOTERAPIA E SCIENZE UMANE 2018. [DOI: 10.3280/pu2018-003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
The term evidence-based therapy is a de facto code word for manualized therapy, most often brief cognitive behavior therapy and its variants. It is widely asserted that "evidence-based" therapy is scientifically proven, superior to other forms of psychotherapy, and the gold standard of care. Research findings do not support such assertions. Research on evidence-based therapies demonstrates that they are weak treatments. They have not shown superiority to other forms of psychotherapy, few patients get well, and treatment benefits do not last. Questionable research practices create a distorted picture of the actual benefits of these therapies.
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Affiliation(s)
- Jonathan Shedler
- Department of Psychiatry, University of Colorado School of Medicine, Denver, CO 80045, USA.
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30
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Stanovich KE. How to Think Rationally about World Problems. J Intell 2018; 6:jintelligence6020025. [PMID: 31162452 PMCID: PMC6480740 DOI: 10.3390/jintelligence6020025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/11/2018] [Accepted: 04/18/2018] [Indexed: 12/02/2022] Open
Abstract
I agree with the target essay that psychology has something to offer in helping to address societal problems. Intelligence has helped meliorate some social problems throughout history, including the period of time that is covered by the Flynn effect, but I agree with Sternberg that other psychological characteristics may be contributing as well, particularly increases in rationality. I also believe that increasing human rationality could have a variety of positive societal affects at levels somewhat smaller in grain size than the societal problems that Sternberg focuses on. Some of the societal problems that Sternberg lists, however, I do not think would be remedied by increases in rationality, intelligence, or wisdom, because remedy might be the wrong word in the context of these issues. Issues such as how much inequality of income to tolerate, how much pollution to tolerate, and how much we should sacrifice economic growth for potential future changes in global temperature represent issues of clashing values, not the inability to process information, nor the lack of information, nor the failure to show wisdom.
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Affiliation(s)
- Keith E Stanovich
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor St. West, Toronto, ON M5S 1V6, Canada.
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Abstract
Beginning with efforts in the late 1940s to ensure that clinical psychologists were adequately trained to meet the mental health needs of the veterans of World War II, the accreditation of clinical psychologists has largely been the province of the Commission on Accreditation of the American Psychological Association. However, in 2008 the Psychological Clinical Science Accreditation System began accrediting doctoral programs that adhere to the clinical science training model. This review discusses the goals of accreditation and the history of the accreditation of graduate programs in clinical psychology, and provides an overview of the evaluation procedures used by these two systems. Accreditation is viewed against the backdrop of the slow rate of progress in reducing the burden of mental illness and the changes in clinical psychology training that might help improve this situation. The review concludes with a set of five recommendations for improving accreditation.
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Affiliation(s)
- Robert W Levenson
- Department of Psychology, University of California, Berkeley, California 94131;
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32
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Stewart RE, Chambless DL, Stirman SW. Decision making and the use of evidence based practice: Is the three-legged stool balanced? ACTA ACUST UNITED AC 2018; 3:56-67. [PMID: 32219174 DOI: 10.1037/pri0000063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This article presents the results of a qualitative analysis of interviews with 25 psychologists in independent practice, with a focus on decision making with a selected patient. We endeavored to examine how clinical decision making intersected with the principles of evidence based practice (EBP) as laid out by Spring (2007). Clinicians reported that diagnostic impressions were generally formulated through unstructured assessment rather than validated instruments, and that treatment selection was based on therapists' perceptions of a treatment's match with client characteristics. Therapists viewed CBTs as appropriate for addressing symptoms but believed they needed to depart from CBT strategies to address underlying issues. Nonetheless, they often defined successes and failures in treatment in terms of symptoms. Overall, clinicians rarely mentioned utilization of research evidence for assessment or treatment selection and practice. Results are discussed within the framework of EBP.
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Gutierrez D, Fox J, Jones K, Fallon E. The Treatment Planning of Experienced Counselors: A Qualitative Examination. JOURNAL OF COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1002/jcad.12180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Daniel Gutierrez
- Department of Counseling; University of North Carolina at Charlotte
- Now at Department of School Psychology and Counselor Education; College of William and Mary
| | - Jesse Fox
- Pastoral Counseling Department; Loyola University Maryland
- Now at Department of Counselor Education; Stetson University
| | - Kendra Jones
- Department of Counseling; University of North Carolina at Charlotte
| | - Elizabeth Fallon
- Department of Counseling; University of North Carolina at Charlotte
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Van Dam NT, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, Fox KC, Field BA, Britton WB, Brefczynski-Lewis JA, Meyer DE. Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2018; 13:36-61. [PMID: 29016274 PMCID: PMC5758421 DOI: 10.1177/1745691617709589] [Citation(s) in RCA: 507] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.
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Affiliation(s)
- Nicholas T. Van Dam
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marieke K. van Vugt
- Institute of Artificial Intelligence and Cognitive Engineering, University of Groningen, The Netherlands
| | - David R. Vago
- Osher Center for Integrative Medicine, Departments of Psychiatry and Physical Medicine & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Laura Schmalzl
- College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, CA, USA
| | - Clifford D. Saron
- Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | | | - Ted Meissner
- Center for Mindfulness, University of Massachusetts Medical School, Shrewsbury, MA, USA
| | - Sara W. Lazar
- Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Catherine E. Kerr
- Department of Family Medicine, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Jolie Gorchov
- Silver School of Social Work, New York University, New York, NY, USA
| | - Kieran C.R. Fox
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Brent A. Field
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ, USA
| | - Willoughby B. Britton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Julie A. Brefczynski-Lewis
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - David E. Meyer
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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35
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Norcross JC, Sayette MA, Pomerantz AM. Doctoral training in clinical psychology across 23 years: Continuity and change. J Clin Psychol 2017; 74:385-397. [DOI: 10.1002/jclp.22517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/11/2017] [Accepted: 05/21/2017] [Indexed: 11/11/2022]
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36
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Dindo L, Van Liew JR, Arch JJ. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics 2017; 14:546-553. [PMID: 28271287 PMCID: PMC5509623 DOI: 10.1007/s13311-017-0521-3] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Psychological interventions have a long history of successful treatment of patients suffering from mental health and certain medical conditions. At the same time, psychotherapy research has revealed key areas of growth for optimizing patient care. These include identifying novel treatment delivery methods that increase treatment adherence, developing new strategies to more effectively address the ever-growing population of patients with comorbid conditions, and elucidating the mechanisms by which effective treatments work in order to further refine their design. Acceptance and commitment therapy (ACT) is an empirically supported psychotherapy that offers promise for patients suffering from a wide range of mental and physical conditions, while addressing these gaps and challenges in the field. ACT rests on the fundamental premise that pain, grief, disappointment, illness, and anxiety are inevitable features of human life, with the therapeutic goal of helping individuals productively adapt to these types of challenges by developing greater psychological flexibility rather than engaging in counterproductive attempts to eliminate or suppress undesirable experiences. This is achieved through committed pursuit of valued life areas and directions, even in the face of the natural desire to escape or avoid painful and troubling experiences, emotions, and thoughts. ACT is transdiagnostic (applies to more than one condition), process-focused, and flexibly delivered. In a relatively short period of time, ACT has been effectively implemented across a broad range of therapeutic settings, including mental health, primary care, and specialty medical clinics. ACT has also been delivered in a variety of formats, including 1-day group workshops, online and smartphone applications, and telehealth. Focus on how best to package and deliver treatment to meet the unique needs of different patient populations helps to ensure treatment adherence and has fostered successful application of ACT for patients in everyday clinical settings.
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Affiliation(s)
- Lilian Dindo
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX, 77030, USA.
| | | | - Joanna J Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Division of Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO, USA
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Contrast-Enhanced Microtomographic Characterisation of Vessels in Native Bone and Engineered Vascularised Grafts Using Ink-Gelatin Perfusion and Phosphotungstic Acid. CONTRAST MEDIA & MOLECULAR IMAGING 2017; 2017:4035160. [PMID: 29097920 PMCID: PMC5612680 DOI: 10.1155/2017/4035160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/18/2017] [Accepted: 04/02/2017] [Indexed: 11/17/2022]
Abstract
Objectives Bone ischemia and necrosis are challenging to treat, requiring investigation of native and engineered bone revascularisation processes through advanced imaging techniques. This study demonstrates an experimental two-step method for precise bone and vessel analysis in native bones or vascularised bone grafts using X-ray microtomography (μCT), without interfering with further histological processing. Methods Distally ligated epigastric arteries or veins of 6 nude rats were inserted in central channels of porous hydroxyapatite cylinders and these pedicled grafts were implanted subcutaneously. One week later, the rats were perfused with ink-gelatin and euthanised and the femurs, tibias, and grafts were explanted. Samples were scanned using μCT, decalcified, incubated with phosphotungstic acid (PTA) for contrast enhancement, rescanned, and processed histologically. Results Contrast-enhanced μCT displayed the course and branching of native bone vessels. Histologically, both central (-17%) and epiphyseal vessels (-58%) appeared smaller than in μCT scans. Hydroxyapatite cylinders were thoroughly vascularised but did not display bone formation. Grafts with a central artery had more (+58%) and smaller (-52%) vessel branches compared to grafts with a vein. Conclusions We present a relatively inexpensive and easy-to-perform two-step method to analyse bone and vessels by μCT, suitable to assess a variety of bone-regenerative strategies.
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Reese RJ, Gismero González E, Clements-Hickman AL, Clemons JM, Farook MW, Conoley CW. The psychotherapy researcher–practice relationship: Through a clinical supervision lens. COUNSELLING PSYCHOLOGY QUARTERLY 2017. [DOI: 10.1080/09515070.2017.1285270] [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]
Affiliation(s)
- Robert J. Reese
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | | | - Alyssa L. Clements-Hickman
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jade M. Clemons
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Minnah W. Farook
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Collie W. Conoley
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
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Gone JP. Alternative Knowledges and the Future of Community Psychology: Provocations from an American Indian Healing Tradition. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 58:314-321. [PMID: 27216322 DOI: 10.1002/ajcp.12046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In the early years of this globalized century, alternative health knowledges and wellness traditions circulate faster and farther than ever before. To the degree that community psychologists seek collaboration with cultural minority and other marginalized populations in support of their collective wellbeing, such knowledges and traditions are likely to warrant attention, engagement, and support. My purpose in this article is to trace an epistemological quandary that community psychologists are ideally poised to consider at the interface of hegemonic and subjugated knowing with respect to advances in community wellbeing. To this end, I describe an American Indian knowledge tradition, its association with specific indigenous healing practices, its differentiation from therapeutic knowledge within disciplinary psychology, and the broader challenge posed by alternative health knowledges for community psychologists.
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Affiliation(s)
- Joseph P Gone
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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McCarthy AK, McCarthy RJ. Rehabilitation Counselors’ Use and Perceptions of Peer-Reviewed Publications. REHABILITATION COUNSELING BULLETIN 2016. [DOI: 10.1177/0034355216683672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Peer-reviewed publications are one way for researchers to communicate information about service delivery to rehabilitation counselors. However, little is known about rehabilitation counselors’ actual use of peer-reviewed publications. Thus, the current research explored the extent to which rehabilitation counselors ( N = 334) read and use peer-reviewed publications, factors associated with their reading and using peer-reviewed publications, and several items assessing their judgments about peer-reviewed publications. Overall, we found that rehabilitation counselors used peer-reviewed publications a moderate amount, held generally positive judgments about peer-reviewed publications, and reported wanting to use information from peer-reviewed publications with a greater percentage of clients than they actually did. We also found that counselors’ reading and using of peer-reviewed publications increased as counselor opinions of peer-reviewed publications were more positive and as counselors perceived their professional organizations, universities, agencies, and supervisors encouraged reading and using peer-reviewed publication. Collectively, we believe the current study is useful for researchers to generate and communicate research to rehabilitation counselors.
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Evaluating a social problem solving intervention for juvenile detainees: Depressive outcomes and moderators of effectiveness. Dev Psychopathol 2016; 29:1035-1042. [PMID: 27758729 DOI: 10.1017/s0954579416001000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study reports findings from the administration of a social problem-solving training (SPST) intervention to juvenile detainees in the Connecticut Youth Detainee Program. SPST is a cognitive behavioral intervention that teaches children and youth how to more effectively cope with interpersonal stress and conflict. In the current study, we tested whether SPST could decrease depressive symptoms in a sample of detained adolescent offenders. The study used a randomized-control design with detention staff administering the intervention. The results showed that SPST, as a main effect, was not more effective in reducing depressive symptoms than treatment as usual. However, the effectiveness of SPST was moderated by fluid intelligence. Juvenile detainees with high intelligence scores were most likely to benefit from SPST compared to treatment as usual. It was surprising that, for those with lower intelligence scores, SPST increased depressive symptoms relative to treatment as usual. These results help fill a critical need for intervention effectiveness data on juvenile detainees and indicate that SPST may not be useful for reducing outcomes such as depression.
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Fox J, Hagedorn WB, Sivo SA. Clinical decision-making and intuition: A task analysis of 44 experienced counsellors. COUNSELLING & PSYCHOTHERAPY RESEARCH 2016. [DOI: 10.1002/capr.12084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jesse Fox
- Department of Pastoral Counseling; Loyola University Maryland; Columbia MD USA
| | - W. Bryce Hagedorn
- Department of Child, Family, and Community Sciences; University of Central Florida; Orlando FL USA
| | - Stephen A. Sivo
- Department of Educational and Human Sciences; University of Central Florida; Orlando FL USA
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McGrew JH, Ruble LA, Smith IM. Autism spectrum disorder and evidence‐based practice in psychology. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12160] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mihura JL, Roy M, Graceffo RA. Psychological Assessment Training in Clinical Psychology Doctoral Programs. J Pers Assess 2016; 99:153-164. [DOI: 10.1080/00223891.2016.1201978] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Manali Roy
- Department of Psychology, University of Toledo
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Rhyee JS, Kwon J, Dak P, Kim JH, Kim SM, Park J, Hong YK, Song WG, Omkaram I, Alam MA, Kim S. High-Mobility Transistors Based on Large-Area and Highly Crystalline CVD-Grown MoSe2 Films on Insulating Substrates. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2016; 28:2316-2321. [PMID: 26755196 DOI: 10.1002/adma.201504789] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/16/2015] [Indexed: 06/05/2023]
Abstract
Large-area and highly crystalline CVD-grown multilayer MoSe2 films exhibit a well-defined crystal structure (2H phase) and large grains reaching several hundred micrometers. Multilayer MoSe2 transistors exhibit high mobility up to 121 cm(2) V(-1) s(-1) and excellent mechanical stability. These results suggest that high mobility materials will be indispensable for various future applications such as high-resolution displays and human-centric soft electronics.
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Affiliation(s)
- Jong-Soo Rhyee
- Department of Applied Physics, Kyung Hee University, Yongin, 17104, Korea
| | - Junyeon Kwon
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
| | - Piyush Dak
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Jin Hee Kim
- Department of Applied Physics, Kyung Hee University, Yongin, 17104, Korea
| | - Seung Min Kim
- Carbon Convergence Materials Research Center, Korea Institute of Science and Technology, Wanju-gun, 565-905, Republic of Korea
| | - Jozeph Park
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
| | - Young Ki Hong
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
| | - Won Geun Song
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
| | - Inturu Omkaram
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
| | - Muhammad A Alam
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Sunkook Kim
- Multi-Functional Nano/Bio Electronics Laboratory, Kyung Hee University, Gyeonggi, 17104, Korea
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Quanbeck A, Brown RT, E Zgierska A, A Johnson R, Robinson JM, Jacobson N. Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care. Health Res Policy Syst 2016; 14:8. [PMID: 26818455 PMCID: PMC4729135 DOI: 10.1186/s12961-016-0079-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 11/13/2022] Open
Abstract
Background Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy – systems consultation –intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy – translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches (‘systems consultants’) to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. Methods/Design The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for ‘fully developed use’ of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. Discussion The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.
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Affiliation(s)
- Andrew Quanbeck
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., Madison, WI, 53706, USA.
| | - Randall T Brown
- School of Medicine and Public Health, University of Wisconsin-Madison, Room 3832, 1100 Delaplaine Ct, Madison, WI, 53715, USA.
| | - Aleksandra E Zgierska
- School of Medicine and Public Health, University of Wisconsin-Madison, Room 3832, 1100 Delaplaine Ct, Madison, WI, 53715, USA.
| | - Roberta A Johnson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., Madison, WI, 53706, USA.
| | - James M Robinson
- Center for Health Systems Research & Analysis, University of Wisconsin-Madison, 1109c Warf Office Building, 610 Walnut St., Madison, WI, 53726, USA.
| | - Nora Jacobson
- School of Nursing, University of Wisconsin-Madison, 5130 Cooper Hall, Signe Skott; 701 Highland Ave, Madison, WI, 53705, USA.
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Moyers TB, Houck J, Rice SL, Longabaugh R, Miller WR. Therapist empathy, combined behavioral intervention, and alcohol outcomes in the COMBINE research project. J Consult Clin Psychol 2016; 84:221-9. [PMID: 26795938 DOI: 10.1037/ccp0000074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Common factors such as therapist empathy play an important role in treatment for addictive behaviors. The present study was a secondary analysis designed to evaluate the relation between therapist empathy and alcohol treatment outcomes in data from a large, multisite, randomized controlled trial. METHOD Audio-recorded psychotherapy sessions for 38 therapists and 700 clients had been randomly selected for fidelity coding from the combined behavioral intervention condition of Project COMBINE. Sessions were evaluated by objective raters for both specific content (coping with craving, building social skills, and managing negative mood) and relational components (empathy level of the therapist). Multilevel modeling with clients nested within therapists evaluated drinks per week at the end of treatment. RESULTS Approximately 11% of the variance in drinking was accounted for by therapists. A within-therapist effect of empathy was detected (B = -0.381, SE = 0.103, p < .001); more empathy than usual was associated with subsequent decreased drinking. The Social and Recreational Counseling module (B = -0.412, SE = 0.124, p < .001), Coping with Cravings and Urges module (B = -0.362, SE = 0.134, p < .01), and the Mood Management module (B = -0.403, SE = 0.138, p < .01) were also associated with decreased drinking. No between-therapist effect was detected, and the Empathy × Module Content interactions were not significant. CONCLUSIONS The results of the study appear consistent with the hypothesis that skills building and therapist empathy are independent contributions to the overall benefit derived from the combined behavioral intervention.
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Affiliation(s)
| | - Jon Houck
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico
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Hoberman HM. Forensic Psychotherapy for Sexual Offenders: Has Its Effectiveness Yet Been Demonstrated? SEXUAL OFFENDING 2016. [DOI: 10.1007/978-1-4939-2416-5_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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49
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The Sex Offender Risk Appraisal Guide. SEXUAL OFFENDING 2016. [DOI: 10.1007/978-1-4939-2416-5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Introduction to the special issue on Cognitive bias modification: Taking a step back to move forward? J Behav Ther Exp Psychiatry 2015; 49:1-4. [PMID: 26118306 DOI: 10.1016/j.jbtep.2015.05.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 12/26/2022]
Abstract
Cognitive bias modification (CBM) research holds important theoretical and clinical potential. CBM represents one of the most exciting translational developments in experimental psychopathology research in recent years. Despite theoretical and methodological advances in the past 15 years, the clinical efficacy of CBM, to-date, has been disappointing. However, it is important to remember that the CBM therapeutics literature is only in its early stages of scientific development. We argue that the potential for novel approaches to CBM to contribute to disseminable psychological interventions is strong and has yet to be realized. Accordingly, we propose 5 inter-related steps that may help advance the basic and clinical science of CBM: (1) Innovation and refinement of the methodology to modify information-processing bias; (2) Advancing understanding of the nature of processing biases in order to guide their modification; (3) Conceptualizing and studying the moderating and mediating mechanisms underlying the modification of information-processing bias and their effects on maladaptation; (4) Focus on augmenting existing validated treatments, by targeting psychobehavioral processes proximally linked to information-processing biases; (5) Encouraging publication of methodologically strong, mixed and unexpected findings. Finally, we introduce papers in the special issue with respect to each of these future directions. These papers provide important new conceptual and methodological perspectives to advance CBM research.
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