A comment on Martin''s relation

Interviews with 80 therapists and 50 patients at a community mental health center revealed that peer review effectively monitored the appropriateness of treatment and allocated limited treatment funds without unduly interfering with established treatment patterns, relationships, or outcomes. Most therapists reported receiving helpful consultation from the peer review committee, and the process encouraged them to focus more clearly on treatment goals. On the other hand, patients were concerned about the committee's role in making decisions about their treatment. Therapists noted as a problem the lack of certainty in establishing a treatment contract prior to peer review since the contract with the patient must remain fluid during the evaluation period. The therapists and patients demonstrated remarkable agreement in their assessment of treatment progress and whether further therapy was needed.     

The impact of peer review on professional practice.

Discusses the history and impact of peer review as an in-house quality control process. It is described as similar to previous steps in that it is developed and administered by psychologists but different because it goes beyond qualifying criteria for engaging in practice to deal with performance after an individual has become a qualified provider. The effects of peer review on several aspects of professional practice are discussed. Vehicles for obtaining information for review judgments are examined in terms of criteria, theoretical orientation, and benefit decisions. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Report from the National Institute on Aging: the research grant support mechanism

Most NIH support of research on aging has been in the area of the biomedical sciences, followed by behavioral and social sciences. Research project and program project grants are the primary mechanisms available to the NIA for support of research on aging. The grant process for aging research begins with preparation and review at the applicant institution. The process of review at NIH proceeds from referral to an intitial review group for peer review and NIA for possible funding, NIA staff review, the National Adivisory Council on Aging review, and concludes with NIA funding action. The primary mode of applicant appeal of a negative decision by NIA on an application is reapplication.     

Invited peer review: The AABT experience.

In response to the growing need to provide the independent evaluation and examination of treatment programs, the Association for Advancement of Behavioral Therapy (AABT) formed the Professional Consultation and Peer Review Committee. The present study describes the peer review process in a hierarchical manner, beginning with the least demanding type of review or consultation and progressing to a full-scale evaluation. In the past 2 yrs, this committee has developed 6 types of review services that it offers free of charge to interested consumers and behavior therapists: individual case consultation between therapists, a compilation of guidelines for behavioral treatment programs, review of written materials of particular programs, on-site review of noncontroversial and controversial programs, and professional assistance in litigation involving determination of appropriate treatment. In all cases the committee promotes reliance on the empirical literature as the justification for treatment decisions and program operation. It is concluded that the review services are designed to protect individual clients and competent therapists and to assist in assuring appropriate treatment. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond expected utility: Rethinking behavioral decision research.

Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Medical Journal of Australia Internet peer-review study

BACKGROUND: Peer review of medical papers is a confidential consultancy between the reviewer and the journal editor, and has been criticised for its potential bias and inadequacy. We explored the potential of the internet for open peer review to see whether this approach improved the quality and outcome of peer review. METHODS: Research and review articles that had been accepted for publication in The Medical Journal of Australia (MJA) were published together with the reviewers' reports on the worldwide web, with the consent of authors and referees. Selected readers' e-mailed comments were electronically published as additional commentary; authors could reply or revise their paper in response to readers' comments. Articles were edited and published in print after this open review. FINDINGS: 60 (81%) of 74 authors agreed to take part in the study, together with 150 (92%) of 162 reviewers. There was no significant difference in the performance of commissioned reviewers before and during the study. Four articles were not included because of insufficient time before print publication. Of the remaining 56 papers, 28 received 52 comments from 42 readers (2% of readers submitted comments). Most readers' comments were short and specific, and seven articles were changed by the authors in response. INTERPRETATION: Open peer review is acceptable to most authors and reviewers. Postpublication review by readers on the internet is no substitute for commissioned prepublication review, but can provide editors with valuable input from individuals who would not otherwise be consulted. Readers also gain insight into the processes of peer review and publication.     

Quality management in medical specialties: the use of channels and dikes in improving health care in The Netherlands

BACKGROUND: In 1989 a Dutch national policy was instituted to ensure that quality management is the responsibility of both health care professionals and management, with input from insurers and patients. In turn, quality management of medical specialists remained to a large extent self-regulatory, with accountability toward third-party payers and patients. Three programs for quality management-peer review, guidelines, and visitation-have sufficiently persuaded patient organizations and care insurers about medical specialists' ability to ensure the quality of the care they provide. PEER REVIEW: Operational since 1976, the national program for peer review in hospitals has stressed the need for explicit evaluative mechanisms. This program led to the foundation of the National Organization for Quality Assurance in Hospitals (CBO), which conducts peer review activities but also support efforts aimed at quality assurance in hospitals. Once it is linked with the other two quality management programs, peer review will realize its full potential as a profession-based method for standardizing and rationalizing medical specialty practice. PRACTICE GUIDELINES: Since 1982, more than 60 consensus guidelines have been developed for and by medical professionals, with input from patient organizations and third-party payers. Medical specialty associations have also created their own guidelines. Although the guidelines' impact has not been evaluated systematically, studies have shown effects on behavioral change and health outcomes. Solid, credible guidelines continue to be developed, although the successful implementation of these guidelines needs to be studied. VISITATION PROGRAM: Visitation, or onsite assessment of specialty practice sites (in training and non-training hospitals), has been a hot issue in Dutch medical quality assurance. All 28 scientific societies have visitation programs, focusing on areas for improvement such as process management, use of guidelines, and evaluation of patient satisfaction and treatment outcomes. Closely linked to other medical quality assurance activities, visitation programs also incorporate clinical guidelines into evaluations. CONCLUSIONS: Profession-driven peer review, practice guidelines, and visitation programs have been effective support tools for quality management in The Netherlands. Future challenges involve creating more synergy among these programs and between the profession-based quality management approaches and recently introduced hospital-based quality systems and maintaining the trust between third-party payers and patients.     

Perspectives and Research on the Positive and Negative Implications of Having Multiple Racial Identities.

Much attention has been directed toward understanding the impact having a multiracial background has on psychological well-being and adjustment. Past psychological research has focused on the challenges multiracial individuals confront in defining a racial identity. The implication is that these challenges lead to outcomes that are psychologically detrimental. However, evidence to support this assertion is mixed. The authors review qualitative and quantitative empirical research examining multiracial individuals' identity development, depression, problem behaviors, peer relationships, school performance, and self-esteem, finding support for detrimental outcomes only in studies sampling clinical populations. Studies on nonclinical samples find that multiracial individuals tend to be just as well-adjusted as their monoracial peers on most psychological outcomes. Earlier assertions of maladjustment may have been due to reliance on qualitative research that sampled clinical populations. Other implications and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer relations and later personal adjustment: Are low-accepted children at risk?

In this review, we examine the oft-made claim that peer-relationship difficulties in childhood predict serious adjustment problems in later life. The article begins with a framework for conceptualizing and assessing children's peer difficulties and with a discussion of conceptual and methodological issues in longitudinal risk research. Following this, three indexes of problematic peer relationships (acceptance, aggressiveness, and shyness/withdrawal) are evaluated as predictors of three later outcomes (dropping out of school, criminality, and psychopathology). The relation between peer difficulties and later maladjustment is examined in terms of both the consistency and strength of prediction. A review and analysis of the literature indicate general support for the hypothesis that children with poor peer adjustment are at risk for later life difficulties. Support is clearest for the outcomes of dropping out and criminality. It is also clearest for low acceptance and aggressiveness as predictors, whereas a link between shyness/withdrawal and later maladjustment has not yet been adequately tested. The article concludes with a critical discussion of the implicit models that have guided past research in this area and a set of recommendations for the next generation of research on the risk hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes

The use of writing, alone or in conjunction with traditional psychotherapy, has increased substantially in recent years. The most widespread use of writing has been for single-shot ad hoc purposes or to log behavior. The purpose of this review is to summarize a decade of research demonstrating the efficacy of writing about past traumatic experiences on mental and physical health outcomes. It is widely acknowledged in our culture that putting upsetting experiences into words can be healthy. Research from several domains indicates that talking with friends, confiding to a therapist, praying, and even writing about one's thoughts and feelings can be physically and mentally beneficial. This review highlights advances in written disclosure that determine some therapeutic outcomes. In addition, we attempt to explore the mechanisms that predict improved psychological and physical health. Finally, limitations of previous studies are highlighted, and suggestions for future research and application are made.     

A review and reformulation of social information-processing mechanisms in children's social adjustment.

Research on the relation between social information processing and social adjustment in childhood is reviewed and interpreted within the framework of a reformulated model of human performance and social exchange. This reformulation proves to assimilate almost all previous studies and is a useful heuristic device for organizing the field. The review suggests that overwhelming evidence supports the empirical relation between characteristic processing styles and children's social adjustment, with some aspects of processing (e.g., hostile attributional biases, intention cue detection accuracy, response access patterns, and evaluation of response outcomes) likely to be causal of behaviors that lead to social status and other aspects (e.g., perceived self-competence) likely to be responsive to peer status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using technology to explore social networks and mechanisms underlying peer effects in classrooms.

Peer interactions among children have long interested social scientists. Identifying causal peer effects is difficult, and a number of studies have used random assignment to produce evidence that peers affect each other's outcomes. This focus by sociologists and economists on whether peers affect each other has not been matched by direct evidence on how these effects operate. The authors argue that one reason for the small number of studies in sociology and economics on the mechanisms underlying peer effects is the difficulty of collecting data on microinteractions. They argue technology reduces data collection costs relative to direct observation and allows for realistic school activities with randomly assigned peers. The authors describe a novel strategy for collecting data on peer interactions and discuss how this approach might shed light on mechanisms underlying peer influence. The centerpiece of this strategy is the use of handheld computers by middle and high school students as part of interactive math and science lessons called the Discussion Game. The handhelds collect data on interactions between students and track how students' answers evolve as they interact with different peers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When reviews attack: Ethics, free speech, and the peer review process.

The peer review process, whether formally applied in publication and grant review, or informally, such as exchange of ideas in scientific and professional newsgroups, has sparked controversy. Writers in this area agree that scholarly reviews that are inappropriate in tone are not uncommon. Indeed commentators have suggested rules and guidelines that can be used to improve the review process and to make reviewers more accountable. In this paper, the authors examine the relevance and impact of ethical codes on the conduct of peer review. They contend that the peer review process can be improved, not by a new set of rules, but through closer attention to the ethical principles to which psychologists already subscribe. The discussion considers the four principles of the Canadian Psychological Association in relation to peer review and to the six principles presented in the code of the American Psychological Association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multisystemic Treatment: A Meta-Analysis of Outcome Studies.

Multisystemic treatment (MST) is a family- and home-based therapeutic approach that has been found to be effective in treating antisocial youths and that has recently been applied to youths with serious emotional disturbances. In light of the increasing dissemination of MST, this review examines the effectiveness of MST by quantifying and summarizing the magnitude of effects (treatment outcomes) across all eligible MST outcome studies. Included in a meta-analysis were 7 primary outcome studies and 4 secondary studies involving a total of 708 participants. Results indicated that across different presenting problems and samples, the average effect of MST was d = .55; following treatment, youths and their families treated with MST were functioning better than 70% of youths and families treated alternatively. Results also showed that the average effect of MST was larger in studies involving graduate student therapists (i.e., efficacy studies; d = .81) than in studies with therapists from the community (i.e., effectiveness studies; d = .26). In addition, MST demonstrated larger effects on measures of family relations than on measures of individual adjustment or peer relations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Legal liability and managed care.

In attempts to reduce the cost of mental health treatment, health insurers are turning to mechanisms for intensive oversight that fall under the rubric of managed care. These approaches have implications for the potential liability of clinicians and managed care entities. Clinicians may be confronted with legal duties to appeal adverse decisions, to disclose the impact of managed care on patients' treatment, and in some circumstances, to continue treatment after payment has been denied. Managed care entities are being held to duties to conduct review in a reasonable fashion, and may also have a duty to disclose the limitations managed care may place on patients' access to treatment, and to select appropriate providers of care. The law in this area is in an early stage of development and is likely to be refined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workshops in Neuropsychological Assessment.

A past issue of Professional Psychology (February 1982) dealt with peer review and quality assurance. These issues are of particular interest to clinical neuropsychology, as evidenced by several articles in Professional Psychology. Over the past 5 years, clinical neuropsychology has rapidly emerged as an important diagnostic and treatment specialty within psychology. Unfortunately, from the standpoint of peer review and quality assurance, this growth has not been appropriately governed. The intention of writing this letter is to bring attention to this particular problem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer cluster theory, socialization characteristics, and adolescent drug use: A path analysis.

A new psychosocial model, peer cluster theory, suggests that the socialization factors that accompany adolescent development interact to produce peer clusters that encourage drug involvement or provide sanctions against drug use. These peer clusters are small, very cohesive groupings that shape a great deal of adolescent behavior, including drug use. Peer cluster theory suggests that other socialization variables, strength of the family, family sanctions against drug use, religious identification, and school adjustment influence drug use only indirectly, through their effect on peer clusters. Correlations of these socialization variables with drug use confirm the importance of socialization characteristics as underlying factors in drug use and also confirm that other socialization factors influence drug use through their effect on peer drug associations. Peer cluster theory suggest that treatment of the drug-abusing youth must alter the influence of the peer cluster or it is likely to fail. Prevention programs aimed at the family, school, or religion must also influence peer clusters, or drug use will probably not be reduced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer rejection as antecedent of young children's school adjustment: An examination of mediating processes.

Ashort-term longitudinal design (N?=?399) was used to examine peer relations processes that may mediate the relation between peer rejection and children's emotional and academic adjustment during kindergarten. These proposed mediating processes extend the current literature by explicating behavioral pathways via which the attitudinal construct of peer rejection may affect adjustment outcomes. Structural equation modeling results supported the hypothesis that negative peer treatment (e.g., victimization, refusal of peer group entry bids, and exclusion from peer activities) and classroom participation partially mediate the relationship between rejection and adjustment outcomes. Rejected children were more likely to experience negative peer treatment, more likely to show decreases in classroom participation, and more likely to report loneliness, to express a desire to avoid school, and to perform less well on achievement measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)