Evaluating a team building intervention in a youth exercise setting.

The purpose of this study was to examine the relationship between the mechanisms in an established team building (TB) activity intervention and cohesion, its proposed outcome as well as conduct a process evaluation of the intervention in a youth exercise setting. Participants (N = 100, 13–17 years) were members of school-based exercise clubs randomly assigned to either a TB or control condition. In the TB condition, trained leaders implemented an established TB protocol (Carron & Spink, 1993). Results revealed a positive association between the specified mechanisms in the TB intervention and the proposed outcome of task cohesion. The evaluation of the intervention also revealed that the TB components were implemented as prescribed, and the intervention appeared to be appropriate for a youth setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of respiratory sinus arrhythmia biofeedback versus passive biofeedback control.

The objective of this study was to examine the acute effects of a portable respiratory sinus arrhythmia (RSA) biofeedback device as compared to passive biofeedback control on state anxiety, heart rate (HR), and Stroop task (Congedo, 2003) performance during repeated administration of the Stroop task cognitive stressor in a single brief session. Participants were individuals reporting stress levels at least 1 SD above the mean on the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983). The RSA group had significantly reduced HR compared to the control group at postintervention and Stressor 2. Both groups significantly improved Stroop scores. Together, these preliminary results suggest that brief relaxation training can reduce state anxiety but that RSA biofeedback appears to have added benefits in reducing state anxiety and HR stress reactivity compared to passive relaxation techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Groupness and adherence in structured exercise settings.

This study examined the relationship between groupness and self-reported exercise adherence. Exercise participants (N = 86) recalled a structured setting where they had been active with others during the last six months. To capture groupness, five group variables (i.e., common fate, mutual benefit, social structure, group processes, and self-categorization) were assessed. Indicators of self-reported adherence were participant's recall of frequency (times/month) and percent attendance in a specified structured exercise setting. Results from structural equation modeling revealed an acceptable fit: χ2 = 18.89, p > .05, Root Mean Square Error of Approximation (RMSEA) = 0.075, Comparative Fit Index (CFI) = 0.95 for the hypothesized model. Groupness was positively related to self-reported adherence explaining 20% of the variance in adherence. These findings provide preliminary support for the idea that perceiving a collection of exercise participants as being more like a group may be associated with adherence in a structured exercise setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.

To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain. Design: By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program. Main Outcome Measures: Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion. Results: LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%). Conclusion: The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Career-intervention outcome: What contributes to client gain?

An earlier research integration of the career-counseling literature (Oliver & Spokane, 1981; Spokane & Oliver, 1983) found moderate effect sizes for various career interventions but did not explore the relations between specific study characteristics. The present study extended the data base of Spokane and Oliver and used more sophisticated coding and analysis procedures to examine the relations between study characteristics and outcomes. Two hundred forty treatment–control comparisons resulted from 58 studies containing 7,311 subjects. Class interventions were the most effective but required the greatest number of intervention hours. Four indexes of the relative efficacy of different career intervention modes revealed that individual counseling produced more client gain per hour (or session) than any other intervention mode. Intensity of treatment was the only significant contributor to outcome magnitude. Contrary to earlier reviews, there were clear differences in effectiveness among intervention modes, a finding that ought to be considered in treatment selection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes.

A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction ratings, intervention participation and attendance, and overall program satisfaction. Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later. Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context. The intervention produced benefits in both parenting outcomes (i.e., general parenting, skill encouragement, overall effective parenting) and youth outcomes (i.e., aggression, externalizing, likelihood of smoking and use of alcohol, marijuana, and other drugs). Differential effects of the intervention were based on youth nativity status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Training group members to set session agendas: Effects on in-session behavior and member outcome": Correction to Kivlighan, Jauquet, Hardie, Francis, and Hershberger.

Reports an error in "Training group members to set session agendas: Effects on in-session behavior and member outcome" by Dennis M. Kivlighan, Carol A. Jauquet, Anne W. Hardie, Anna Maria Francis and Bernard Hershberger (Journal of Counseling Psychology, 1993[Apr], Vol 40[2], 182-187). In Table 4 (p. 186) the values for the means and standard deviations in the second, third, and fourth rows of the "Agenda setting" column were transposed with those in the "No contact" column. The corrected table is presented in this erratum. (The following abstract of the original article appeared in record 1993-26598-001.) Addressed I. D. Yalom's (1983) hypothesis that group members who set session agendas would participate more effectively in group sessions and have enhanced outcomes. The independent variable, agenda, was manipulated by assigning the 24 members of established personal growth groups to 1 of 3 conditions: (1) training in agenda setting, (2) stabilizing interviews, and (3) no-contact control. Group members filled out pre- and posttest measures of enactments of intimate behaviors and attitudes toward these enactments. They also filled out self- and other ratings of in-group enactments of intimate behaviors, and group leaders rated group members' intimate behavior at the end of each group session. Group members who set here-and-now session agendas enacted more in-group intimate behaviors and had better outcomes. Implications of these results and suggestions for group counseling are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlation between health outcome and length of hospital stay in lumbar microdiscectomy

STUDY DESIGN: Prospective observational trial in a community hospital setting. OBJECTIVES: To examine the effect on patient-reported outcome of a clinical practice, namely, decrease in hospital length of stay for single-level lumbar microdiscectomy. SUMMARY OF BACKGROUND DATA: Health care reform and the economic demands of managed care have created increasing pressure to manage health care resources more effectively. Spine surgery is one of the most common surgeries. METHODS: Starting in October 1993, length of stay for patients undergoing lumbar microdiscectomy was decreased at the study institution. Patients completed questionnaires (SF-36) before surgery and 3 months after surgery that assessed health status, back-related functional status, and treatment satisfaction. Comparisons were made between the intervention group and a historical control group and between 1-day and 2-day patients. RESULTS: SF-36 scores 3 months after surgery approximated age and sex norms of five of the eight SF-36 scales and improved significantly on the remaining three scales. The physical functioning and general health scores were significantly better for the 1-day than the 2-day patients. Patient satisfaction was similar in all groups. Hospital charges for the 1-day patients were $781 less per patient than for the 2-day patients. CONCLUSIONS: Hospital length of stay for lumbar microdiscectomy can be decreased without adverse effect on short-term patient self-reported health status or satisfaction and with lower hospital charges. This model assesses the effect of efficient management of health care resources on patient-perceived quality and satisfaction.     

A school-based group activity therapy intervention with at-risk high school students as it relates to their moral reasoning.

The main goal of this study was to examine whether group therapy is useful for developing moral reasoning in at-risk youth. This research compared the impact of 10 weeks of group activity therapy (n = 27) and group talk therapy (n = 34) on the moral reasoning of at-risk ninth grade students. Group activity therapy is the developmentally appropriate extension of child centered play therapy for adolescents. Using pretest and posttest scores on the Maintaining Norms Schema subscale of the Defining Issues Test 2 (DIT-2; Rest, Narvaez, Thoma, & Bebeau, 1999), an analysis of covariance indicated significant difference between groups. Implications for counselors who work with this population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using psychodynamic, cognitive behavioral, and control mastery prototypes to predict change: A new look at an old paradigm for long-term single-case research.

This article illustrates a method of testing models of change in individual long-term psychotherapy cases. A depressed client was treated with 208 sessions of control mastery therapy (CMT), an unmanualized approach that integrates elements of psychodynamic therapy (PDT) and cognitive behavioral therapy (CBT). Panels of experts developed prototypes of ideal PDT, CBT, and CMT process using the Psychotherapy Process Q-set (PQS; J. S. Ablon & E. E. Jones, 1999; E. E. Jones, L. A. Parke, & S. Pulos, 1992; E. E. Jones & S. M. Pulos, 1993). Independent observers rated every 4th session (N = 53) with the PQS. Using correlations between ideal and actual PQS ratings followed by paired t tests, the authors compared adherence to the CMT prototype with adherence to plausible alternative models advocated by the PDT and CBT experts. Bivariate time series analyses determined whether prototype adherence predicted an estimated index of symptom change. Results showed that the therapist's behavior was most consistent with the CMT prototype and that this aspect of the CMT prototype along with particular aspects of the other prototypes influenced estimated symptom change. The results, which replicate and extend earlier findings, support the validity of this approach to studying long-term therapies but also highlight its limitations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient adherence predicts outcome from cognitive behavioral therapy in obsessive-compulsive disorder.

Objective: To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). Method: Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory sessions and 15 exposure sessions. Because there were no significant group differences in adherence or outcome, the groups were combined to examine the effects of patient adherence on outcome. Independent evaluators assessed OCD severity using the Yale–Brown Obsessive Compulsive Scale. Therapists assessed patient adherence to between-session EX/RP assignments at each session using the Patient EX/RP Adherence Scale (PEAS). Linear regression models were used to examine the effects of PEAS scores on outcome, adjusting for baseline severity. The relationship between patient adherence and other predictors of outcome was explored using structural equation modeling. Results: Higher average PEAS ratings significantly predicted lower posttreatment OCD severity in intent-to-treat and completer samples. PEAS ratings in early sessions (5–9) also significantly predicted posttreatment OCD severity. The effects of other significant predictors of outcome in this sample (baseline OCD severity, hoarding subtype, and working alliance) were fully mediated by patient adherence. Conclusions: Patient adherence to between-session EX/RP assignments significantly predicted treatment outcome, as did early patient adherence and change in early adherence. Patient adherence mediated the effects of other predictors of outcome. Future research should develop interventions that increase adherence and then test whether increasing adherence improves outcome. If effective, these interventions could then be used to personalize care. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pupillometric assessment of compensatory effort in a memory search task under physical and pharmacologically-induced suboptimal states

Extensive research has shown that the phasic pupil size (peak level on each trial) is a sensitive measure of the degree of mental effort demanded by a task. In the present study, the validity of the pupil response as an index of mental effort in suboptimal conditions was investigated. Thirteen males (19-29 years) performed a memory and display-search task in a practice session, followed in random order by an oxazepam session, a placebo session, a physical exercise session, and a control session. After both oxazepam and physical exercise, decision times increased, but pupil response increased only after physical exercise. This result was explained by the possibility that under physical fatigue, compensatory effort was exerted, whereas under drug-induced fatigue, subjects seemed unable to compensate for the performance decrement. The pupil response appears to be a valuable tool for gaining more insight into different effects of suboptimal states.     

Negative priming for obsessive-compulsive checkers and noncheckers.

Negative priming—the slowing of a response to an item that was recently ignored—was investigated in three groups: obsessive-compulsive disorder (OCD) checkers, OCD noncheckers, and nonclinical control participants. All groups performed both a standard negative priming task, selecting targets based on a perceptual feature (i.e., color), and a modified negative priming task, selecting targets based on a semantic feature (i.e., referent size). All three groups demonstrated significant negative priming in both tasks, although the negative priming was much larger in the novel, semantic task than in the common perceptual one. The findings suggest that patients with OCD do not demonstrate impairments in negative priming, contrary to earlier claims (Enright & Beech, 1990, 1993a, 1993b; Enright, Beech, & Claridge, 1995). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring gratitude in youth: Assessing the psychometric properties of adult gratitude scales in children and adolescents.

Before the developmental trajectory, outcomes, and related interventions of gratitude can be accurately and confidently studied among the youth, researchers must ensure that they have psychometrically sound measures of gratitude that are suitable for this population. Thus, considering that no known scales were specifically designed to measure gratitude in youth, this study aimed to answer an important question: Are the existing gratitude scales used with adults valid for use with youth? The present study is an empirical investigation, based on a large youth sample (N = 1,405) with ages ranging from 10 to 19 years old, of the psychometric properties of scores of the Gratitude Questionnaire-6 (GQ-6; M. E. McCullough, R. A. Emmons, & J.-A. Tsang, 2002), the Gratitude Adjective Checklist (GAC; M. E. McCullough, R. A. Emmons, & J.-A. Tsang, 2002), and the Gratitude Resentment and Appreciation Test (GRAT)-short form (M. Thomas & P. Watkins, 2003). Single-group and multiple-group confirmatory factor analyses indicated that the factor structures of these gratitude scales resemble those found with adults and were invariant across age groups. Scores of all three gratitude scales revealed acceptable internal consistency estimates (i.e., >.70) across age groups. Results showed that whereas scores of all three gratitude scales were positively correlated with each other for 14- to 19-year-olds, GRAT-short form scores tended to display relatively low correlations with scores of the other two measures for younger children (10–13 years old). Furthermore, the nomological network analysis showed that scores of all three gratitude scales were positively correlated with positive affect and life satisfaction scores across the age groups. The relationships with negative affect and depression scores, however, seemed dependent on the child's age. Pending results from subsequent research recommendations for researchers interested in studying gratitude in youth are offered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Where is the relationship in research on the alliance? Two methods for analyzing dyadic data.

Researchers examining the therapy relationship are encouraged "to study both patients' and therapists' contribution to the relationship and the ways in which these contributions combine to impact treatment outcome" (Steering Committee, 2002, p. 443). Research on the therapeutic alliance, however, is dominated by studies that examine the individual contributions of the counselor and client. Relationship researchers have developed alternative ways to analyze dyadic data that do take into account the relationship. One alternative paradigm is to model the interdependence in dyadic alliance data with the Actor-Partner Interdependence Model (APIM; D. A. Kashy & D. A. Kenny, 2000). The APIM examines interdependence by modeling the impact of 1 dyad member's alliance ratings on the other member's session impact rating. APIM can also examine how alliance agreement interacts with alliance ratings to predict session impact. The other alternative paradigm is to use the latent group model (R. Gonzalez & D. Griffin, 2002) to examine the individual-level and dyad-level covariance in alliance and session impact ratings. The APIM and latent group models are illustrated with alliance and session impact measures from 53 client-counselor dyads. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving adherence to physical activity.

Tested the efficacy of G. A. Marlatt and I. R. Gordon's (1980, 1985) relapse-prevention approach in increasing attendance during an exercise program and continuation of exercise activities for 12 wks following termination of the formal program. The 350 Ss in Study 1 and 243 Ss in Study 2 were registrants in 10-wk exercise groups (jogging, aerobic dance, and pre-ski training). The intervention, designed to increase awareness of obstacles to exercise and to develop appropriate techniques for coping with them, was delivered by group leaders within the context of the regular program. Results indicate a small but consistent superiority of adherence in the experimental condition compared to the control condition. The low cost of this intervention, however, makes even small gains cost effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in counselor adherence over the course of training.

Following recommendations of S. F. Butler and H. H. Strupp (1993), novice counselors were used to examine the development of adherence and counselor interactional style over the course of manual-based training in time-limited dynamic psychotherapy (TLDP; H. H. Strupp & J. Binder; 1984). Adherence to TLDP was assessed with the Vanderbilt Therapeutic Strategies Scale. Counselor interactional style was assessed with the client version of the Working Alliance Inventory. Growth curve analyses showed a significant linear increase in TLDP adherence and in client-rated working alliance for the novice counselors across 4 supervised training sessions. Time-series analysis (cross-correlations) indicated there was a lead-lag relationship with (a) counseling sessions in which higher ratings of counselor interactional style followed sessions with more counselor adherence to a general psychodynamic interviewing style and (b) sessions with higher ratings on adherence to psychodynamic interviewing style preceded sessions with higher level of adherence to TLDP specific strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor affecting adherence to rehabilitation interventions for individuals with fibromyalgia.

Examined treatment adherence of 87 Ss (mean age 43.96 yrs) with fibromyalgia syndrome enrolled in a rehabilitation clinical trial study and randomly assigned to 1 of 3 treatment groups: (1) biofeedback, (2) exercise, (3) combination (biofeedback and exercise) or to an attention control condition. Ss completed a 6-wk training program, questionnaires, and a physical exam. Between-group differences on an adherence measure were examined, and multiple regression analyses were used to determine the best model for predicting adherence. Results show that adherence among people with fibromyalgia is multidetermined. Those in the biofeedback intervention were more adherent, suggesting that treatment factors impact adherence. Furthermore, the best model for predicting adherence suggests that subject characteristics like age and education also influence adherence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of a feedback intervention on group process and outcome.

The effects of a feedback intervention directed at both members and leaders was examined in psychotherapy groups held in a university counseling center. Feedback consisted of group climate information using scores from the Group Climate Questionnaire, completed by members after each group session. The direct effects of the feedback intervention were assessed using scores on the Curative Climate Instrument as well as Group Climate Questionnaire subscales. These instruments were administered after each group session. Distal effects of the feedback intervention were examined using member symptom improvement (Outcome Questionnaire) and group attendance. Members and leaders in the experimental condition were given weekly written and graphical feedback and contrasted against comparable groups receiving no feedback. Results indicate the feedback intervention had little impact on the therapeutic factors and outcome. However, for members who reported that the group was high in conflict, the feedback intervention had a significant negative effect on outcome. Implications and directions for future research are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)