Telehealth Interventions for Individuals With Chronic Illness: Research Review and Implications for Practice.

This article reviews outcome research on telehealth interventions for individuals with chronic illnesses. Only randomized controlled trials that provided data on specific health, quality of care, or clinical interview outcomes were selected. The overall findings suggested that telehealth interventions have shown promise as effective modes of treatment for people with chronic health conditions. Suggestions for improving the rigor and quality of future research are proposed, including the use of larger samples, conceptually meaningful control groups, cost analyses, strategies for enhancing ethnic minority recruitment, and experimental designs that examine interactions among different types of telecommunication technologies, specific health problems, and different patient populations. Implications for incorporating telehealth into psychological practice are also addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Parent-child interaction and development disabilities: Theory, research, and intervention.

Reviews the book, Parent-child interaction and development disabilities: Theory, research, and intervention by Kofi Marfo (see record 1988-98167-000). The growing interest in social support family-centered interventions for developmentally disabled children has found expression in this volume. The editor has outlined an ambitious set of objectives for the book, including "the integration of theoretical, research and clinical perspectives" on parent-child interactions with handicapped children. While certainly not the first attempt to apply a family focus to this population (e.g., Gallagher & Vietze, 1986), this book provides both a multidisciplinary approach to the field with an emphasis on data presentation. The book is divided into four major parts: (1) social-emotional aspects of parent-child interaction, (2) maternal response style and language development, (3) issues in intervention and evaluation, and (4) a review of parent-child observational systems. Each section is preceded by a brief introduction to the authors and topics to be covered. Although this method of organization enhances the cohesion of each section, certain topics are covered in much greater depth than others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research on telehealth and chronic medical conditions: Critical review, key issues, and future directions.

Objective: To provide a critical review of studies on the impact of telecommunication-based interventions for persons with chronic disabilities. Design: Only those studies that focused on specific health care or clinical interview outcomes and included at least 1 comparison condition were selected for review. Ten studies met these criteria. Results: Overall, the results of initial studies suggest that telecommunication-based interventions may be an efficient and effective way of providing services for chronically disabled populations, even for those who have no previous experience with the technologies. Conclusions: The number of controlled trials examining telecommunication-based interventions for those with chronic disabilities remains small. Future research should endeavor to increase sample size, use conceptually meaningful control groups, focus on cost utility, and investigate which types of telecommunication-based interventions provide the best match with specific populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary: Computer technologies and postsecondary students with disabilities: Implications of recent research for rehabilitation psychologists.

Computer and information technologies have the potential both to enhance the lives of people with disabilities as well as to deny them equality of access to education, jobs, and community life. In particular, these new technologies have the potential to enable or to create difficulties for people with disabilities in the new knowledge-based economy. Concerns about these technologies and their accessibility are evolving issues for the next decade. The authors summarize the findings of a 5-year research program that involved over 1,000 participants from postsecondary educational institutions across Canada. They then highlight emerging issues. Finally, they make broad-based recommendations to rehabilitation psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth: A clinical application model for rural consultation.

This article describes how a child psychologist in a rural community provides the necessary comprehensive consultation and clinical services using a video telephone and the services of Kentucky Telecare. The authors present a clinical consultation model of health care for underserved populations where professional consultation with a team of professionals may benefit service providers in rural communities. The article examines an innovative model of telehealth care delivery through a university-based telehealth system to an underserved regional school system. A number of applications within a broad spectrum of services using telehealth technology are offered. Finally, shifts in administrative paradigms, clinical models, and information technology prevention services through telehealth are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Supervision in Rural Settings: A Telehealth Model.

The task of providing supervisory services to clinical interns, trainees, and new psychologists in rural settings is often complicated by a host of environmental and economic constraints. Given the reemergence of telecommunication applications as a means of transcending similar obstacles in service delivery, the authors discuss the use of telecommunication technology as a means of enabling the traditional supervisor-supervisee relationship in settings in which face-to-face contact is difficult if not impossible. The evolution of telesupervision is discussed, followed by an outline of an integrated model of telesupervision and the goals, benefits, and challenges associated with the use of telecommunications technology in clinical supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth Interventions in Rehabilitation Psychology: Postcards From the Edge.

This special section grew out of a symposium at the 112th Annual Convention of the American Psychological Association in Honolulu, Hawaii, that presented innovative telehealth interventions in rehabilitation from around the world. Several presentations represented the cutting edge of science and technology for which only preliminary data were available--hence the subtitle "Postcards From the Edge." The collected articles represent emerging approaches by pioneers in telehealth rehabilitation and are intended to inform the clinical and research efforts of others who are grappling with the particular blend of psychological and technological issues that these interventions provide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perinatal exposure in later psychological and behavioral disabilities.

The purpose of this miniseries is to introduce the field of school psychology to prenatal and perinatal exposures that may result in later psychological and behavioral disability. These outcomes often remain clinically silent until later in development, such as school entry, when the cognitive, behavioral, and language tasks become more complex and demanding. To our knowledge, this is the first time that a codified special issue on this topic has appeared in the school psychology literature. We have endeavored to make this issue multidisciplinary and have been fortunate to attract leading figures from the fields of psychiatry, public health, neuropsychology, and school psychology. Each article in this issue discusses the implications for school psychology prevention, assessment, and intervention. Consistent with any progressive model of physical or psychological health, the general consensus of each article is that prevention is essential, and early assessment is clearly desirable to understand etiology and inform intervention. Thus, this Special Issue represents a beginning step toward more fully exploring and conceptualizing the relationship between prenatal and perinatal exposures and later educational and behavioral disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth Brain Injury Training for Rural Behavioral Health Generalists: Supporting and Enhancing Rural Service Delivery Networks.

Rural psychologists are frontline primary behavioral health care providers for nearly 60 million Americans, but they face limited access to peer consultation and continuing education. This article describes a program that matched 70 rehabilitation inpatients who had new brain injury with rural clinicians from patients' home communities. Neuropsychologists provided one-on-one training for clinicians through telehealth video teleconferencing. Clinicians showed gains in brain injury knowledge, and clients rated trained providers higher than untrained providers. Families seeking brain injury services can connect with these trained rural providers through a Web site, which receives more than 800 hits per month. Telehealth offers potential for rural clinicians to receive support, reduce professional isolation, gain working knowledge of specialty conditions, and deliver high-quality services for their rural clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth and neuropsychological assessment: New opportunities for psychologists.

The advent of telehealth technology gives psychologists new opportunities to expand their practices in a cost-effective manner, but little is known about telehealth efficacy and costs. This study of 49 neuropsychology clients interviewed using videoconferencing and 49 matched in-person controls yielded no group differences in client ratings of interpersonal factors. Telehealth clients were more likely to want to repeat their experience, but psychologist satisfaction was lower for telehealth sessions. Telehealth costs were significantly lower than in-person costs. Concerns about ethical issues, billing, and licensure must be addressed to help practitioners capitalize on new telehealth opportunities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond the illusion of structural change: A process priming approach to psychotherapy outcome research.

Psychoanalytically oriented psychotherapy outcome research has yet to differentiate between a psychological structure that is present but temporarily inactive and genuine change in that underlying structure. Thus, a decrease in maladaptive responding following treatment may sometimes reflect illusory structural change, with the patient remaining vulnerable to relapse in situations that activate the underlying pathogenic structure. Genuine structural change would be better assessed by deliberately seeking and failing to find evidence of the enduring presence of a pathogenic structure under conditions that typically activate that structure, using both implicit (e.g., free response) and explicit (self-report) outcome measures. Because implicit and explicit measures are differentially affected by situational variables (e.g., mood, mindset priming), rigorous psychotherapy research must use experimental techniques and multimodal assessments to assess outcome under the conditions most likely to evoke a pathological reaction in a seemingly recovered individual. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Federal research and development: Policies and prospects.

The "Office of Science and Technology was established… as a focal point for comprehensive science policies in the Executive Branch." This 1963 statement to a congressional committee indicates that "the problems of determining how to bring scientists into the formation of national scientific policies have been met in a pragmatic manner." There is substantial commitment of the federal budget to research and development and it has sharply risen during the past 5 years. Major sections are: The Federal Effort, Federal Mechanisms for Science and Technology, The Tasks Ahead, and Summary and Conclusions. Recent budget cuts "will severely arrest the capability of the NSF to meet its statutory responsibilities in research as well as in education." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Listening to parents' voices: Participatory action research in the schools.

How can schools and parents work together more effectively? This article describes a participatory action research (PAR) project with a group of parents whose children had been classified as having emotional disabilities. As the parents shared their stories of trying to navigate the special education system, they developed critical consciousness about their experiences of stress, powerlessness, and alienation. They became mobilized and obtained information about testing, diagnostic classification, and educational options for their children. Armed with this information, they developed and implemented an action plan to improve family-school relationships at the local, community, and state levels. The article concludes with an example of how the PAR model can be exported to a variety of mental health settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Giving parents a voice: A qualitative study of the challenges experienced by parents of children with disabilities.

Background: This study sought to examine the specific sources of challenges as identified by parents of children with disabilities. Method: Focus groups were conducted with 40 parent caregivers. Data gathered were coded into themes which were then analyzed through an intentional process of data reduction that resulted in the cross site validation of four superordinate themes. Results: Four themes emerged as the most prominent barriers to positive parent wellbeing: (a) access to information and services, (b) financial barriers, (c) school and community inclusion, and (d) family support. These four themes are indicative of problems associated with a lack of match between caregiver needs and services, resources, or support available in the community to meet those needs. Conclusion: Caring for a child with a disability can be challenging, but many of these challenges are likely due to a lack of necessary environmental supports. Future research should expand on these findings and policy makers, scientists and providers should give particular attention to the environmental support needs of parents in order to create policies and interventions that are more family-centered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Person-centered play therapy for adults with developmental disabilities.

Due to problems in communicating with psychologists, counselors, and other daily helpers, adults with developmental disabilities may experience a lifetime of daily routines that involve few if any opportunities for emotional expression, validation, and growth. This paper presents two case studies that utilize an adapted form of Child-Centered Play Therapy in working with adults with developmental disabilities (ages 22 and 24 yrs). Person-Centered Play Therapy is used to help two adults with developmental disabilities overcome behavioral and emotional difficulties. Results indicate positive growth and changes in self-expression, self-direction, self-efficacy, and emotional well-being. Changes are indicated both within sessions, and outside of sessions in a residential day treatment program. Possibilities for future work with this population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A plan for integrated programs of personnel research and development.

Describes the administrative organization of the program of personnel research as established in the Navy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intellectual disabilities and depression: How to adapt psychological assessment and intervention.

Persons with intellectual disabilities (ID) are at higher risk of developing a depressive disorder than are members of the general population. This article attempts to answer the question of how best to adapt psychological assessment and intervention for depressive disorder to the needs of adults with ID. Current knowledge suggests that a diagnostic assessment conducted by a multidisciplinary team is the best way to evaluate the influence of biological and psychosocial factors that may contribute to the development of depressive symptoms, and identify potential differential diagnoses. The greater the person's communication and cognitive deficits are, the greater the clinician's difficulties are in assessing and treating depressive disorder in persons with ID. Family and caregivers of such persons are therefore essential partners in assessment and therapeutic process. The recommended interventions are education, skill development, environment modification, and cognitive and behavioural therapy. All of these must, however, be adapted to the person's level of functioning. While the use of antidepressants may prove necessary, side effects must be carefully monitored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the outcome of social therapy with chronic psychotics.

A group of 69 male, long-hospitalized chronic psychotics in an experimental rehabilitation unit was tested on a new device, the Hunter problem box, prior to their treatment by 1 or 3 variants of social therapy. A summary score, the Hunter Process Index, was developed to relate to patients' postprogram adjustment on completion of a social therapy program. The index reflects changes in the degree of problem solving rigidity displayed by the patient as he moves from a simple, 2-light, single alternation problem to a more complex, 4-light, double alternation problem. The Hunter Process Index was validated with a group of 71 long-hospitalized, female psychotics who also had been exposed to the social therapy approach of the rehabilitation unit, and again with a group of 48 male chronic psychotics who had received some slight variation in the program. The index scores were predictive of the outcome of patients in these groups. Clinical judgments failed to predict outcomes. A normal control group in a separate study earned better Hunter index scores than did either the released or hospitalized groups of male chronic psychotics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fostering scholarly productivity through academic and internship research training environments.

How can training programs foster counseling and clinical psychologists' scholarly productivity? This study examined the impact of academic and internship research training environments (RTEs) on the scholarly activity of 223 early career professionals. Results supported the construct validity of the Internship Research Training Environment scale through cross-validation and confirmatory factor analysis. Findings revealed differences in perceptions of the internship RTE and scholarly productivity as a function of academic training philosophy and internship training philosophy. Finally, results suggested that academic and internship RTEs could influence research interest and scholarly productivity indirectly by enhancing research self-efficacy and research outcome expectations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)