Facilitating outpatient treatment entry following detoxification for injection drug use: A multisite test of three interventions.

A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (CTN) was conducted to test 3 interventions to enhance treatment initiation following detoxification: (a) a single session, therapeutic alliance intervention (TA) added to usual treatment; (b) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment; and (c) treatment as usual (TAU) only. Injection drug users (n = 632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry. Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

For suicidal young adults with comorbid depressive and anxiety disorders, probem-solving treatment may be better than treatment as usual.

Practicing psychologists face many complexities and challenges in caring for suicidal patients who have comorbid mood and anxiety disorders. Not only must suicidal crises be addressed, but co-occurring depressive and anxiety symptoms compete for attention as well and are associated with relatively poor clinical prognosis in usual treatments. The current study compared problem-solving treatment to treatment as usual among depression–anxiety comorbid versus noncomorbid clinically suicidal young adults. Suicidal patients with mood and anxiety disorders were randomized to the 2 treatments and followed over time. Comorbid suicidal patients, in particular, experienced notable symptom improvements from the problem-solving treatment. Features of the problem-solving treatment are described for use in clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of Compensation and Capitalization Models When Treating Suicidality in Young Adults.

The current study examined compensation and capitalization treatment models with specific reference to problem-solving appraisal and problem-solving treatment of suicidal behavior (M. D. Rudd, T. Joiner, & M. H. Rajab, 2000). A sample of 98 young adults (mean age = 22), who had recently attempted suicide or ideated about suicide to the degree that they came to clinical attention, were randomly assigned to either problem-solving or control treatment. Participants with poorer problem-solving appraisal at baseline responded better than did participants with greater problem-solving appraisal to problem-solving treatment at 6-month follow-up, as would be predicted by the compensation model. Results suggest that treatment of suicidality for individuals with problem-solving skill deficits may be most effective by targeting these deficits rather than capitalizing on strengths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief-term counseling with sexually abused girls: The impact of sex of counselor on clients' therapeutic involvement, self-concept, and depression.

Two overlapping studies were conducted with sexually abused girls referred to a university outpatient clinic for 6 sessions of psychoeducationally based individual counseling in which participants were alternately assigned to either male or female counselors. Ratings of videotaped segments of 21 girls' in-session behavior revealed no significant effect for sex of counselor, although a significant improvement was found in girls' participation in counseling across the 6 treatment sessions. Results for 30 girls who completed all aspects of the counseling program revealed significant pretreatment–posttreatment improvement in Piers-Harris Children's Self-Concept Scale and Children's Depression Inventory (CDI) scores, including responses to the CDI suicidal ideation item. Again, no significant effect was found for sex of counselors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do We Know How We Cope? Relating Daily Coping Reports to Global and Time-Limited Retrospective Assessments.

The current study examined the concordance among daily, trait (global retrospective), and time-limited retrospective reports of coping. A sample of 93 adults completed the COPE (C. S. Carver, M. F. Scheier, & J. K. Weintraub, 1989) prior to recording coping with the day's most negative event for 30 consecutive days. At the end of daily data collection, participants recalled to what extent they used each of 16 coping strategies over the past 30 days. Whereas findings indicate generally good concordance between daily and time-limited retrospective reports, concordance between global and daily reports was weak. Only limited evidence was found for systematic individual differences in concordance. Time-limited reports appear to be an adequate, though not ideal, method of determining usual patterns of coping with stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goals and practical considerations in outpatient medical crises intervention.

Patients confronting medical crises are likely to benefit from treatment using a short-term medical crisis intervention model. This article describes how to generate focused goals that direct an efficient, helpful treatment from the perspective of the medical crisis counseling model. Illustrative case material is used to summarize strategies for setting goals and time parameters in a time-limited, outpatient format for patients confronting chronic illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are body dissatisfaction, eating disturbance, and body mass index predictors of suicidal behavior in adolescents? A longitudinal study.

Disordered eating, body dissatisfaction, and obesity have been associated cross sectionally with suicidal behavior in adolescents. To determine the extent to which these variables predicted suicidal ideation and attempts, the authors examined these relationships in a longitudinal design. The study population included 2,516 older adolescents and young adults who completed surveys for Project EAT-II (Time 2), a 5-year follow-up study of adolescents who had taken part in Project EAT (Time 1). Odds ratios for suicidal behaviors at Time 2 were estimated with multiple logistic regression. Predictor variables included Time 1 extreme and unhealthy weight control behaviors (EWCB and UWCB), body dissatisfaction, and body mass index percentile. Suicidal ideation was reported by 15.2% of young men and 21.6% of young women, and suicide attempts were reported by 3.5% of young men and 8.7% of young women. For young women, suicidal ideation at Time 2 was predicted by Time 1 EWCB. The odds ratio for suicide attempts was similarly elevated in young women who had reported EWCB at Time 1. These odds ratios for both suicidal ideation and suicide attempts remained elevated even after controlling for Time 2 depressive symptoms. In young men, EWCB was not associated with suicidal ideation or suicide attempts 5 years later. Body mass index and body dissatisfaction did not predict suicidal ideation or suicide attempts in young men or young women. These results emphasize the importance of EWCB. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal, abused African American women's response to a culturally informed intervention.

Objective: This study examined (a) the efficacy of a manualized, culturally informed, empowerment-focused psychoeducational group intervention (Nia) designed in accord with the theory of triadic influence or treatment as usual (TAU) for reducing psychological symptomatology (suicidal ideation, depressive symptoms, posttraumatic stress symptoms, general psychological distress), and (b) the effect of Nia versus TAU on the relation between exposure to intimate partner violence (IPV) and psychological symptomatology in these women. Method: Two hundred eight low-socioeconomic-status African American women with a recent history of IPV and a suicide attempt were randomized to Nia or TAU and assessed at baseline, postintervention, and 6- and 12-month follow-up. They were assessed on their levels of IPV (Index of Spouse Abuse), suicidal ideation (Beck Scale for Suicidal Ideation), depressive symptoms (Beck Depression Inventory–II), posttraumatic stress symptoms, and general psychological distress (Brief Symptom Inventory). Results:Hierarchical linear modeling found that women receiving the culturally informed Nia intervention showed more rapid reductions in depressive symptoms and general distress initially, and the between-group difference in depressive symptoms persisted at follow-up. Following intervention, compared with women randomized to TAU, women in Nia exhibited less severe suicidal ideation when exposed to physical and nonphysical IPV. Conclusions:Findings highlight the value of incorporating Nia as an adjunctive intervention for abused, suicidal, low-income women. They underscore the ways the intervention needs to be bolstered to address more directly more mediating and moderating constructs, as well as the need to target more effectively the key outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of age in four alternative forced-choice item and associative recognition tasks.

Seventy-three young and 84 older adults were taught interactive imagery as a strategy for learning word pairs. In the control condition, participants viewed word pairs 1 at a time and formed an interactive image for each. In the experimental condition, participants first formed individual mental images for both the cue and the target and then formed an interactive image for the pair. Participants in both conditions then completed 4 alternative forced-choice item and associative recognition tasks that avoid influences of age differences in retrieval strategies such as recall-to-reject. Unlike findings with typical yes–no recognition tests, associative recognition was superior to item recognition in the control condition. This effect was attenuated in the experimental condition. Older adults had poorer recognition memory for both associative and item tests, with a larger age difference for recognizing new associations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Forgiveness as an intervention goal with incest survivors

An intervention, with forgiveness toward their abuser as the goal, was implemented with 12 female incest survivors. The women, from a midwestern city, were 24 to 54 years old, and all were Caucasian. A yoked, randomized experimental and control group design was used. The participants were randomly assigned to an experimental group (receiving the forgiveness intervention immediately) or a waiting-list control group (receiving the intervention when their matched experimental counterpart finished the intervention). Each participant met individually with the intervener once per week. The average length of the intervention for the 12 participants was 14.3 months. A process model of forgiveness was used as the focus of intervention. Dependent variables included forgiveness, self-esteem, hope, psychological depression, and state-trait anxiety scales. After the intervention, the experimental group gained more than the control group in forgiveness and hope and decreased significantly more than the control group in anxiety and depression. When the control group then began the program they showed similar change patterns to the above, as well as in self-esteem improvement.     

A randomized trial of a brief mental health intervention for primary care patients.

This randomized trial is a first evaluation of a brief psychotherapeutic intervention for primary care patients. Sixty-two participants were randomly assigned to the intervention or to treatment as usual. As compared with treatment as usual, the intervention led to significant reductions in symptoms of anxiety and depression. The reduction was maintained for 3 months after the end of treatment, but some return of symptoms occurred by 6 months after treatment. The treatment was well accepted by patients. This study provides good preliminary evidence for the effectiveness of this intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of child teacher relationship training on the children of focus: A pilot study.

Head Start teachers (n = 24) were assigned to either the experimental group or the active control group in this pilot study to determine the effects of child–teacher relationship training (CTRT) on 22 disadvantaged preschool children identified with behavioral problems. CTRT is based on the principles and procedures of child–parent relationship therapy (CPRT; Landreth & Bratton, 2006), a structured, time-limited approach that trains young children's caregivers to be active participants in an early mental health delivery system. Results indicate that children whose teachers participated in CTRT made statistically significant improvements in both externalizing behavior problems and total problems when compared with the active control group. Children in the CTRT group demonstrated a large treatment effect on their internalizing behavior problems compared with those in the active control group. The statistical, practical, and clinically significant results of this pilot study indicate that CTRT is a promising option for preschool children with clinically significant behavior problems. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Evaluating initial reach and robustness of a practical randomized trial of smoking reduction.

Objective: This study evaluated the reach, initial effectiveness, and potential moderators and mediators of results of a smoking reduction program. Design: A generally representative sample of 320 adult smokers from an HMO, scheduled for outpatient surgery or a diagnostic procedure, were randomized to enhanced usual care or a theory-based smoking reduction intervention that combined telephone counseling and tailored newsletters. Main Outcome Measures: Self-reported number of cigarettes smoked and carbon monoxide levels. Results: The intervention enrolled 30% of known eligible smokers and produced reductions of 3 cigarettes per day greater than enhanced usual care. Intervention participants were significantly more likely than control participants to achieve at least a 50% reduction in self-reported number of cigarettes using complete cases, imputation analyses, and intent-to-treat procedures. Similar patterns were seen for carbon monoxide results but were significant only in complete case analyses. The intervention was generally robust across patient characteristics (e.g., education, ethnicity, health literacy, and dependence) and phone counselors. Conclusion: Initial results suggest that this program has potential to reach and assist smokers who may not participate in cessation programs. Additional research is indicated to enhance intervention effects, assess maintenance, and evaluate public health impact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving appraisal, hopelessness, and suicide ideation: Evidence for a mediational model.

Extended the research on D. E. Schotte and G. Clum's (see PA, Vols 69:1287 and 74:15906, respectively) theory of suicidal behavior using structural equation modeling involving latent variables to evaluate whether the construct of hopelessness mediates between the constructs of problem-solving appraisal and suicide ideation (SI). Participants in the study were 217 individuals in an intensive outpatient program targeting suicidal behavior in young adults. Results indicated a significant direct effect for hopelessness in predicting suicide ideation. Consistent with the mediational hypothesis, the results also indicated a significant indirect effect for problem-solving appraisal (through its impact on hopelessness) in predicting SI. Results not only replicate but also extend previous research by testing theory and increase the field's conceptualization of SI and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping the suicidal client: Some aspects of assessment and treatment.

All manifestations of suicidal intent need to be taken seriously by the clinician, who must make an assessment of the level of suicidal risk and implement an active suicide prevention plan when risk is judged to be substantial. Suicidal behavior is more difficult to predict in schizophrenic compared with depressed people; factors correlated with increased risk of suicide in both contexts are elaborated. Hospitalization is indicated when acute suicidal risk is assessed to be high; its length is ideally limited to the period of acute risk, which may be as short as several days. During hospitalization, there should be active intervention to change real-life conditions, such as lack of social support, which may be central to the person's motivation to commit suicide. Antipsychotic medication may be introduced and the person helped to continue with it as an outpatient. For those at lesser levels of acute risk, outpatient treatment is seen as appropriate and effective. An important feature of such a plan is the involvement of the person's family and associates. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of extended versus brief treatments for marijuana use.

Adult marijuana users (N?=?291) seeking treatment were randomly assigned to an extended 14-session Cognitive–behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at l-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of an Internet-based program for reducing risk factors for eating disorders.

This study evaluated an Internet-delivered computer-assisted health education (CAHE) program designed to improve body satisfaction and reduce weight/shape concerns—concerns that have been shown to be risk factors for the development of eating disorders in young women. Participants were 60 women at a public university randomly assigned to either an intervention or control condition. Intervention participants completed the CAHE program Student Bodies. Measures of body image and disordered eating attitudes were assessed at baseline, postintervention, and 3-month follow-up. At follow-up, intervention participants, compared with controls, reported a significant improvement in body image and a decrease in drive for thinness. This program provides evidence for the feasibility and effectiveness of providing health education by means of the Internet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency management improves abstinence and quality of life in cocaine abusers.

Contingency management (CM) treatments enhance drug abstinence. This study evaluated whether CM also improves quality of life and if these effects are mediated by abstinence. Across 3 independent trials, cocaine abusers in intensive outpatient treatment (n = 387) were randomly assigned to 12 weeks of standard treatment as usual or standard treatment with CM. The Quality Of Life Inventory (QOLI) was administered at baseline and at Months 1, 3, 6, and 9. Changes in QOLI scores over time differed significantly by treatment, with QOLI scores rising over time in CM participants and remaining stable in standard treatment participants. CM participants also achieved greater durations of abstinence, and duration of abstinence was correlated with posttreatment QOLI scores. During-treatment abstinence mediated the relationship between treatment condition and QOLI scores over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

One-day psychological skills intervention: An example of cost effective workshop evaluation.

Suggests that outcome evaluation has typically not been a part of very short-term psychological interventions, such as workshops or microlabs, because assessment of treatment effects is viewed as more time consuming and costly than very brief treatments warrant. This article describes a workshop evaluation procedure in which a quasi-experimental design was employed, and most data collection doubled as treatment. The setting was a workshop for 17 mid-level employees of a state government agency who were responsible for communicating sometimes unpopular decisions to the public. Measures of relevant traits in combination with self-report, behavioral ratings, audience impressions of behavior, and physiological measures were employed to demonstrate the efficacy of the intervention, as well as to expand the awareness of participants and refine and objectify feedback to the participants. The future utility of such evaluation of time-limited treatment and the applicability of quasi-experimental design to such evaluation are described. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)