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Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth. 流行病中的育儿:通过远程保健提供简短的行为父母培训的初步支持。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 DOI: 10.1177/01454455221103226
Jacob B W Holzman, Jessica L Hawks, Sarah M Kennedy, Bruno J Anthony, Laura G Anthony

Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.

行为问题,如不服从和侵略,是幼儿心理健康服务的常见原因。行为父母训练(BPT)是解决行为问题的主要干预措施,并在各种父母因素(如父母效能和父母压力)中产生益处。虽然COVID-19大流行使服务提供大幅转向远程医疗服务,但有限的工作评估了通过远程医疗以简短的分组形式提供BPT的有效性。目前的回顾性图表审查研究评估了通过远程医疗向64个因行为问题转诊的3至7岁儿童家庭提供的简短版BPT的参与程度和初步效果。在6个疗程中,平均有4.55个家庭参加,大多数家庭有两名照顾者参与干预。结果,照料者对儿童行为问题的报告显著减少,父母自我效能的提高。讨论了未来的研究和临床意义。
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引用次数: 1
A Retrospective Analysis of Therapists' Coaching Behavior When Directing Parents to Conduct Behavioral Assessments and Treatments Via Telehealth. 治疗师通过远程医疗指导家长进行行为评估和治疗时的指导行为回顾分析。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2023-01-01 Epub Date: 2022-06-22 DOI: 10.1177/01454455221106127
Alesia Larsen, Kelly M Schieltz, Amanda Barrett, Matthew J O'Brien

Research on the delivery of behavioral assessment and treatment via telehealth has focused largely on child outcomes and parent procedural fidelity. By contrast, the behavior of the therapists coaching parents to conduct assessment and treatment has garnered little research consideration. In this study, we conducted a retrospective analysis of behavior therapists' coaching behaviors when directing parents to conduct functional analysis (FA) and functional communication training (FCT) with their young children with autism via telehealth. Coaching behaviors for five experienced behavior therapists across seven parent-child dyads were scored using a combination of standardized and novel behavior codes. Therapists displayed more social engagement behaviors than any other type of behavior throughout the study, and rates of antecedent and consequence behaviors shifted across the FA and FCT phases. Results are discussed in relation to therapists' goals during behavioral assessment and treatment and the implications for training behavioral therapists to coach parents via telehealth.

有关通过远程医疗提供行为评估和治疗的研究主要集中在儿童结果和家长程序的忠实性上。相比之下,治疗师指导家长进行评估和治疗的行为却很少得到研究的关注。在本研究中,我们对行为治疗师通过远程医疗指导家长对自闭症幼儿进行功能分析(FA)和功能性沟通训练(FCT)时的指导行为进行了回顾性分析。我们采用标准化行为代码和新行为代码对五位经验丰富的行为治疗师在七个亲子二人组中的指导行为进行了综合评分。在整个研究过程中,治疗师表现出的社会参与行为多于其他类型的行为,前因后果行为的发生率在FA和FCT阶段有所变化。研究结果与治疗师在行为评估和治疗过程中的目标以及培训行为治疗师通过远程医疗指导家长的意义进行了讨论。
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引用次数: 0
The Impact of Integrated Support and Context on Treatment Implementation and Child Outcomes Following Behavioral Consultation. 行为咨询后,综合支持和环境对治疗实施和儿童结局的影响。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2021-10-28 DOI: 10.1177/01454455211054020
George Noell, Kristin Gansle, Veronica Gulley

Assuring treatment plan implementation following consultation is critically important because implementation is strongly related to outcomes. Treatment implementation has been hypothesized to be influenced by both the nature of the follow-up support provided and contextual variables. However, studies to date have not examined both issues while directly measuring implementation. This study examined treatment implementation following consultation for 48 teachers in public schools who had referred a student for intervention services in a randomized clinical field trial. Participating teachers in the experimental group received Integrated Support (IS). IS includes social influence, planning, and performance feedback elements. IS was compared to weekly follow-up meetings alone. Treatment implementation and child outcomes were markedly superior for IS as compared to weekly follow-up. Three school climate factors were found to be correlated with treatment implementation for the IS group, but not the weekly follow-up group. Participants rated treatment implementation, treatment acceptability, and consultant effectiveness positively and similarly across conditions. The implications of these findings for future work examining school culture, consultation and intervention are discussed.

确保咨询后治疗计划的实施至关重要,因为实施与结果密切相关。治疗实施被假设受到所提供的随访支持的性质和环境变量的影响。然而,迄今为止的研究并没有在直接衡量执行情况时审查这两个问题。本研究调查了48名公立学校教师的治疗实施情况,这些教师在随机临床领域试验中推荐了一名学生进行干预服务。实验组参与教师接受综合支持(IS)。信息系统包括社会影响、计划和绩效反馈等要素。IS与每周单独的随访会议进行了比较。与每周随访相比,IS的治疗实施和儿童结局明显优于对照组。三个学校气候因素被发现与IS组的治疗实施相关,但与每周随访组无关。参与者在不同条件下对治疗实施、治疗可接受性和咨询师有效性的评价都是积极的,相似的。这些发现对未来研究学校文化、咨询和干预工作的意义进行了讨论。
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引用次数: 0
Assessing and Treating Anxiety in Individuals with Autism. 评估和治疗自闭症患者的焦虑。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2021-10-29 DOI: 10.1177/01454455211051678
Keira Moore, Amanda Bullard, Gemma Sweetman, William H Ahearn

Anxiety is a cluster of responses that can involve both operant and respondent behavior, which can be both public and/or private in nature, and occurs when an upcoming aversive stimulus is signaled. Despite the reported high comorbidity of autism and anxiety, there has been very limited research on how to directly assess and treat anxiety, especially with individuals who have limited communication skills. In Study 1, anxiety was assessed in five individuals with autism, ranging in age from 10 to 19 years old. Anxiety was assessed by measuring behavior during (1) a baseline (with no putative anxiety-provoking stimuli present), (2) signals for an upcoming aversive event, and (3) exposure to that aversive event. Anxiety presented in several different ways, as both conditioned activation and suppression, and both with and without problem behavior during the aversive event. In Study 2, individualized treatments involving differential reinforcement of alternative responses and stimulus fading were used to successfully reduce anxious responding in all four participants who displayed anxiety. These studies demonstrated a potentially useful means of assessing anxiety in individuals with autism which may not only help to measure anxious behavior and identify anxiety-provoking events, but may also lead to effective treatment.

焦虑是一组反应,可以涉及操作性和应答性行为,可以是公开的和/或私人的,当即将到来的厌恶刺激发出信号时发生。尽管有报道称自闭症和焦虑有很高的合并症,但关于如何直接评估和治疗焦虑的研究非常有限,尤其是对那些沟通能力有限的人。在研究1中,对5名自闭症患者的焦虑进行了评估,他们的年龄从10岁到19岁不等。焦虑是通过测量行为来评估的:(1)基线(没有假定的引起焦虑的刺激存在),(2)即将到来的厌恶事件的信号,(3)暴露于该厌恶事件。焦虑以几种不同的方式表现出来,如条件激活和抑制,以及在厌恶事件中有或没有问题行为。在研究2中,采用个体化治疗,包括选择性反应的差异强化和刺激消退,成功地减少了所有四名表现出焦虑的参与者的焦虑反应。这些研究证明了一种潜在的评估自闭症患者焦虑的有用方法,它不仅有助于测量焦虑行为和识别引发焦虑的事件,而且可能导致有效的治疗。
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引用次数: 2
Systematic Review and Meta-Analysis of Token Economy Practices in K-5 Educational Settings, 2000 to 2019. 2000年至2019年K-5教育环境中代币经济实践的系统回顾和元分析。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2021-11-16 DOI: 10.1177/01454455211058077
Ji Young Kim, Daniel M Fienup, Alice E Oh, Ye Wang

Token economy systems have been widely used as an evidence-based classroom management strategy to reinforce and improve prosocial responses. While token economies have been widely applied to educational settings, there have been mixed results regarding the effectiveness depending on the classroom type. To better understand the components contributing to the effectiveness, the researchers analyzed 24 token economy studies conducted in general and special education classrooms from kindergarten to fifth grade between 2000 and 2019. Eight token economy components and effect sizes were identified for each study and compared across different classroom types. The results showed that the token economy intervention yielded large effect sizes for both general and special education classroom types. There were differences in the usage of token components including backup reinforcer types, token production rate, and exchange production rate based on classroom types. Implications for future research and practice for educators and clinicians are discussed.

代币经济系统已被广泛用作以证据为基础的课堂管理策略,以加强和改善亲社会反应。虽然代币经济已广泛应用于教育环境,但根据课堂类型的不同,其有效性的结果好坏参半。为了更好地了解影响有效性的因素,研究人员分析了2000年至2019年间在幼儿园到五年级的普通教育和特殊教育教室进行的24项代币经济研究。为每项研究确定了八个代币经济成分和效应量,并在不同的教室类型中进行了比较。结果表明,代币经济干预对普通教育和特殊教育教室类型都产生了很大的效应。基于教室类型,令牌组件的使用存在差异,包括备份强化器类型、令牌生成率和交换生成率。讨论了未来研究和实践对教育工作者和临床医生的影响。
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引用次数: 3
Cognitive Restructuring Before Versus After Exposure: Effect on Expectancy and Outcome in Individuals With Claustrophobia. 幽闭恐惧症患者暴露前后的认知重构:对预期和结果的影响。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2022-02-12 DOI: 10.1177/01454455221075754
Kirstyn L Krause, Naomi Koerner, Martin M Antony

Maximizing the discrepancy between expected and actual outcomes during exposure (i.e., expectancy violation) is thought to optimize inhibitory learning. The current study examined Craske et al.'s suggestion that engaging in cognitive restructuring (CR) before exposure prematurely reduces expectancy and mitigates outcomes. Participants (N = 93) with claustrophobia were randomly assigned to either 15 minutes of CR before exposure (CR Before) or 15 minutes of CR after exposure (CR After). Although the CR Before condition experienced greater expectancy reduction before exposure than the CR After condition, both groups experienced similar overall expectancy reduction by the end of the intervention. Groups experienced similar gains, with large significant improvement at posttreatment and follow-up. Results suggest that both cognitive therapy and exposure therapy lead to expectancy reduction, but that the order of these interventions does not impact outcome. Clinicaltrials.org registration #NCT03628105.

在暴露过程中,最大化预期结果与实际结果之间的差异(即期望违反)被认为可以优化抑制性学习。目前的研究检验了Craske等人的建议,即在过早暴露之前进行认知重构(CR)会降低预期并减轻结果。有幽闭恐惧症的参与者(N = 93)被随机分配到暴露前15分钟的CR (CR before)或暴露后15分钟的CR (CR after)。尽管暴露前的CR组比暴露后的CR组经历了更大的期望降低,但两组在干预结束时都经历了相似的总体期望降低。各组均有类似的收获,在治疗后和随访中均有显著改善。结果表明,认知疗法和暴露疗法都会导致预期降低,但这些干预措施的顺序不会影响结果。Clinicaltrials.org注册#NCT03628105。
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引用次数: 2
Investigation of Regression-Based Effect Size Methods Developed in Single-Subject Studies. 单受试者研究中基于回归的效应量方法的研究。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2021-11-02 DOI: 10.1177/01454455211054018
Nihal Sen

The purpose of this study is to provide a brief introduction to effect size calculation in single-subject design studies, including a description of nonparametric and regression-based effect sizes. We then focus the rest of the tutorial on common regression-based methods used to calculate effect size in single-subject experimental studies. We start by first describing the difference between five regression-based methods (Gorsuch, White et al., Center et al., Allison and Gorman, Huitema and McKean). This is followed by an example using the five regression-based effect size methods and a demonstration how these methods can be applied using a sample data set. In this way, the question of how the values obtained from different effect size methods differ was answered. The specific regression models used in these five regression-based methods and how these models can be obtained from the SPSS program were shown. R2 values obtained from these five methods were converted to Cohen's d value and compared in this study. The d values obtained from the same data set were estimated as 0.003, 0.357, 2.180, 3.470, and 2.108 for the Allison and Gorman, Gorsuch, White et al., Center et al., as well as for Huitema and McKean methods, respectively. A brief description of selected statistical programs available to conduct regression-based methods was given.

本研究的目的是简要介绍单受试者设计研究中的效应量计算,包括对非参数和基于回归的效应量的描述。然后,我们将教程的其余部分集中在用于计算单受试者实验研究中效应大小的常见基于回归的方法上。我们首先描述五种基于回归的方法之间的差异(Gorsuch, White等人,Center等人,Allison和Gorman, Huitema和McKean)。接下来是使用五种基于回归的效应大小方法的示例,并演示如何使用样本数据集应用这些方法。这样就回答了不同效应量方法得到的值有何不同的问题。展示了这五种基于回归的方法中使用的具体回归模型以及如何从SPSS程序中获得这些模型。本研究将这五种方法得到的R2值转换为Cohen’s d值进行比较。对于Allison和Gorman、Gorsuch、White等人、Center等人,以及Huitema和McKean方法,从同一数据集获得的d值分别估计为0.003、0.357、2.180、3.470和2.108。简要介绍了可用于进行基于回归的方法的统计程序。
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引用次数: 2
Meta-Analysis of Mindfulness-Based Program Soles of the Feet for Disruptive Behaviors. 破坏性行为的脚底正念程序的元分析。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2022-02-03 DOI: 10.1177/01454455211073738
Joshua C Felver, Adam J Clawson, Tory L Ash, Brian K Martens, Qiu Wang, Nirbhay N Singh

Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years (SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was -0.87. Moderator analyses indicated SOF's effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.

基于正念的项目是减少破坏性行为的一种很有前途的干预方式,而脚底(SOF)是一种教授对个人事件(例如,不愉快的情绪)的内在意识和减少破坏性行为的自我调节策略的项目。本研究对单个案例研究设计(SCRD)研究进行了荟萃分析,这些研究实施了软件设计以减少破坏性行为。现有的SOF研究使用高质量的SCRD标准进行评估,结果纳入了15项研究(49名参与者;平均年龄23.12岁(SD = 15.87);高度异质背景)。研究分析使用Tau-U来计算效应量,Tau-U是一种创新的非参数统计方法,用于估计SCRD研究中的效应量。所有研究中sofs的总加权Tau-U效应量为-0.87。调节分析表明,sofs的有效性在参与者特征和交付格式中都是稳健的。这一荟萃分析表明,对于减少破坏性行为,软软件是一种适度有效的循证实践。
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引用次数: 7
Adolescent Safety Behaviors and Social Anxiety: Links to Psychosocial Impairments and Functioning with Unfamiliar Peer Confederates. 青少年安全行为和社交焦虑:与不熟悉同伴联盟的社会心理障碍和功能的联系。
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 Epub Date: 2021-11-11 DOI: 10.1177/01454455211054019
Hide Okuno, Taylor Rezeppa, Tabitha Raskin, Andres De Los Reyes

Socially anxious adolescents often endure anxiety-provoking situations using safety behaviors: strategies for minimizing in-the-moment distress (e.g., avoiding eye contact, rehearsing statements before entering a conversation). Studies linking safety behaviors to impaired functioning have largely focused on adults. In a sample of one hundred thirty-four 14 to 15 year-old adolescents, we tested whether levels of safety behaviors among socially anxious adolescents relate to multiple domains of impaired functioning. Adolescents, parents, and research personnel completed survey measures of safety behaviors and social anxiety, adolescents and parents reported about adolescents' evaluative fears and psychosocial impairments, and adolescents participated in a set of tasks designed to simulate social interactions with same-age, unfamiliar peers. Relative to other adolescents in the sample, adolescents high on both safety behaviors and social anxiety displayed greater psychosocial impairments, evaluative fears, and observed social skills deficits within social interactions. These findings have important implications for assessing and treating adolescent social anxiety.

社交焦虑的青少年经常使用安全行为来忍受引发焦虑的情况:减少当下痛苦的策略(例如,避免眼神接触,在进入谈话前排练语句)。将安全行为与功能受损联系起来的研究主要集中在成年人身上。在134名14至15岁青少年的样本中,我们测试了社交焦虑青少年的安全行为水平是否与多个功能受损领域有关。青少年、父母和研究人员完成了安全行为和社交焦虑的调查测量,青少年和父母报告了青少年的评估性恐惧和心理社会障碍,青少年参与了一系列旨在模拟与同龄、不熟悉的同龄人的社交互动的任务。与样本中的其他青少年相比,安全行为和社交焦虑水平较高的青少年在社交互动中表现出更大的社会心理障碍、评估性恐惧和观察到的社交技能缺陷。这些发现对于评估和治疗青少年社交焦虑具有重要意义。
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引用次数: 8
Amplification of Positivity Therapy for Co-occurring Alcohol Use Disorder with Depression and Anxiety Symptoms: Pilot Feasibility Study and Case Series. 放大积极疗法治疗酒精使用障碍伴抑郁和焦虑症状:试点可行性研究和病例系列
IF 2.3 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2022-09-01 DOI: 10.1177/01454455211030506
Elisabeth Akeman, Evan White, Kate Wolitzky-Taylor, Jessica Santiago, Timothy J McDermott, Danielle C DeVille, Jennifer L Stewart, Martin Paulus, Charles T Taylor, Robin L Aupperle

Positive valence system dysregulation is a relatively unexplored transdiagnostic mechanism and potential treatment target underpinning alcohol use and anxiety and depression symptoms. The current study examined the feasibility and potential benefit of a behavioral intervention focused on amplification of positivity (AMP) with eight adults (five female) diagnosed with alcohol use disorder and clinically significant depression or anxiety (ClinicalTrials.gov: NCT04278365). AMP for alcohol use (AMP-A) was delivered in 11 individual sessions involving positive activity interventions integrated alongside psychoeducation and alcohol use monitoring. Case descriptions are provided to illustrate treatment implementation. Treatment credibility and acceptability, participant endorsement of the therapy, and homework compliance were rated moderate to high. Exploratory, intent-to-treat analyses suggested medium to large effect sizes for post-treatment improvements in alcohol use, depression, anxiety, and positive affect. Results provide initial evidence of feasibility and acceptability of AMP-A and will be useful for informing future randomized clinical trials to examine clinical efficacy.

正效价系统失调是一个相对未被探索的跨诊断机制和潜在的治疗目标,支持酒精使用和焦虑和抑郁症状。目前的研究检查了8名成年人(5名女性)诊断为酒精使用障碍和临床显著抑郁或焦虑的行为干预的可行性和潜在益处(临床试验.gov: NCT04278365)。针对酒精使用的AMP (AMP- a)在11个单独会议中提供,包括积极的活动干预,以及心理教育和酒精使用监测。提供了案例描述来说明治疗实施。治疗的可信度和可接受性、参与者对治疗的认可和作业依从性被评为中至高。探索性、意向治疗分析表明,治疗后酒精使用、抑郁、焦虑和积极影响的改善具有中等到较大的效应。结果为AMP-A的可行性和可接受性提供了初步证据,并将为未来的随机临床试验提供有用的信息,以检查临床疗效。
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引用次数: 1
期刊
Behavior Modification
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