Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems

The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.     

Changes in couple,parenting, and individual functioning following Family Expectations program participation

The current study investigated changes in couple, parenting, and individual functioning following participation in Family Expectations, a relationship and parenting education program for new or expectant parents. The sample comprised 339 couples who participated in most sessions of the Family Expectations program and completed assessments at three different time points over a 12-month period. Study analyses examined: (a) change shortly following completion of the program, (b) associations between short-term change and subsequent change in outcomes at 12-month follow-up, and (c) differences in short-term change between married and unmarried couples. Significant improvements were observed in all three domains at short-term follow-up. Short-term changes, particularly for psychological distress, were predictive of long-term change in multiple domains. Few moderation effects by marital status were evident; those that appeared suggested stronger effects for married participants compared to unmarried. Study findings inform ongoing discussions into the utility of federally-funded relationship and parenting programming.     

Parent training to reduce problem behaviors over the transition to high school: Tests of indirect effects through improved emotion regulation skills

Adolescent problem behaviors are costly for individuals and society. Promoting the self-regulatory functioning of youth may help prevent the development of such behaviors. Parent-training and family intervention programs have been shown to improve child and adolescent self-regulation. This study helps fill gaps in knowledge by testing for indirect effects of the Common Sense Parenting® (CSP) program on reduced substance use, conduct problems, and school suspensions through previously identified short-term improvements in parents' reports of their children's emotion regulation skills. Over two cohorts, 321 low income families of 8th graders were enrolled and randomly assigned to either the standard CSP program, an adapted CSP Plus program, or a minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey assessments were completed by parents and students with 94% retention. Intent-to-treat multivariate path analyses were conducted. Neither intervention had statistically significant total effects on the three targeted adolescent outcomes. CSP, but not CSP Plus, had statistically significant indirect effects on reduced substance use and school suspensions at the 1-year follow-up as well as conduct problems and school suspensions at the 2-year follow-up through increased child emotion regulation skills at posttest. Findings provide some support for emotion regulation as one pathway through which the intervention was associated, indirectly, with reduced substance use, conduct problems, and school suspensions among at-risk students over the high school transition.     

Evaluation of a personal safety program with Latino preschoolers

This study evaluated a personal safety educational program designed for Latino families attending preschools in a large metropolis. Seventy-eight children who participated in the Kids Learning About Safety program were compared to 45 control children. Compared with controls, participating children demonstrated enhanced ability to recognize inappropriate touches, learned correct genital terminology, were able to recognize the inappropriateness of touch requests made by "good" people, demonstrated higher levels of personal safety skills, and learned general safety rules. Gains in knowledge were maintained at three-month follow-up testing for all content areas except genital terminology. Although feedback provided by participating families was positive, recruiting participants and maintaining attendance at sessions was difficult. Discussion includes recommendations for future research and engagement of this population.     

Evolve Therapeutic Services: A 5-year outcome study of children and young people in out-of-home care with complex and extreme behavioural and mental health problems

BackgroundLittle evaluation research has been conducted on the effectiveness of services and intervention provided to children in out-of-home care. This study evaluated an innovative Queensland, Australia program employing a collaborative wrap-round model of care in combination with a flexible intervention approach, individually tailored to children and young people in out-of-home care presenting with complex and extreme behavioural and mental health problems.MethodThe sample consisted of 664 children and young people. Two clinician-rated measures, the CGAS and HoNOSCA, were used to assess young people's functioning via a pre-post-treatment design.ResultsResults revealed significant improvements across a range of problems areas: general functioning and adjustment; disruptive, antisocial and aggressive behaviour; overactivity, poor attention and concentration; non-accidental self-injury; problems with scholastic and language skills; non-organic somatic symptoms; emotional symptoms; peer and family relationships; self-care and independence; and school attendance.ConclusionFindings provide good evidence for the effectiveness of the therapeutic intervention program. Implications for future research are explored.     

An Evaluation of Group Intervention Programs for Violent and Abusive Men

Using the Abusive Behaviour Inventory and Rosenberg's Self Esteem Questionnaire, we assessed the efficacy of six group intervention programs for abusive and violent men. We predicted that both physical and psychological abuse levels would be significantly lower and that self-esteem would increase significantly post-treatment. The six group programs, involving forty-five male participants overall, were conducted over ten to fourteen weeks in the Melbourne metropolitan area. Sixteen non-abusive male subjects were used as a comparison group. Results indicated that the programs were more effective than no treatment in significantly reducing psychological (but not physical) abuse and had no effect on self-esteem. No post-program differences were found between the comparison and treatment groups. We concluded that the programs had positive effects on the participants, particularly in the reduced levels of psychological abuse, and that self-esteem was not a meaningful factor in level of abusive behaviour. The relatively low mean preprogram score on the physical abuse sub-scale for the program groups may explain the lack of significant differences between the physical abuse pre-program and post-program scores.     

Impairments and perceived competence in persons living with HIV/AIDS

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.     

Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.     

An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease

A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.     

An integrated relapse prevention and relationship safety intervention for women on methadone: testing short-term effects on intimate partner violence and substance use

This study tests the feasibility, safety, and short-term preliminary effects of a relapse prevention and relationship safety (RPRS) intervention in reducing drug use and the experience of intimate partner violence (IPV) among women on methadone. For this randomized controlled trial, 34 women who met IPV and drug use criteria were randomly assigned to either the RPRS condition (n = 16) or a one-session informational control (IC) condition (n = 18). RPRS participants were more likely than IC participants to report a decrease in minor physical or sexual IPV (OR = 7.1, p = .05), minor psychological IPV (OR = 5.3, p = .03) and severe psychological IPV (OR = 6.07, p = .03) at the 3-month follow-up. Data suggest that RPRS participants were also more likely than IC participants to report a decrease in any drug use at 3 months (OR = 3.3, p = .08). This study provides preliminary evidence that the RPRS intervention is effective in reducing IPV and drug use among women on methadone.     

Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

Connecting and Strengthening Young Aboriginal Men: A Family Wellbeing Pilot Study

A significant proportion of young people in Australia are currently not being engaged in school and other social systems. This article presents the results of a mixed-methods study of a pilot Family Wellbeing intervention designed to enhance the social and emotional wellbeing (SEWB) of young Aboriginal men and improve engagement in education, employment, and other social participation. A questionnaire incorporating the Kessler Psychological Distress Scale and respondent self-assessment SEWB questions was administered to program participants pre and post intervention (N = 30) and qualitative data were collected from program organisers (N = 6). The results suggest that the Family Wellbeing intervention has the capacity to make a marked contribution to the SEWB of young Aboriginal men; participants experienced strong improvement in capacity to manage relationships, engagement in education and employment, and mental and physical health. The factors that enabled the program to be adapted to the target group and setting are documented.     

A randomized controlled trial of a 5-year marriage checkup booster session for a subsample of responder couples

This study examined maintenance and booster effects of a brief couple intervention, the Marriage Checkup (MC), across 5 years. A subsample of 63 couples who benefitted from two previous MCs (responder couples), were randomly assigned to a third MC or control. Before randomization (at 4-years-9-months), the responder sample had maintained small to medium effects on two measures of relationship functioning. After randomization, we found no significant between-group effects. Yet, within-group analyses revealed that while control couples showed flat trajectories in all outcomes after the 4-year-9-months baseline, couples receiving a third MC (at Year 5) reported small to medium improvements in three measures of relationship functioning and maintained follow-up effect in one measure. Findings indicate that couples who initially improved from the MC can maintain some of their improvements over long periods. The potential of boosting such improvements with recurrent MCs is a relevant target for further investigation in larger samples.     

Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes

The association between relationship functioning and depressive symptoms is well established. This study examined the effects of the Marriage Checkup, a brief two-session Assessment and Feedback relationship intervention, on depressive symptoms. Two hundred and nine married couples participated in the Marriage Checkup and were randomized into Treatment (N = 108) and Waitlist-Control Conditions (N = 101). Compared to the control condition, intervention participants reported significant improvements in depressive symptoms (d = 0.55), with an even greater effect for those who were reporting more severe baseline depression symptoms (d = 0.67). These outcomes are comparable to those within long-term individual psychotherapy, couple therapy, and pharmacology trials, making this the briefest intervention to date to demonstrate significant improvements in depressive symptoms. Clinical implications are discussed.     

Reducing inequality summer by summer: Lessons from an evaluation of the Boston Summer Youth Employment Program

Many U.S. cities have implemented Summer Youth Employment Programs (SYEPs) with the hope of improving long-term behavioral, academic, and economic outcomes among program participants, particularly inner-city, low-income, and non-white youth. While recent empirical studies show positive impacts for some outcomes, little is known about program mechanisms and the potential to reduce inequality across groups. Using an embedded randomized control trial, this study evaluates improvements in short-term outcomes for the Boston SYEP based on survey data collected for both treatment and control groups during the summers of 2015, 2016, and 2017. Participants reported increases in community engagement and social skills, job readiness skills, and college aspirations that were significantly different from the control group. In most cases, the largest gains were observed for non-white youth suggesting that the program may have the capacity to reduce inequality across groups. Our hope is that this article will serve as a resource for those seeking to understand how summer jobs programs work and for whom, and to use these findings to strengthen and target the SYEP intervention. We also provide practical lessons learned regarding the development and deployment of our survey instrument to both the treatment and control groups among the youth population.     

An analysis of participation factors and effects of the active labour market measure Graduate practice in Slovakia – Counterfactual approach

The paper presents the results of the evaluation of the selected active labour market policy measure “Contribution to the Graduate practice” in Slovakia. The measure is of a voluntary nature and its main aim is to prevent long-term unemployment among young people and to support a competitive ability of young school-leavers and thus their employability and sustainability in the labour market through the acquisition of work experience, professional skills and work habits. In the study, we analyse the selected characteristics of young jobseekers who participated in this measure in 2016 and their counterfactuals who did not participate. In addition to 2016, the observed period includes a subsequent 2 years – the individual impact period of the measure for each participant, i.e. the years 2017 and 2018. We evaluated the effects of the measure by applying the exact matching of treated and non-treated individuals using the outcome variables, namely wages and placement in the labour market in the impact period of the measure. The results indicate that the Graduate practice had a positive impact on the employability and sustainability of its participants, but rather in short-term or maximum long-term. Regarding the wage levels referring to the financial appraisal of the participants of the measure, the results suggest that non-treated individuals were better financially evaluated and so the Graduate practice did not guarantee better salary to its participants. The findings of the study are important in the setting of conditions of the measure for future periods in order to achieve its better functioning and efficiency in the way of proper targeting, more efficient use of funds, and for a system of their redistribution.     

Minimal Treatment Approaches for Concerned Significant Others of Problem Gamblers: A Randomized Controlled Trial

The goal of this study was to examine the efficacy of minimal treatment interventions for concerned significant others (CSOs) of problem gamblers. One hundred and eighty-six participants (82% females, 56% spouses) were randomly assigned to one of three groups: the first minimal intervention group received a self-help workbook [based on behavioral principles, modified from the Community Reinforcement and Family Therapy (CRAFT) model] and the second minimal intervention group received the workbook plus telephone support. The control condition received a treatment resource information package. Overall, all participants reported significant improvement in personal and relationship functioning and gambling behavior and consequences at the 3- and 6-month follow-up. The data demonstrated differences in favor of the interventions in three areas: days gambling, satisfaction with the program, and number who had their needs met. There was no difference in the number who had entered treatment. It may be that CSOs require more guidance and follow-up support to achieve these goals using the CRAFT procedures and strategies.     

Pediatrics: The emerging psychosocial challenges of the AIDS epidemic

HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological manifestations of HIV in children. Direct effects are the outcome of the virus acting on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect effects involve psychological responses to the stress of living with a life threatening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Institute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate interventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative intervention techniques, and for providing advocacy services concerning possible legal, financial, housing, and educational issues.     

What mattered ten years on? Young people's reflections on their involvement with a charitable youth participation project

Youth work in England is experiencing ongoing rapid and significant change, fuelling debate about its very function. This paper contributes to this debate by presenting original research on what young people themselves prioritised as significant in-service provision and highlights the longer-term impact that engagement with a voluntary sector organisation can have on the lives of vulnerable young people. Drawing on qualitative interviews with ten former youth participants involved in youth participation projects, the findings presented in this paper suggest that participants felt the support they received was, in many cases, ‘transformative’. However, they primarily defined their experiences and the impact through their relationships with individuals supporting them, through the sense of achievement and ability to effect change they developed and through finding a voice to affect community decisions.     

The effects of a pedometer-based intervention on first-year university students: A randomized control trial

ABSTRACT

Objectives: To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior, health-related quality of life (HRQOL), and psychological well-being of first-year university students. Participants: First-year university students (N = 184) were recruited during September 2012 and randomly assigned to an intervention or a control group. Methods: Intervention participants were provided with a pedometer, monthly tracking logs, and follow-up e-mails. Control participants received no intervention. Physical activity, HRQOL, and psychological well-being were measured at baseline and post intervention. Data were analyzed using multivariate/univariate analysis of variance (MANOVA/ANOVA). Results: All participants experienced an increase in mild physical activity (p < .01) from baseline to follow-up. The intervention failed to produce significant differences between groups for physical activity (p = .28), HRQOL (p = .80), or psychological well-being (p = .72). Psychological well-being (p < .001), vigorous physical activity (p = .04), and mental health status (p < .001) decreased across the duration of the study. Conclusions: More intensive interventions may be required to elicit physical activity behavior change.