Walk-in clinic counselling for emotional regulation with low-needs youth on the autism spectrum

A single-session consultation model for low-needs youth on the autism spectrum is presented with the mental health concern of emotional self-regulation, a common issue in family psychotherapy. This research is contextualised within the growing field of short-term therapy as it intersects the growing demand to therapeutically address clients on the autism spectrum. The treatment intervention is delineated through five sequential phases within the walk-in clinic setting for the practitioner clinician. A rationale, overview, and instruction for the practitioner clinician utilising this novel model is provided through a case study format. By using a more structured and integrated approach to treatment, organised through an externalised metaphor, it is suggested that the current model will be more effective for this specific clinical population. Additionally, a case illustration is provided that scaffolds the treatment model, which includes table formats and pictures. The case study illustrates the self-regulation map metaphor visually and interactively linking client challenges, strategies, and motivations simultaneously on multiple electronic devices in session. Relevant works were selected to explore the effectiveness of single-session consultation models for those presenting on the autism spectrum. Treatment interventions for specific clinical populations are recommended, especially within walk-in clinic therapy. This clinical research introduces a paradigm shift towards therapeutically addressing emotional self-regulation with low-needs youth on the spectrum through virtual, interactive technology.     

Improving precision and power in randomized trials with a two-stage study design: Stratification using clustering method

In a randomized controlled trial (RCT), it is possible to improve precision and power and reduce sample size by appropriately adjusting for baseline covariates. There are multiple statistical methods to adjust for prognostic baseline covariates, such as an ANCOVA method. In this paper, we propose a clustering-based stratification method for adjusting for the prognostic baseline covariates. Clusters (strata) are formed only based on prognostic baseline covariates, not outcome data nor treatment assignment. Therefore, the clustering procedure can be completed prior to the availability of outcome data. The treatment effect is estimated in each cluster, and the overall treatment effect is derived by combining all cluster-specific treatment effect estimates. The proposed implementation of the procedure is described. Simulations studies and an example are presented.     

Generalized phase I-II designs to increase long term therapeutic success rate

Designs for early phase dose finding clinical trials typically are either phase I based on toxicity, or phase I-II based on toxicity and efficacy. These designs rely on the implicit assumption that the dose of an experimental agent chosen using these short-term outcomes will maximize the agent's long-term therapeutic success rate. In many clinical settings, this assumption is not true. A dose selected in an early phase oncology trial may give suboptimal progression-free survival or overall survival time, often due to a high rate of relapse following response. To address this problem, a new family of Bayesian generalized phase I-II designs is proposed. First, a conventional phase I-II design based on short-term outcomes is used to identify a set of candidate doses, rather than selecting one dose. Additional patients then are randomized among the candidates, patients are followed for a predefined longer time period, and a final dose is selected to maximize the long-term therapeutic success rate, defined in terms of duration of response. Dose-specific sample sizes in the randomization are determined adaptively to obtain a desired level of selection reliability. The design was motivated by a phase I-II trial to find an optimal dose of natural killer cells as targeted immunotherapy for recurrent or treatment-resistant B-cell hematologic malignancies. A simulation study shows that, under a range of scenarios in the context of this trial, the proposed design has much better performance than two conventional phase I-II designs.     

Separate Spheres or Increasing Equality? Changing Gender Beliefs in Postwar Japan

This research investigates change in gender beliefs in Japan during a period of economic hard times in the late 1990s. Using data from the International Social Survey Programme on the Japanese population from 1994 (n = 1,054) and 2002 (n = 872), we examined how cohort replacement and intracohort change contributed to changes in gender beliefs. We found important differences from the patterns of change reported for many Western countries, namely, a decoupling between societal trends in the female labor force participation rate and beliefs about gender. Such differences may be attributable to factors such as the high societal valuation of the housewife role compared to that in other postindustrial countries and sanctions against full‐time employment for women in Japan.     

Substance abuse and dependency risk: the role of peer perceptions, marijuana involvement, and attitudes toward substance use among college students

Many college students are using substances at levels consistent with Substance Abuse or Dependence, yet little explanation for this phenomenon exits. The aim of this study was to explore a risk factor profile that best separates those with low and high potential for having a substance use disorder (SUD). A discriminant function analysis revealed that participants with a high probability of having a SUD misperceive others' alcohol and marijuana use to a greater extent than those with a low probability of having a SUD. Implications for educators and counselors on college campuses are discussed.     

One Decade of Self Exclusion: Missouri Casino Self-Excluders Four to Ten Years after Enrollment

For more than a decade, casinos around the world have offered self-exclusion programs (SEPs) to gamblers seeking help with their gambling behavior. Despite the proliferation of SEPs, little is known about the long-term outcomes for gamblers who utilize these programs. The current study assessed the experiences of a sample (N = 113) of Missouri self-excluders (SEs) for as long as 10 years after their initial enrollment in the Missouri Voluntary Exclusion Program (MVEP). Most SEs had positive experiences with MVEP and reduced their gambling and gambling problems after enrollment. However, 50% of SEs who attempted to trespass at Missouri casinos after enrollment were able to, indicating that the benefit of MVEP was attributable more to the act of enrollment than enforcement. SEs who engaged in complementary treatment or self-help groups had more positive outcomes than those who did not, suggesting that SEPs ought to encourage and provide information about additional support and treatment options to participants.     

The Effects of Early Institutionalization on the Discrimination of Facial Expressions of Emotion in Young Children

The current study examined the effects of institutionalization on the discrimination of facial expressions of emotion in three groups of 42‐month‐old children. One group consisted of children abandoned at birth who were randomly assigned to Care‐as‐Usual (institutional care) following a baseline assessment. Another group consisted of children abandoned at birth who were randomly assigned to high‐quality foster care following a baseline assessment. A third group consisted of never‐institutionalized children who were reared by their biological parents. All children were familiarized to happy, sad, fearful, and neutral facial expressions and tested on their ability to discriminate familiar versus novel facial expressions. Contrary to our prediction, all three groups of children were equally capable of discriminating among the different expressions. Furthermore, in contrast to findings at 13–30 months of age, these same children showed familiarity rather than novelty preferences toward different expressions. There were also asymmetries in children’s discrimination of facial expressions depending on which facial expression served as the familiar versus novel stimulus. Collectively, early institutionalization appears not to impact the development of the ability to discriminate facial expressions of emotion, at least when preferential looking serves as the dependent measure. These findings are discussed in the context of the myriad domains that are affected by early institutionalization.