Experiences and Perceptions of Problem Gamblers on Cognitive and Exposure Therapies When Taking Part in a Randomised Controlled Trial: A Qualitative Study

In South Australia (SA) problem gambling is mainly a result of the widespread availability of electronic gaming machines. A key treatment provider in SA offers free cognitive and behavioural therapy (CBT) to help-seeking problem gamblers. The CBT program focuses on the treatment of clients’ urge to gamble using exposure therapy (ET) and cognitive therapy (CT) to restructure erroneous gambling beliefs. The aim of this study was to explore treatment specific and non-specific effects for CT alone and ET alone using qualitative interviews. Interviewees were a sub-sample of participants from a randomised trial that investigated the relative efficacy of CT versus ET. Findings revealed that all interviewees gained benefit from their respective therapies and their comments did not appear to favour one therapy over another. Both treatment specific and treatment non-specific effects were well supported as playing a therapeutic role to recovery. Participants’ comments in both therapy groups suggested that symptom reduction was experienced on a gambling related urge–cognition continuum. In addition to symptom improvement from therapy-specific mechanisms, ET participants described a general acquisition of “rational thought” from their program of therapy and CT participants had “taken-over” their gambling urges. The findings also highlighted areas for further improvement including therapy drop-out.     

The effectiveness of PREP with lower-income racial/ethnic minority couples

The current study examined the effectiveness of the Prevention and Relationship Enhancement Program (PREP) with lower-income and racial/ethnic minority (African American and Latino/a) couples. Additionally, we tested whether relationship outcomes varied based on the delivery format (i.e., group format vs. couple format). The sample included 321 unmarried couples expecting a child or who have a child 3 month old or younger. The couples participated in 16 hr of PREP via a group or a couple format over the course of 2-3 months. Couples relationship quality was assessed prior to and directly after the program. The results showed that men and women demonstrated significant gains in their communication skills, relationship functioning, friendship, dedication, and relationship confidence. Couples who participated in PREP via the couple format had better outcomes on three of the seven relational outcomes as compared to couples who participated in PREP via the group format.     

Training and Generalization of Peer-Directed Mands With Non-vocal Children With Autism

The current investigation evaluated the effects of extinction and prompts on training and generalization of peer-directed mands for preferred items using a picture exchange communication system with 2 children diagnosed with autism. Results showed that independent mands with a peer increased during treatment for both participants, generalized to a novel peer without explicit training for 1 participant and following training for the second participant, and maintained in a more naturalistic setting that simulated a free-play activity in a classroom.     

Relationship Education in Community Settings: Effectiveness with Distressed and Non‐Distressed Low‐Income Racial Minority Couples

Couple relationship education (CRE) programs are intended to prevent negative couple outcomes, however, some evidence suggests couples in greater distress may still benefit. The current study examined pre‐ and postchanges in relationship functioning of 362 low‐income African American and Hispanic couples. Outcomes (dedication and communication) were assessed by examining differences between two distinct groupings of couples; distressed (both partners reporting clinically significant distress) and nondistressed (neither partner reporting clinically significant distress) couples. Distressed couples at predemonstrated large‐sized gains in all outcome variables, as compared to nondistressed couples. Those who participated in the single‐couple format demonstrated lower gains in positive communication as compared to those in the group format. Implications for distressed couples in CRE programs are offered.     

Endothelial progenitor cell therapy for atherosclerosis: the philosopher's stone for an aging population?

Much of the increased risk for atherosclerosis progression with age may be a result of age-related declines in the capacity of precursor cells to repair damage in the arterial endothelium. To estimate the impact of progenitor cell therapy for atherosclerosis on cardiovascular disease (CVD) mortality, life expectancy, and survival, as compared with the lifetime control of conventional risk factors, we modeled the health effects of bone marrow-derived endothelial progenitor cell therapy using data from the 1950 to 1996 follow-up of the Framingham Heart Study. To model cardiovascular disease mortality, we assumed that progenitor cell therapy was applied at age 30, with the effect assumed to be a 10-year delay in atherosclerosis progression. Age projections were constructed analytically using the stochastic process model for risk factor dynamics and mortality and microsimulation techniques. We considered three types of interventions: (i) keeping risk factors within selected limits to model current clinical recommendations; (ii) an age shift of 10 years to model the effects of progenitor cell therapy; and (iii) elimination of a competing risk (such as cancer). Our study suggests that progenitor cell therapy might increase life expectancy in the population as much as the complete elimination of cancer (in females, an additional 3.67 versus 3.37 years; in males, an additional 5.94 versus 2.86 years, respectively).     

The Safety First Assessment Intervention: A Whole Family Approach for Young People with High Risk Mental Health Presentations

The following article provides a comprehensive guide to the clinical implementation of the Safety First Assessment Intervention (SFAI). The SFAI is a systemised, whole family approach for young people with high‐risk issues presenting in a mental health crisis. It is underpinned by the Safety First Model (Bickerton et al., 2007 ) and promotes community‐based care. The SFAI operationalises the foundation levels of the Safety First Model (SFM) through a highly structured clinical process. It draws on family systems theory, predominantly the work of Bowen ( 1978 ), to conceptualise distress through a multi‐generational systems lens and to prioritise the young person's natural support system (their family, friends, school and community) as their key resource. The SFAI engages this natural support system and facilitates open communication about symptoms, distress, safety and risk. This promotes a shared understanding of the key issues in a relational context and forms the basis of collaborative risk management. Thus, a system of safety emerges prioritising the family's role in optimising the young person's community‐based recovery. The need for pharmacotherapy and hospitalisation is therefore minimised. The article includes background theory, an outline of the structured assessment intervention and clinical techniques, including strategies for complex family situations. Specific strategies are illustrated with fictional vignettes. The work is based on the authors' accumulated experiences of working with young people and their families and carers in an acute Child and Adolescent Mental Health Service (CAMHS) for over a decade.