Inside the interview: Clinical considerations in the research interview

The clinical interview is the major therapeutic tool which develops and directs psychological understanding of clients. Concepts and skills already refined by therapists in their clinical work and training can be extrapolated and adapted to do research about sensitive life experiences with a normal population. Transmission of knowledge thus gained expands the social work field in important ways.     

The effect of postural lean and body congruence on the judgment of psychotherapeutic rapport

Naturalistic studies have implicated both forward postural lean and interpersonally congruent limb configurations as nonverbal indices of social rapport, although both variables have been confounded with verbal and other nonverbal concomitants. In the present study direction of postural lean and congruence of body positions were systematically manipulated in each of six 40-second videotaped segments of simulated client-therapist interactions. Participating in the study were 30 male and 30 female undergraduate students, each of whom viewed one of six orders of the segments and rated the level of rapport in each interaction. A 2 × 3 × 2 × 6 analysis of variance on factors of Congruence, Lean, Sex, and Order revealed main effects of the Lean and Congruence variables (p<.001 andp<.05, respectively), and no significant main effects of Sex or Order. Both congruent limbs and forward-leaning postures on the part of the therapist and client were significant contributors to attributions of rapport.The authors wish to thank Philip Lawlis, Louis Gamino, Edward Wike, B. Kent Houston, and Dennis Karpowitz for their assistance with the study.     

Multivariate regression analysis and canonical variates

A method called FICYREG of estimating regression coefficients is introduced. This is a generalization to the multivariate regression problem of the James-Stein estimator. When suitably représentés FICYREG emerges as a rule in which the canonical variates and canonical correlations have an intrinsic role to play. By exploiting these objects FICYREG is able to achieve stability against the influence of the “noise” present in problems where the responses are correlated so that some of the response vector's canonical variates will be essentially independent of all others including the predictors. The least squares (LS) estimator is, by contrast, highly sensitive to this noise. The use of FICYREG is illustrated in terms of an example, and its peformance is compared to the LS estimator when a quadratic loss function is assumed. The cases of both fixed and random predictors are considered. Overall, FICYREG outperforms the LS estimator.     

Reaching the hard to reach: innovative housing for homeless youth through strategic partnerships

This article features three housing programs designed to target the needs of youth aging out of child welfare. One program combines housing and treatment to move substance-dependent youth off the streets; one combines the resources of Urban Peak, the only licensed homeless and runaway youth shelter in Colorado, with the Denver Department of Human Services to prevent youth in child welfare from discharging to the streets; and one addresses the intense mental health needs of this population. It costs Colorado 53,655 dollars to place a young person in youth corrections for one year and 53,527 dollars for residential treatment. It costs Urban Peak 5378 dollars to move a young person off of the streets. This article describes how data have driven program development and discusses how policy implications and relationships with the public and private sector can leverage additional resources.     

Eternal work place change: Chaplains' response

A detailed chronology of a unique response to organizational change is explored and discussed through the example of the Chaplaincy Staff Support Service at Hamilton Health Sciences. Highlighted are the corporate and staff benefits of using chaplains' skills, training and existing roles in hospital life. A summary of the specific methodologies are provided to clarify the theoretical discussion. It is concluded that this is a fiscally efficient means of supporting staff to live out the highest organizational principles in difficult times.     

The clinical practice of juvenile forensic psychiatric nurses

The differences in working with an adolescent population within the nonmedical structure of the juvenile justice system provides a basis for claiming forensic psychiatric nursing has a specialized knowledge and skill base for meeting the needs of this juvenile population. Future development of forensic psychiatric nursing depends on continued articulation of the role of forensic nurses in these highly specialized settings and development of empirically based forensic psychiatric nursing interventions. Juvenile forensic psychiatric nursing requires specific personal attributes and new competencies that extend beyond traditional psychiatric nursing skills. These nurses must be confident in their clinical skills, demonstrate strong leadership capabilities, and be tolerant of the uncertainties associated with these unique environments.     

Affective and self-efficacy responses to acute aerobic exercise in sedentary older and younger adults

This study examined the psychological responses to an acute bout of aerobic exercise in sedentary older and younger adults. Eighteen young (mean age 24 years) and 15 older adults (mean age 64 years) completed a 20-min bout of stationary cycling at 65% of VO2peak. Affective responses were assessed before, during, and immediately after exercise. Participants'exercise self-efficacy beliefs were assessed before and immediately after exercise. Both groups reported reduced pleasant feeling states and self-efficacy and increased physical exhaustion in response to acute exercise. Older adults also demonstrated a significant decrease in revitalization during and after cycling. Correlation analyses revealed that self-efficacy was related to feelings of fatigue during exercise and postexercise feelings of energy and fatigue. Both groups reported negative shifts in affect and self-efficacy during and 5 min after cycling.Acute affective and self-efficacy responses might influence one's motivation to adopt and maintain regular physical activity. The relationship between these acute responses and physical activity behavior across the life span warrants future inquiry.     

Are risks and benefits of oncological research protocols both incommensurable and incompensable?

Institutional review boards (IRBs) are legally required to determine whether the balance between the risks and benefits (the risk-benefit ratio or RBR) of a proposed study is "reasonable" or "proportional". This obligation flows from their duty to protect the interests of research subjects. It has been argued that it is difficult, perhaps even impossible for IRBs to determine the RBR of studies, because the risks and benefits are not only heterogeneous, but also incommensurable. After arguing that the relevant meaning of incommensurability is incomparability, we discuss whether the risks of participating in a trial and the benefits are comparable. We conclude that at least the risks and the benefits to participants are comparable. In the last section we show that the main problem of RBR analyses is that of interpersonal incompensability. IRBs have to assume that risks to research subjects be compensated by benefits to others. The question is: To what extent? When does it become unreasonable to ask that patients accept the risks of participating in a trial for the benefit of science and/or future patients?     

Assessing the Effect of an Electronic Decision Support System on Children's Mental Health Service Outcomes

This study examined the effect of clinician adoption on an agency built Electronic Discussion Support System on the reduction of youth risk factors. This exploratory study is the first of its kind to assess an agency-built Electronic Decision Support Systems (EDSS) within a children's mental health program to see how it is utilized in a treatment as usual climate. The results showed a significant difference between the reduction-in-risk rating for two of the domains of the North Carolina Family Assessment Scale (Parental Capability and Environment). Yet findings showed that only a few staff utilized the EDSS regularly. Based on the findings, it appears there was a break down in the implementation process. Although the agency had the best of intentions by building the Dashboard, without proper emphasis on implementation their goal was never fully actualized.     

Effects and Costs of Tracing Strategies on Nonresponse Bias in a Survey of Workers with Low-Back Injury

Declining rates of participation are an increasing challengefor studies that involve telephone surveys. This study examinedthe costs of a telephone survey methodology that used increasinglyintensive tracing methods to track a pool of claimants who hadsustained occupational back injuries. It also compared the respondentsample to people who refused the survey and/or were not locatedor contacted. 3,181 claimants were drawn from a database maintainedby the Missouri Division of Workers’ Compensation (DWC)and 1,475 completed a telephone interview. The DWC databaseprovided data reflecting monetary and disability outcomes forall potential participants; telephone interviews provided additionalself-reported data. More intensive tracing strategies improvedthe representativeness of the sample, yielding more women andminority participants. Relative to less intensive techniques,advanced tracing efforts located people whose DWC records weremore similar to claimants not located. While the hands-on tracingefforts reduced the apparent bias of the respondent sample,costs increased as tracing strategies intensified – over$98,000 was spent to trace 1,027 claimants who were never locatedor contacted. The results suggest some guidelines that may facilitatedecision-making for researchers and funders who must balancethe trade-off between costs and nonresponse bias when planningsurveys.