47 results on '"Suzanne Levy"'
Search Results
2. Attachment-based family therapy: Theory, clinical model, outcomes, and process research
- Author
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Suzanne Levy, Gary M. Diamond, and Guy S. Diamond
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Family therapy ,medicine.medical_specialty ,Psychotherapist ,Adolescent ,Family Conflict ,Process (engineering) ,Emotions ,Interpersonal communication ,Object Attachment ,Outcome (game theory) ,Article ,Clinical trial ,Suicide ,Psychiatry and Mental health ,Clinical Psychology ,Distress ,Empirical research ,medicine ,Humans ,Family Therapy ,Outcomes research ,Psychology - Abstract
Attachment-based family therapy (ABFT; Diamond G.S. et al., 2014 ) is an empirically supported treatment designed to capitalize on the innate, biologically based, caregiving instinct and adolescent need for attachment security. This therapy is grounded in attachment and emotional processing theory and provides an interpersonal, process-oriented, trauma-informed approach to treating adolescents struggling with suicide and associated problems such as depression and trauma. ABFT offers a clear structure and road map to help therapists quickly address the attachment ruptures that lie at the core of family conflict, which can fuel adolescent distress. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanisms of change. In this paper, we provide an overview of the theories underlying the model, the clinical strategies that guide the treatment, the outcome research that demonstrates efficacy, and the process research that explores the proposed mechanisms of change.
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- 2021
3. Effects of earlens lens placement on sound field thresholds, tympanometric measurements and wideband acoustic immittance
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Matthew Lucas, Paula Folkeard, Suzanne Levy, Drew Dundas, Susan Scollie, and Sumit Agrawal
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Speech and Hearing ,Linguistics and Language ,tympanic membrane ,power absorbance ,direct drive hearing aid ,Earlens ,tympanometry ,wideband acoustic immittance ,Language and Linguistics - Abstract
Objective: The Earlens is a direct-drive hearing device consisting of a lens which physically displaces the umbo to achieve appropriate gain. The objective is to determine the clinical acceptability of clinical immittance measurements in Earlens wearers. Design: Controlled before-after within-subjects repeated measures study. Study sample: Data is reported for measurements obtained on 15 subjects (average age of 72.2 years) with data from 30 ears. Results: There was a small effect of lens placement on sound field thresholds in most subjects. The largest damping effect of 4 dB was observed at 1000 Hz. An average reduction of 0.17 mL was identified in compliance following lens placement (p < 0.05). An effect of the lens on power absorbance obtained at ambient and peak pressure was found. The lens resulted in an increase in power absorbance at low frequencies (below 500 Hz) and a decrease in the mid to high-frequency range of approximately 500–3500 Hz (p < 0.05). Conclusions: Lens wear had a small effect on audiometric thresholds and tympanometry for most patients. Clinicians who use compliance and power absorbance should take into consideration lens effects on these measurements. Additional work is required to develop clinical normative ranges of these measures for wearers of the Earlens.
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- 2022
4. Attachment‐Based Family Therapy in a Psychiatric Inpatient Unit for Young Adults
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Ilse Devacht, Suzanne Levy, Steven Dewulf, Guy Bosmans, and Guy S. Diamond
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Family therapy ,medicine.medical_specialty ,Sociology and Political Science ,medicine ,Psychology (miscellaneous) ,Young adult ,Psychology ,Psychiatry ,Unit (housing) - Published
- 2019
5. A Randomized Controlled Trial: Attachment-Based Family and Nondirective Supportive Treatments for Youth Who Are Suicidal
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Robert Gallop, Guy S. Diamond, Jody Russon, Suzanne Levy, Joanna Herres, E. Stephanie Krauthamer Ewing, and Roger Kobak
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Male ,Family therapy ,Social Sciences ,Psychology, Developmental ,Poison control ,Suicide, Attempted ,Pediatrics ,THERAPY ,Suicide prevention ,law.invention ,SELF-HARM ,Randomized controlled trial ,law ,ADOLESCENTS ,Developmental and Educational Psychology ,Psychology ,Child ,Suicidal ideation ,11 Medical and Health Sciences ,Psychiatry ,Reactive Attachment Disorder ,treatment ,Depression ,05 social sciences ,17 Psychology and Cognitive Sciences ,Psychiatry and Mental health ,RELIABILITY ,ATTEMPTERS ,Family Therapy ,Female ,medicine.symptom ,Life Sciences & Biomedicine ,INTERVENTION ,050104 developmental & child psychology ,Clinical psychology ,Adolescent ,Developmental & Child Psychology ,Suicidal Ideation ,PSYCHOTHERAPY ,Injury prevention ,medicine ,Humans ,0501 psychology and cognitive sciences ,VALIDITY ,IDEATION ,suicide ,attachment ,Science & Technology ,business.industry ,Pennsylvania ,Object Attachment ,Clinical trial ,Supportive psychotherapy ,Self Report ,business - Abstract
Objective: To evaluate the efficacy of attachment-based family therapy (ABFT) compared with a family-enhanced nondirective supportive therapy (FE-NST) for decreasing adolescents’ suicide ideation and depressive symptoms. Method: A randomized controlled trial of 129 adolescents who are suicidal ages 12- to 18-years-old (49% were African American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline and 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms. Results: There was no significant between-group difference in the rate of change in self-reported ideation (Suicidal Ideation Questionnaire-Jr; F1,127 = 181, p = .18). Similar results were found for depressive symptoms. However, adolescents receiving ABFT showed a significant decrease in suicide ideation (t127 = 12.61, p < .0001; effect size, d = 2.24). Adolescents receiving FE-NST showed a similar significant decrease (t127 = 10.88, p < .0001; effect size, d = 1.93). Response rates (ie, ≥50% decrease in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST. Conclusion: Contrary to expectations, ABFT did not perform better than FE-NST. The 2 treatments produced substantial decreases in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes could be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators. Clinical trial registration information: Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419. Published (Publication status)
- Published
- 2019
6. Therapist Adherence to Two Treatments for Adolescent Suicide Risk: Association to Outcomes and Role of Therapeutic Alliance
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Suzanne Levy, Maliha Ibrahim, Bob Gallop, Jessica L. Chou, Guy S. Diamond, Aaron Hogue, and Stephanie Krauthamer Ewing
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Family therapy ,Social Psychology ,Adolescent ,Therapeutic Alliance ,Psychological intervention ,Affect (psychology) ,law.invention ,Suicidal Ideation ,Randomized controlled trial ,law ,Medicine ,Humans ,0501 psychology and cognitive sciences ,Association (psychology) ,business.industry ,05 social sciences ,Moderation ,Psychotherapy ,Clinical Psychology ,Alliance ,Treatment Outcome ,050902 family studies ,Supportive psychotherapy ,Family Therapy ,Disease Susceptibility ,0509 other social sciences ,business ,Social Sciences (miscellaneous) ,050104 developmental & child psychology ,Clinical psychology - Abstract
In psychotherapy research, adherence refers to the extent to which therapists deliver a treatment as intended. This study examined whether therapist adherence to two different manualized treatments was associated with improved client outcomes and whether the association was moderated by therapeutic alliance. The study sample included 320 video recordings of therapy sessions from 118 cases in a randomized controlled trial (RCT) comparing attachment-based family therapy (ABFT) with family-enhanced nondirective supportive therapy (FE-NST). Recordings were selected from early, middle, and late stages of treatment. The adherence measure consisted of 24 items representing essential therapist interventions from both treatments. Trained raters coded tapes from both therapies. Adolescent self-report of alliance was measured at session 4. Adherence to ABFT was associated with a significant increase in family cohesion at mid-treatment but not at posttreatment. Adherence to FE-NST was significantly associated with an increase in suicide ideation posttreatment. Using therapeutic alliance as a moderator, adherence to ABFT was significantly associated with a reduction in suicide ideation, family conflict, and higher client satisfaction posttreatment. Alliance did not positively affect the association of FE-NST adherence to outcomes. Findings suggest that adherence to ABFT interventions may be better linked to treatment outcomes when adolescents feel a strong alliance with their therapist. Implications for future research and therapist training are explored.En la investigación sobre psicoterapia, la adhesión se refiere al grado en el cual los terapeutas brindan un tratamiento según lo previsto. Este estudio analizó si la adhesión del terapeuta a dos tratamientos estandarizados diferentes estuvo asociada con mejores resultados en los pacientes y si la asociación estuvo moderada por la alianza terapéutica. La muestra del estudio incluyó 320 videograbaciones de sesiones de terapia de 118 casos en un ensayo aleatorizado controlado donde se comparó la terapia familiar basada en el apego (TFBA) con la terapia de apoyo no directiva optimizada por la familia (TAND-OF). Se eligieron grabaciones de las etapas iniciales, intermedias y finales del tratamiento. El instrumento de medición de la adhesión consistió en 24 ítems que representaban intervenciones esenciales del terapeuta de ambos tratamientos. Un grupo de calificadores capacitados codificaron las grabaciones de ambas terapias. El autoinforme de alianza de los adolescentes se midió en la cuarta sesión. La adhesión a la TFBA estuvo asociada con un aumento considerable de la cohesión familiar en la mitad del tratamiento, pero no después del tratamiento. La adhesión a la TAND-OF estuvo asociada considerablemente con un aumento de la ideación suicida después del tratamiento. Utilizando la alianza terapéutica como moderadora, la adhesión a la TFBA estuvo asociada considerablemente con una reducción de la ideación suicida, el conflicto familiar y una mayor satisfacción del paciente después del tratamiento. La alianza no afectó positivamente la asociación de la adhesión a la TAND-OF con los resultados. Los resultados sugieren que la adhesión a las intervenciones de TFBA puede asociarse mejor con los resultados del tratamiento cuando los adolescentes sienten una alianza fuerte con su terapeuta. Se analizan las implicancias para futuras investigaciones y para la capacitación de los terapeutas.在心理治疗研究中,治疗一致性是指治疗师按照预设方案提供治疗的程度。本研究考察了治疗师自始至终地执行两种不同的遵循手册式的治疗是否与改善病人治疗结果相关,以及治疗联盟是否调节了这种关联性。研究样本包括来自118例随机对照试验(RCT)的320个治疗过程的视频记录, 试验比较了基于依恋的家庭治疗(ABFT)和家庭赋能强化的非指导性的支持治疗(FE-NST) 这两种方式。从治疗的早期、中期和晚期选取视频记录。治疗一致性措施由24个项目组成, 代表两种治疗手段中的基本的治疗师干预。训练有素的评价员对两种疗法的视频进行编码。在第4阶段测量了青少年关于联盟的自我报告。忠实执行ABFT与治疗中期的家庭凝聚力显著增加有关联, 但治疗后并没有。遵循FE-NST的治疗与治疗后自杀意念增加显著相关。以治疗联盟作为调节因子, 坚持ABFT与治疗后自杀意念的减少、家庭冲突减少和更高的病人满意度显著相关。联盟对FE-NST坚持治疗的一致性结果没有积极影响。研究结果表明, 当青少年感觉与他们的治疗师有很强的联盟时, 坚持ABFT干预可能与治疗结果有更好的联系。本文对未来的研究和治疗师培训的启示都进行了探讨。.
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- 2021
7. Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation
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Tara Santens, Suzanne Levy, Guy S. Diamond, Karin Hannes, and Guy Bosmans
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Referral sources ,Family therapy ,Male ,Evidence-based practice ,Systems Analysis ,Social Psychology ,media_common.quotation_subject ,Child Welfare ,Interview data ,Belgium ,Humans ,0501 psychology and cognitive sciences ,Child ,Qualitative Research ,media_common ,Medical education ,05 social sciences ,Process Assessment, Health Care ,Health Plan Implementation ,Object Attachment ,Poor coordination ,Clinical Psychology ,050902 family studies ,Family Therapy ,Female ,Implementation research ,0509 other social sciences ,Process evaluation ,Psychology ,Welfare ,Social Sciences (miscellaneous) ,050104 developmental & child psychology - Abstract
Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.Los sistemas de asistencia de menores de todo el mundo demuestran cada vez más interés en adoptar estrategias clínicas empíricamente informadas para aumentar la eficacia de los tratamientos. Existen muchos tratamientos respaldados empíricamente, pero se sabe poco acerca de los elementos obstaculizadores y facilitadores para la implementación de dichos tratamientos en los sistemas de asistencia de menores. Este estudio analizó las experiencias de los prestadores de sistemas de asistencia de menores a la hora de implementar la terapia familiar basada en el apego en los servicios domiciliarios del sistema flamenco de asistencia de menores (en Bélgica). Se entrevistó a dieciséis prestadores de sistemas de asistencia de menores (doce terapeutas y cuatro supervisores) implicados en tres servicios domiciliarios. Se utilizó el “Marco Consolidado para la Investigación de Implementación” (Consolidated Framework for Implementation Research,CFIR) para guiar la recopilación, la codificación y el análisis de los datos de las entrevistas. Los resultados revelaron que el éxito de la implementación estuvo relacionado con la adecuación de la terapia familiar basada en el apego con la misión, la filosofía y las prácticas existentes de los sistemas de asistencia de menores. La confianza de los prestadores de sistemas de asistencia de menores en la compatibilidad entre la terapia familiar basada en el apego y los sistemas de asistencia de menores aumentó la inversión en los esfuerzos de implementación y en la perseverancia para superar dificultades y contratiempos. Algunos obstáculos estuvieron relacionados con el aprendizaje de la terapia familiar basada en el apego y algunos otros con dificultades a nivel de los sistemas, como la falta de liderazgo y apoyo, la mala coordinación con fuentes de derivaciones y con otros acompañantes en el cuidado de los jóvenes, y con la falta de apoyo a las políticas. Para diseminar satisfactoriamente los tratamientos respaldados empíricamente en el marco de los sistemas de asistencia de mejores es necesario abordar diferentes obstáculos en múltiples niveles sistémicos.世界儿童福利系统(CWSs)的研究表明越来越多研究者把兴趣放在采用经验主义的临床策略来增加治疗的有效性。已有很多实证支持的治疗方法(ESTs)为人所知,但是人们对于EST在实施过程中遇到哪些障碍和哪些起到促进作用还知之甚少。本研究探索的是比利时的以弗兰德人家庭为基础的服务中,CWS供应者实施的以情感依恋为基础的家庭治疗(ABFT)的经验。服务于三家以家庭为基础的服务机构的16位CWS供应者(12位咨询师和4位管理者)接受了采访。在采访数据搜集,解码和分析过程中使用了实践研究强化框架(CFIR)来给予指导。研究结果表明实施成功与否和ABFT是否与CWS的使命,哲学和已有的措施有关联。 CWS提供者越来越相信ABFT和CWS的相互兼容性,这有助于执行过程中的不断付出和在遭遇挑战和挫折时仍能坚持应对。 有些障碍是和ABFT的学习有关, 有些是和系统水平的挑战有关,比如缺乏领导力和支持,外推的转诊资源和青少年医疗合作者之间协调不得力,缺乏政策支持等。对于ESTs成功得拓展应用到CWS情境中,还有不同系统层面的各种障碍有待于探索解决方法。.
- Published
- 2019
8. Psychodynamic principles in attachment-based family therapy
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Suzanne Levy, Guy S. Diamond, and Syreeta Mason
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Family therapy ,Psychotherapist ,Empirical research ,General partnership ,Attachment theory ,Family conflict ,Narrative ,Psychodynamics ,Psychology ,Disease course - Abstract
Attachment-based family therapy is an empirically supported manualized treatment that was developed to reduce depression and suicide ideation in adolescents and young adults. This process-oriented, trauma-informed approach aims to identify and resolve family conflicts that have damaged trust between parents and adolescents. Attachment theory provides the theoretical framework that guides specific stages of the treatment course. Five treatment tasks provide structure and scaffolding that keep the treatment focused on attachment and brief in its delivery. Although this is a family systems therapy, several modern psychodynamic attachment-based principles characterize some of the hypothesized treatment mechanisms. These include coherent attachment narratives, reflective functioning, and goal-corrected partnership. The chapter provides an overview of the theory, treatment structure, and core mechanisms of change; 20 years of empirical research; and a case study demonstrating the treatment approach.
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- 2019
9. Diamond, Guy
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Jody Russon and Suzanne Levy
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- 2019
10. Attachment-Based Family Therapy
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Guy Diamond, Jody Russon, and Suzanne Levy
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- 2019
11. List of contributors
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Dana Atzil-Slonim, Louise Balfour, Jacques P. Barber, Anthony Bateman, Fredric N. Busch, Eve Caligor, Richard A. Chefetz, John F. Clarkin, Katherine Crits-Christoph, Paul Crits-Christoph, Celine De Meulemeester, Martin Debbané, Guy Diamond, Nel Draijer, Johannes C. Ehrenthal, Peter Fonagy, Mary Beth Connolly Gibbons, Geoff Goodman, Charles A. Granoff, Robert J. Gregory, James Higginbotham, Mark J. Hilsenroth, Robert Johansson, David Kealy, John R. Keefe, Johannes Kruse, Falk Leichsenring, Kenneth N. Levy, Suzanne Levy, Vittorio Lingiardi, Patrick Luyten, Norka T. Malberg, Syreeta Mason, Helga Mattheß, Kevin S. McCarthy, Nick Midgley, Barbara L. Milrod, Nicola Nardelli, Pamela Nathan, John S. Ogrodniczuk, Seth R. Pitman, Bent Rosenbaum, Frank Sacco, Frank C. Sacco, Björn Salomonsson, Daniel Smyth, Christiane Steinert, Giorgio A. Tasca, Pratyusha Tummala-Narra, Pauline Van Zon, Wolfgang Wöller, Frank E. Yeomans, and Sigal Zilcha-Mano
- Published
- 2019
12. Attachment-Based Family Therapy for Suicidal Lesbian, Gay, and Bisexual Adolescents: A Case Study
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Suzanne Levy, Jody Russon, and Gary M. Diamond
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Family therapy ,050103 clinical psychology ,medicine.medical_specialty ,Sociology and Political Science ,Suicide attempt ,1607 Social Work ,05 social sciences ,050109 social psychology ,Context (language use) ,Family Studies ,Mental health ,1117 Public Health and Health Services ,Sexual minority ,Vignette ,1701 Psychology ,medicine ,0501 psychology and cognitive sciences ,Psychology (miscellaneous) ,Lesbian ,medicine.symptom ,Psychology ,Psychiatry ,Suicidal ideation ,Clinical psychology - Abstract
The majority of sexual minority adolescents are well-adjusted and healthy, however, on average, 28% report suicidal ideation and between 15% and 40% make a suicide attempt each year. These rates are two to seven times higher than those found among heterosexual youths. Research has shown the protective function of parental support and acceptance, as well as the deleterious effects of parental criticism, invalidation, and rejection on the mental health of sexual minority adolescents. Given these risk and protective factors, these adolescents might benefit from an intervention that targets family relationships. Toward this goal, Attachment-Based Family Therapy (ABFT) specifically aims to improve the quality of adolescent–parent relationships. In prior treatment developmental work, ABFT was adapted and pilot tested for depressed and suicidal lesbian, gay, and bisexual (LGB) adolescents. By adopting an evidence-based case study format, this paper provides a case summary to illustrate how the therapy was conducted. The case study consists of a vignette, followed by therapy task descriptions and illustrative transcripts. Examples of key therapeutic moments in ABFT, for depressed and suicidal LGB adolescents, are discussed in the context of the case. Published (Publication status)
- Published
- 2016
13. Attachment-Based Family Therapy as an Adjunct to Family-Based Treatment for Adolescent Anorexia Nervosa
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Ingrid Wagner, Jody Russon, Suzanne Levy, Richard Litster, and Guy S. Diamond
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Family therapy ,050103 clinical psychology ,medicine.medical_specialty ,Sociology and Political Science ,End of therapy ,1607 Social Work ,Family Studies ,Anorexia nervosa ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,medicine ,0501 psychology and cognitive sciences ,Psychiatry ,Depression (differential diagnoses) ,05 social sciences ,medicine.disease ,Adjunct ,030227 psychiatry ,1701 Psychology ,Well-being ,Anxiety ,Psychology (miscellaneous) ,medicine.symptom ,Family based ,Psychology ,Clinical psychology - Abstract
Adolescent anorexia nervosa (AN) has a significant and long-standing impact for the health and well being of young people and their families. The determinants of illness are multi-factorial, however, adolescent AN has been consistently associated with parental distress (e.g., depression, anxiety, alcoholism), family conflict, and low parental warmth toward the adolescent. Whilst Family Based Therapy (FBT) for adolescent AN is the recommended first line of treatment, a substantial proportion of patients do not experience remission by the end of therapy or may relapse following remission. Although a range of adjuncts to FBT have been proposed, no preferred model has emerged. In this paper, we compare and contrast Attachment-Based Family Therapy (ABFT) with FBT, and argue that ABFT’s focus on relationships, rather than behaviours, could make a substantive contribution to the practice of FBT. We present a case study to demonstrate how ABFT may help to alleviate some of the maintaining factors of adolescent AN through the repair of parent–child relational ruptures. Published (Publication status)
- Published
- 2016
14. Attachment-Based Family Therapy in Australia: Introduction to a Special Issue
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Guy S. Diamond, Ingrid Wagner, and Suzanne Levy
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Family therapy ,050103 clinical psychology ,Medical education ,Evidence-based practice ,Psychotherapist ,Sociology and Political Science ,Treatment adherence ,05 social sciences ,Targeted interventions ,Mental health ,Variety (cybernetics) ,Relevance (law) ,0501 psychology and cognitive sciences ,Psychology (miscellaneous) ,Psychology ,Dissemination ,050104 developmental & child psychology - Abstract
In Australia the movement toward evidence based practice was supported by the first National Mental Health Strategy. For mental health clinicians the shift from evaluating process to outcome measurement also brought greater focus on specific disorders and targeted interventions, raising questions about the efficacy and effectiveness of treatment. The gap between research and practice is well documented, and has engendered much debate particularly in regard to empirically supported treatments (ESTs) and the technologies to widely disseminate practice whilst supporting treatment adherence. In this paper we first, describe the Attachment Based Family Therapy (ABFT) model before giving consideration to the criticisms of ESTs, and reviewing the dissemination of ABFT in Australia, and the perspectives of Australian clinicians in respect to the model and its relevance to their practice. Finally, we turn to the mission of this Special Issue which is to increase the awareness of ABFT primarily amongst practicing clinicians as we introduce the selected papers that demonstrate the application of the model to a variety of clinical presentations, and clinical settings.
- Published
- 2016
15. Attachment-Based Family Therapy for Suicidal Adolescents: A Case Study
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Guy S. Diamond, Suzanne Levy, and Syreeta W. Scott
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Family therapy ,Psychotherapist ,Sociology and Political Science ,05 social sciences ,Context (language use) ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Suicide ideation ,Attachment theory ,0501 psychology and cognitive sciences ,Psychology (miscellaneous) ,Psychology ,Intrapsychic ,050104 developmental & child psychology ,Cause of death ,Clinical psychology - Abstract
Suicide is the primary cause of death in Australia for youth between the ages of 15 and 24. This is common worldwide as well. Unfortunately, very few treatments have been developed, tested, and successful for treating this difficult clinical problem. Attachment-Based Family Therapy (ABFT) is one of the therapies demonstrating a significant decrease in suicide ideation and attempts. The effectiveness of this model may rest on the fact that ABFT targets the clinical context (e.g., family, trauma, etc.) of this problem as well as intrapsychic processes. Based on attachment theory, the model aims to help adolescents recover a more secure attachment relationship with parents so that secure-based parenting can help protect the adolescent from future stress and self-harm. A case study is used to demonstrate how the model unfolds, systemically seeking to repair the attachment relationships while also keeping the adolescent safe from suicidal thoughts and behaviours.
- Published
- 2016
16. Devoted to 'Auntie Beeb'
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Suzanne Levy
- Published
- 2018
17. Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support
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Guy S. Diamond, Suzanne Levy, and E. Stephanie Krauthamer Ewing
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Family therapy ,Psychotherapist ,Adolescent ,Parenting ,Depression ,Emotions ,Psychology, Adolescent ,Poison control ,Models, Psychological ,Object Attachment ,Suicide prevention ,Suicidal Ideation ,Psychiatry and Mental health ,Empirical research ,Structural family therapy ,Transactional leadership ,Intervention (counseling) ,Developmental and Educational Psychology ,Attachment theory ,Humans ,Family Therapy ,Parent-Child Relations ,Psychology ,Clinical psychology - Abstract
Attachment-Based Family Therapy (ABFT) is a manualized family-based intervention designed for working with depressed adolescents, including those at risk for suicide, and their families. It is an empirically informed and supported treatment. ABFT has its theoretical underpinnings in attachment theory and clinical roots in structural family therapy and emotion focused therapies. ABFT relies on a transactional model that aims to transform the quality of adolescent-parent attachment, as a means of providing the adolescent with a more secure relationship that can support them during challenging times generally, and the crises related to suicidal thinking and behavior, specifically. This article reviews: (1) the theoretical foundations of ABFT (attachment theory, models of emotional development); (2) the ABFT clinical model, including training and supervision factors; and (3) empirical support.
- Published
- 2015
18. Diamond, Guy
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Jody Russon and Suzanne Levy
- Published
- 2017
19. Attachment-Based Family Therapy With a 13-Year-Old Girl Presenting With High Risk for Suicide
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E. Stephanie Krauthamer Ewing, Linda Boamah-Wiafe, Guy S. Diamond, Suzanne Levy, and Roger Kobak
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Suicide Prevention ,Family therapy ,medicine.medical_specialty ,Adolescent ,Sociology and Political Science ,Social Psychology ,media_common.quotation_subject ,Poison control ,Suicide prevention ,Article ,Suicidal Ideation ,Injury prevention ,Attachment theory ,History of depression ,medicine ,Humans ,0501 psychology and cognitive sciences ,Girl ,Psychiatry ,Suicidal ideation ,media_common ,Depression ,business.industry ,05 social sciences ,Object Attachment ,Clinical Psychology ,050902 family studies ,Family Therapy ,Female ,0509 other social sciences ,medicine.symptom ,business ,Social Sciences (miscellaneous) ,050104 developmental & child psychology ,Clinical psychology - Abstract
This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth.
- Published
- 2014
20. Bindungsorientierte Familientherapie als ambulante Nachsorge für Jugendliche nach Suizidversuch
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Suzanne Levy and Guy S. Diamond
- Published
- 2012
21. Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings
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Guy Diamond, Tonya Ladipo, Gary M. Diamond, Suzanne Levy, Lynne Siqueland, and Cynthia Closs
- Subjects
Male ,Family therapy ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,media_common.quotation_subject ,Population ,Pilot Projects ,Anger ,Suicidal Ideation ,Gender Studies ,Individuation ,Manuals as Topic ,Professional-Family Relations ,medicine ,Humans ,Homosexuality ,Homosexuality, Male ,education ,Psychiatry ,Suicidal ideation ,General Psychology ,media_common ,Depressive Disorder, Major ,education.field_of_study ,Treatment development ,Homosexuality, Female ,Object Attachment ,Mother-Child Relations ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Personal Autonomy ,Sexual orientation ,Bisexuality ,Feasibility Studies ,Anxiety ,Family Therapy ,Female ,medicine.symptom ,Lesbian ,Psychology ,Clinical psychology - Abstract
The objective of this paper is to adapt attachment-based family therapy (ABFT) for use with suicidal lesbian, gay, and bisexual (LGB) adolescents and to obtain preliminary data on the feasibility and efficacy of the treatment with this population. In Phase I, a treatment development team modified ABFT to meet the unique needs of LGB suicidal youth. In Phase II, 10 suicidal LGB youth were offered 12 weeks of LGB sensitive ABFT. Adolescents' report of suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance were gathered at pretreatment, 6 weeks, and 12 weeks (posttreatment). In Phase I, the treatment was adapted to: (a) include more individual time working with parents in order to process their disappointments, pain, anger, and fears related to their adolescent's minority sexual orientation; (b) address the meaning, implications, and process of acceptance; and (c) heighten parents' awareness of subtle yet potent invalidating responses to their adolescents' sexual orientation. Results of Phase II suggest this population can be recruited and successfully treated with a family based therapy, evidenced by high levels of treatment retention and significant decreases in suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance. This is the first family-based treatment adapted and tested specifically for suicidal LGB adolescents. Though promising, the results are preliminary and more research on larger samples is warranted.
- Published
- 2012
22. Bindungsorientierte Familientherapie für depressive Jugendliche
- Author
-
Guy S. Diamond and Suzanne Levy
- Published
- 2010
23. Attachment-Based Family Therapy for Adolescents with Suicidal Ideation: A Randomized Controlled Trial
- Author
-
Guy S. Diamond, Matthew B. Wintersteen, Gregory K. Brown, Gary M. Diamond, Robert Gallop, Karni Shelef, and Suzanne Levy
- Subjects
Male ,Philadelphia ,Reactive Attachment Disorder ,Depressive Disorder ,Adolescent ,Family Conflict ,Mental Disorders ,Suicide, Attempted ,Comorbidity ,Object Attachment ,Psychiatry and Mental health ,Developmental and Educational Psychology ,Humans ,Family Therapy ,Female ,Child ,Follow-Up Studies - Abstract
To evaluate whether Attachment-Based Family Therapy (ABFT) is more effective than Enhanced Usual Care (EUC) for reducing suicidal ideation and depressive symptoms in adolescents.This was a randomized controlled trial of suicidal adolescents between the ages of 12 and 17, identified in primary care and emergency departments. Of 341 adolescents screened, 66 (70% African American) entered the study for 3 months of treatment. Assessment occurred at baseline, 6 weeks, 12 weeks, and 24 weeks. ABFT consisted of individual and family meetings, and EUC consisted of a facilitated referral to other providers. All participants received weekly monitoring and access to a 24-hour crisis phone. Trajectory of change and clinical recovery were measured for suicidal ideation and depressive symptoms.Using intent to treat, patients in ABFT demonstrated significantly greater rates of change on self-reported suicidal ideation at post-treatment evaluation, and benefits were maintained at follow-up, with a strong overall effect size (ES = 0.97). Between-group differences were similar on clinician ratings. Significantly more patients in ABFT met criteria for clinical recovery on suicidal ideation post-treatment (87%; 95% confidence interval [CI] = 74.6-99.6) than patients in EUC (51.7%; 95% CI = 32.4-54.32). Benefits were maintained at follow-up (ABFT, 70%; 95% CI = 52.6-87.4; EUC 34.6%; 95% CI = 15.6-54.2; odds ratio = 4.41). Patterns of depressive symptoms over time were similar, as were results for a subsample of adolescents with diagnosed depression. Retention in ABFT was higher than in EUC (mean = 9.7 versus 2.9).ABFT is more efficacious than EUC in reducing suicidal ideation and depressive symptoms in adolescents. Additional research is warranted to confirm treatment efficacy and to test the proposed mechanism of change (the Family Safety Net Study).Clinical Trial Registry Information: Preventing Youth Suicide in Primary Care: A Family Model, URL: http://www.clinicaltrials.gov, unique identifier: NCT00604097.
- Published
- 2010
24. Attachment-Based Family Therapy for Adolescents with Suicidal Ideation: A Randomized Controlled Trial
- Author
-
Matthew B. Wintersteen, Robert Gallop, Gregory K. Brown, Suzanne Levy, Gary M. Diamond, Karni Shelef, and Guy S. Diamond
- Subjects
medicine.medical_specialty ,Intention-to-treat analysis ,Referral ,business.industry ,Poison control ,Odds ratio ,medicine.disease ,Suicide prevention ,Comorbidity ,law.invention ,Psychiatry and Mental health ,Randomized controlled trial ,law ,Internal medicine ,Developmental and Educational Psychology ,medicine ,medicine.symptom ,Psychiatry ,business ,Suicidal ideation - Abstract
Objective To evaluate whether Attachment-Based Family Therapy (ABFT) is more effective than Enhanced Usual Care (EUC) for reducing suicidal ideation and depressive symptoms in adolescents. Method This was a randomized controlled trial of suicidal adolescents between the ages of 12 and 17, identified in primary care and emergency departments. Of 341 adolescents screened, 66 (70% African American) entered the study for 3 months of treatment. Assessment occurred at baseline, 6 weeks, 12 weeks, and 24 weeks. ABFT consisted of individual and family meetings, and EUC consisted of a facilitated referral to other providers. All participants received weekly monitoring and access to a 24-hour crisis phone. Trajectory of change and clinical recovery were measured for suicidal ideation and depressive symptoms. Results Using intent to treat, patients in ABFT demonstrated significantly greater rates of change on self-reported suicidal ideation at post-treatment evaluation, and benefits were maintained at follow-up, with a strong overall effect size (ES = 0.97). Between-group differences were similar on clinician ratings. Significantly more patients in ABFT met criteria for clinical recovery on suicidal ideation post-treatment (87%; 95% confidence interval [CI] = 74.6–99.6) than patients in EUC (51.7%; 95% CI=32.4–54.32). Benefits were maintained at follow-up (ABFT, 70%; 95% CI=52.6–87.4; EUC 34.6%; 95% CI=15.6–54.2; odds ratio=4.41). Patterns of depressive symptoms over time were similar, as were results for a subsample of adolescents with diagnosed depression. Retention in ABFT was higher than in EUC (mean = 9.7 versus 2.9). Conclusions ABFT is more efficacious than EUC in reducing suicidal ideation and depressive symptoms in adolescents. Additional research is warranted to confirm treatment efficacy and to test the proposed mechanism of change (the Family Safety Net Study). Clinical Trial Registry Information: Preventing Youth Suicide in Primary Care: A Family Model, URL: http://www.clinicaltrials.gov, unique identifier: NCT00604097.
- Published
- 2010
25. Communication about smoking between depressed adolescents and their parents
- Author
-
Guy S. Diamond, Allison M. Reamy, Tahniat Syed, Jacqueline C. Reyner, Anna M. L. Westin, and Suzanne Levy
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Young Adult ,Intervention (counseling) ,medicine ,Humans ,Parent-Child Relations ,Psychiatry ,Depression (differential diagnoses) ,Heavy smoking ,Depression ,Communication ,Smoking ,Socialization ,Public Health, Environmental and Occupational Health ,medicine.disease ,Treatment engagement ,Substance abuse ,Smoking initiation ,Smoking cessation ,Female ,Psychology ,Clinical psychology - Abstract
Introduction: Better understanding of effective parent-adolescent communication regarding tobacco use could inform smoking cessation intervention. Methods: Semistructured interviews related to communication about smoking were conducted with 15 depressed adolescent smokers and their parents, primarily from urban areas. This study, conducted in 2006-2008, was funded by the Pennsylvania Department of Health. Interview transcripts (N = 30) were coded in QSR N6. Results: Quality of communication, rather than content, seemed to determine whether parental communication was effective. Parents reactivity to, or avoidance of, adolescent smoking presented a barrier to effective communication. In this sample, parents and adolescents were more concerned about problems, such as depression, than smoking. Discussion: Involving parents in adolescent smoking cessation programs may be promising. Parental involvement may include teaching parent-child communication skills, building stronger relational bonds, or helping parents quit simultaneously. Further research is needed to explore whether coupling smoking cessation with depression treatment increases parent and adolescent treatment engagement and effectiveness. Despite decreases in rates of adolescent cigarette smoking and development of effective cessation programs (National Institute on Drug Abuse, 2003; Stanton & Smith, 2002; Sussman, Sun, & Dent, 2006), smokers are increasingly resistant to cessation efforts (Augustson & Marcus, 2004). One group particularly resistant to intervention is smokers with depression, who comprise 22%-61% of adolescent smokers (e.g., Wilhelm, Wedgwood, Niven, & Kay-Lambkin, 2006). Depression likely increases the risk of smoking initiation and is associated with both regular and heavy smoking (Duncan & Rees, 2005; Escobedo, Reddy, Giovino, 1998; Fleming, Kim, Harachi, & Catalano, 2002; Patton et al., 1998; Windle & Windle, 2001). Furthermore, depression may inhibit adolescent cessation efforts (e.g., Burgess et al., 2002; Thompson et al., 2007). Thus, depressed adolescents are at increased risk of suffering the negative health consequences of cigarette smoking. Adolescence may be an opportune time to intervene, given that smoking and depression commonly onset during adolescence (Vogel, Hurford, Smith, & Cole, 2003). Adolescence also presents a prime time to intervene because the quality of parent-adolescent relationships is known to exacerbate or buffer against adolescent risk-taking behaviors, including smoking (Ary, Duncan, Duncan, & Hops, 1999). Parents influence smoking through antismoking socialization, restrictive home smoking rules, modeling nonsmoking behaviors, monitoring of adolescents, restricting cigarette access, and positive parenting (Castrucci & Gerlach, 2006; Chassin, Presson, Todd, Rose, & Sherman,1998; Chilcoat & Anthony,1996; Griesler & Kandel,1998; Jackson & Henriksen, 1997; Kegler, Cleaver, & Yazzie-Valencia, 2000; Kegler et al., 2002; Komro, McCarty, Forster, Blaine, & Chen, 2003; Proescholdbell, Chassin, & MacKinnon, 2000). Most research focuses on how parents influence smoking initiation rather than cessation. While this can inform prevention efforts, it may be less informative for intervention development. Parent and adolescent communication about cessation is an area of particular interest for intervention researchers. For depressed teens, improved communication has been shown to influence the course of their depression, and consequently, parents have increasingly been involved in depression treatment (Restifo & Bogels, 2009; Sheeber, Hops, & Davis, 2001). Better understanding of parent-adolescent communication around smoking cessation might lead to similar intervention developments.
- Published
- 2010
26. Results of Random Drug Testing in an Adolescent Substance Abuse Program
- Author
-
John R. Knight, Matthew Germak, Suzanne Levy, Lon Sherritt, and Brigid L. Vaughan
- Subjects
Adult ,Male ,Narcotics ,Program evaluation ,medicine.medical_specialty ,Adolescent ,Substance-Related Disorders ,Poison control ,Sensitivity and Specificity ,Cohort Studies ,Random Allocation ,Risk Factors ,Enzyme Multiplied Immunoassay Technique ,Injury prevention ,medicine ,Humans ,Drug test ,Registries ,Medical prescription ,False Negative Reactions ,medicine.diagnostic_test ,Illicit Drugs ,business.industry ,United States ,Surgery ,Substance Abuse Detection ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Female ,Substance Abuse Treatment Centers ,business ,Oxycodone ,Program Evaluation ,medicine.drug ,Cohort study - Abstract
OBJECTIVE. The objective of this study was to estimate from a random urine drug-testing program for adolescents the proportion of drug tests that are susceptible to interpretation errors. METHODS. This was a secondary analysis of a clinical database and chart review from an adolescent outpatient substance abuse program at a large children's hospital. We analyzed from 110 adolescent patients (13–21 years of age) all 710 urine drug test results that were collected between December 2002 and July 2005 and 85 original laboratory reports for tests that were collected between December 2002 and May 2006 and were confirmed positive for opioids. We calculated the percentage of tests that were too dilute to interpret (potential false-negatives) and the percentage of confirmed positive tests for oxycodone that did not result in a positive initial screen (potential false-negatives). We also reviewed clinical information to determine whether confirmed positive tests resulted from legitimate use of prescription or over-the-counter medication (potential false-positives). RESULTS. Of 710 drug tests, 40 negative tests were too dilute to interpret properly, and 45 of 217 positive tests resulted from prescription medication use for a total of 85 tests that were susceptible to error. Of the 85 confirmatory laboratory reports reviewed, 43 were positive for oxycodone, but only 16 of these had produced a positive opiate screen. CONCLUSIONS. Unless proper procedures are used in collecting, analyzing, and interpreting laboratory testing for drugs, there is a substantial risk for error.
- Published
- 2007
27. Drug testing of adolescents in general medical clinics, in school and at home: physician attitudes and practices
- Author
-
Sion Kim Harris, Suzanne Levy, Lon Sherritt, Michelle Angulo, and John R. Knight
- Subjects
Adult ,Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Adolescent ,Poison control ,Urinalysis ,Suicide prevention ,Occupational safety and health ,Adolescent medicine ,medicine ,Humans ,Drug test ,Physician's Role ,Psychiatry ,Aged ,School Health Services ,medicine.diagnostic_test ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Home Care Services ,Mental health ,Substance Abuse Detection ,Substance abuse ,Psychiatry and Mental health ,Adolescent Behavior ,Health Care Surveys ,Family medicine ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
Purpose To determine (1) whether physicians agree with recommendations for home and school drug screening, (2) under what circumstances physicians recommend urine drug tests for adolescents, and (3) how physicians manage adolescent patients with positive results. Few clinical practice guidelines have been published on urine drug testing of adolescents, and it is not known when physicians recommend this procedure or how they manage positive results. Methods Multi-modal survey of a nationally representative sample of physicians conducted April–July 2004. We computed simple frequencies and used backwards selection logistical regression to determine if there were differences in agreement or practices among physicians from different specialties (pediatrics, family medicine, adolescent medicine) or by demographic factors (physician age, gender, practice type or location). Results A total of 359 physicians (43% after eliminating ineligibles) completed the survey. Thirty-eight percent would recommend a drug test if were required to return to school, 41% if a parent was concerned, and 46% based on history (without a parent's concern). Forty-eight percent of physicians would share a positive drug test result with parents. A large majority (83%) disagreed with high school drug testing programs. Conclusions There is little consensus among physicians regarding the indications for drug testing in the general medical clinic. However, most disagree with school drug testing programs. There is little consistency among physicians in how to proceed when a urine drug test is positive. Professional organizations should consider publishing clinical practice guidelines in order to assist physicians in using this procedure effectively.
- Published
- 2006
28. Online Distance Learning Among the California Community Colleges: Looking at the Planning and Implementation
- Author
-
Rodney Beaulieu and Suzanne Levy
- Subjects
Medical education ,Distance education ,Educational technology ,Computer Science Applications ,Education ,Pedagogy ,ComputingMilieux_COMPUTERSANDEDUCATION ,Curriculum development ,Program development ,Sociology ,Student training ,Faculty development ,Curriculum ,Staff training - Abstract
In this article we summarize the planning and implementation of online distance learning programs at various community colleges in California. We examine six areas: the institutions' vision, curriculum and programs, staff training and support, student services, student training and support, and policies.
- Published
- 2003
29. Introduction: The context of adolescent depression
- Author
-
Gary M. Diamond, Guy S. Diamond, and Suzanne Levy
- Subjects
medicine.medical_specialty ,Child and adolescent psychiatry ,medicine ,Context (language use) ,Psychiatry ,Psychology ,Depression (differential diagnoses) - Published
- 2013
30. Task IV: Repairing attachment
- Author
-
Suzanne Levy, Gary M. Diamond, and Guy S. Diamond
- Subjects
Computer science ,Cognitive psychology ,Task (project management) - Published
- 2013
31. Task V: Promoting autonomy
- Author
-
Gary M. Diamond, Guy S. Diamond, and Suzanne Levy
- Subjects
media_common.quotation_subject ,Psychology ,Autonomy ,Task (project management) ,Cognitive psychology ,media_common - Published
- 2013
32. Task I: Relational reframe
- Author
-
Suzanne Levy, Gary M. Diamond, and Guy S. Diamond
- Subjects
Family therapy ,Family conflict ,Cognitive reframing ,Adolescent development ,Psychology ,Task (project management) ,Cognitive psychology - Published
- 2013
33. Task III: Parent alliance
- Author
-
Guy S. Diamond, Suzanne Levy, and Gary M. Diamond
- Subjects
Alliance ,Psychology ,Cognitive psychology ,Task (project management) - Published
- 2013
34. Task II: Adolescent alliance
- Author
-
Guy S. Diamond, Gary M. Diamond, and Suzanne Levy
- Subjects
Alliance ,Applied psychology ,Psychology ,Task (project management) - Published
- 2013
35. PSYCHOLOGICAL STRESS AND MATERNAL CORTISOL WHEN CARRYING A FETUS WITH CONGENITAL HEART DISEASE
- Author
-
Agbenu Ejembi, Okan U. Elci, Jack Rychik, Guy S. Diamond, Jill Combs, Brooke Davey, Denise Donaghue, Suzanne Levy, and Zhiyun Tian
- Subjects
medicine.medical_specialty ,Fetus ,Heart disease ,business.industry ,Physiology ,030204 cardiovascular system & hematology ,medicine.disease ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,030228 respiratory system ,Internal medicine ,medicine ,Psychological stress ,Cardiology and Cardiovascular Medicine ,business - Published
- 2016
36. Screening for adolescents' internalizing symptoms in primary care: item response theory analysis of the behavior health screen depression, anxiety, and suicidal risk scales
- Author
-
Katherine B. Bevans, Suzanne Levy, and Guy S. Diamond
- Subjects
Adult ,Male ,Risk ,medicine.medical_specialty ,Adolescent ,Psychometrics ,Affect (psychology) ,Young Adult ,Sex Factors ,Ambulatory care ,Item response theory ,Developmental and Educational Psychology ,medicine ,Humans ,Mass Screening ,Young adult ,Psychiatry ,Child ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Depressive Disorder ,Primary Health Care ,Differential item functioning ,Mental health ,Anxiety Disorders ,Psychiatry and Mental health ,Suicide ,Mental Health ,Pediatrics, Perinatology and Child Health ,Anxiety ,Female ,medicine.symptom ,Psychology ,Clinical psychology - Abstract
Objective: To apply a modern psychometric approach to validate the Behavioral Health Screen (BHS) Depression, Anxiety, and Suicidal Risk Scales among adolescents in primary care. Methods: Psychomet- ric analyses were conducted using data collected from 426 adolescents aged 12 to 21 years (mean 15.8, SD 2.2). Rasch-Masters partial credit models were fit to the data to determine whether items supported the comprehensive measurement of internalizing symptoms with minimal gaps and redundancies. Results: Scales were reduced to ensure that they measured singular dimensions of generalized anxiety, depressed affect, and suicidal risk both comprehensively and efficiently. Although gender bias was observed for some depression and anxiety items, differential item functioning did not impact overall subscale scores. Future revisions to the BHS should include additional items that assess low-level internalizing symptoms. Conclusions: The BHS is an accurate and efficient tool for identifying adolescents with internalizing symptoms in primary care settings. Access to psychometrically sound and cost-effective behavioral health screening tools is essential for meeting the increasing demands for adolescent behavioral health screening in primary/ambulatory care. (J Dev Behav Pediatr 33:283-290, 2012) Index terms: screening, depression, anxiety, suicide, adolescents.
- Published
- 2012
37. Development, validation, and utility of internet-based, behavioral health screen for adolescents
- Author
-
Joel A. Fein, Matthew B. Wintersteen, Guy Diamond, Suzanne Levy, Katherine B. Bevans, Allen Tien, and Torrey A. Creed
- Subjects
Biopsychosocial model ,Male ,medicine.medical_specialty ,Psychometrics ,Adolescent ,Health Behavior ,Poison control ,Suicide prevention ,Sensitivity and Specificity ,Occupational safety and health ,Young Adult ,Rating scale ,medicine ,Humans ,Mass Screening ,Diagnosis, Computer-Assisted ,Psychiatry ,Psychiatric Status Rating Scales ,Internet ,Primary Health Care ,business.industry ,Mental Disorders ,Beck Depression Inventory ,Health Surveys ,United States ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,Anxiety ,Female ,medicine.symptom ,business - Abstract
OBJECTIVES: The goals were to develop and to validate the Internet-based, Behavioral Health Screen (BHS) for adolescents and young adults in primary care. METHODS: Items assessing risk behaviors and psychiatric symptoms were built into a Internet-based platform with broad functionality. Practicality and acceptability were examined with 24 patients. For psychometric validation, 415 adolescents completed the BHS and well-established rating scales. Participants recruited from primary care waiting rooms were 12 to 21 years of age (mean: 15.8 years); 66.5% were female and 77.5% black. RESULTS: The BHS screens in 13 domains by using 54 required items and 39 follow-up items. The administration time was 8 to 15 minutes (mean: 12.4 minutes). The scales are unidimensional, are internally consistent (Cronbach's α = 0.75–0.87), and discriminate among adolescents with a range of diagnostic syndromes. Sensitivity and specificity were high, with overall accuracy ranging from 78% to 85%. Patients with scores above scale cutoff values for depression, suicide risk, anxiety, and posttraumatic stress disorder symptoms were ≥4 times more likely to endorse other risk behaviors or stressors. CONCLUSIONS: The BHS addresses practical and clinical barriers to behavioral health screening in primary care. It is a brief but comprehensive, self-report, biopsychosocial assessment. The psychiatric scales are valid and predictive of risk behaviors, which facilitates exclusion of false-positive results, as well as assessment and triage.
- Published
- 2010
38. Providers' experiences caring for adolescents who smoke cigarettes
- Author
-
Guy S. Diamond, Sarah L. Stevens, Sara B. Kinsman, Megan E. Pailler, Shehreen Latif, and Suzanne Levy
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Health Personnel ,Psychological intervention ,Coding (therapy) ,Grounded theory ,Risk-Taking ,Intervention (counseling) ,Health care ,Medicine ,Humans ,Situational ethics ,Applied Psychology ,business.industry ,Smoking ,Professional-Patient Relations ,Focus Groups ,Pennsylvania ,Focus group ,Psychiatry and Mental health ,Adolescent Behavior ,Family medicine ,Smoking cessation ,Female ,Smoking Cessation ,business - Abstract
OBJECTIVE To describe providers' experiences screening for and counseling adolescent patients who smoke cigarettes. DESIGN Eight qualitative focus groups were conducted with 51 health care providers in primary care settings. Focus groups were video- and audiotaped; tapes were transcribed for coding by an interdisciplinary team using the constant comparative method. MAIN OUTCOME MEASURES Providers reported experiences screening for and managing adolescent patients who reported smoking cigarettes. RESULTS Providers expressed confidence in their ability to screen adolescent patients for tobacco use, particularly as part of regularly scheduled preventive and medical visits. Providers reported difficulty balancing screening for smoking with their concern for maintaining rapport with their adolescent patients. In addition, providers reported that adolescent smoking patterns differed from those of adults, and consequently, providers were not certain at what level of smoking an adolescent required intervention. Furthermore, providers were unclear regarding what interventions were recommended for and effective with adolescents. CONCLUSION Providers are interested in adolescent evidence-based screening methods and cessation interventions that are supportive of a nonjudgmental and empathic approach to caring for adolescent smokers, particularly those with irregular and situational smoking patterns.
- Published
- 2009
39. Low incidence of delirium in very old patients after surgery for hip fractures
- Author
-
Nadya Kagansky, Lutzy Cojocaru, Suzanne Levy, Elena Dvornikov, Ephraim Rimon, and Simona Naor
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Poison control ,behavioral disciplines and activities ,Cohort Studies ,Surveys and Questionnaires ,mental disorders ,Medicine ,Humans ,Cumulative incidence ,Postoperative Period ,Prospective Studies ,Prospective cohort study ,Aged ,Demography ,Aged, 80 and over ,Hip fracture ,Rehabilitation ,business.industry ,Hip Fractures ,Incidence ,Delirium ,Perioperative ,medicine.disease ,nervous system diseases ,Surgery ,Psychiatry and Mental health ,Socioeconomic Factors ,Female ,Geriatrics and Gerontology ,medicine.symptom ,business ,Cognition Disorders ,Cohort study - Abstract
Objective The authors sought to determine the incidence of delirium, its predisposing and precipitating factors, and its implications for rehabilitation outcomes and mortality in elderly patients. Methods This was a prospective cohort study, conducted in Gedera, Israel, from August 2001 to January 2002, with 137 consecutive patients over age 75, with hip fractures, who were admitted to the orthopedic section of the emergency department. They were evaluated at admission, 1 week after the surgery for hip fracture, and 1 month after surgery. The evaluation included assessments of delirium, cognitive, and functional status, and a wide range of demographic and clinical parameters. Results The cumulative incidence of delirium was 11.4%. No significant difference was found between delirium and non-delirium patients in terms of all demographic, socioeconomic, and perioperative parameters. Mild or moderate cognitive impairment before the fracture and four or more regular medications prescribed to the patient were the only predictive factors for the development of delirium in a multivariate model. Delirium was not a significant predictor of any rehabilitation outcome. Conclusion Results documented that the incidence of delirium after hip fracture in elderly patients is much lower than was reported in several previous studies. Premorbid cognitive impairment was the most significant predisposing factor for the development of delirium. Thorough evaluation of earlier cognitive status could improve the probability of the diagnosis of delirium and pinpoint a limited group of patients for a delirium-prevention approach.
- Published
- 2004
40. OP04.02: Serial prenatal counseling reduces traumatic stress in mothers carrying a fetus with congenital heart disease
- Author
-
Guy S. Diamond, Denise Donaghue, Clara Fajardo, Jill Combs, Anita Szwast, Jack Rychik, and Suzanne Levy
- Subjects
Pediatrics ,medicine.medical_specialty ,Fetus ,Radiological and Ultrasound Technology ,Prenatal counseling ,Heart disease ,business.industry ,Traumatic stress ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Reproductive Medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2012
41. FDA at BIO 2011 – Weighing a hefty mission: Where is the balance?
- Author
-
Suzanne Levy
- Subjects
Economics and Econometrics ,medicine.medical_specialty ,Government ,Public health ,media_common.quotation_subject ,Certification ,Bioethics ,Convention ,State (polity) ,Investor relations ,Management of Technology and Innovation ,Market analysis ,Economics ,medicine ,Marketing ,Biotechnology ,media_common - Abstract
The mission of the Food and Drug Administration (FDA) is to promote public health by ensuring the safety and quality of food and medical products sold in the United States. At this year's annual Biotechnology Industry Organization (BIO) convention, significant discussion revolved around the appropriate interpretation and execution of that mission. The BIO meeting hosted 15 646 participants from across industry, government and the nonprofit sector, focusing on the current state of the biotechnology industry, as well as its challenges in seeking to further improve public welfare. Perhaps partly because this year's meeting was held in Washington, DC – the seat of the federal government and of BIO's headquarters – much attention was paid to the US regulatory environment. In particular, attendees debated the quandary faced every day by the FDA: how to enable access to novel therapies quickly, but only once their safety has been certified.
- Published
- 2011
42. 779: Maternal cortisol is elevated in association with psychological stress in pregnant women with prenatal diagnosis of congenital heart disease
- Author
-
Brooke Davey, Guy S. Diamond, Denise Donaghue, Jack Rychik, Agbenu Ejembi, Suzanne Levy, Zhiyun Tian, and Jill Combs
- Subjects
medicine.medical_specialty ,Heart disease ,business.industry ,Obstetrics ,medicine ,Obstetrics and Gynecology ,Psychological stress ,Prenatal diagnosis ,medicine.disease_cause ,business ,medicine.disease ,Association (psychology) - Published
- 2014
43. 'Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings': Correction to Diamond et al. (2011)
- Author
-
Lynne Siqueland, Cynthia Closs, Guy S. Diamond, Tonya Ladipo, Gary M. Diamond, and Suzanne Levy
- Subjects
Family therapy ,Psychiatry and Mental health ,Clinical Psychology ,Psychotherapist ,media_common.quotation_subject ,Treatment development ,Treatment Effectiveness Evaluation ,Homosexuality ,Adolescent development ,Lesbian ,Open label ,Psychology ,media_common - Published
- 2013
44. 55: Providers’ experiences with identification, management and referral of adolescents with depression
- Author
-
Shehreen Latif, Sara B. Kinsman, Guy S. Diamond, Megan E. Pailler, Suzanne Levy, and Sarah L. Stevens
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Referral ,business.industry ,Family medicine ,Pediatrics, Perinatology and Child Health ,Public Health, Environmental and Occupational Health ,medicine ,Identification (biology) ,Psychiatry ,business ,Depression (differential diagnoses) - Published
- 2007
45. The Rite of Spring at Seventy Five
- Author
-
Suzanne Levy
- Subjects
Rite ,geography ,geography.geographical_feature_category ,Visual Arts and Performing Arts ,media_common.quotation_subject ,Spring (hydrology) ,Art ,Ancient history ,Demography ,media_common - Published
- 1988
46. FDA at BIO 2011 â€' Weighing a hefty mission: Where is the balance?
- Author
-
Suzanne Levy
- Subjects
Economics and Econometrics ,Management of Technology and Innovation ,Biotechnology - Abstract
The mission of the Food and Drug Administration (FDA) is to promote public health by ensuring the safety and quality of food and medical products sold in the United States. At this year's annual Biotechnology Industry Organization (BIO) convention, significant discussion revolved around the appropriate interpretation and execution of that mission.The BIO meeting hosted 15 646 participants from across industry, government and the nonprofit sector, focusing on the current state of the biotechnology industry, as well as its challenges in seeking to further improve public welfare. Perhaps partly because this year's meeting was held in Washington, DC – the seat of the federal government and of BIO's headquarters – much attention was paid to the US regulatory environment. In particular, attendees debated the quandary faced every day by the FDA: how to enable access to novel therapies quickly, but only once their safety has been certified.
- Published
- 1969
47. Baryshnikov in Russia
- Author
-
Nina Alovert, Suzanne Levy, Irene Huntoon, and Gennady Smakov
- Subjects
Visual Arts and Performing Arts ,Gennady ,media_common.quotation_subject ,Art history ,Art ,media_common - Published
- 1986
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