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Online trainings in evidence-based treatments (EBT) can be effective platforms and may provide better access to community providers as compared with traditional in-person trainings. However, questions remain as to whether online trainings can achieve similar rates of training engagement and model application to traditional in-person trainings. We compared training engagement and model application (e.g., extent of use, fidelity) between participants attending in-person (n = 127) and synchronous online (n = 277) trainings for an EBT (Alternatives for Families: a Cognitive Behavioral Therapy; AF-CBT). Data were collected through pre- and post-training questionnaires and trainers' records. Chi-square analyses and t-tests were used to test for differences between groups. Engagement regarding attendance at workshops and consultation calls was high for both groups, with no significant differences. A total of 81% and 76% presented at least one case and submitted at least one audio recording of an actual AF-CBT session, respectively. Participants rated the training workshop as high quality (M > 4.5/5), and the consultation calls as medium-to-high quality (M > 4/5) across both modalities, indicating good training engagement. In-person training participants were significantly more likely to submit two or more audio recorded sessions than online training participants. This was the only training requirement outcome that differed between the two groups. In examining model application, there were no significant differences between in-person and online training participants in self-reported delivery of AF-CBT, the number of clients with whom it was implemented, the extent they used the model, or the fidelity with which they delivered it. Both groups reported similar improvements in comfort when working with aggressive families, being directive, and using learning techniques like role plays. Online evidence-based treatment skills training appears to be feasible, efficient, and beneficial, with engagement and performance comparable to in-person training. We discuss potential advantages of online training (e.g., fewer costs, greater flexibility for staff from independent practices) and disadvantages (e.g., less satisfaction).

Background: Narrative exposure therapy (NET) is a trauma-focused cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence in 2018, to treat posttraumatic stress disorder in adults. There is a lack of research exploring the effectiveness of NET with adults with intellectual disabilities. The aim of this study is to develop an adapted version of the NET protocol (IDNET) for use with adults with mild intellectual disability. Methods: A qualitative research design was employed. Stage one involved systematically adapting the NET protocol for adults with mild intellectual disabilities in collaboration with a service user group comprising eight consultants. Stage two involved gaining professionals' views on the adapted protocol and on the use of NET in intellectual disability services. This comprised a focus group of eight clinical psychologists specialising in intellectual disabilities and an expert panel of three NET clinicians. The framework approach was conducted on the focus group data only following guidance from a previous study. Findings: An adapted NET protocol and collection of 'easy read' therapy materials were developed (IDNET), which incorporated feedback from the three stakeholder groups. Key concepts of 'Optimism and motivation to adapt NET for people with mild intellectual disabilities' and 'Factors related to NET in practice' were developed to describe the views of clinical psychologists. A number of issues were raised by professionals regarding the delivery of IDNET. Conclusions: Professionals were optimistic about IDNET; however, issues raised regarding the delivery of IDNET require exploration when IDNET is trialled in practice. Specific implications for clinical practice and future research are discussed.

Although verbal bullying has no impact on physical health, it hurts mental health. The effectiveness of counseling to address these issues varies, and requires testing. This study aims to compare the effectiveness of cognitive behavior counseling with reframing and group counseling with discussion techniques for students who are victims of verbal bullying. This research method is an experimental study with 80 senior high school students as subjects, 40 students are in the experimental group (cognitive behavior counseling with reframing), and 40 students are in the control group (group counseling with discussion). This study showed that the experimental group was superior in helping students do forgiveness to the control group. The involvement of cognitive-behavior elements in counseling has proven to help evoke forgiveness in students who are victims of verbal bullying. This research is then used as a reference for handling victims of verbal bullying effectively with forgiveness in cognitive-behavior counseling. This research contributes to counseling science in implementing appropriate counseling strategies.

Managing health and well-being issues can be challenging for college students. Alternative supports, such as online programs, have been identified as cost-effective and efficient methods of providing inclusive support to college students, removing numerous barriers to health and well-being promotion. The article summarized a novel, evidence-based approach to developing an online health and well-being program. The program is based on Cognitive Behavioral Therapy (CBT), the positive emotion, engagement, relationships, meaning, and accomplishments (PERMA) construct, and the analysis, design, development, implementation, and evaluation (ADDIE) model. It discusses future directions in the evaluation, assessment, and documentation of the fitness-for-purpose process.

Aggressive student behavior is considered a leading risk factor for teacher stress. However, teachers' coping styles may affect how they perceive and respond to aggressive student behavior. This study tests whether teachers' perceptions of aggressive student behavior mainly mirror objectively observed aggression in presence of the teacher (as coded by external observers) or whether teachers' perception of aggressive student behavior primarily reflects teachers' avoidant coping styles, such as chronic worry and resignation. Finally, we examine whether observed and teacher-perceived aggression relates to increased vital exhaustion and psychophysiological stress among teachers (i.e., higher hair cortisol concentration). In an ambulatory assessment study, we administered self-reports to 42 Swiss teachers to assess perceived student aggression, chronic worry, resignation, and vital exhaustion. Additionally, four consecutive lessons per teacher were filmed, and aggressive student behavior in presence of the teacher was coded by four trained external observers. The concentration of cortisol was assessed in hair samples. Results showed that teacher-perceived and observed aggression were moderately associated. Observed aggression was related to teacher perceptions to a much lesser extent than teachers' avoidant coping styles, that is, chronic worry and resignation. While teacher-perceived student aggression was associated with teachers' self-reported vital exhaustion, we did not find any significant association with hair-cortisol concentration. Our findings suggest that teachers perceive student aggression through the lens of their coping styles. Teachers' dysfunctional coping styles are associated with an overestimation of student aggression. Teachers' overestimation of student aggression relates to higher levels of vital exhaustion. Therefore, it is crucial to identify and change teachers' dysfunctional coping styles to prevent a vicious cycle of dysfunctional teacher-student interactions.

Understanding how cognitive-behavioral therapy programs can be best implemented within the school environment is critical for ensuring that preventative mental health efforts reach all children and are most effective. The purpose of this study was to provide a qualitative analysis of students and school-based facilitators' perspectives of a cognitive-behavioral school-based intervention. Thematic analysis was used to evaluate the feasibility of the program, with a focus given to acceptability, implementation, and perceived utility. School-based facilitators (n = 10) provided data via weekly checklists. At the end of the program, facilitators also completed an online survey, and elementary students (n = 186) completed a questionnaire and open-ended worksheet. Results indicated that the program was feasible for teaching important coping skills to elementary school students. While there were specific challenges and barriers reported regarding program implementation, the program was deemed useful, engaging, and beneficial for students overall. These findings provide invaluable information from key stakeholders that will permit revisions and improvements to the program post-validation. This study also serves to further bridge the research-to-practice gap by incorporating facilitator and student perspectives into existing interventions to ensure the successful and sustained transfer of clinical practice into the school setting.

This study examined the effects of cognitive behavioural therapy (CBT), mindful yoga and positive psychology interventions and identified common psychotherapeutic elements that exert critical treatment effects on Hong Kong Chinese students with special educational needs (SENs). Forty-seven participants received CBT intervention while 42 and 41 participants received mindful yoga and positive psychology interventions, respectively (N = 130). Mixed ANOVAs revealed no significant interaction effect between time and intervention condition on any outcome variables. However, within-subjects ANOVA revealed significant improvements in some dimensions within each intervention, including areas of behavioural problems, positive feelings and positive relationships. Changes in negative automatic thoughts were also found to lessen negative emotions in all three interventions. This study ascertained the differential effects of the selected approaches in ameliorating negative emotion, reducing behavioural problems and enhancing positive relationships among students with SENs in various treatment approaches. In addition, this study highlighted several common psychotherapeutic elements, which could potentially serve as important factors and constitute the formulation of an integrative psychotherapeutic framework for enhancing the well-being of students with SENs in Hong Kong. Finally, implications for practice and the possible development of an integrative intervention model were discussed.

Background: Parent-only psychological interventions can be effective treatments for child anxiety. Involving parents in treatment may be beneficial for children, ensuring that interventions are delivered effectively in a supportive environment. Few studies have investigated the feasibility and acceptability of parent-only interventions for child anxiety. Objective: In this study, we report on feasibility, acceptability and preliminary clinical outcomes of a brief cognitive behavioural group intervention for parents of children (4- to 10-years-olds) experiencing anxiety in the absence of a diagnosed anxiety disorder. Method: Parent participants attended a three-session group intervention delivered online. We collected feasibility information (recruitment and retention rates); parents and children (when appropriate) completed acceptability and clinical outcome measures after each session. Participants were also interviewed about the acceptability of the intervention and study processes. Results: Nineteen parents consented to take part (child mean age 6.47, SD 1.23). Participant retention rates (68.4%) and intervention satisfaction (total mean CSQ score 28.52) were high?. Calculated effect sizes were moderate to large for parent-rated outcomes, small for child self-reported anxiety, and small to moderate for parent confidence/efficacy. Thematic analysis of interview data identified benefits, such as connecting with parents and learning strategies, as well as challenges associated with the intervention. Conclusions: Attendance appeared to be associated with positive changes for parents and children. Overall, participants found this to be an acceptable and useful intervention. These findings demonstrated the potential benefit of a brief intervention for parents of anxious children. A larger trial is required to further investigate these preliminary findings.

Social-cognitive and emotional factors as well as behavior problems contribute to the social difficulties experienced by many students with or at high risk for emotional and behavioral disorders (EBDs). The way that teachers and peers treat and respond to these students can either mitigate or exacerbate their challenges in establishing and maintaining positive social relationships and adjusting adaptively to the school context. Managing behavior alone does not address the self-regulatory skills deficits that contribute to social maladjustment, nor does it create socializing contexts that can support self-regulatory skill development. This article reviews research on neurodevelopmental processes and contextual constraints that contribute to the social-emotional difficulties of students with or at high risk for EBD. Implications for intervention design are explored, with a focus on the need for more consistent use of tiered social-emotional learning programs in schools to promote the self-regulation skills and social competence of vulnerable students with or at risk of EBDs. The authors also highlight the need for future research to enhance capacity to support tiered systems of intervention in schools and tailor them effectively to meet the varied needs of these students. [For the corresponding grantee submission, see ED610547.]

This study developed and tested the effectiveness of an app-based cognitive behavioral therapy (CBT) program in alleviating anxiety among adolescents and adults with autism without co-occurring intellectual disability. Thirty participants from 15 to 35 years old were randomly assigned to either the intervention or waitlist control group, and self- and caregiver proxy report questionnaires were administered, accompanied by direct behavior observation before and after the intervention period. There was a significant decrease in anxiety level, an increase in positive affect, and a decline in stereotypic behaviors, hyperactivity, noncompliance, and inappropriate speech in proxy reports for the intervention group, compared to the control group. A significant rise in passive response in the direct observation was also seen in the intervention group.

Background: School-based sleep education programmes can promote the importance of sleep health and may improve adolescent sleep. To date, only limited research has examined the feasibility of integrating sleep programmes into the school curriculum. Objectives: This study evaluated the feasibility, acceptability and preliminary efficacy of the Strathclyde intervention to encourage good sleep health in teenagers (SIESTA). Methods: A total 171 students (12-15 years, 53% women) from secondary schools in Scotland participated in the study. Recruitment and retention, data collection and design procedures were assessed to establish feasibility. Qualitative feedback on acceptability was collected via focus group discussions. Outcome measures assessing insomnia symptoms, sleep hygiene, depression, anxiety and stress were completed at baseline and post-intervention to explore the preliminary effects of SIESTA. Results: All schools that were approached consented to participate, and most students completed assessments at both time points (171) with a dropout rate of 5%. Assessment measures provided sufficient data to compare baseline and post-intervention values. Training and delivery manuals ensured successful delivery of the programme. Qualitative feedback indicated SIESTA was acceptable, and students spoke favourably about the content, delivery and techniques. Students reported that SIESTA was age-appropriate, relevant and the techniques were beneficial. There were significant improvements in insomnia and stress, but no improvements were noted for sleep hygiene, depression or anxiety. Conclusion: The findings suggest that SIESTA is feasible and acceptable for delivery via the school curriculum. The results indicate that a controlled trial is required to further investigate the efficacy of SIESTA implemented in an educational context.

This paper has two objectives, namely, to map the problems of history learning to promote peace in post-conflict societies and offer applicable solutions. The research questions are (1) How do schools in post-conflict areas experience pedagogical conflict, especially when confronting "difficult history" events that arise in classroom discussions? (2) How does the impacts caused? and (3) What solutions can be offered? This research paper is a qualitative research design with a phenomenological approach. The primary informants in this post-conflict generational research are teachers and students in East Aceh. Involved 55 participants from schools scattered in locations with predefined characteristics. The gender ratio was 69.6% females and 30.4% males. The youngest volunteer was 12 and the oldest was 52 of age. The main techniques used in the data collection was observation, which aims to observe the learning process in the classroom and various other potentials outside the classroom that contribute to conflict. Interviews were carried out to deepen the results of observations as data comparisons. The documentation study was conducted to analyze curriculum documents and the used teaching materials. The results of the research show that schools in post-conflict areas, especially in the research setting of "difficult history" learning, experience pedagogical conflict by placing teachers, students, and schools in a latent conflict structure. The behavior of teachers and students in a learning atmosphere is the culmination of contradictions in the knowledge and epistemology that students have before they enter the classroom. The most visible impact is the emergence of cognitive biases and unconscious history due to the tug of war between the psychological and social modalities of the post-conflict generation. Cognitive Behavioral Therapy application is in accordance with the peace education postulate started by deconstructing the image of the enemy and ended with conflict management skills.

Selective mutism is a disorder that can negatively impact a student's learning. It can be treated effectively if it is understood as an anxiety related condition and if it is diagnosed early. Intervention strategies can be complex and are therefore difficult for educational practitioners to implement. Simplifying intervention by addressing the anxiety of the child and then moving to video self-monitoring, fading, contingency management, and cognitive behavioural therapy can make treatment more practical. By using these select methods, educators will have an easier time addressing a difficult problem, and children will benefit substantially.

Rates of anxiety and depression in youth have been increasing, and helicopter parenting although not the only factor, is at the core of the problem. When parents overprotect children and control their lives, children do not gain the skills needed to face the world; this lack of preparedness leads to anxiety and depression. As teachers, we can help by giving students opportunities for choices about their work, and by teaching social-emotional skills and cognitive behaviour techniques. Making these changes can arm the students with the skills, confidence, and resilience they need to feel prepared for the world, which would lower levels of anxiety and depression.

The study investigated the interaction effect gender on academic procrastination and achievement orientation among in-school adolescents. The study adopted a pretest posttest non-equivalent control group quasi-experimental design with a population of 804 SS II students (518 female and 286 males). The sample size of 129 SS II students from Udenu Local Government Area of Enugu State was drawn through purposive sampling technique. Procrastination Assessment Scale for Students (PASS) and Achievement Orientation Questionnaire (AOQ) were used for data collection. Confirmatory factor analysis was used to validate the measures. Internal consistency reliability coefficients of 0.69 and 0.87 for PASS and AOQ were estimated through Cronbach alpha. Mean and standard deviation were used to answer the research questions while ANCOVA and t-test were used to test the hypotheses at 0.05 level of significance. It was found that gender does not significantly have effect on in-school adolescents' academic procrastination and achievement orientation. The researchers recommended that among others that the government at all levels should employ competent educational psychologists/psychotherapists and provide enabling environment and facilities for regular cognitive behavioural change programme for in-school adolescents who may be facing problems with academic procrastination. More so, government agencies and professional bodies whose responsibility is to design and revise curriculum for secondary schools should incorporate and emphasize the use of rational emotive behavioural therapy in secondary schools.

As the adults battle the COVID-19 pandemic's effects, children are also dealing with its fallout. In addition to the health effects, since March 2020, the pandemic has caused long-term school closure, which forced school-aged youth to deal with the stress of social isolation; moreover, since youth have returned to school, there has been an uptick in school violence (Maxwell et al., 2021). These experiences have produced trauma that has affected youth mental health and academic performance. Consequently, educational systems need a better understanding of the intersecting effects of these traumatic events on the youth's mental health and academic performance to implement evidence-based interventions to mitigate the negative impacts of youth trauma.

The purpose of this study was to investigate the effects of an anxiety-coping program for children based on cognitive behavioral therapy on children's anxiety levels. The study was conducted with 12 students in the fourth grade of primary school. Screen for Child Anxiety Related Disorders (SCARED) was during the study for data collection. Students in the experimental group participated in a Cognitive Behavioral Therapy based anxiety coping program consisting of eight sessions. No study was conducted with the students in the control group. A mixed design of 2x3 was used in the study. Follow-up measurement was performed six months after the study was completed. In the analysis of the data, Mann Whitney U test and Friedman test were used. As a result of the analysis, a significant decrease was observed in the general anxiety, general anxiety disorder, separation anxiety and social anxiety levels of the participants in the experiment group after the intervention which continued during the follow-up period. Furthermore there was no statistically significant decrease in panic disorder/somatic symptoms and school phobia levels of the participants in the experimental group. The findings indicated that the anxiety-coping program for children based on cognitive behavioral therapy is effective in terms of decreasing the anxiety levels of children.

Every year school districts must fill tens of thousands of teacher vacancies in mathematics and science. Reasons for the high rate of attrition are described in general terms, such as lack of administrative support and dissatisfaction. Analysis of direct quotes from qualitative research, however, suggests the presence of cognitive errors within the decision-making process of those teachers who quit. Cognitive errors include all or nothing thinking and fortune telling, among others. Results of this study are interpreted in comparison to the attrition literature. Suggestions for future research, such as Cognitive Behavioral Therapy training for preservice teachers, are presented.

School attendance is a complex topic for all school stakeholders preparing students for college and career success. Students who refuse to attend or avoid school are affected or influenced by a myriad of reasons such as their own physical or mental health issues. This article explores the various factors at the root of school refusal, particularly anxiety. Considering students' possible sources of distress, cognitive-behavioral and mindfulness interventions are discussed as well as other strategies across a multi-tiered system of supports model. Three case studies provide insight into various interventions that school counselors and other school personnel may use in school refusal situations.

Objective: College students with attention deficit/hyperactivity disorder (ADHD) are at increased risk for numerous educational and psychosocial difficulties. This study reports findings from a large, multisite randomized controlled trial examining the efficacy of a treatment for this population, known as ACCESS -- Accessing Campus Connections and Empowering Student Success. Method: ACCESS is a cognitive--behavioral therapy program delivered via group treatment and individual mentoring across two semesters. A total of 250 students (18-30 years of age, 66% female, 6.8% Latino, 66.3% Caucasian) with rigorously defined ADHD and comorbidity status were recruited from two public universities and randomly assigned to receive ACCESS immediately or on a 1-year delayed basis. Treatment response was assessed on three occasions, addressing primary (i.e., ADHD, executive functioning, depression, anxiety) and secondary (i.e., clinical change mechanisms, service utilization) outcomes. Results: Latent growth curve modeling (LGCM) revealed significantly greater improvements among immediate ACCESS participants in terms of ADHD symptoms, executive functioning, clinical change mechanisms, and use of disability accommodations, representing medium to large effects (Cohen's d, 0.39 - 1.21). Across these same outcomes, clinical significance analyses using reliable change indices (RCI; Jacobson & Truax, 1992) revealed significantly higher percentages of ACCESS participants showing improvement. Although treatment-induced improvements in depression and anxiety were not evident from LGCM, RCI analyses indicated that immediate ACCESS participants were less likely to report a worsening in depression/anxiety symptoms. Conclusions: Findings from this RCT provide strong evidence in support of the efficacy and feasibility of ACCESS as a treatment for young adults with ADHD attending college.

The breadth of available non-pharmacological interventions for autistic children, with varying evidence for efficacy summarised in multiple systematic reviews, creates challenges for parents, practitioners, and policymakers in navigating the research evidence. In this article, we report the findings of an umbrella review of 58 systematic reviews of non-pharmacological interventions for autistic children (aged 0-12 years). Positive therapeutic effects were identified for "Behavioural interventions," "Developmental interventions," "Naturalistic Developmental Behavioural Interventions," "Technology-based interventions," and "Cognitive Behaviour Therapy" across several child and family outcomes. Positive effects for certain practices within "Sensory-based interventions" and 'other' interventions were limited to select child and family outcomes. Both inconsistent and null intervention effects were found for "Treatment and Education of Autistic and related Communication-handicapped Children," and "Animal-assisted interventions" across outcomes. The possible influence of child (chronological age, core autism characteristics, and related skills) and delivery (agent, mode, format, and amount) characteristics on intervention effects was rarely examined, and inconsistent where reported. Twenty-seven systematic reviews (47%) were rated as 'high' quality. Few systematic reviews examined children's participation and quality of life or adverse effects. The findings highlight the need for individualised evidence-based decision-making when selecting interventions for autistic children.

Cognitive Behavioural Therapy (CBT) programs adapted to children with Autism Spectrum Disorder (ASD) effectively reduce anxiety when run in university clinics. Forty-nine children aged 8-14 years participated in a waitlist controlled study in a general child psychiatric hospital setting. Post-treatment 30% of the children were free of their primary anxiety diagnoses and 5% were free of all anxiety diagnoses. No statistically significant difference between the two trial conditions were found on primary outcomes. However, statistically significant differences were found on secondary outcomes indicating clinically meaningful treatment responses. Together with high program satisfaction this study shows the CBT program to be feasible and potentially efficacious in treating anxiety in children with ASD in a general child psychiatric hospital setting.

Co-occurring psychiatric diagnoses are very common in individuals with ASD. Little is known about the effect that co-occurring psychiatric conditions may have on treatment response to CBT for children with ASD and anxiety. The present study examined the relationship between co-occurring psychiatric diagnoses and response to CBT for anxiety in ninety youth with ASD. Psychiatric complexity did not appear to differentially impact treatment response. A notable portion of youth with anxiety and externalizing disorders such as ADHD, no longer met criteria for those externalizing diagnoses following intervention. Results indicate that youth with ASD and anxiety present with complex psychiatric profiles and CBT for anxiety may positively affect co-occurring diagnoses. In addition, thorough and nuanced assessment of psychiatric symptoms in youth with ASD is needed to ensure the differentiation between diagnoses of anxiety and other co-occurring psychiatric symptoms.

Versions of cognitive behavioral therapy (Coping Cat, CC; Behavioral Interventions for Anxiety in Children with Autism, BIACA) have shown efficacy in treating anxiety among youth with autism spectrum disorder. Measures of efficacy have been primarily nomothetic symptom severity assessments. The current study examined idiographic coping outcomes in the Treatment of Anxiety in Autism Spectrum Disorder study (N = 167). Longitudinal changes in coping with situations individualized to youth fears (Coping Questionnaire) were examined across CC, BIACA and treatment as usual (TAU) in a series of multilevel models. CC and BIACA produced significantly greater improvements than TAU in caregiver-reported coping. Youth report did not reflect significant differences. Results show the efficacy of CC and BIACA in improving idiographic caregiver-, but not youth-, reported youth coping.

Anxiety has been on the rise since the pandemic, yet teachers are often unsure how to help students with anxiety. Anxiety is characterized by rumination and negative or distracting thoughts, and teachers can help by changing those inaccurate thoughts. In this updated version of a November 2019 Kappan article, Jessica Minahan provides a series of practical strategies for helping students recognize their inaccurate negative thoughts and replace them with more accurate thoughts. For instance, teachers might help students see that only one part of a daunting task is actually difficult or that experiences students previously dreaded turned out to not be so bad. Over time, with the daily support of their teachers, students can learn to think more accurately, allowing them to develop anxiety-reducing strategies and fully engage in the classroom. [This is an updated version of an article originally published in the November 2019 issue of Phi Delta Kappan (EJ1233050).]

Background: Psychogenic nonepileptic seizures (PNES) are attacks that often look like epileptic seizures (ES). Unlike ES, PNES are not triggered by underlying neurological factors. PNES are relatively rare in the general population; however, their prevalence in people with learning disabilities is much higher--up to 10%. Individuals with PNES and learning disabilities often have psychiatric comorbidities, such as anxiety disorders, depression and posttraumatic stress disorder. There are currently no treatment guidelines for PNES in people with or without learning disabilities. However, talking therapies, such as cognitive-behavioural therapy (CBT), are recommended. This study explores the effectiveness of CBT for the treatment of PNES in a woman (Susan) with PNES and learning disabilities. Methods: We used a single-case experimental design (SCED) to investigate the effectiveness of CBT intervention. Specifically, the withdrawal (also known as ABA) design was applied. The patient's average PNES frequency, as well as idiosyncratic mood measure and standardised outcome measures for people with learning disabilities (Glasgow Anxiety Scale for People with an Intellectual Disability and Mini-Maslow Assessment of Needs Scale-Learning Disabilities), were used to assess the effectiveness of treatment. Findings: Results show that Susan's monthly PNES frequency reduced from phase A1 (assessment phase) to phase B (treatment phase), and this persisted to the follow-up phase (phase A2). However, the reduction was not statistically significant. The intervention was associated with improvements in Susan's mood, anxiety and quality of life. Reduction of Susan's anxiety was clinically significant. Conclusions: This SCED study demonstrates that CBT might be associated with reduction of PNES frequency and improvements in general functioning in people with PNES and learning disabilities; however, further research, especially around confounding variables is needed.

Background: People with learning disabilities experience bereavement in the same emotionally overwhelming way as the general population. The Dual-Process Model of grief is characterised by the oscillation between "Loss-Orientation" and "Restoration-Orientation." These processes involve experiencing and accepting the emotional pain of grief ("Loss-Orientation") and adapting to a new world without the deceased person ("Restoration-Orientation"). Methods: A single case study sought to explore how Cognitive Behavioural Therapy (CBT) and Compassion Focused Therapy (CFT) principles can be used to support people with a learning disability to navigate the grieving process, as understood by the Dual-Process Model. Findings: This case study describes CBT formulation and assessment, and implementation of CBT and CFT strategies in a man with Williams syndrome, demonstrating improvements in mood, and a greater ability to turn towards suffering and experience both "Loss-" and "Restoration-Oriented" processing. Conclusion: CBT and CFT may be useful and appropriate modalities for clinicians to consider when supporting people with a learning disability to navigate loss, as understood through the Dual Process Model.

The Compassionate Arts Psychotherapy (CAP) program integrates self-compassion and arts psychotherapy practices, which are informed by a compassionate arts media (CAM) continuum. A mixed methods pilot program evaluation with a pretest-posttest single group design, followed by an open-ended survey, was conducted. Participants included 18 graduate students who engaged in ten 2.5-hour meetings, over the course of two weekends. Results showed statistically significant increases in self-compassion, and cognitive and affective mindfulness over time and at two-week follow-up. Qualitatively, participants reported positive gains, specifically: openness to new experiences, here-and-now mindful awareness, and self-compassion. These results suggest the clinical utility of CAP and provide novel perspectives on the directionality of the traditional art therapy media continuum.

This practice paper demonstrates an art therapy session that revealed the internalized monstrous and demonic identities amongst those who have sexually offended. Several of the participants represented their shadow-self as: (1) nebulous demonic self-representations, (2) internalized monstrous selves as hurtful or uncontrolled, or (3) a dichotomy of power and helplessness. Making these negative self-images visible during such an art therapy process can inform the initial step toward reconciliation, especially within the transitional space of reintegrating into society post-incarceration. Implications demonstrate the use of metaphorical expression and how such images can address the stigmatized and internalized negative self-perceptions of those who have sexually offended.

Background: In recent years, third-wave therapies have risen to prominence. Research into adapting and evaluating third-wave therapies for adults with intellectual disabilities has identified that third-wave therapies are accessible, acceptable, and effective (improving a range of symptoms and skills). Method: This meta-ethnography followed Noblit and Hare's approach to synthesising findings from qualitative studies to examine how adults with intellectual disabilities experience third-wave therapy groups. A systematic review of three databases identified 13 studies that met our inclusion criteria. Results: We identified that third-wave therapy groups can be a 'Transformational' process for adults with intellectual disabilities that involves three stages: 'Concealment', 'Opening up' and 'Flourishing'. Conclusion: Findings highlight the importance of therapeutic processes; especially, working with defences, and developing and maintaining safety/trust. Recommendations include the development of an objective measure of group safety/trust.

Millions of college students across the United States experience anxiety disorders, evidencing a high need for evidence-based counseling techniques. At the same time, impairment resulting from anxiety often necessitates classroom accommodations at the postsecondary level. Cognitive-behavioral therapy with exposure (CBT ERP) involves a thorough assessment of the function of a client's behaviors and a personalized treatment plan that gradually exposes them to feared stimuli. Yet students often underutilize classroom accommodations, and accommodations may conflict with the theoretical underpinnings of CBT ERP. We present a brief and accessible explanation of CBT ERP, discuss common classroom accommodations, and suggest methods for successfully integrating accommodations into cognitive-behavioral interventions.

The effect size of psychological counseling based on the Cognitive Behavioral Therapy (CBT) approach on depression and anxiety, was conducted using a meta-analysis method. According to the defined criteria, eight primary studies on anxiety and 21 on depression are included in the meta-analysis. The effect sizes based on a random-effects model are also determined. The mean effect size was -0.936 (95% CI [-1.215, -0.657]) for anxiety and -0.844 (95% CI [-1.065, - 0.624]) for depression. Accordingly, CBT can have a large effect on reducing the level of depression and anxiety in participants. As a result of the moderator analysis, the effect sizes relating to depression did not significantly differ according to the type of test and experimental design. The number of sessions was a non-significant predictor of depression, but the experimental group size was a significant predictor of CBT's effect size on depression. As for the moderator analysis in the anxiety variable, the effect sizes relating to anxiety did not significantly differ by age group, types of publication, counseling, experimental design, test, and anxiety. Also, the number of sessions and experimental group size were not significant predictors of anxiety. According to these results, CBT is effective in reducing the depression and anxiety levels of individuals.

This triple-arm, double-blind, randomized clinical trial investigated the effect of multisession prefrontal transcranial direct current stimulation (tDCS) on social functioning in individuals with autism spectrum disorder (ASD). A total of 105 individuals (age 14-21 years) diagnosed with ASD were randomized into the active-tDCS, sham-tDCS, and waitlist control groups. The experimental group received 20 min of 1.5 mA tDCS stimulation (cathode: F3; anode: Fp2) for 10 days with concurrent computerized cognitive remediation training. Changes in overall social functioning, social communication, and restricted, repetitive behaviors (RRB) were measured by the Social Responsiveness Scale-2nd edition (SRS-2). Two-level hierarchical linear mixed-model analysis showed significant group*time interactions for SRS-2 total [F(2, 107.09) = 7.82; p = 0.001] and RRB [F(2, 90.26) = 5.62; p = 0.005] T-scores. When compared with the waitlist control group, the changes in scores were only significant in active-tDCS (SRS-2 total T-score p < 0.001, d = 0.61; SRS-2 RRB T-score p = 0.002, d = 0.88), but not sham-tDCS (SRS-2 total T-score p < 0.12, d = 0.30; SRS-2 RRB T-score p = 0.54, d = 0.17) group. Multiple sessions of prefrontal tDCS coupled with cognitive training is a safe and effective treatment for improving social functioning in people with ASD. Trial Registration: ClinicalTrials.gov (ID: NCT03814083; URL: https://clinicaltrials.gov/ct2/show/NCT03814083).

A growing number of adolescents are using a number of different identities to describe their gender. Schools have been noted for their uninclusive environments and high levels of discrimination for LGBTQ + individuals, yet research has neglected the school experiences of UK gender-diverse adolescents. This article explores the school experiences and navigation strategies of gender-diverse adolescents in the UK, examining the experiences of binary-trans, non-binary and gender-questioning adolescents separately. The data presented in this article come from a large survey of LGBTQ + young people's social experiences; a subsample of 74 adolescents' (25 binary-trans, 25 non-binary, and 24 gender-questioning) open-ended responses were selected for qualitative thematic analysis. Findings highlight that gender-diverse adolescents experience discrimination within the school environment from the curriculum, space, peers and teachers, and a number of strategies, including disclosure negotiation, cognitive restructuring and proactive protection, are used to navigate this environment. Findings shed light on the school experiences of gender-diverse adolescents, and suggest that the British school system is fundamentally unsuitable for non-binary and gender-questioning identities.

Taking into account the complementary treatments used today, this study examines the impact of cognitive mindfulness therapy in persons with Attention Deficit Hyperactivity Disorder (ADHD). A systematic review was carried out following the PRISMA method, including a total of 34 experimental articles from scholarly journals indexed in Web of Science and Scopus whose year of publication is limited to the last five years (2017-2021). The variables studied the most in the scholarly publications are divided into two categories: cognitive (attention, concentration and emotional regulation) and behavioural (hyperactivity, impulsiveness and inhibitory control). A standard table reflects what variables are used in each publication examined. A strong positive impact was found for both types of variables after the application of this therapy, which produced positive effects in the samples. Mindfulness is a positive complementary treatment in people with ADHD. [English translation by Mary Black.]

Despite the fact that bullying has been consistently linked to moral disengagement among schoolchildren, research that distinguishes among the four loci of moral disengagement (cognitive restructuring, minimizing one's agentive role, distorting consequences, and victim attribution) to better understand bullying is scarce. The aim of this longitudinal study, conducted in Sweden, was to explore in both female and male students whether the four loci of moral disengagement are concurrently associated with bullying when students are around age 12 and then again around age 14, and whether the four loci of moral disengagement in age 12 predict bullying at age 14. The current paper is based on data from 1,053 students who completed a questionnaire both in sixth and then, two years later, in eighth grade to collect self-reported data on moral disengagement, traditional school bullying perpetration, sex and age. According to the findings, concurrent associations between moral disengagement loci and bullying vary across age and sex, but cognitive restructuring was consistently related to bullying in all conditions. Cognitive restructuring was the only moral disengagement locus from grade six that significantly predicted bullying in grade eight, but not when controlling for bullying in grade six. The results indicate the need to individualize intervention actions to address moral disengagement in terms of sex and age.

Background: Dialectical behavior therapy (DBT) is an evidence-based treatment for self-harm and emotion regulation difficulties. A modified version, DBT-Skills System (DBT-SS), has been developed in the USA for individuals with cognitive difficulties. The present study is a pilot study, testing the DBT-SS in a Swedish context. Methods: Six participants were treated with individual therapy and group skills training for 48 sessions each. A case series design was used to follow individual development over time. The primary outcome measure was reduction in challenging behaviors. Secondary outcomes were level of functioning in daily life, hospital admissions, and resilience and vulnerabilities in different risk domains. Data was analyzed using time-series diagrams. Effect sizes of changes were calculated using Cohen's d. Results: Challenging behaviors decreased over time and participants' global level of functioning increased. There was a reduction in number of hospital admissions over time. As for resilience and vulnerabilities, participants' overall level of risk in various areas remained unchanged or decreased after treatment. Conclusions: The results indicate that DBT-SS might be a promising treatment for cognitively challenged individuals with emotion regulation difficulties and challenging behaviors in a Swedish context. The study provides suggestions for a future randomized controlled trial.

Academic self-handicapping (ASH) has been linked to a number of negative academic outcomes. Thus, it becomes essential to develop and test the efficacy of suitable interventions for the same. The present study aims to explore the effectiveness of integrating Rational Emotive Behavior Therapy (REBT) and Acceptance and Commitment Therapy (ACT) to manage ASH among young adults. A before-after with control experimental research design was adopted. The Academic Self-Handicapping Scale was employed. The sample comprised 53 undergraduate female students (M[subscript age] = 18.5, SD = 0.88) selected through purposive sampling. Participants who scored at or above the 50th percentile (n = 25) were randomly assigned to the experimental (n[subscript 1] = 13) or control group (n[subscript 2] = 12). The experimental group was exposed to an 8-hour online intervention. Tests were re-administered at the end of the intervention. Student's t-test and one-way multiple analysis of co-variance (MANCOVA) were used to analyze the data. The results revealed a significant reduction in overall ASH scores as well as the sub-scale scores within the experimental group as well as in comparison to the control group. The effect size was greater for Claimed self-handicapping. The findings have implications in adopting an eclectic approach to manage academic difficulties.

Background: Contemporary clinical and empirical perspectives indicate that management of the psychosocial features of stuttering is fundamental for effective treatment. Interventions that improve psychosocial outcomes for school-age children who stutter are, therefore, needed. Aims: This systematic review identifies what psychosocial outcomes have been explored in existing school-age clinical research, the measures used and the potential treatment effects. This will provide guidance for developing interventions that reflect contemporary perspectives of stuttering management. Methods & Procedures: A total of 14 databases and three conference proceedings were searched for clinical reports of psychosocial outcomes of children aged 6-12 years. The review did not include pharmacological interventions. Psychosocial measures and outcomes were analysed in each study based on data recorded pre-treatment, immediately post-treatment and for any follow-up assessments. Main Contributions: Of the 4051 studies identified from the databases, a total of 22 studies met criteria for inclusion in the review. From these 22 studies, the review identified four prominent psychosocial domains that have been explored in school-age clinical research to date: Impact of stuttering, communication attitude, anxiety and speech satisfaction. These domains vary in measurement and effect sizes. Two behavioural treatments were associated with anxiety reduction, even though they did not contain anxiolytic procedures. No evidence of potential treatment effects emerged for communication attitudes. Quality of life--an important psychosocial domain pertinent to health economics--did not feature in school-age clinical reports. Conclusions & Implications: The psychosocial features of stuttering need to be managed during the school years. Three psychosocial domains--impact of stuttering, anxiety and speech satisfaction--show evidence of potential treatment effects. This review provides direction for future clinical research so that speech-language pathologists can effectively and holistically manage school-age children who stutter.

Objective: Adjustment to retirement is heterogeneous in nature, and for some, but not all individuals, may require well-being support. However, limited information is available on the types of psychosocial interventions that can be effective during this time of transition with pre-retirees or retirees. This review identified psychosocial interventions with adults before and during retirement, and their effectiveness in maintaining or increasing well-being. Method: Following PRISMA guidelines, a multi-database systematic literature review, with a two-stage screening process, was conducted utilising narrative synthesis. Records were independently screened by two screeners against set inclusion and exclusion criteria. Results: Two thousand four hundred and thirty-six records were identified for screening with 20 studies found eligible for final review. These included seven randomised controlled trial studies (RCT), six non-randomised quasi-experimental controlled studies, and seven single group pre/post intervention studies. Interventions covered cognitive behavioural therapy (CBT), positive psychology, mentoring, family therapy and others. Conclusions: The review highlighted the benefits of psychosocial support to adults' well-being before and after they retire, especially with participation in group-based programs utilising elements of CBT. There was also evidence for well-being maintenance with longer running interventions. Results should be considered in the development of future psychosocial interventions to support individuals during this important life phase in older adulthood.

Positive social relationships have been variously linked to mental well-being, and it is therefore important to more fully understand the factors that may impede positive relationship development. The aim of this study was to explore the relationships between elementary school-age children's emotion regulation, relationship problems, adaptive behaviour (communication, daily living, social skills), and parental emotion regulation. A sample of 210 parents of children ages 7 to 10 years old reported on their child's socioemotional functioning by completing the Child Behaviour Checklist, Vineland Adaptive Behaviour -- III, and the Emotion Regulation Checklist. Parents also reported on their own emotion regulation strategies with the Emotion Regulation Questionnaire. Results showed parental emotion regulation (cognitive restructuring) to be associated both with child emotion regulation and child adaptive functioning. Negative covariance was found between child emotion dysregulation and adaptive functioning ratings. Structural modelling revealed child emotion dysregulation to be the direct predictor of relationship problems.

Novel and unpredictable learning environments are a feature of school-to-college transitions that erode students' academic control, emotional resilience, and achievement (Perry, Hall, & Ruthig, 2005). Although motivation interventions can benefit college students (Koenka, 2020), few studies have examined treatment efficacy for students of varying socioeconomic backgrounds. This randomized treatment-control study assessed whether a cognitive-reframing intervention (attributional retraining [AR]) improved cognitive, affective, and performance outcomes of students with debt in a two-semester, online course. For in-debt students, AR (vs. no-AR) fostered cognitive reframing of achievement setbacks to increase academic control, adaptive emotions, post-treatment performance, and final course grades. Changes in maladaptive causal attributions mediated AR-grades efficacy in a path sequence specified by Weiner's (1985, 2014, 2018) attribution theory. Findings advance motivation intervention research by showing AR boosts achievement for students with debt, mediated by theory-derived cognitive and affective processes.

Mental health difficulties are prevalent in autistic people with [approximately]14%-50% having experienced depression and [approximately]40%-80% having experienced anxiety disorders. Identifying interventions that improve autistic people's mental health is a top priority. However, at present, there is no high-quality network meta-analysis of benefits and harms of different interventions. We conducted a systematic review and network meta-analysis of randomised controlled trials, searching MEDLINE, EMBASE, other databases, and trial registers until 17 October 2020. We included randomised controlled trials reporting anxiety or depression in a suitable format. We calculated effect estimates and 95% credible intervals using Bayesian network meta-analysis. Our search identified 13,794 reports, of which 71 randomised controlled trials (3630 participants) were eligible for inclusion. All trials had high risk of bias. The follow-up period ranged from 1 to 24 months. Evidence indicates uncertainty about the effects of different interventions, with more high-quality evidence needed. Available evidence suggests that some forms of cognitive behavioural therapy may decrease anxiety and depression scores in autistic children and adults; mindfulness therapy may decrease anxiety and depression scores in autistic adults with previous mental health conditions; and behavioural interventions may provide some benefit for depression in autistic children. We recommend that autistic people are given access to mental health interventions available to non-autistic people, following principles of person-centred care.

This article reports on a pilot study of a parent-only cognitive behavioural therapy (CBT) programme for parents of children with autism spectrum disorders (ASD) and anxiety difficulties. Twenty-one parents of anxious children with ASD (5-11 of age) completed the From Timid to Tiger intervention. Parent outcome measures were assessed at post-intervention and at 3-month follow-up. Analysis indicated significant reductions in both parent and clinician reports of child anxiety symptoms. Specifically, 38% of children were free of their primary diagnosis at treatment end and this increased to 57% when measured at 3-month follow-up. Positive gains were evidenced regarding parents' ability to manage their child's anxiety without accommodating to it. The results provide preliminary evidence of parent-only CBT programs for children with ASD.

This study examined social workers' perceived use of theories and methods in practice through a questionnaire completed by social workers in New York City (N=105) followed by individual interviews (N=20). Social workers received approximately one to six courses on theory in their education that moderately influenced their current practice. The most commonly used theories in practice included Cognitive Behavioral Therapy, Strengths Perspective, and Trauma-Informed Care. Social workers either applied theory to practice in an intentional and systematic way or indicated their "practice was not that intentional." Social work education was reported to provide a breadth but not depth of knowledge on theory. Recommendations for social work education to strengthen the link between theory and practice are provided.