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In this article, we present evidence that disorders of attention are present in wide range of psychological disorders, and that the appropriate assessment and treatment of these attention difficulties can be an important adjunct to traditional therapeutic approaches. We review approaches to attention training in some detail and discuss how attention-focused treatment might be implemented in clinical practice. (Contains 1 figure.)

Objective: The identification of reliable predictors of course in major depressive disorder (MDD) has been difficult. Evidence suggests that the co-occurrence of personality pathology is associated with longer time to MDD remission. Interpersonal pathoplasticity, the mutually influencing nonetiological relationship between psychopathology and interpersonal traits, offers an avenue for examining specific personality vulnerabilities that may be associated with depressive course. Method: This study examined 312 participants with and without a co-occurring personality disorder diagnosis who met criteria for a current MDD episode at baseline and who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Results: Latent profile analysis (LPA) identified 6 interpersonal groups (extraverted, dominant, arrogant, cold, submissive, and unassuming), and circular statistical profile analysis confirmed group interpersonal distinctiveness. No significant differences between groups were found in comorbid Axis I disorders or baseline MDD severity. Chronicity and functioning analyses found significantly greater chronicity and poorer functioning in individuals with a submissive interpersonal style over 10 years. Conclusions: These findings support the relevance of interpersonal pathoplasticity in depressive course and that this heterogeneity has clinical significance. This study is the first to use LPA and circular profiles to examine interpersonal heterogeneity within a diagnostic group. The implications of these findings for therapeutic intervention, interpersonal functioning, and psychopathological course are discussed. (Contains 7 footnotes, 5 tables, and 3 figures.)

Objective: Shame has long been seen as relevant to substance use disorders, but interventions have not been tested in randomized trials. This study examined a group-based intervention for shame based on the principles of acceptance and commitment therapy (ACT) in patients (N = 133; 61% female; M = 34 years old; 86% Caucasian) in a 28-day residential addictions treatment program. Method: Consecutive cohort pairs were assigned in a pairwise random fashion to receive treatment as usual (TAU) or the ACT intervention in place of 6 hr of treatment that would have occurred at that same time. The ACT intervention consisted of three 2-hr group sessions scheduled during a single week. Results: Intent-to-treat analyses demonstrated that the ACT intervention resulted in smaller immediate gains in shame, but larger reductions at 4-month follow-up. Those attending the ACT group also evidenced fewer days of substance use and higher treatment attendance at follow-up. Effects of the ACT intervention on treatment utilization at follow-up were statistically mediated by posttreatment levels of shame, in that those evidencing higher levels of shame at posttreatment were more likely to be attending treatment at follow-up. Intervention effects on substance use at follow-up were mediated by treatment utilization at follow-up, suggesting that the intervention may have had its effects, at least in part, through improving treatment attendance. Conclusions: These results demonstrate that an approach to shame based on mindfulness and acceptance appears to produce better treatment attendance and reduced substance use. (Contains 3 tables and 3 figures.)

Objective: This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. Method: African American youths (M age, pretest = 17.7 years) were assigned randomly to the AIM (n = 174) or control (n = 173) group. Past 3-month alcohol use, past 6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest. Pretest assessments of parent-child conflict, affiliations with substance-using companions, and perceived racial discrimination were used to construct a contextual risk factor index. Results: A protective stabilizing hypothesis was supported; the long-term efficacy of AIM in preventing escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-moderation hypothesis, AIM-induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM x contextual risk prevention effects on alcohol use and substance use problems. Conclusions: Training in developmentally appropriate protective parenting processes and self-regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems. (Contains 2 tables and 5 figures.)

Objective: This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups. Method: Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover. Results: Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance, droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels. Conclusions: The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population. (Contains 1 footnote, 3 tables, and 4 figures.)

Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with a new diagnosis of OSA. Method: One hundred six Australian adults (69% male) with a new diagnosis of OSA and a clinical recommendation for CPAP treatment were recruited from a tertiary sleep disorders center. Participants were randomly assigned to receive either 3 sessions of a motivational interviewing intervention (MINT; n = 53; mean age = 55.4 years) or no intervention (control; n = 53; mean age = 57.74 years). The primary outcome was the difference between the groups in objective CPAP adherence at 1-month, 2-month, 3-month, and 12-month follow-ups. Results: Fifty (94%) participants in the MINT group and 50 (94%) participants in the control group met all inclusion and exclusion criteria and were included in the primary analysis. The number of hours of CPAP use per night in the MINT group at 3 months was 4.63 hr and was 3.16 hr in the control group (p = 0.005). This represents almost 50% better adherence in the MINT group relative to the control group. Patients in the MINT group were substantially more likely to accept CPAP treatment. Conclusions: MINT is a brief, manualized, effective intervention that improves CPAP acceptance and objective adherence rates compared to standard care alone. (Contains 4 tables and 2 figures.)

Objective: Unresolved questions exist concerning diagnosis of ADHD. First, some studies suggest a potential overdiagnosis. Second, compared with the male-female ratio in the general population (3:1), many more boys receive ADHD treatment compared with girls (6-9:1). We hypothesized that this occurs because therapists do not adhere to "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; "DSM-IV") and International Classification of Diseases (10th rev.; ICD-10) criteria. Instead, we hypothesized that, in accordance with the representativeness heuristic, therapists might diagnose attention-deficit/hyperactivity disorder (ADHD) if a patient resembles their concept of a prototypical ADHD child, leading therapists to overlook certain exclusion criteria. This may result in overdiagnosis. Furthermore, as ADHD is more frequent in males, a boy might be seen as a more prototypical ADHD child and might therefore receive an ADHD diagnosis more readily than a girl would. Method: We sent a case vignette to 1,000 child psychologists, psychiatrists, and social workers and asked them to give a diagnosis. Four versions of the vignette existed: Vignette 1 (ADHD) fulfilled all "DSM-IV"/ICD-10 criteria of ADHD. Vignettes 2-4 (non-ADHD) included several ADHD symptoms but stated other ADHD criteria were nonfulfilled. Therefore, an ADHD diagnosis could not be given. Furthermore, boy and girl versions of each vignette were created. Results: In Vignettes 2-4 (non-ADHD), 16.7% of therapists diagnosed ADHD. In the boy version of these vignettes, therapists diagnosed ADHD around 2 times more than they did with the girl vignettes. Conclusions: Therapists do not adhere strictly to diagnostic manuals. Our study suggests that overdiagnosis of ADHD occurs in clinical routine and that the patient's gender influences diagnosis considerably. Thorough diagnostic training might help therapists to avoid these biases. (Contains 3 tables and 1 figure.)

Objective: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. Method: The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev. ["DSM-IV-TR"]) lifetime anxiety disorders (American Psychiatric Association, 2000). Adolescents ranged in age from 13 to 18 years (M = 15.2 years, SE = 0.08 years) and were 39% non-White. Multiple-group latent class analysis was conducted by adolescent sex and age to identify subgroups of adolescents with similar anxiety disorder profiles. Developmental and clinical correlates of empirically derived classes were also examined to assess the nomological validity of identified subgroups. Results: A 7-class solution provided the best fit to the data, with classes defined primarily by one rather than multiple anxiety disorders. Results also indicated that classes displayed similar diagnostic profiles across age, but varied by sex. Classes characterized by multiple anxiety disorders were consistently associated with a greater degree of persistence, clinical severity, impairment, and comorbidity with other "DSM-IV-TR" psychiatric disorders. Conclusions: The presentation of lifetime anxiety disorders among adolescents and the observation of unique correlates of specific classes provide initial evidence for the utility of individual "DSM-IV-TR" anxiety disorder categories. Although findings of the present study should be considered preliminary, results emphasize the potential value of early intervention and gender-specific conceptualization and treatment of anxiety disorders. (Contains 3 footnotes, 4 tables, and 1 figure.)

Like many domains of professional psychology, school psychology continues to struggle with the problem of distinguishing scientific from pseudoscientific and otherwise questionable clinical practices. We review evidence for the scientist-practitioner gap in school psychology and provide a user-friendly primer on science and scientific thinking for school psychologists. Specifically, we (a) outline basic principles of scientific thinking, (b) delineate widespread cognitive errors that can contribute to belief in pseudoscientific practices within school psychology and allied professions, (c) provide a list of 10 key warning signs of pseudoscience, illustrated by contemporary examples from school psychology and allied disciplines, and (d) offer 10 user-friendly prescriptions designed to encourage scientific thinking among school psychology practitioners and researchers. We argue that scientific thinking, although fallible, is ultimately school psychologists' best safeguard against a host of errors in thinking. (Contains 3 tables.)

Although there are certainly traditions of conducting longitudinal/developmental analyses to trace outcomes of preventive behavior and academic interventions (i.e., traditions that collectively can be referred to as "development through intervention" practices), less attention has been given to combined analyses of the changes behavior interventions introduce within and across specific developmental changes. This essay considers the rationale for and the benefits of such analyses for developmental science.

Mental health practitioners' exposure to threats and acts of nonfatal violence are among the highest of all professions. Implementing a comprehensive workplace violence prevention program specific to the clinical setting is paramount to decreasing these risks. However, generic security recommendations at times come in conflict with the professional, legal, ethical, and budgetary constraints unique to the clinical environment. This article discusses how the various types of security surveys, policy considerations and practical training applications can be implemented with sensitivity to those challenges and still enhance the safety of staff and clients alike.

This study analyzes informal learning, drawing on video recordings of staff-child interaction in a pediatric unit. It is shown that even very young patients engage in intent community participation, carefully noting fine variations in examination and treatment practices. They orient to everyday routines in successively more complex ways, gradually acquiring novel repertoires of practices; advancing from nonverbal uptake to an active use of medical terminology, and to actively assisting staff members. Ultimately, the children themselves assume almost full responsibility for routine procedures. The unit had adopted partnership-oriented routines, and the doctors and nurses spent much time in securing the children's consent and participation in their own treatment. In contrast to much earlier work in pediatric settings which has shown children to be marginal participants; even the youngest patients were engaged, and they successively acquired a set of novel practices related to treatment procedures. Together with doctors and nurses, the children could be seen to form a community of practice. But community is not something fixed; instead it is seen as an emergent phenomenon, dependent on staff members' and children's mutual alignments and collaborative action. Learning is thus analyzed as a social and relational phenomenon.

Commonly used in clinical and medical settings, no-suicide contracts (NSCs) solicit commitment from suicidal individuals not to attempt suicide. The prevalence of community and school-based Mental Health Professionals' (MHPs) use of NSCs with suicidal youth (SY) is unknown. Additionally, minimal feedback is available regarding MHPs' current practice and perceptions of implementing NSCs. Likewise, school and agency policy directing intervention with SY is not well described, or clearly understood. Of 326 individuals attending Utah's Annual Youth Suicide Prevention Conference, 243 completed questionnaires (74.5% participation rate) assessing perceptions and current practice related to NSCs. Of these questionnaires, 229 were completed by MHPs who specifically worked with youth under the age of 18 years. These questionnaires were included in data analysis. When intervening with SY, half of participants reported using NSCs. However, only 3.5% of participants (n = 8) reported knowledge of formal "written" school district or community mental health agency policy that offered guidelines for implementing NSCs. Implications for clearly specifying current policy to guide interventions with SY are discussed. (Contains 2 tables.)

This study examined posttreatment patterns of polysubstance use and heroin relapse in a sample of 43 adolescents (ages 14-20) entering short-term residential treatment for primary heroin use. At 12-month follow-up, youths that achieved heroin abstinence (N = 19) were significantly less likely than youths that relapsed to heroin (N = 24) to endorse polysubstance use and cannabis, cocaine, or benzodiazepine use. Furthermore, heroin-abstinent youths significantly reduced their cannabis and cocaine use across the study period while youths that relapsed made initial reductions before returning to their pretreatment levels of use for these drugs. Clinical implications for heroin-using youths and areas for future research are discussed. (Contains 2 figures, 2 tables and 2 notes.)

Introduction: Continuing education is one of the means by which professionals maintain and increase their level of competence. However, the relationship between continuing education and the professional's sense of personal competence and other practice-related variables remains unclear. This study examined practicing psychologists' continuing education activities and how these relate to feelings of perceived competence, professional value, and professional support. Methods: Psychologists (n = 418) licensed to practice in Quebec were surveyed by pencil-and-paper mail-in survey concerning their continuing education activities, as well as their perceptions of their competence in practice, and their feelings of being professionally valued and professionally supported. Results: Results indicated that feelings of "competence in practice" were related to professional reading, taking courses/workshops, years being licensed, and attending psychology conferences/conventions. Feelings of "professional value" were related to age and participating in psychology networking groups, and feelings of "professional support" were related to participating in case discussion groups, supervision groups, and psychology networking groups. Discussion: The results showcase the complexity of professional development. Although relationships were found between continuing education activities and the 3 factors of interest, these relationships were moderate. Findings are discussed in the context of their value to individual psychologists, as well as to psychology licensing and regulatory boards, such as promoting participation in those activities related to feelings of competence and support. (Contains 3 tables.)

This paper addresses the topic of assistive technology (AT) to offer a direction for its future role within the rehabilitation profession. A brief overview of the five AT legislative acts to date is provided. Next, future considerations for AT are offered in the context of what we know within the U.S. and global communities followed by the imperative to apply AT evenly to all types of disabilities as well as all groups defined by various demographic dimensions. Recommendations for improving the viability of research efforts for AT are provided along with several strategies for mainstreaming its role within graduate rehabilitation education programs to develop a future workforce that has a more astute understanding of AT and a greater inclination to use it. The current status of AT in producing clinical outcomes is discussed. Finally, frameworks for involving key stakeholder voices to holistically evaluate the success of AT policy as well as measure its impact are provided.

Counseling studies have shown that increasing experience is not always associated with better judgments. However, in such studies performance is assessed against external criteria, which may lack validity. The authors applied the Cochran-Weiss-Shanteau (CWS) index, which assesses the ability to consistently discriminate. Results showed that novice counselors performed almost on the same level as very experienced counselors. The authors thus replicated earlier findings with a novel approach: applying an internal coherence criterion. (Contains 1 figure.)

This paper explores the idea of possible proto-experiences of the prenatal child in the context of Bion's model of container/contained. The physical configuration of the embryo/foetus contained in the maternal uterus represents the starting point for an enquiry into the unborn child's possible experiences of its state of being contained in a container. The paper takes into consideration the sensory dimensions of auditory, tactile and kinaesthetic levels of awareness of the prenatal child in relation, respectively, to the maternal voice and the uterine environment. The author's hypothesis is that concrete prenatal experiences of containment may have their mental counterpart in the development of a proto-mental container and memory, the existence of which can be observed in the newborn infant. It is also suggested that prenatal proto-experiences of containment may prepare the child for further postnatal realisations of the pre-conception of containment and represent the experiential basis for the encounter with the breast. Observations of newborn babies in an obstetric ward, as well as the observation of a prematurely born child, seem to confirm the idea that the intrauterine experience of container/contained plays a role in the child's prenatal development. The meaning of prenatal thumb-sucking is explored in terms of the model of container/contained at a part-object level. An observation of the play of a three-year-old child offers material for further thought about the meaning and function of the introjected configuration of container/contained for the development of a sense of identity and symbolic thinking. The clinical case of an autistic child who survived a threatened miscarriage shows how the emotional containment in psychotherapy allowed the formerly inaccessible nameless dread to re-emerge and be represented and shared. (Contains 2 notes.)

This article examines the history of accreditation in psychology and applies the lessons learned to the Association for Gerontology in Higher Education's (AGHE) consideration of forming an organization to accredit programs in gerontology. The authors identify the challenges met and unmet, the successes and failures, and the key issues that emerged from psychology's experience with accreditation. Psychology has been accrediting programs in clinical psychology for more than 65 years, and the process has been marked by several false steps, considerable tension, and some controversy and at times significant dissatisfaction. The accreditation process that has emerged today, which includes counseling, school psychology, graduate practica, and postdoctoral practica sites, is generally well received yet some tensions exist. The authors apply the lessons learned from psychology's evolution to AGHE. The experience of psychology suggests a need for clear minimum standards and consistency across programs in training goals, if not in curricula and practica. However, setting standards for specific curricula and practice content may result in a similar contentiousness that has plagued psychology. Ultimately, the authors conclude that the benefits of accreditation of programs outweigh the deficits.

The authors review widely accepted criteria for program accreditation and compare gerontology with well-established accredited fields including clinical psychology and social work. At present gerontology lacks many necessary elements for credible professional accreditation, including defined scope of practice, applied curriculum, faculty with applied professional credentials, and resources necessary to support professional credentialing review. Accreditation with weak requirements will be dismissed as "vanity" accreditation, and strict requirements will be impossible for many resource-poor programs to achieve, putting unaccredited programs at increased risk for elimination. Accreditation may be appropriate in the future, but it should be limited to professional or applied gerontology, perhaps for programs conferring bachelor's or master's degrees. Options other than accreditation to enhance professional skills and employability of gerontology graduates are discussed.

The aim of this study was to evaluate the structure of posttraumatic stress reaction factors and their relation to general mental health problems in Norwegian children exposed to the tsunami on December 26, 2004. A total of 133 children and adolescents (ages 6-17) were interviewed 10 months posttsunami using the UCLA PTSD Reaction Index, and 104 were interviewed again 2.5 years after the tsunami. Confirmatory factor analyses supported the theory of a four-factor model of intrusion, active avoidance, numbing, and arousal as a better division of symptoms than the three-factor model used in the present diagnostic criteria. The factors of intrusion and active avoidance were highly correlated 2.5 years posttsunami. This association may be due to nonspecificity in these trauma-related factors as posttraumatic stress reaction levels diminish over time. General mental health problems were highly related to arousal at both assessments, supporting the theory that some symptoms of posttraumatic stress reactions overlap with other, concurrent mental problems. (Contains 4 tables.)

Traditional student feedback mechanisms have been criticised for being teacher-centred in design and, in particular, for their absence of transparent follow-up actions. In contrast, this study describes the process and the evaluation of a participatory research and action (PRA) approach used in an undergraduate physiotherapy degree. This approach aimed to give students a stronger voice in order to identify the issues they felt were most important and to involve them in the subsequent actions to change or influence their curriculum. Using group consensus, key areas were identified by the students using a variety of PRA techniques, solutions were recommended and some actions were implemented. Both students and staff maintained that the process had gone some way to empowering students and had begun a ripple effect in relation to student involvement in ongoing curriculum design and debate. (Contains 2 figures.)

Research has been carried out on the application of "mindfulness" to a number of different populations in varying contexts, some of which traverse the field of educational psychology. This discussion paper explores what is understood as mindfulness and outlines the breadth of its application. As well as more extensive research into the use of mindfulness with adults in clinical settings, there has been initial research carried out in the use of Mindfulness-Based Approaches (MBA) with children and parents. MBA have also been used within therapy and coaching which has some similarity to educational psychology consultation with teachers and parents. This paper proposes that the future role of MBA within educational psychology might be one of cautious use by practitioners and the development of a greater body of evidence relating to efficacy in this field.

Asperger syndrome (AS) patients show heterogeneous intelligence profiles and the validity of short forms for estimating intelligence has rarely been studied in this population. We analyzed the validity of Wechsler Intelligence Scale (WIS) short forms for estimating full-scale intelligence quotient (FSIQ) and assessing intelligence profiles in 29 AS patients. Only the Information and Block Design dyad meets the study criteria. No statistically significant differences were found between dyad scores and FSIQ scores (t(28) = 1.757; p = 0.09). The dyad has a high correlation with FSIQ, good percentage of variance explained (R[superscript 2] = 0.591; p less than 0.001), and high consistency with the FSIQ classification (chi[superscript 2](36) = 45.202; p = 0.14). Short forms with good predictive accuracy may not be accurate in clinical groups with atypical cognitive profiles such as AS patients.

Developmental relational counseling (DRC) is an integrative framework designed to help clients develop personal awareness and relational functioning and conceptualize personal growth. DRC emerged from both authors' clinical work and was significantly influenced by relational-cultural theory and guided by the Enneagram personality typology and cognitive and narrative therapies. DRC provides a roadmap for understanding the dynamics of personal awareness and relational functioning. (Contains 1 figure.)

Using 65 items from a mental health screening questionnaire, the History Opinion Inventory-Revised (HOI-R), the present study compared three strategies of scale construction--(1) internal (based on factor analysis), (2) external (based on empirical performance) and (3) intuitive (based on clinicians' opinion)--to predict whether 203,595 U.S. Air Force trainees would be discharged early for mental health or behavior-related reasons within a 4-year follow-up period. The external strategy significantly outperformed the internal strategy, which in turn outperformed the intuitive strategy. For all strategies, predictive accuracy was consistently higher when items and scales were scored using empirically derived weights rather than unit weights. These findings suggest that the external strategy of scale construction provides the highest accuracy when sample sizes are large and the aim is to predict a specific behavioral event. However, the internal strategy also yields valid results and can be a reasonable choice when outcome data are unavailable. (Contains 6 tables.)

We present a detailed framework for understanding the numerous and complicated interactions among psychological and social determinants of pain through examination of the process of pain communication. The focus is on an improved understanding of immediate dyadic transactions during painful events in the context of broader social phenomena. Fine-grain consideration of social transactions during pain leads to an appreciation of sociobehavioral events affecting both suffering persons as well as caregivers. Our examination considers knowledge from a variety of perspectives, including clinical health psychology, social and developmental processes, evolutionary psychology, communication studies, and behavioral neuroscience. (Contains 2 figures.)

This study aims to examine the relationship between spirituality and believing in God's presence and depressive symptoms among 160 inpatient individuals who abuse substances. Findings indicated that both spirituality and believing in God's presence were significant predictors of depressive symptoms, whereby spirituality was inversely related to depressive symptoms and believing in God's presence was positively related to depressive symptoms. These findings may have implications for mental health practitioners considering implementation of spiritually based interventions that can develop and strengthen clients' spirituality. (Contains 1 table.)

Objective: To examine changes in observed communication after therapy termination in distressed couples from a randomized clinical trial. Method: A total of 134 distressed couples were randomly assigned to either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Videotaped samples of each couple's interactions were coded from pre-therapy, post-therapy, and 2-year follow-up assessments. At these 3 time points, each partner chose 1 current relationship problem to discuss. Relationship satisfaction was assessed at 2-year follow-up, and clinically significant treatment response and marital status were assessed 5 years after treatment. Results: Observed negativity and withdrawal decreased from therapy termination through the 2-year follow-up as expected, but problem solving did not change, and observed positivity "decreased." IBCT produced superior changes from post-therapy to the 2-year follow-up assessment compared with TBCT. Post-therapy levels and changes in communication over follow-up were associated with wife satisfaction at 2-year follow-up; only post-therapy to 2-year follow-up changes in communication were associated with husband satisfaction at 2-year follow-up. Post-therapy levels of problem solving and changes in wives' positivity from pre-therapy to post-therapy were associated with 5-year relationship outcomes. We found some counterintuitive results with positivity, but they were no longer significant after controlling for withdrawal. Conclusions: We found support for improvements in observed communication following treatment termination, with IBCT demonstrating greater maintenance of communication improvement over follow-up. We found limited evidence of associations between communication and relationship outcomes at 5-year follow-up. (Contains 2 figures, 4 tables, and 5 footnotes.)

Objectives: Determining a patient's psychiatric diagnosis is an important first step for the selection of empirically supported treatments and a critical component of evidence-based practice. Structured diagnostic assessment covers the range of psychiatric diagnoses and is usually more complete and accurate than unstructured assessment. Method: We conducted a national survey of training in empirically supported psychotherapy in which information on teaching of structured diagnostic assessment using "Diagnostic and Statistical Manual of Mental Disorders," 4th edition (DSM-IV) criteria was collected from a probability sample of accredited social work, psychiatry residency, and clinical psychology programs in the United States. Results: A minority of programs required both a didactic and clinical supervision in structured diagnostic assessment. Conclusions: Gaps in the training of clinicians have implications for the appropriate care of patients. (Contains 3 tables.)

The present investigation explores the impact of counselor self-disclosure of sexual orientation on self-identified heterosexuals. Two hundred and thirty-eight psychology undergraduate students read a short description of a counselor and one of eight versions of a counseling transcript. Transcripts were identical with the exception of the gender of the counselor and the inclusion of a single counselor statement, in which the counselor either disclosed his/her sexual orientation through a "feeling" subtype disclosure (Knox and Hill in "Journal of Clinical Psychology: Special Issue: In Session: Self-Disclosure" 59(5):529-539, 2003) or made a reflective statement. A total of 184 respondents who self-identified as "exclusively heterosexual," and accurately completed four validation check items, rated the target counselor on Expertness, Trustworthiness, and Attractiveness Subscales of the Counselor Rating Form-Short Version (CRF-S; Corrigan and Schmidt in "Journal of Counseling Psychology," 30:64-75, 1983). A significant interaction effect was found between self-disclosure status and sexual orientation of the counselor. Participants perceived the disclosing gay and lesbian counselors as significantly more trustworthy than their nondisclosing gay and lesbian counterparts.

This study investigated raters' personality traits in relation to scores they assigned to offenders using the Psychopathy Checklist-Revised (PCL-R). A total of 22 participants, including graduate students and faculty members in clinical psychology programs, completed a PCL-R training session, independently scored four criminal offenders using the PCL-R, and completed a comprehensive measure of their own personality traits. A priori hypotheses specified that raters' personality traits, and their similarity to psychopathy characteristics, would relate to raters' PCL-R scoring tendencies. As hypothesized, some raters assigned consistently higher scores on the PCL-R than others, especially on PCL-R Facets 1 and 2. Also as hypothesized, raters' scoring tendencies related to their own personality traits (e.g., higher rater Agreeableness was associated with lower PCL-R Interpersonal facet scoring). Overall, findings underscore the need for future research to examine the role of evaluator characteristics on evaluation results and the need for clinical training to address evaluators' personality influences on their ostensibly objective evaluations. (Contains 2 tables and 2 notes.)

In this commentary, the author reflects on two articles that have been among the most highly cited publications in "Psychology of Women Quarterly" ("PWQ") over its first 35 years, "The Hidden Rape Victim: Personality, Attitudinal, and Situational Characteristics" (Koss, 1985) and "Stranger and Acquaintance Rape: Are There Differences in the Victim's Experience?" (Koss, Dinero, Seibel, & Cox, 1988). Looking back, the author has made decisions that were motivated both by unselfish and selfish motives. In terms of the former, initially she had not been drawn to academia; instead she sought a practice job where she could help people. Her mentor, however, was insistent that she would help more people through scholarship than using other facets of clinical psychology. Thus, she embarked on a research academic career with the naive belief that changes in attitudes, policy, law, treatment, and prevention were simply awaiting the right data. Here, the author focuses on situating the two "PWQ" articles both in the past and in the present by highlighting (a) the intellectual context in which the author and her colleagues began their work; (b) their use of language; (c) definitions of research questions, design, and methodology; and (d) dissemination of knowledge.

Iranian clinical psychologists have devised family therapy methods that use cognitive behavior models that ft with their collectivist Islamic culture. The authors review Islamic-based strategies and describe family therapy with a culturally specific case of childhood obsessive-compulsive disorder. Family therapy, adapted to integrated, religious-based cognitive behavior therapy, seems appropriate for clients who are served in Iran.

This study used a national sample of PhD students in clinical psychology (N = 1,034) to explore when students decided to pursue their graduate degree, reasons for their decisions, and associated satisfaction. Results indicated that immediately after completing their undergraduate degree, 57% of current graduate students reported postponing graduate studies, 10% went directly to a terminal master's program, and 33% went directly to a clinical psychology PhD program. A variety of reasons for these decisions were documented. Individuals who postponed graduate school were significantly more satisfied with their decision than individuals who went directly to a terminal master's program and reported less frequent thoughts of withdrawal from their program than individuals who went directly to a clinical psychology PhD program. Implications for undergraduate advisors are discussed. (Contains 3 tables.)

The current study investigated clinicians' perspectives on the effectiveness of interventions designed to support the development of children with autistic spectrum disorders (ASDs). Researchers developed a semi-structured interview which was administered to 11 clinicians involved in the assessment and treatment of ASDs (5 = clinical psychologists, 6 = psychiatrists). Content analysis of qualitative data revealed that Irish clinicians typically endorse an eclectic approach to treatment, combining facets of different methods of interventions in a complementary fashion. The process that clinicians engaged in when evaluating modes of treatment was assessed. Significant variation was observed in how clinicians merge clinical experience with empirical evidence. Challenges which clinicians face in assessing individuals on the autistic spectrum, such as the proliferation of misinformation on interventions, as well as the role of parents in treatment, were also discussed within the interviews. The implications of the findings for understanding the process of selecting interventions for children with ASDs are discussed. (Contains 2 figures.)

Training in supervisory competencies is essential to effective clinical practice and helps address the current national crisis in the behavioral health workforce. Interactional supervision, the approach used in the current study, is well established in clinical social work and focuses the task of the supervisee on the interpersonal exchanges encountered in clinical practice. This study examines the feasibility of supervisory competency training and associated gains in competencies among 81 clinical supervisors. Three types of competencies are assessed before and after training and at a 3-month follow-up--managing supervisory relationships, managing job performance, and promoting professional development. The results show that competency training is a feasible and potentially effective approach and is associated with supervisor satisfaction and stress management. The training employed is compatible with skills-based and intervention-specific supervisor training common among evidence-based treatments and is appropriate for use with clinical social workers, counseling and clinical psychologists, and psychiatric nurses. (Contains 6 tables.)

The recent release of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) has received much attention from the clinical psychology community. Particular concerns have focused on Restructured Clinical Scale 3 (RC3; Cynicism). This article briefly reviews the major criticisms and responses regarding the restructuring of Clinical Scale 3. The primary purpose of the article is to provide expanded interpretive perspectives on RC3 by correlating it with a selection of external variables that are conceptually related. Forty undergraduate volunteers completed the MMPI-2-RF as well as measures of Machiavellianism, alienation, faith in people, and locus of control. Results showed strong correlations between RC3 and Machiavellianism (0.47) and alienation (0.60), with item-level information that may extend existing interpretive statements to include, not just a cynical view of others, but a willingness to intentionally lie, cheat, deceive, and manipulate (i.e., Machiavellianism). (Contains 3 tables.)

Health and social care students spend up to 50% of their course in practice. Placements are distributed across a wide geographical area and have varying degrees of IT access and support. Consequently, students may feel isolated from peers, academic staff, and resources required for effective learning. Mobile technology has considerable potential to enhance the learning of these students. This paper presents the development and implementation of the Centre for Excellence in Professional Placement Learning's mobile learning project and the principles that both drove and emerged from this work. Handheld devices were matched to students' pedagogic need. Principles covered areas such as pedagogy, partnership working, technology, inclusivity, evaluation, and research. Collaboration across sectors and institutions and an understanding of professional cultures and contexts were seen as key in instigating and embedding mobile learning to support students on placement. (Contains 1 table.)

In this study, 123 children with a diagnosis of developmental dyslexia were assigned to different treatment groups, either variations of Bakker's intervention program based on the balance model or a control, a specific reading training group. Thorough cognitive and neuropsychological assessment allowed determination of the subtype of dyslexia according to the balance model and the neuropsychological profile with respect to reading and spelling abilities, verbal memory, and phonemic awareness. Characteristics of hemisphere-specific stimulation were systematically manipulated in an effort to shed light on the bases and mechanisms of reading improvement. It was shown that the effects of treatment vary according to type of dyslexia and that the different intervention programs have differential effects on reading-related neuropsychological functions. Since opposite effects can be produced by the same type of treatment in different dyslexia subtypes, the results of the study suggest that accurate classification of subtype on the base of reading and reading-related variables is advantageous for an optimal planning of the therapy. (Contains 2 tables, 3 figures and 6 notes.)

This study investigated the effects of experimentally modifying interpretation biases for children's cognitions, avoidance behavior, anxiety vulnerability, and physiological responding. Sixty-seven children (6-11 years) were randomly assigned to receive a positive or negative interpretation bias modification procedure to induce interpretation biases toward or away from threat about ambiguous situations involving Australian marsupials. Children rapidly learned to select outcomes of ambiguous situations, which were congruent with their assigned condition. Furthermore, following positive modification, children's threat biases about novel ambiguous situations significantly decreased, whereas threat biases significantly increased after negative modification. In response to a stress-evoking behavioral avoidance test, positive modification attenuated behavioral avoidance compared to negative modification. However, no significant effects of bias modification on anxiety vulnerability or physiological responses to this stress-evoking Behavioral Avoidance Task were observed. (Contains 1 table and 2 figures.)

This study explores the association between white privilege attitudes and multicultural counseling competencies among white European-American graduate students (N = 298) in clinical psychology and social work. Results revealed a significant positive association between white privilege attitudes and multicultural counseling competencies. Social work students reported significantly greater levels of white privilege awareness in comparison to clinical psychology students. Female participants reported greater levels of multicultural awareness. The results of this study confirm the assertion that white privilege attitudes are associated with multicultural counseling competencies. Implications of these results for theory, clinical practice, and training were reviewed. (Contains 4 tables.)

African Americans underuse counseling services because of factors such as cultural mistrust, stigma, and culturally incongruent treatment interventions. As a result, this population relies on informal healing networks. The foundations of these networks have been outlined within the professional literature. However, limited attention has been given to the indigenous healing methods used by African Americans in lieu of counseling. This article explores the conceptual, diagnostic, and treatment strategies of the indigenous healing system, Yoruba-based Ifa.

Comprehensive--yet cost-effective--provision of psychological care is a timely concern for most college counseling centers. The current review summarizes the components of a program designed to meet such seemingly discordant demands. The Counselor-in-Residence program places live-in, doctoral students in clinical psychology/counselor education, in residence halls in order to provide on-site, easily accessible, and professionally supervised mental health support services for residents and residence life staff. The process of program development and implementation of the Counselor-in-Residence program at a medium-sized Midwestern university is discussed. (Contains 3 tables.)

Anxiety disorders are prevalent in the school-aged population and are present across cultural groups. Scant research exists on culturally relevant prevention and intervention programs for mental health problems in the Aboriginal populations. An established cognitive behavioral program, FRIENDS for Life, was enriched to include content that was culturally relevant to Aboriginal students. Students (N = 533), including 192 students of Aboriginal background, participated in the cluster randomized control study. Data were collected three times over 1 year. A series of multilevel models were conducted to examine the effect of the culturally enriched FRIENDS program on anxiety. These analyses revealed that the FRIENDS program did not effectively reduce anxiety for the total sample or for Aboriginal children specifically. However, all students, regardless of intervention condition, Aboriginal status, or gender, reported a consistent decrease in feelings of anxiety over the 6-month study period. (Contains 1 figure and 3 tables.)

5-HTTLPR, episodic stressors, depressive and anxious symptoms were assessed prospectively (child and parent report) every 3 months over 1 year (5 waves of data) among community youth ages 9 to 15 (n = 220). Lagged hierarchical linear modeling analyses showed 5-HTTLPR interacted with idiographic stressors (increases relative to the child's own average level over time), but not nomothetic stressors (higher stress exposure relative to the sample), to predict prospective elevations in depressive, but not anxious, symptoms. Youth with copies of the S or L[subscript G] alleles of 5-HTTLPR, who experienced more stressors relative to their typical level, exhibited prospective increases in depressive symptoms over time. These findings suggest that 5-HTTLPR confers susceptibility to depression via stress reactivity. (Contains 1 figure and 2 tables.)

School belonging, measured as a unidimensional construct, is an important predictor of negative affective problems in adolescents, including depression and anxiety symptoms. A recent study found that one such measure, the Psychological Sense of School Membership scale, actually comprises three factors: Caring Relations, Acceptance, and Rejection. We explored the relations of these factors with negative affect in a longitudinal study of 504 Australian Grade 7 and 8 students. Each school belonging factor contributed to the prediction of negative affect in cross-sectional analyses. Scores on the Acceptance factor predicted subsequent negative affect for boys and girls, even controlling for prior negative affect. For girls, the Rejection factor was also significant in the prospective analysis. These findings have implications for the design of interventions and are further confirmation that school belonging should be considered a multidimensional construct. (Contains 4 tables.)