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Teaching individuals a safety response when they encounter a firearm may be one way to prevent accidental injuries or death. Previous researchers have used behavioral skills training (BST) with and without in situ training to teach individuals with and without disabilities to engage in a safety response in the presence of a firearm. However, few studies have arranged BST to ensure the safety response occurred in response to a representative sample of all relevant stimulus features for which a response should be evoked. The purpose of the current study was to evaluate the extent to which BST conducted in a single context established stimulus control that would evoke the safety response across a range of contexts under which young children could encounter a dangerous stimulus in a room in their house. All participants demonstrated a discriminated safety response following BST. Further, safety responses generalized across all contexts not associated with training for all participants. [ABSTRACT FROM AUTHOR]

Mindfulness-based interventions are increasingly used to treat binge eating. The effects of these interventions have not been reviewed comprehensively. This systematic review and meta-analysis sought to summarize the literature on mindfulness-based interventions and determine their impact on binge eating behavior. PubMED, Web of Science, and PsycINFO were searched using keywords binge eating, overeating, objective bulimic episodes, acceptance and commitment therapy, dialectical behavior therapy, mindfulness, meditation, mindful eating. Of 151 records screened, 19 studies met inclusion criteria. Most studies showed effects of large magnitude. Results of random effects meta-analyses supported large or medium-large effects of these interventions on binge eating (within-group random effects mean Hedge's g = −1.12, 95 % CI −1.67, −0.80, k = 18; between-group mean Hedge's g = −0.70, 95 % CI −1.16, −0.24, k = 7). However, there was high statistical heterogeneity among the studies (within-group I = 93 %; between-group I = 90 %). Limitations and future research directions are discussed. [ABSTRACT FROM AUTHOR]

BackgroundThere is an abundant literature on the unfavourable attitudes held by staff working in mental health care settings towards patients with borderline personality disorder. The aim of this study was to assess whether attendance at a training session about the neurobiological underpinnings of borderline personality disorder could improve knowledge and produce positive attitudinal change within staff members working in a low secure inpatient setting.MethodStaff knowledge and attitudes (Mental Health Locus of Origin, Empathic Concern and Perspective Taking) were assessed at baseline, post-training attendance and at an eight-week follow up.ResultsAttendance at the training session was associated with significant increases in theoretical knowledge, Perspective Taking and Locus of Origin scores. However, there were no changes observed in Empathic Concern scores.ConclusionThis research suggests that a relatively brief training session, that utilises the neurobiological framework, can be effective in facilitating knowledge and attitudinal change for those working with borderline personality disorder. The implications of the findings are discussed along with suggestions for further research. [ABSTRACT FROM AUTHOR]

The present study sought to evaluate the efficacy of group contingency procedures via meta-analysis. A total of 182 studies published between 1980 and 2010 were identified via PsychInfo that included group contingency as a keyword. Studies that met inclusion criteria (e.g., single-subject design, school-aged children; N = 50), were coded and effect sizes were calculated. Results strongly support the efficacy of group contingencies with an overall effect size of 3.41. Types of group contingencies were also evaluated for dependent group contingencies (ES = 3.75, n = 11), independent group contingencies (ES = 3.27, n = 8), and interdependent group contingencies (ES = 2.88, n = 35). These results clearly establish all varieties of group contingencies as efficacious for a wide range of target behaviors with school-aged children. Results are discussed with regard to practical implications. [ABSTRACT FROM PUBLISHER]

The purpose of this meta-analysis was to quantitatively summarize the single-case research (SCR) literature on the use of behavior contracts with children and youth. This study examined the efficacy of behavior contracts on problem behaviors and academic behaviors across 18 SCR studies. Academic and behavioral outcomes were examined for 58 children and youth ages 5 to 21 using the TauU effect size index. Results indicated the overall moderate effect of the use of behavior contracts was ES = .57 (95% confidence interval [CI95] = [0.55, 0.58]) with a range of effects across studies (ES = .27 to ES = 1.00). Moderator analyses indicated that behavior contracts are beneficial for students regardless of grade level, gender, or disability status. Findings suggest that the intervention is more effective in reducing inappropriate behaviors than increasing appropriate behaviors, and that academic outcomes are positively affected by behavior contracting. [ABSTRACT FROM PUBLISHER]

Purpose: Although fragile X syndrome (FXS) is the leading inherited cause of intellectual disability, there are no published intervention studies focused on improving communication and language outcomes for affected children. The current study utilized a collaborative coaching approach incorporating strategies from speech-language pathology and applied behavior analysis to examine the efficacy of a naturalistic parent-implemented language intervention for a young boy with FXS. Methods: The mother was taught the language and behavioral support strategies and submitted weekly video recordings of a caregiving routine. Written feedback was provided. Results: Results indicated moderate increases in maternal use of targeted language support strategies and variable performance in maternal use of behavior support strategies. Child use of appropriate requests increased while challenging behaviors decreased. Conclusions: This collaborative approach model should be used to guide future larger scale replications and develop new intervention models. [ABSTRACT FROM AUTHOR]

Borderline personality disorder ( BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema-focused therapy ( SFT) and dialectical behavioral therapy ( DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual ( TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts ( CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire ( YSQ-L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD. [ABSTRACT FROM AUTHOR]

Background A growing literature suggests that people with mild intellectual disability ( ID) who have depressed mood may benefit from cognitive-behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural strategies; and (iii) combined cognitive-behavioural ( CB) strategies on depressed mood among a sample of 70 individuals with mild ID. Methods Staff from three participating agencies received training in how to screen individuals with mild ID for depressive symptoms and risk factors for depression. Depressive symptoms and negative automatic thoughts were assessed prior to and at the conclusion of the intervention, and at 6-month follow-up. The interventions were run in groups by the same therapist. Results A post-intervention reduction in depression scores was evident in participants of all three interventions, with no significant difference between groups. A significant reduction in negative automatic thoughts post-intervention was evident in the CB combination group and was maintained at follow-up. Examination of clinical effectiveness suggests some advantage of the CB combination in terms of improvement and highlights the possible short term impact of behavioural strategies in comparison with the longer-term potential of cognitive strategies. Conclusions The findings support the use of group cognitive-behavioural interventions for addressing symptoms of depression among people with ID. Further research is necessary to determine the effectiveness of components. [ABSTRACT FROM AUTHOR]

Objective: Nonsuicidal self-injury (NSSI) and suicidality among undergraduates represent important public health issues. This analysis identified risk factors that distinguished 3 groups, those who reported no history of self-harm; self-injury, but no suicide attempts (NSSI only); and self-injury and a suicide attempt (NSSI + SA) in the past year.Methods: Data came from 16,044 undergraduates who completed the Fall 2010 National College Health Assessment.Results: Over 3% of students reported NSSI, and one third of these individuals also attempted suicide. Factors that distinguished the NSSI only and NSSI + SA groups from the no self-harm group included current depressive symptoms, nonheterosexual orientation, an eating disorder/extreme weight control behavior, and diagnosis of an internalizing disorder. Factors that distinguished the NSSI + SA group from the NSSI only group were current depressive symptoms and diagnosis of an internalizing disorder.Conclusions: Students experiencing mental health problems demonstrate increased risk for NSSI and/or suicidal behavior. [ABSTRACT FROM PUBLISHER]

ABSTRACT Objective Anorexia Nervosa (AN) is associated with excessive self-control. This iterative case series describes the augmentation of Dialectical Behavior Therapy (DBT) for outpatient adult AN with skills addressing emotional and behavioral overcontrol. An overly controlled style is theorized to develop from the transaction between an individual with heightened threat sensitivity and reduced reward sensitivity, interacting with an environment reinforcing overcontrol and punishing imperfection. Method Case Series 1 utilized standard DBT, resulting in retention of 5/6 patients and a body mass index (BMI) effect size increase of d = −0.5 from pre- to post-treatment. Case series 2, using standard DBT augmented with skills addressing overcontrol, resulted in retention of 8/9 patients with an effect size increase in BMI at post-treatment that was maintained at 6- and 12-months follow-up ( d = −1.12, d = −0.87, and d = −1.12). Discussion Findings suggest that skills training targeting rigidity and increasing openness and social connectedness warrant further study of this model and treatment for AN. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:123-132) [ABSTRACT FROM AUTHOR]

Although still a matter of some debate, there is a growing body of research supporting Early and Intensive Behavioral Intervention as the intervention of choice for children with autism. Learning rate is an alternative to change in standard scores as an outcome measure in studies of early intervention. Learning rates can be displayed graphically as developmental trajectories, which are easy to understand and avoid some of the counter-intuitive properties of changes in standard scores. The data used in this analysis were from 453 children with autism, previously described by Eldevik et al. Children receiving Early and Intensive Behavioral Intervention exhibited significantly steeper developmental trajectories than children in the control group, in both intelligence and adaptive behaviors. However, there was a considerable variability in individual learning rates within the group receiving Early and Intensive Behavioral Intervention. This variability could partly be explained by the intensity of the treatment, partly by children’s intake intelligence quotient age-equivalents. Age at intake did not co-vary with learning rate. [ABSTRACT FROM PUBLISHER]

We reviewed studies utilizing task sequencing to improve academic outcomes for children with emotional and/or behavioral disorders (EBD) in educational settings. Task sequencing interventions included high-probability, high-preference, and task interspersal interventions. Although task sequencing is commonly used in research, a synthesis of recent applications in educational settings for students with EBD is absent. Systematic searches of electronic databases and ancestral references identified 11 studies meeting inclusion criteria. These 11 studies were reviewed and analyzed for (a) participant characteristics, (b) experimental design, (c) type of academic outcome as the dependent variable, (d) intervention description, (e) certainty of evidence and research quality, and (f) reported student academic outcomes. Implications for continued applied practice and future research are discussed. [ABSTRACT FROM PUBLISHER]

The relapse of problem behavior after apparently successful treatment is an enduring problem for the field of applied behavior analysis. Several theoretical accounts of treatment relapse have emerged over the years. However, one account that has received considerable recent attention is based on behavioral momentum theory (BMT). BMT has shown that behavior is more persistent in contexts that are correlated with higher rates of reinforcers after disruption of the response-reinforcer relation. Accordingly, relapse after successful treatment can be viewed as the persistence of behavior when treatment is compromised in some manner. We review basic BMT research, alternative accounts of treatment relapse, and translational research studies derived from BMT research. The implications for applied behavior analysis in practice are discussed along with potential solutions to the problem of treatment relapse. [ABSTRACT FROM AUTHOR]

We evaluated the effects of behavioral skills training in the home for teaching children with autism to abstain from going with strangers and immediately inform a familiar adult of the stranger's attempt to lure them in the natural environment. All participants learned to respond correctly to lures in the home and demonstrated concomitant changes in untrained natural settings. In situ training and an added incentive were necessary for 1 participant. [ABSTRACT FROM AUTHOR]

The efficacy of nonremoval of the cup or spoon as treatment for feeding refusal is dependent on prevention of escape from presentations. In the current investigation, 1 child with feeding refusal escaped presentations during nonremoval of the cup and spoon by clenching his teeth. Therefore, we used a syringe to deposit liquids and solids, increased the volume of liquids and solids in the syringe, and conducted syringe-to-cup and syringe-to-spoon fading. [ABSTRACT FROM AUTHOR]

Children with feeding disorders exhibit a variety of problem behaviors during meals. One method of treating problem mealtime behavior is to implement interventions sequentially after the problem behavior emerges (e.g., Sevin, Gulotta, Sierp, Rosica, & Miller, 2002). Alternatively, interventions could target problem behavior in anticipation of its emergence. In the current study, we implemented nonremoval and re-presentation of bites either on a spoon or on a Nuk for 12 children with feeding problems. The nonremoval and re-presentation treatment improved feeding behavior for 8 of 12 children. Of those 8 children, 5 had lower levels of expulsions, and 4 of the 8 children had higher levels of mouth clean with the Nuk than with the spoon. We describe the subsequent clinical course of treatment and present follow-up data for 7 of the 8 children who responded to the nonremoval and re-presentation treatment with the spoon or Nuk. The data are discussed in terms of potential reasons why the utensil manipulation improved feeding behavior for some children. [ABSTRACT FROM AUTHOR]

This study is a replication and extension of Reeve, Reeve, Townsend, and Poulson (2007) evaluating the effects of a treatment package that included multiple-exemplar training, video modeling, prompting, and reinforcement on helping of 3 adolescents with autism. Results demonstrated that all participants acquired the helping responses. Probes before and after intervention also demonstrated generalization of helping across settings and categories of helping behavior. [ABSTRACT FROM AUTHOR]

The current investigation sought to determine whether a standard outpatient dose of dialectical behavior therapy (DBT) skills training (2 h per week) coupled with standard CBT treatment would be sufficient to produce changes in affect regulation over the course of day hospitalization treatment. In an uncontrolled pre-post treatment design, 65 women diagnosed with anorexia nervosa or bulimia nervosa were assessed at the beginning of treatment and at the end of treatment on affect regulation. Findings indicated that participants demonstrated a significant improvement in their ability to regulate affect, suggesting that weekly DBT treatment may play an important role in producing changes in affect regulation. Secondary analyses on eating disorder outcomes revealed a significant increase in weight gain as well as a significant reduction in restriction, bingeing, purging and eating disordered cognitions. Findings are discussed in the context of clinical and treatment implications for those with severe eating disorders. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effectiveness of the computerized CBT (cCBT) programme, MoodGYM, for the reduction in symptoms of general psychological distress (the primary outcome), depression, anxiety, stress, and impaired daily functioning. Design A randomized controlled trial, with a waiting list control condition, in a routine clinical setting. Methods Participants were 149 public mental health service users (aged 18-61 [ M = 35.3 years; SD = 10.3]) waiting for interventions. Self-report outcome measures were administered online at baseline and post-intervention (i.e., after 32 days). Results After high dropout rates, a post-intervention completers analysis examined 28 MoodGYM participants and 38 waiting list control participants. MoodGYM was significantly more effective than the waiting list control for the reduction of symptoms of general psychological distress ( F[1, 64] = 4.45; p < .05) and stress ( F[1, 64] = 5.35; p < .05) but not depression, anxiety, or impaired daily functioning. Conclusions Due to their high associated dropout rates, self-help cCBT programmes such as MoodGYM should not be provided as front-line treatments. However, as it is likely to be agreeable and beneficial to some service users, perhaps self-help cCBT should be provided as an additional treatment option. Practitioner points Computerized CBT has predominantly been evaluated in 'efficacy' trials which often include motivated, self-referred participants unrepresentative of clinical populations. Multi-site recruitment in the present trial allowed participants with characteristics typical of public mental health service users across Ireland to be included., MoodGYM's effectiveness was demonstrated for the primary outcome, general psychological distress symptoms, and one of four secondary outcomes (i.e., stress symptoms). However, 56.3% of MoodGYM participants (and 85% of males) dropped out of the study, limiting the validity of findings., Feedback to MoodGYM (for those who engaged with it) was generally positive (e.g., 68% of respondents would recommend MoodGYM to a friend if they needed some help). However, 73% of MoodGYM participants did not complete all five sessions., Due to their limited effectiveness and high associated dropout rates, self-help cCBT programmes such as MoodGYM should not be provided as front-line treatments, in place of higher intensity interventions such as one-to-one psychotherapy. However, as it is likely to be agreeable and beneficial to some service users, self-help cCBT is perhaps best offered as an additional treatment option. [ABSTRACT FROM AUTHOR]

This study employed a multiple baseline, across-participants, single-subject design to investigate the feasibility of an individual, narrative-based, social problem-solving intervention on the social problem-solving, narrative, and theory of mind (ToM) abilities of 3 incarcerated adolescent youth offenders identified as having emotional disturbance (ED). Students participated in individual intervention sessions in which they were taught strategies for storytelling and social problem solving and the application of ToM. All 3 students completed the program to mastery. Visual inspection and mean score differences across conditions were used to analyze baseline and postintervention measures. All students demonstrated increased inclusion of social problem-solving steps, narrative components, and use of landscape of consciousness in their personal narratives following intervention. Although there were limitations in the study, results supported the feasibility of conducting this type of intervention with youth offenders with ED in the criminal justice system. [ABSTRACT FROM AUTHOR]

Behavioral parent training offers mothers in drug treatment a valuable opportunity to improve their parenting skills through real-time, individualized coaching, but these mothers might be reluctant to participate with their child. Participants were 23 mothers or female guardians from 4 drug treatment programs with children 1 to 10 years old. Focus group discussions and questionnaires asked about their perspectives on parenting and their interest in and obstacles to participating in behavioral parent training. Detailed narrative responses and quantitative analyses identified some unique issues in parenting for this population as well as logistical, attitudinal, and emotional barriers to participating in behavioral parent training with their children. [ABSTRACT FROM AUTHOR]

Although massed-trial instruction, distributed-trial instruction, and task interspersal have been shown to be effective methods of teaching skills to children with autism spectrum disorders, they have not been directly compared. In the current study, we taught 6 children to tact shapes of countries using these methods to determine which would result in the quickest acquisition. Five of the 6 participants acquired the targets in the massed-trial condition before the other 2 conditions. [ABSTRACT FROM AUTHOR]

Publication bias arises when studies with favorable results are more likely to be reported than are studies with null findings. If this bias occurs in studies with single-subject experimental designs (SSEDs) on applied behavior-analytic (ABA) interventions, it could lead to exaggerated estimates of intervention effects. Therefore, we conducted an initial test of bias by comparing effect sizes, measured by percentage of nonoverlapping data (PND), in published SSED studies (« = 21) and unpublished dissertations («=10) on 1 well-established intervention for children with autism, pivotal response treatment (PRT). Although published and unpublished studies had similar methodologies, the mean PND in published studies was 22% higher than in unpublished studies, 95% confidence interval (4%, 38%). Even when unpublished studies are included, PRT appeared to be effective (PNDAf=62%). Nevertheless, the disparity between published and unpublished studies suggests a need for further assessment of publication bias in the ABA literature. [ABSTRACT FROM AUTHOR]

Each day, people encounter stimuli they find unpleasant. Some children with autism may require systematic instruction to acquire the communication skills necessary to request the termination of such aversive stimuli. We taught 2 school-aged boys with autism a mand (e.g., signing "stop") that could be used to escape a variety of aversive stimuli. First, we employed a systematic assessment to identify aversive stimuli to use during training. We then conducted mand training sequentially across those stimuli until sufficient exemplars were trained for generalization to occur to untrained stimuli. For both participants, cross-stimulus generalization was observed after training with 2 stimuli. Participants manded for escape in the presence of aversive stimuli, but almost never manded in the presence of preferred stimuli or when the programmed stimuli were absent. In addition, we found an inverse relation between acquisition of the mand and engagement in problem behavior and evidence of generalization to nontraining contexts. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effects of extinction when the reinforcer was present versus absent. These effects were examined with 2 human operant procedures (i.e., a computer program and a mechanical apparatus) with college students as participants. Discriminable properties of the apparatus appeared to influence responding during extinction. In general, responding during extinction was less likely with the mechanical apparatus when the reinforcer was absent and more likely with the computer program. [ABSTRACT FROM AUTHOR]

We used a multiple baseline design across skills to evaluate the effects of a program to teach a classroom of children to respond to their name and a group call (i.e., precursors) as well as to peer mediate these precursors to promote compliance with a variety of multistep instructions. Teachers taught these skills via classwide behavior skills training and a lottery-based reward contingency. Results showed that precursors to compliance, peer mediation, and compliance increased as a function of classwide teaching, and the teachers found the procedures and their effects to be highly acceptable [ABSTRACT FROM AUTHOR]

The present study reflects on the encounter of Feminist Therapy (FT) and Functional Analytic Psychotherapy (FAP). A study of the literature compared their clinical styles. It highlighted the compatibility of their views concerning the management of the therapeutic relationship; inclusion of social and cultural elements in treatment; emphasis on the acquisition of abilities to transform the client's environment; openness about therapist and client values and feelings; and the validation of the client's emotional experience instead of trying to change it. On these points the two clinical styles are highly similar to each other. Their conceptual registers, however, are based on different sensibilities, namely clinical pragmatics in the case of FAP and political values in the case of FT. The study suggests that joining the perspectives of the two therapies can produce a broader clinical vision and provide a relevant and viable strategy to work on gendered themes in clinical practice. [ABSTRACT FROM AUTHOR]

Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation is turn taking, or the manner in which the therapist facilitates back-and-forth interaction with the child. The current study used an alternating treatments design to examine the efficacy of four types of turn taking. Six children, ages 30 to 39 months, received behavioral treatment while therapists systematically varied the nature of the turn taking component. Children’s responses were behaviorally scored to examine differences based on turn condition. Consistent patterns of behavior were found across children. Results suggest that the optimal type of turn is dependent on developmental level and target skill. Implications for treatment of ASD and future research directions are discussed. [ABSTRACT FROM PUBLISHER]

Children with feeding disorders often cannot or do not chew when presented with table food. Children with chewing deficits also often swallow the bite before masticating it appropriately, which we will refer to as early swallowing. In the current study, we evaluated a clinical protocol to increase chews per bite, assess mastication, and eliminate early swallowing with three children with feeding disorders. The current study adds to a small body of literature on chewing and mastication of children with feeding disorders. Suggestions for future research are also discussed. [ABSTRACT FROM PUBLISHER]

Objective: To examine the feasibility and initial efficacy of 2 abbreviated dialectical behavior therapy (DBT) skills training groups: emotion regulation skills only and emotion regulation with mindfulness skills.Participants: Participants were 24 undergraduates (aged 18–29) with significant emotion dysregulation who participated between February and May of 2010, 2011, and 2012.Methods: Participants participated in 2-hour weekly group sessions for 8 weeks and completed outcome measures at baseline, midtreatment, posttreatment, and 4-week follow-up.Results: Participants in both conditions made significant gains, with large effect sizes, across measures of emotion regulation, affect, skills use, and functioning. There were no differences between the 2 groups, suggesting no additive benefit of mindfulness skills.Conclusions: This pilot study provides support for the acceptability and efficacy of abbreviated DBT skills training in colleges, given significant improvements, positive feedback, and low attrition. Impediments to feasibility included recruitment difficulties, particularly due to scheduling constraints. [ABSTRACT FROM AUTHOR]

Educating children on a global level is a dynamic process where policy, procedure and guideline changes can leave teachers searching for new programs to resolve new challenges. This brief report shows a successful application of the Good Behavior Game in a school in the country of Belize following a significant change in policy regarding acceptable practices in addressing school-based behavioral challenges. [ABSTRACT FROM PUBLISHER]

This paper discusses the case studies applying Developmental Behavioral Analytic Therapy (dbat), a new behavioral therapy with developmental underpinnings. It also lays out the sequence of procedures of this therapy. The procedures have been illustrated with examples from six case studies of individuals who have undergone the therapy. It also presents the methodology and results of intervention using dbat on those six individuals. With dbat, five out of the six individuals achieved their target behaviors and increased their developmental stages. The positive results yielded from this small sample suggest potential benefit and success of dbat therapy. [ABSTRACT FROM AUTHOR]

To date, there are no empirically validated treatments of good quality for adolescents showing suicidal ideation and behavior. Risk factors for suicide are impulsive and non-suicidal self-injurious behavior, depression, conduct disorders and child abuse. Behind this background, we tested the main hypothesis of our study: that Mode Deactivation Therapy (MDT) is an effective treatment for these patients. MDT has been developed by Jack Apsche especially for the individual or family-based residential or outpatient treatment of adolescents with problem behaviors and complex comorbid conditions. The efficacy of MDT was measured by a pre- and post-treatment comparison with the aid of standardized instruments (CBCL, STAXI-2, BDI-II, and SIQ) and compared to the results of a treatment-as-usual (TAU) control group. The comparative results confirmed that MDT is a consistent effective treatment for suicidal adolescents that appear to outperform other therapy approaches. [ABSTRACT FROM AUTHOR]

Approximately 4,600 American adolescents commit suicide each year, and adolescent suicide rates are on the rise. The consequences of suicidal behavior are far-reaching, and understanding the development of patterns that contribute to ideation and attempt are crucial to prevention and intervention. This paper outlines an experiential avoidance model of suicidality and discusses an Acceptance and Commitment Therapy (ACT) approach to treating adolescent suicidal behavior. A case study is reviewed, along with literature relevant to the risk factors and trajectories correlated with suicide in adolescents. Although recent evidence indicates that ACT is generally useful with adolescents with related concerns, a thorough literature review indicates that no specific work has investigated the efficacy of ACT for suicidal behavior in youth. [ABSTRACT FROM AUTHOR]

The promise of Dialectical Behavior Therapy (DBT) has been substantiated by a growing body of work demonstrating its efficacy for addressing suicidal and non-suicidal self-injury as well as pervasive emotional and behavioral dysregulation, among adolescents. Research elucidating the neurobiological correlates and biosocial factors contributing to the development of emotion dysregulation and self-harm is presented. A recent milestone is the completion of the first randomized controlled trial of DBT with self-harming adolescents. The results of this five-year study are presented along with an overview of the treatment as adapted for this population [ABSTRACT FROM AUTHOR]

Toddlers often display problem behavior during transitions. We rearranged naturally occurring events in a toddler classroom to promote more desirable classroom behavior during transitions to meals. In the intervention condition, teachers transitioned each child to meals only when that child was seated on a play mat (a requisite for engagement in teacher-led play activities). In the reversal condition, teachers selected each child to transition when that child was by the barrier to the meal area (a practice commonly observed under natural conditions). The intervention increased the mean percentage of intervals when children were on the play mat and decreased the percentage of intervals when children were by the barrier. Individual child data show positive outcomes for five of six children. Results are discussed in terms of the positive effects of small manipulations to existing contingencies on classroom behavior as well as their potential influence on the adoptability of classroom interventions. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The current study investigated the effects of a Video Self-Modeling (VSM) intervention on the compliance and aggressive behavior of three children placed in a psychiatric hospital. Each participant viewed brief video clips of himself following simple adult instructions just prior to the school's morning session and the unit's afternoon free period. A multiple baseline design across settings was used to evaluate the effects of the VSM intervention on compliance with staff instructions and aggressive behavior on the hospital unit and in the hospital-based classroom. All three participants exhibited higher levels of compliance and fewer aggressive episodes during the intervention condition, and the effects were generally maintained when the intervention was withdrawn. Hospital staff reported at the conclusion of the study that the VSM intervention was easy to implement and beneficial for all participants. Taken altogether, the results suggest VSM is a promising, socially acceptable, and proactive intervention approach for improving the behavior of noncompliant children. [ABSTRACT FROM AUTHOR]

First-year students in higher education deal with an increasing number of mental health issues. Cost-effective and time-efficient programs that ease transitions and reduce risk of depression are needed. To date, programs informed by both cognitive-behavioral and acceptance-based-behavioral therapy (ABBT) approaches have produced some positive outcomes, but methodological limitations limit their utility. The aim of the present study was to address some of these limitations, by developing and preliminary testing the efficacy of a one-session ABBT intervention with first-year undergraduates and first-year law students. Ninety-eight first-year students were randomly assigned to receive either a single-session 90-min ABBT workshop within their first month of school or to a waitlist control condition. Students who received the intervention reported significantly less depression and more acceptance. Moreover, increase in acceptance over the course of the semester was associated with reductions in depression. Implications of these findings for future interventions are discussed. [ABSTRACT FROM AUTHOR]

Depression and social anxiety disorder (SAD) are highly comorbid, resulting in greater severity and functional impairment compared with each disorder alone. Although recently transdiagnostic treatments have been developed, no known treatments have addressed this comorbidity pattern specifically. Preliminary support exists for acceptance-based approaches for depression and SAD separately, and they may be more efficacious for comorbid depression and anxiety compared with traditional cognitive-behavioral approaches. The aim of the current study was to develop and pilot test an integrated acceptance-based behavioral treatment for depression and comorbid SAD. Participants included 38 patients seeking pharmacotherapy at an outpatient psychiatry practice, who received 16 individual sessions of the therapy. Results showed significant improvement in symptoms, functioning, and processes from pre-to post-treatment, as well as high satisfaction with the treatment. These results support the preliminary acceptability, feasibility, and effectiveness of this treatment in a typical outpatient psychiatry practice, and suggest that further research on this treatment in larger randomized trials is warranted. [ABSTRACT FROM AUTHOR]

The attentional impairments associated with schizophrenia are well documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations, we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who were being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside the immediate treatment context to both other treatment groups and real-world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments. [ABSTRACT FROM PUBLISHER]

We focus on Robert P. Liberman's influence on the development and adaptation of a behavioral learning approach used in the rehabilitation of individuals with schizophrenia called errorless learning. In this article we present: the origins of errorless learning; first proof-of-concept study of errorless learning in a sample of individuals with psychotic disorders; follow-up laboratory-based studies of errorless learning; and a community-based study of errorless learning. [ABSTRACT FROM PUBLISHER]

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Dialectical behavior therapy (DBT) is one empirically supported treatment for individuals diagnosed with borderline personality disorder (BPD), and has demonstrated efficacy in reducing distress and behaviors that are often utilized by those with BPD to manage that distress. Treatment dropout rates of those with BPD receiving DBT are high, with serious deleterious effects. Increasing motivation for treatment, including treatment adherence, homework completion and skill use, in those with BPD is a critical factor in improving daily functioning and overall quality of life for these individuals. As described in ACT, values work in the service of increasing values-consistent behavior, or valued or committed action, may be one way to improve treatment motivation both in-session and out of session. This paper outlines the theoretical rationale for adding values components to existing DBT skills, including suggestions for where and how values work might be done in this population and potential difficulties. [ABSTRACT FROM AUTHOR]

Background Little is known about coping specificities, as operationalization of the concept of affect regulation, in borderline personality disorder (BPD). It is most important to take into account methodological criticisms addressed to the self-report questionnaire approach and to compare BPD coping specificities to the ones of neighbouring diagnostic categories, such as bipolar disorder (BD). Sampling and Methods The present exploratory study compared the coping profiles of N = 25 patients presenting BPD to those of N = 25 patients presenting BD and to those of N = 25 healthy controls. All participants underwent a clinical interview that was transcribed and rated using the Coping Patterns observer-rater system. Results Results partially confirmed study hypotheses and showed differences between BPD patients and healthy controls in all coping domains (competence, resources and autonomy), whereas the only coping domain presenting a BPD-specific lack of skills, compared with the BD patients, was autonomy, a set of coping strategies facing stress appraised as challenge. These coping processes were linked to general and BPD symptomatology. Conclusions These results extend conclusions of earlier studies on affect regulation processes in BPD and bear important clinical implications, in the context of dialectical behavior therapy and other therapeutic approaches. Limitations of this exploratory study, such as the small sample size, are acknowledged. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message Coping can be reliably assessed in the narrative process in an non-structured interview frame., Patients with borderline personality disorder present with a specific lack of skills in affect regulation related to autonomy issues, compared to patients with bipolar disorder and healthy controls., Lack of skills in accommodation to distressing emotions in borderline personality disorder is related to symptom gravity and may be treated using radical acceptance strategies. [ABSTRACT FROM AUTHOR]

Background The purpose of the present study was to examine the factors predicting a greater motivation to change in a clinical sample of adolescents. Method A total of 107 adolescents participated in this research prior to beginning outpatient treatment. Participants completed a modified version of the Motivational Stages of Change for Adolescents Recovering from an ED, the Difficulties in Emotional Regulation Scale and the Behavioral Assessment System for Children-Self-Report. Results More advanced stages of change were associated with better parent-adolescent relationships and better emotional regulation. Conclusion Incorporating parents in treatment to enhance parent-adolescent relationships and instructing parents in emotional regulation techniques to assist the adolescent may enhance their motivation to recover. [ABSTRACT FROM AUTHOR]

We evaluated the effects of matched and unmatched stimuli on nail biting for three typically developing children and adolescents. Antecedent-based assessments identified conditions when subjects were most likely to engage in nail biting. Treatment included the noncontingent delivery of four types of highly preferred stimuli: items hypothesized to match the oral, the tactile, or both the oral and tactile stimulation inherent to nail biting, as well as items that did not involve oral or tactile stimulation. Results suggested that all forms of alternative stimulation decreased nail biting. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct. [ABSTRACT FROM AUTHOR]

The recent rapid proliferation of “new wave” treatments, also loosely referred to as the third wave cognitive-behavioral therapies, has renewed interest in their comparative performance, scientific validity, and theoretical and methodological integrity. However, critics are also expressing concerns that these therapies are not well enough supported and “getting ahead of the data”. This article engages the literature on a small selection of modern therapy approaches, namely Mode Deactivation Therapy (MDT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), and more specifically compared to Cognitive Behavioral Therapy (CBT). On the one hand, it challenges the assumption that third wave therapies in general, but more specifically in reference to MDT, ACT, and DBT, have little new to offer by way of superior performance, often in reference to populations that are usually deemed as difficult-to-treat in traditional approaches such as CBT. While, on the other hand, it investigates claims that third wave treatments are more part of a CBT family of approaches rather than distinct treatments. It draws from the conceptualizations, practices, and experiences of the respective developers themselves to argue for the distinct value and prospects that these third wave therapies offer in terms of scientifically established treatment outcomes. For example, it is difficult and unwise to dismiss the superior results that MDT has established in treating severe multi-problem adolescents, a population that has inarguably an extremely high human and economic impact in the long run. By an improved understanding and differentiation of the third wave therapies, their proliferation can be accelerated without compromise to harness their potential more effectively and focused. [ABSTRACT FROM AUTHOR]