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Research on functional analytic psychotherapy's (FAP) proposed process of change has focused on the turn-by-turn coding of FAR In these studies, FAP-consistent therapeutic techniques result in decreased idiographically defined problem behavior in session. The decreased in-session problem behavior generalizes and reduces the problem behaviors outside of session. Although theoretically consistent and methodologically rigorous, this turn-by-turn coding approach has yet to be explicitly linked to a process of change that can be assessed via questionnaires. In the current study, three participants were treated in a multiple baseline design study that compared an interaction without personal detail exchange, reading plays, to FAP as implemented using the awareness, courage, and love model, a popular treatment dissemination strategy that identifies treatment targets as midlevel terms. Data presented explore the implementation of FAP on a turn-by-turn basis, the resulting change in treatment targets via questionnaires (in and out-of-session relating), and the treatment's impact on reported symptoms of psychopathology. Findings provide additional, yet still inconclusive, support for FAP's proposed process of change. The current results call into question the effects of treatment implementation using the awareness, courage, and love model in place of traditional implementation anchored in operant conditioning. Keywords Social intimacy * Functional analytic psychotherapy * Single-subject design * Psychotherapy process * Loneliness, Introduction Despite showing efficacy, manualized treatment protocols frequently lack the specificity needed to identify the therapy components responsible for change (Kupfer et al., 2008). This lack of specificity has led [...]

Changes in token exchange-production schedules may alter behavior when token-production schedules and tokenexchange schedules are held constant. Although research suggests accumulated exchange-production schedules may support higher rates of responding relative to distributed exchange-production schedules, this finding is inconsistent across different participants and studies. The concept of rate dependence--which describes a characteristic pattern in which changes in responding following an intervention are dependent upon baseline rates of behavior--may partly explain these inconsistent findings. Thus, the purpose of this preliminary investigation was to examine token schedule effects for the presence of rate-dependent characteristics using data obtained from published token economy investigations with human participants. Results from these analyses demonstrate that rate-dependent phenomena may have generality to token reinforcement, and potentially explain some heterogeneity in the applied literature on exchange-production schedules. Keywords Exchange-production schedules * Rate dependence * Tokens * Token economy, Token-reinforcement procedures are widely used in behavioral interventions to increase appropriate behavior (e.g., academic task engagement) and/or decrease problem behavior (e.g., disruption; Ivy et al., 2017). These procedures have a [...]

Context: Depression in primary care remains challenging; patients with depression often do not seek help. Interventions to increase help-seeking (HS) behavior have been ineffective or decreased HS. Mental Contrasting and Implementation Intentions (MCII) is a behavioral intervention to create action plan in advance. It has been effective among patients seeking to increase exercise, reduce smoking, and other health behaviors. However, it has not been used for initiating help- seeking for depression. Objective: To assess whether an online MCII training program increases HS or the intention to seek help at 2 weeks post-intervention among those with elevated depressive symptoms, compared to information-only controls (C). Study Design and Analysis: RCT comparing HS and C at 2 weeks using pre-post survey. Analysis using t-test and ANOVA; intention to treat. Setting: MTurk online cloud research toolkit (Feb-March 2020). Population Studied: Adults with Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) or above and who were not seeking professional help at baseline. Intervention: Published online MCII intervention. Outcome Measures: Primary: Self-reported help seeking success (single-item). Secondary: Strength of Implementation Intentions Scale (SIIS), depressive symptoms (BDI-II), current perceived depression (single item). Results: Of the 2134 participants prescreened for depression and HS, 228 met eligibility criteria (37.2 [+ or -] 12.1 yrs, 65% F, 67% white). Demographics and disease severity were similar between groups at baseline. The HS group (n=105) reported greater HS success (p = .013) as well as intention to seek help (p = .001) 2 weeks post intervention compared to C (n=124). Further, perceived HS success was more likely for those who received the HS intervention and either did not perceive themselves as currently depressed at Time 2 (OR = 3.7) or individuals whose actual BDI-II score at follow up was below 14 points (OR = 10.6). Conclusions: Among participants with elevated depression symptoms, an online training in MCII effectively increased help-seeking behavior and intention to seek help compared to information-only control participants 2 weeks after delivery. The intervention is relatively brief and potentially scalable. Further research is warranted to determine clinical utility., Presenters Amanda Keeler, MA, Liesl Nydegger, PhD, [...]

The purpose of this study was to evaluate the feasibility of delivering a supervised physical activity program plus standard exercise counseling (PA + EC) versus a supervised physical activity plus motivationally-enhanced behavioral counseling (PA + BC) in prostate cancer survivors. Secondary outcomes included objectively assessed PA, quality of life, body composition, cardiorespiratory fitness, cognitive functioning, and physical function. Twenty-six prostate cancer survivors were randomized to a 12-week supervised PA program plus standard exercise counseling or a 12-week supervised PA plus behavioral counseling based on the Multi-Process Action Control framework. Feasibility was determined through enrolment rate, measurement completion rate, loss-to-follow-up, adherence to the intervention, adverse events, and program evaluation items assessing burden and satisfaction. Of the 26 prostate cancer survivors enrolled (M.sub.age = 65.6 ± 6.8), 96% completed the intervention. Measurement completion rates for the study measures were 88.5%. Adherence to the supervised PA sessions was 92% (completed 11/12 supervised PA sessions) and 100% (completed 12/12 supervised PA sessions) in the PA + EC and PA + BC group, respectively. Adherence to the home-based PA sessions was 70% (completed 7/10 home-based sessions) and 90% (completed 9/10 home-based sessions) in the PA + EC and PA + BC group, respectively. Overall, prostate cancer survivors were highly satisfied with the intervention components and found it rewarding, useful for research helping others, and useful for them personally. The patterns in the secondary outcomes were consistent with a positive impact of the intervention, favoring the PA + BC group. Preliminary evidence suggests that adding behavioral counseling to supervised PA in prostate cancer survivors may be feasible and result in better adherence to PA compared to exercise counseling alone, although additional refinement is needed. A combination of supervised and home-based PA may be feasible for behavior change in the self-management of prostate cancer. The study is registered with http://ClinicalTrials.gov (ID NCT03191968)., Author(s): Linda Trinh [sup.1] , Arthur F. Kramer [sup.2] [sup.5] , Kendrith Rowland [sup.3] , Dominick A. Strom [sup.4] , Jaime N. Wong [sup.4] , Edward McAuley [sup.4] [sup.5] Author [...]

Most children in the UK are not eating enough fruit and vegetables to support optimum health. Evidence-based interventions are needed to change this trend. In the present pilot study, effectiveness of simple behavioural nudges on children's lunchtime consumption of fruit and vegetables was tested in two primary (elementary) schools. Children's (n = 107) lunchtime consumption was measured directly through the use of a validated digital photography protocol; measures were taken at baseline and again after a 3-week long intervention. Changes to the choice architecture of dining rooms included improved presentation and provision of target foods, attractive advertisements and labelling, and prompting by staff. For children who took school lunches (n = 67), both selection and consumption of fruit increased as the result of the intervention. Their selection of vegetables did not change over time, however, and their consumption ether remained unchanged or declined. No changes were observed in the comparison group (n = 40), who brought their lunch boxes from home. These results caution against using selection (serving sizes), as estimates of consumption or a measure of behaviour changes. They also show that all evaluations should consider the effects of each intervention on children's eating overall, rather than just report changes in target item consumption, to check for any unintended consequences of the intervention., Author(s): Mihela Erjavec [sup.1] , Samantha Williams [sup.1] , Simon Viktor [sup.1] , Mariel Marcano-Olivier [sup.2] Author Affiliations: (1) Bangor University, Bangor, UK (2) Birmingham City University, Birmingham, UK Background [...]

Functional communication training (FCT) is one of the most common treatments for challenging behavior and is considered an empirically supported practice for children and adolescents with autism spectrum disorder (ASD). However, no previous systematic review has evaluated the quality of FCT for adults with ASD, and the empirical support for this practice among adults is unknown. The purpose of the current review was to synthesize the extant research, including a quality appraisal of the literature on the use of FCT to treat challenging behavior for adults with ASD. We identified 20 studies that evaluated the efficacy of FCT in reducing challenging behavior for adults with ASD. The quality of each article was evaluated based on the What Works Clearinghouse design and evidence standards. Following the quality and evidence evaluations, eight studies, including eight experiments, were found to have moderate or strong evidence of effectiveness. The current body of literature provides some evidence for the efficacy of FCT in reducing challenging behavior for adults with ASD, but additional research in this area is warranted., Author(s): Emily Gregori [sup.1] , Oliver Wendt [sup.2] , Stephanie Gerow [sup.3] , Corey Peltier [sup.4] , Derya Genc-Tosun [sup.5] , Catharine Lory [sup.1] , Zachary S. Gold [sup.6] Author [...]

Interventions to change children's behavior typically target adults or children, but rarely both. The aims were to: (a) evaluate acceptability and feasibility of an innovative theory-based intervention designed to change both child and adult behavior, and (b) generate effect sizes for a definitive randomized controlled trial. The oral health of sixty children aged 5-9 years with a repaired cleft lip and/or palate was assessed before randomization to one of three conditions: (a) control group, (b) intervention group in which children and adults were asked to form implementation intentions, or (c) intervention plus booster group in which adults were additionally sent a reminder about the implementation intentions they and their children formed. Oral health assessments were repeated at 6-month follow-up alongside exit interviews. The procedures proved popular and participants exposed to the intervention additionally reported believing that forming implementation intentions was effective. Descriptive statistics generally showed oral health improvements across all conditions, although the effects were more marked in the intervention plus booster condition, where plaque improved by 44.53%, gingivitis improved by 20.00% and free sugar consumption improved by 8.92% (vs. 6.43% improvement, 15.00% deterioration and 15.58% improvement in the control group, respectively). Data collection procedures were acceptable and the intervention feasible. The effect sizes suggest that the intervention plus booster condition has sufficient promise to proceed to a fully-powered randomized controlled trial. The intervention has the potential to be adapted to tackle other child health behaviors and to be deployed at scale., Author(s): Christopher J. Armitage [sup.1] [sup.2] , Tanya Walsh [sup.1] [sup.2] , Jeanette Mooney [sup.1] [sup.2] , Stephanie Tierney [sup.3] , Peter Callery [sup.1] Author Affiliations: (1) grid.5379.8, 0000000121662407, Manchester [...]

We examined the long-term effectiveness of a group-based psychological intervention ('MoVo-LISA') to promote physical activity in patients with coronary heart disease. In this randomized controlled trial, N = 202 inactive patients with coronary heart disease were assigned to the control group (n = 102; treatment as usual) or the intervention group (n = 100; treatment as usual plus MoVo-LISA). Physical activity was assessed at baseline, 6 weeks (post-treatment), 6 months, and 12 months after discharge. ANCOVA for repeated measures revealed a significant interaction effect [p < .001; [eta]p2= .214] indicating a large effect [d = 1.03] of the intervention on behavior change post-treatment. At 12-month follow-up, the level of physical activity in the intervention group was still 94 min per week higher than in the control group (p < .001; d = 0.57). Results of this RCT indicate that the MoVo-LISA intervention substantially improves the level of physical activity among initially inactive patients with coronary heart disease up to 1 year after the intervention., Author(s): Ramona Wurst [sup.1] , Stephan Kinkel [sup.2] , Jiaxi Lin [sup.1] , Wiebke Goehner [sup.3] , Reinhard Fuchs [sup.1] Author Affiliations: (1) grid.5963.9, Department of Sport Psychology, University of [...]

Background There is ongoing clinical and research interest in determining whether providing personalised risk information could motivate risk-reducing health behaviours. We aimed to assess the impact on behaviours and risk factors of feeding back to individuals' images of their bodies generated via medical imaging technologies in assessing their current disease status or risk. Methods and findings A systematic review with meta-analysis was conducted using Cochrane methods. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to July 28, 2021, with backward and forward citation searches up to July 29, 2021. Eligible studies were randomised controlled trials including adults who underwent medical imaging procedures assessing current health status or risk of disease, for which personal risk may be reduced by modifying behaviour. Trials included an intervention group that received the imaging procedure plus feedback of visualised results and assessed subsequent risk-reducing health behaviour. We examined 12,620 abstracts and included 21 studies, involving 9,248 randomised participants. Studies reported on 10 risk-reducing behaviours, with most data for smoking (8 studies; n = 4,308), medication use (6 studies; n = 4,539), and physical activity (4 studies; n = 1,877). Meta-analysis revealed beneficial effects of feedback of visualised medical imaging results on reduced smoking (risk ratio 1.11, 95% confidence interval [CI] 1.01 to 1.23, p = 0.04), healthier diet (standardised mean difference [SMD] 0.30, 95% CI 0.11 to 0.50, p = 0.003), increased physical activity (SMD 0.11, 95% CI 0.003 to 0.21, p = 0.04), and increased oral hygiene behaviours (SMD 0.35, 95% CI 0.13 to 0.57, p = 0.002). In addition, single studies reported increased skin self-examination and increased foot care. For other behavioural outcomes (medication use, sun protection, tanning booth use, and blood glucose testing) estimates favoured the intervention but were not statistically significant. Regarding secondary risk factor outcomes, there was clear evidence for reduced systolic blood pressure, waist circumference, and improved oral health, and some indication of reduced Framingham risk score. There was no evidence of any adverse effects, including anxiety, depression, or stress, although these were rarely assessed. A key limitation is that there were some concerns about risk of bias for all studies, with evidence for most outcomes being of low certainty. In particular, valid and precise measures of behaviour were rarely used, and there were few instances of preregistered protocols and analysis plans, increasing the likelihood of selective outcome reporting. Conclusions In this study, we observed that feedback of medical images to individuals has the potential to motivate risk-reducing behaviours and reduce risk factors. Should this promise be corroborated through further adequately powered trials that better mitigate against risk of bias, such interventions could usefully capitalise upon the widespread and growing use of medical imaging technologies in healthcare., Author(s): Gareth J. Hollands 1,2,*, Juliet A. Usher-Smith 3, Rana Hasan 3, Florence Alexander 3, Natasha Clarke 1, Simon J. Griffin 3,4 Introduction Achieving and sustaining changes in health-related behaviours [...]

A previous experimental analog study by Sierra et al. International Journal of Psychology and Psychological Therapy, 16, 265-279 (2016) showed that including common physical properties of participants' pain in the metaphor content improved its effect in promoting pain tolerance. Using a 2x2 factorial design, this study analyzed the effect of common physical properties in the context of multiple examples of functionally equivalent metaphors. Eighty-four participants responded to a measure of experiential avoidance. They were subsequently exposed to a cold-pressor task at pretest. Participants were then randomly assigned to four experimental protocols: (a) three functionally equivalent metaphors with common physical properties of participants' pain, (b) three functionally equivalent metaphors without common physical properties, (c) a metaphor with common physical properties that was repeated three times, and (d) a metaphor without common physical properties that was repeated three times. Participants were then reexposed to the cold-pressor task (posttest). Bayesian data analyses showed that the presence of common physical properties was the only variable associated with an increase of the metaphor effect, and this was independent of the number of metaphors proposed. The update of evidence by means of a Bayes factor meta-analysis showed that data very strongly support the hypothesis of common physical properties being an effective component of metaphors. These results highlight the relevance of training therapists in designing metaphors with common physical properties of the clients' discomfort.Keywords Metaphor * Acceptance and commitment therapy * Relational frame theory * Physical properties * Multiple examples, Multiple forms of psychological interventions use metaphors as a powerful tool to promote behavior change (e.g., Kopp 1995; Tay 2013; Torneke 2017; Villatte et al. 2016). Metaphors provide enriching verbal [...]

We study the effects of reminders on people's behavior in investment activities characterized by up-front costs and delayed benefits, such as getting an education and maintaining a healthy lifestyle. We conduct a field experiment and show that simple weekly reminders induce users of a gym to substantially increase their gym attendance over an extensive period. Users' response to reminders is immediate (within hours) and recurrent for any subsequent reminder, which can be explained by limited attention. We find some evidence of habit formation, leading to more frequent physical activity also after treatment, although with an effect smaller than during treatment. Simple reminders are thus a cost-effective policy tool. History: Accepted by Uri Gneezy, behavioral economics. Funding: The authors are grateful to Einaudi Institute for Economics and Finance (EIEF) for financial support of the field experiment and David Kovo for excellent research assistance. This paper is part of the SONIC project on behavioral and experimental economics at the University of Bologna [Miur Firb Grant RBFR084L83]. This is a thorough revision of our previous working paper, 'Nudging with Information: A Randomized Field Experiment' (CEPR Discussion papers, n. 8571). Supplemental Material: Data and the online appendix are available at https://doi.org/10.1287/ mnsc.2016.2499. Keywords: field experiment * limited attention * reminders * habit-formation * exercise * gym * cost-effective policy, 1. Introduction When individuals perform activities involving immediate costs or effort, but promising future benefits only (i.e., 'investment activities'), they may underinvest and perform poorly even by their own judgment. [...]

Independent juror research is an old problem for jury trials. It invites potentially prejudicial, irrelevant, and inaccurate information to guide jury decisionmaking. At the same time, independent juror research compromises [...]

2. ENVIRONMENTAL HEALTH Environmental Health (EH) is an HP 2020 topic that has particular relevance to health equity and is well-suited to coercive legal interventions. In economic terms, environmental effects [...]

ABSTRACT Principles of health equity require that all people have equal opportunity to develop and maintain their health, yet in the face of widespread and presumptively inequitable health disparities, the [...]

In this study, the researchers evaluated the sensitivity of Direct Behavior Rating Single-Item Scales (DBR-SIS) for assessing behavior change in response to an intervention. Included in the analyses were data from 20 completed behavioral consultation cases involving a diverse sample of elementary participants and contexts using a common intervention in an A-B design. Secondary purposes of the study were to investigate the utility of 5 metrics proposed for understanding behavioral response, as well as the correspondence among these metrics and teachers' ratings of intervention acceptability. Overall, results suggest that DBR-SIS demonstrated sensitivity to behavior change regardless of the metric used. Further, we found limited association between student change and teachers' ratings of acceptability., Student behavior in school settings continues to receive substantial attention within policy, practice, and research arenas. For example, research has clearly documented the important role that school settings can serve [...]

Introduction Sharks are the much maligned apex predators that frequent horror films and sensationalized nature documentaries. Sharks have come to represent the unknown; a toothed menace. Perceptions are starting to [...]

This research evaluated the effectiveness of an adaptation of motivational interviewing (the Short Motivational Programme) to enhance motivation to change in a high risk offender sample. The Short Motivational Programme (SMP) aimed to increase offenders' motivation to change prior to their release from prison. An outcome evaluation was conducted using a quasi-experimental repeated measures within-group design. Participants consisted of 38 male offenders, deemed to be at a high risk of recidivism, from two New Zealand prisons. Offenders' motivation to change significantly increased from pre- to post-SMP and a follow-up group showed this change was maintained 3-12 months after the programme. The results provided preliminary evidence for the effectiveness of SMP to increase the motivation to change of high risk offenders., Systematic interest in motivation to change emerged from the addictions field due to low rates of treatment compliance. This was commonly conceptualised as a motivational problem (Hettema, Steele, & Miller, [...]