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Objective: Based on a single intake interview, mental health clinicians must distill their assessment to brief statements reflecting essential information. We explored how clinicians organi...

BACKGROUND Social determinants of health (SDOH) contribute to racial disparities in asthma outcomes. Community health worker (CHW) programs represent a promising way to screen for SDOH and connect patients to resources, but the impact of CHW programs in the inpatient pediatric setting has been examined in few studies. In this study, we aimed to evaluate a CHW program for children hospitalized with asthma in a predominantly Hispanic community by examining rates of SDOH and social resource navigation. METHODS This pilot study involved a CHW intervention to improve pediatric asthma care. Patients were included if they were hospitalized with asthma over an 18-month period and enrolled in the CHW program during their hospitalization. In an intake interview, CHWs screened caregivers for SDOH and provided tailored social resource navigation. Descriptive statistics were used to assess rates of social risk factors and social resource navigation. RESULTS Eighty patients underwent SDOH screening. The majority of patients were Hispanic (81.3%, n = 65). Half of caregivers reported food or housing insecurity over the past 12 months (50.0%, n = 40), and most reported inadequate housing conditions (63.8%, n = 51). CHWs coordinated social resources for the majority of families (98.8%, n = 79), with the most common being food resources (42.5%, n = 34), housing resources (82.5%, n = 66), and appointment navigation (41.3%, n = 33). CONCLUSIONS CHWs identified a high burden of unmet social needs and provided associated social resource navigation in a largely Hispanic pediatric population hospitalized for asthma. CHW programs have potential to improve asthma outcomes by linking high-risk patients with social resources.

Nonverbal behavior is a central factor influencing the therapeutic relationship. Despite broad agreement on its importance, empirical studies assessing nonverbal behavior in counseling and psychotherapy are relatively scarce and often limited to few cases. One restraining factor may be the resources needed when assessing nonverbal behavior. Movement dynamics are an exemplary aspect of nonverbal behavior that can be captured with computer vision-a discipline concerned with the automated analysis of footage captured on video. One of the simplest methods requiring no special detectors, devices, or markers on patients or therapists is based on the assessment of differences in sequences of pictures (frames) found in video recordings. Algorithms of so-called frame-differencing methods may be implemented on commonly available computers, and they provide a good, straightforward assessment of, for example, patients' and therapists' movement dynamics in counseling and therapy sessions. Frame-differencing methods in psychology date back 36 years, but their use in counseling and psychotherapy research is only recently gaining momentum. In this introductory article, the use of one specific application suitable for the assessment of human motion from archival video material is presented. Motion energy analysis (MEA) is a procedure particularly appropriate for clinicians and researchers who have access to recordings of sessions or who wish to record their own video material. Focusing on the phenomenon of nonverbal synchrony-the coordination of movement between patient and therapist-a step-by-step demonstration of the stages involved in a successful application of MEA in psychotherapy research is provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Insomnia is a major predictor of adverse outcomes in mild traumatic brain injury (mTBI), including concussion; although insomnia symptoms may be due to various sleep disorders, those related to circadian rhythm sleep-wake disorders (CRSWDs) require specific assessment and treatment. The objective of the current study was to determine the prevalence of CRSWD in a sample of treatment-seeking people with chronic insomnia symptoms after an mTBI. Methods Participants aged 17-65 years who had experienced an mTBI and reported chronic insomnia were recruited from diverse community clinics in Ontario 3-24 months after their injury to participate in this cross-sectional observational study. Potential participants were screened by both telephone and intake interview. Exclusion criteria were alcohol or substance use disorders, preexisting brain disorder or previous neurosurgery, recent travel across more than 2 time zones or shift work. Assessments included a clinical interview, questionnaires, 2 weeks of actigraphy and a sleep diary, and a dim-light melatonin onset test. The main outcome measure was the proportion of patients with CRSWDs. Results Of the 50 participants (32 [64%] female; median age 39.5 yr), 13 (26% [standard deviation 12%]) had an CRSWD. The most common circadian diagnosis was delayed sleep-wake phase disorder (10 participants [20%]). Interpretation The prevalence of CRSWDs may be exceptionally high among people with chronic insomnia symptoms following mTBI. Proper detection and treatment of CRSWDs in this population is essential to facilitate recovery. The findings emphasize the relevance of a diagnostic circadian assessment in patients with mTBI presenting with chronic insomnia symptoms.

This chapter discusses the evolution of vocational rehabilitation programs for persons with traumatic brain injury (TBI); describes the Work Re-entry program, as an example of a model TBI vocational rehabilitation program; describes program components and processes; discusses how persons with TBI access the program and provides examples of what actually occurs using selected case examples; reports the program’s outcomes; and discusses directions for future development. The Sharp Work Re-entry Program in San Diego, California was developed in direct response to the California Department of Rehabilitation’s request for a model program which would substantially increase the return-to-work rate for persons with TBI. The Work Re-entry process is based on the belief that there is more than one blueprint for returning to work. A critical dimension of the return-to-work process is the initial intake interview and a comprehensive evaluation of the individual’s existing skills and occupational potential.

In psychiatric diagnostic interviews, a clinician's question designed to elicit a specific symptom description is sometimes met with the patient's self-disclosure of their subjective experience. In shifting the topical focus to their subjective experiences, the patients do something more or something other than just answering the question. Using conversation analysis, we examined such sequences in diagnostic interviews in an outpatient clinic in Finland. From 10 audio-recorded diagnostic interviews, we found 45 segments where medical questions were met with patients' self-disclosures. We show four sequential trajectories that enable this shift of topic and action. There are four possible trajectories: (1) the patient first answers the medical question and the clinician acknowledges this answer, whereupon the patient shifts to a self-disclosure of their subjective experience; (2) the patient first gives the medical answer but shifts to self-disclosure without the clinician's acknowledgement of that answer; (3) the patient produces an extensive answer to the medical question and, in the course of producing this, shifts into the self-disclosure; (4) the patient does not offer a medical answer but designs the self-disclosure as if it were the answer to the medical question. We argue that in the shifts to the self-disclosure of their subjective negative experience, the patients take local control of the interaction. These shifts also embody a clash between the interactional projects of the participants. At the end of the paper, we discuss the clinical relevance of our results regarding the patient's agency and the goals of the psychiatric assessment. publishedVersion

Objective Subthreshold perceptual abnormalities are commonly used to identify individuals at clinical high risk (CHR) for developing a psychotic disorder. Predictive validity for modality-specific perceptual abnormality severity on psychosis risk is unknown. Methods We examined prospectively collected data from 164 individuals age 12-35 meeting criteria for CHR followed for 6-24 months or until conversion to psychosis. Using intake interview notes, baseline perceptual abnormality scores were split into auditory, visual, somatic/tactile, and olfactory/gustatory components, and auditory scores were further split into those for verbal vs non-verbal content. Relationships between perceptual abnormality characteristics and conversion were assessed with Cox proportional hazards regression and logistic regression. Results Unusual thought content and paranoia were predictive of conversion, but no modality-specific perceptual abnormality score predicted conversion status or days to conversion. However, when auditory perceptual abnormalities were further categorized as verbal vs non-verbal, the severity of verbal experiences was predictive of conversion to psychosis (P = 0.007). Conclusions Perceptual abnormality scores failed to meaningfully predict conversion to psychosis in either direction in this CHR sample. However, verbal auditory experiences may identify a group of CHR individuals at elevated risk of conversion. Further exploration of the relationship between phenomenological aspects of perceptual abnormalities and conversion risk is warranted.

Due to the increasing age of the global population, rates of visual disability are increasing. Visual rehabilitation is an effective method for increasing quality of life among individuals with low vision or blindness due to unpreventable or untreatable causes. The goal of low vision rehabilitation is to produce people who are independent, have an economically viable profession or skill, and are able to enjoy their lives. The stages of modern low vision rehabilitation include the intake interview, assessment of residual visual functions, assessment of residual functional vision, interventions and recommendations, and vision rehabilitation therapies.

Multicultural counseling competencies (MCC) in an intake interview is the most fundamental component of affirmative counseling practice for individuals that identify as lesbian, gay, bisexual, transgender, queer (LGBTQ), or other sexual-relational orientation or gender identity. Despite the importance of counselors’ MCC in the area of intake interviews, little practical guidance exists to help counselors conduct multicultural competent intake interviews. This article provides practical guidelines and strategies for counselors to engage clients in multiculturally competent intake interviews.

The current study uses an initial intake interview as an assessment tool in the Supporting Father Involvement (SFI) intervention and considers it from a family systems theoretical perspective. SFI includes a 32-hour group for parents with young children that aims to reduce child abuse and promote family well-being through a curriculum focused on enhancing positive father involvement and coparenting. For this study, the initial clinical interview assessed partners’ synchronies and dissonance in parenting, coparenting, and relationship satisfaction domains. Using thematic analysis, we qualitatively analyzed interviews with 15 committed, heterosexual couples, exploring themes that correspond with higher versus lower couple satisfaction measured by the Quality of Marital Satisfaction Index. Results showed a strong concordance between partners’ satisfaction scores, with fathers less satisfied than mothers. Thematic differences between higher and lower satisfaction parents centered on approach to discip...

Diabetics militus is a group of metabolic diseases with hyperglichemic that is caused by abnormality insulin secretion, insulin works, or both of them. One of alternative for decreasing sugar levels is yam bean and tomato juices consumption. The aim of the research is to exposed the influence of yam bean juice and tomato juice againts sugar levels of diabetics militus type 2. This research is experimental study with pretes-posttest with control group design. We used purposive sampling with 18 respondenses. The primary data are intake interview, IMT measurement, and blood sugar levels. And the secondary data are the data resources about diabetics militus. Data are analyzed statically by T-test two mean differences dependent and independent with error degree 5%. The result showed that the avarage of sugar blood levels before and after intervension respectively is 287,6 mg/dl and 220,8 mg/dl. There was the significant difference between blood sugar levels before and after group cases (p

Objectives: This study aimed to investigate the effect of waiting for inpatient psychosomatic psychotherapy and the prediction of treatment outcome from the effect of waiting in depressed patients. Methods: A total of N = 519 patients were assessed for depressive symptoms before their initial intake interview, at the time of their hospital admission (on average 6 weeks after the intake), and at discharge (after eight weeks of inpatient psychotherapy). Results: There was a small to moderate reduction in depressive symptoms from intake interview to hospital admission. This effect was independent from the waiting duration. Latent change from intake interview to hospital admission was a significant moderate predictor of treatment outcome at discharge. Conclusions: Findings imply that the prospect of inpatient psychotherapy may affect patients' depression severity. Furthermore, patients who benefit more from the prospect of treatment may also achieve higher therapeutic effects.

Background: Quality cancer care includes routine screening for psychosocial distress. This quality improvement project focused on the implementation of distress screening at a licensed affiliate of Cancer Support Community, a community-based non-profit organization that provides professionally led cancer support. Methods: An advanced practice oncology nurse assisted the staff in implementing and evaluating the process of distress screening. CancerSupportSource (CSS), a validated web-based distress screening program developed by Cancer Support Community for use in community cancer settings, was employed to screen for distress, identify potential resources, and improve in-house and community referrals. For purposes of this quality improvement project, CSS was administered in interview format by staff. The Plan-Do-Study-Act (PDSA) quality improvement approach was used to implement CSS. Results: To implement the practice of distress screening, 21 patient participants were initially screened and evaluated for distress, including risk for clinically significant levels of depression, using CSS. The tool identified participant concerns and flagged thirteen persons as at risk for depression. After implementation and evaluation of distress screening using PDSA, in a year, 51 participants were screened. Participants stated that distress screening allowed for discussion of intimate questions that may not have otherwise occurred in an intake interview. Conclusion: It was demonstrated that CSS identified psychosocial and practical needs, facilitating the referral process and identification of community resources. Application of the PDSA model was an effective quality improvement model that can be used for the implementation and sustainability of distress screening across settings.

Deficit models of care for clients experiencing social vulnerability have become increasingly unsustainable; and there is a shift towards models of care that promote and protect resiliency for lifelong health. We defined clients as socially vulnerable if they were living with poverty, mental health problems and addictions, disability, and social isolation. Scales to measure outcomes of resiliency-focused programming have limited reliability and have not been validated with vulnerable populations. The aim of this study was to develop and conduct preliminary psychometric assessment of two measures: CUPS (formerly Calgary Urban Project Society) Resiliency Interview Schedule (RIS) and Resiliency Questionnaire (RQ) for adults experiencing social vulnerability. To engage clients who were seeking integrated services at a social services agency, we developed the RIS and accessed data collected between April 2017 and December 2018. In a structured intake interview, the client and staff prioritised goals and identified resiliency in three domains: (a) economic, (b) social-emotional, and (c) health. On average, clients (N = 545) who completed the CUPS-RIS were 45.9 years old (SD = 12.62). For the CUPS-RIS, Cronbach's alphas at intake and outcome assessments were 0.80. Exploratory factor analysis demonstrated a four-factor solution with two unexpected results: executive functioning/self-regulation loaded with mental and physical health, and client education failed to load on any factor. We found significant improvements between client intake and outcome measurement points on eight of 12 sub-domains. As a brief self-report measure of resiliency, we developed the CUPS-RQ and accessed data collected between November 2018 and May 2019. Clients (N = 29) who completed the CUPS-RQ concurrently with the Resilience Research Centre-Adult Resilience Measure (RRC-ARM) were, on average, 42.46 years old (SD = 12.87). The CUPS-RQ was correlated with RRC-ARM, r = 0.819. In preliminary psychometric assessment, the CUPS-RIS and CUPS-RQ demonstrated satisfactory reliability and validity and show promise as measures of resiliency for agencies serving clients experiencing social vulnerability.

Introduction The opioid overdose crisis in the United States has prompted an expansion of treatment services, including pharmacotherapy with buprenorphine. However, many people who use illicit opioids (PWUIO) self-treat their opioid-use disorder (OUD) with non-prescribed buprenorphine (NPB) in lieu of attending formal treatment. The present study aims to qualitatively understand motivations of people who are self-treating their OUD with NPB. Methods Qualitative study designed to supplement and contextualize quantitative findings from natural history study of buprenorphine diversion, self-treatment, and use of substance use disorder treatment services. Interviews were audio-recorded, transcribed, systematically coded and analyzed via Iterative Categorization. Study Setting The Dayton, Ohio metropolitan area in the midwestern United States; a site previously characterized as high impact in the national opioid overdose crisis. Participants Sixty-five individuals (35 men and 30 women) who met the DSM-5 criteria for OUD (moderate or severe) and had used NPB at least one time in the six months prior to their intake interview. Results Participants described four key motivators for self-treating with NPB: perceived demands of formal treatment, the desire to utilize non-prescribed buprenorphine in combination with a geographic relocation, to self-initiate treatment while preparing for formal services, and to bolster a sense of self-determination and agency in their recovery trajectory. Conclusions Use of NPB is a recognized self-treatment modality among PWUIO, with some PWUIO transitioning into sustained recovery episodes or enrollment in formal treatment. Understanding the motivations for opting out of treatment is crucial for improving forms of care for people with OUD.

When helping struggling medical students, a “one size fits all” approach is often ineffective, as many different factors affect academic success. In our experience, these factors may overlap or be distinct for each student, and thus require individualized interventions based on student needs. We recommend an individualized model of academic support includes an intake interview, assessment, individualized interventions, and follow up to assess progress. This paper provides a recommended framework of resources for medical school faculty and staff who work with struggling students. Different issues that lead students to struggle are categorized in the main domains of Bloom’s taxonomy: cognitive, affective, and psychomotor. A discussion of the impact of the factors in each domain includes detailed tables with corresponding manifestations, assessments, and support strategies literature for each issue. An application of a proposed framework is presented on a case example. Individualized approaches to improving medical student success are presented to address the complex and interrelated areas of academic success, wellbeing, quality of life, career potential, and satisfaction with medical school.

Objective To identify maternal characteristics associated with social support among new mothers of premature infants who are at social–environmental risk. Design Cross-sectional analysis of intake interview data from a larger randomized controlled trial of a mother–premature infant developmentally based intervention. Setting Two urban community-based hospitals. Participants One hundred ninety-four women (50% Black, 50% Hispanic) who recently gave birth to otherwise healthy, premature (29–34 weeks gestational age) infants. Participants had at least 2 of 10 social–environmental risks (e.g., poverty). Methods In-hospital interviews were conducted to obtain data on sociodemographic characteristics, prior mental health problems, and social support through the use of the Personal Resources Questionnaire 2000. Bivariate and multivariable linear regression analyses were performed to identify factors associated with social support. Results Mean Personal Resources Questionnaire 2000 scores were significantly lower for Hispanic than Black participants (92.0 vs. 96.0, respectively), those interviewed in Spanish versus English (89.8 vs. 96.1), those with low versus age-appropriate education levels (89.7 vs. 95.3), multiparous versus primiparous women (92.7 vs. 96.0), and those reporting versus not reporting histories of mental health problems (84.7 vs. 94.8). After multivariable adjustment, only younger age, Spanish language preference, multiparity, and a history of mental health problems were associated with significantly lower levels of social support ( R 2 = 0.18). Conclusion More programs should be made available to provide social support to at-risk mothers, especially younger mothers, and those with limited English ability, other children at home, or histories of mental health problems. Nurses should target these mothers for additional support during their premature infants' NICU stay.

The Performance Interview Guide (PInG) is a semistructured approach to initial sport and performance psychology (SPP) consultations. The PInG is designed to be person centered and strengths based with a focus on performance excellence. We emphasize building a safe, trusting, and collaborative relati

Clinicians are often tasked with identifying and managing patients who are at risk for suicide. Therefore, greater understanding of factors that impact the efficacy of suicide risk assessments (SRA) are of critical importance. One potential factor that may affect assessments of risk severity is the timing of the evaluation during clinical interview. Given that some patients are reluctant to disclose suicide-related symptoms, it is possible that asking about suicide at the beginning of an interview elicits more false negatives. It is also possible that if risk assessments are conducted in a manner that is encouraging to the patient, timing does not significantly impact patient report. This study examined whether SRA timing within an initial intake interview affects risk severity ratings. Adult psychiatric outpatients (N=169) were randomly assigned to receive a SRA during the beginning or middle of a one-hour intake. We failed to find a significant difference in suicide risk ratings between those who were evaluated at the beginning as compared to the middle of intake (14% versus 15% rated at elevated risk). Findings were not moderated by age, gender, or attempt history. Our results provide preliminary evidence that the timing of SRA may not impact risk severity ratings.

Background: Pediatric chronic inflammatory rheumatism (CIR) has a significant impact on daily life, especially on schooling, that can lead to child’s drop-out. In this context, a French paediatric health network, RESRIP (Reseau pour les Rhumatismes Inflammatoires Pediatriques), has been created in 2014 for children with CIR and living in the Ile-de-France region. Patients are included in this network if they meet certain criteria such as the need to find trained health professionals close to their home or for support because of adverse social conditions or difficulties with their schooling. If the criteria are fulfilled, the patient and his family participate in an intake interview which allows RESRIP to understand the patient’s need and to set up targeted actions. Objectives: In our study, we aim to describe and evaluate RESRIP’s role on improving school attendance and tackling absenteeism Methods: A descriptive retrospective study was performed regarding the support provided by RESRIP with respect to patients’ schooling and education professionals. Rates of non-attendance were collected at inclusion and every 6 months from 2014 to 2017, through a standardized auto-questionnaire. Results: 278 patients (M/F: 0.29) aged 12.7 years on average (± 4.9, range 2-21) were taken care of between 2014 and 2017 by RESRIP. Juvenile idiopathic arthritis (JIA) (n = 142), connective tissue disease (n = 49) and auto-inflammatory disease (AID) (n = 32) are the 3 main pathologies covered. Among the 278 patients, twenty-one percent of patients needed academic support when entering the network, including: 37% in the JIA group, 34% in the connective tissue group and 18% in the AID group. Educational assistance was set up for all patients with school difficulties at inclusion but also for all the patients during their follow-up. Patient Support: 178 Individual Action Plan (IAP) were implemented by RESRIP. Twelve patients benefited from additional time for their school exams and 10 were allowed to pass the baccalaureat (French final college exam) over two years instead of a year. In thirty patients, sports education has been adapted. Forty-one MDPH files (Departmental Houses for the Disabled) were produced to enable the establishment of a school life assistant (AVS), teaching materials and/or technical aids. Finally, 8 patients received home schooling assistance through Home Learning Assistance Services (SAPAD). Education professional support: RERSIP established partnerships with the French National Education (FNE) and the SAPAD (home tuition service for ill children). For the FNE, RESRIP provided school doctors or nurses with: 8 continuing medical training and 25 personal interviews to explain the pathologies. In addition, 5 multidisciplinary meetings, within the institutions were organized, for 5 patients with social integration difficulties and stigmatization. RESRIP actions, has allowed a significant decrease in school absenteeism between 2014 and 2017: 3.2 days per year on average at day 1 to 0.5 days per year on average (p Conclusion: Over time, a better understanding of the impact of chronic illness over school and education professionals, has allowed RERSIP to improve its support. The result is a notable decline in school absenteeism and in unjustified physical education exemptions. Several projects are underway: The development of a standard IAP available for doctors, the set-up of a partnership with hospital school, willing to help for the implementation of home school support courses in addition to SAPAD. Disclosure of Interests: : Perrine Dusser: None declared, Chrystelle Hascoet: None declared, Isabelle Kone-Paut Grant/research support from: SOBI has supported drug product (anakinra) for the presented study, Consultant for: SOBI, Novartis, Pfizer, Abbvie, UCB, CHUGAI, ROCHE, Linda Rossi-Semerano Grant/research support from: Roche

Background Opioid use disorder (OUD) is highly prevalent among justice-involved individuals. While risk for overdose and other adverse consequences of opioid use are heightened among this population, most justice-involved individuals and other high-risk groups experience multiple barriers to engagement in opioid agonist treatment. Methods This paper describes the development of Project Connections at Re-Entry (PCARE), a low-threshold buprenorphine treatment program that engages vulnerable patients in care through a mobile van parked directly outside the Baltimore City Jail. Patients are referred by jail staff or can walk in from the street. The clinical team includes an experienced primary care physician who prescribes buprenorphine, a nurse, and a peer recovery coach. The team initiates treatment for those with OUD and refers those with other needs to appropriate providers. Once stabilized, patients are transitioned to longer-term treatment programs or primary care for buprenorphine maintenance. This paper describes the process of developing this program, patient characteristics and initial outcomes for the first year of the program, and implications for public health practice. Results From November 15, 2017 through November 30, 2018, 220 people inquired about treatment services and completed an intake interview, and 190 began treatment with a buprenorphine/naloxone prescription. Those who initiated buprenorphine were primarily male (80.1%), African American (85.1%), had a mean age of 44.1 (SD = 12.2), and a mean of 24.0 (SD = 13.6) years of opioid use. The majority of patients (94.4%) had previous criminal justice involvement, were unemployed (72.9%) and were unstably housed (70.8%). Over a third (32.1%) of patients had previously overdosed. Of those who began treatment, 67.9% returned for a second visit or more, and 31.6% percent were still involved in treatment after 30 days. Of those who initiated care, 20.5% have been transferred to continue buprenorphine treatment at a partnering site. Conclusions The PCARE program illustrates the potential for low-threshold buprenorphine treatment to engage populations who are justice-involved and largely disconnected from care. While more work is needed to improve treatment retention among vulnerable patients and engaging persons in care directly after release from detention, offering on-demand, flexible and de-stigmatizing treatment may serve as a first point to connect high-risk populations with the healthcare system and interventions that reduce risk for overdose and related harms.

Current methods in psychiatric assessment and diagnosis are reviewed and critiqued. Problems encountered when evaluating causes and meanings of cognitive, affective, and behavioral symptoms are described. The ambiguous status of “disorder” in psychiatry and problems in the Diagnostic and Statistical Manual are discussed. Criteria used to classify affective, cognitive, and behavioral states as “disorders” vary widely across cultures and there is no consensus definition of what constitutes a “mental disorder.” The goals of the interview and formulation in integrative mental health care are described. Approaches widely used in Western medicine and CAM to assess mental health problems are described and their limitations are pointed out. Most CAM assessment approaches that have been carefully evaluated in Western-style research studies have resulted in findings that are not reproducible, sensitive, or specific. Novel practitioner-centered assessment approaches and emerging technologies will permit future integrative practitioners to capture information that is unattainable using contemporary biomedical assessment approaches. A general methodology is introduced for planning integrative assessment incorporating biomedical and CAM approaches. A methodology is introduced for determining the optimal individualized assessment strategy, that is, the strategy that will most reliably yield accurate and complete information about the causes and meanings of symptoms in a unique patient. Finally, important considerations when making clinical decisions on the type, number, and order of assessment approaches are discussed.

Introduction: Published studies suggest that augmentation of the sensorimotor rhythm (SMR), a commonly used neurofeedback protocol for patients with epilepsy, changes thalamocortical regulatory systems and increases cortical excitation thresholds. Recent meta-analyses showed that at least 50% of patients with medically refractory epilepsy had a post-therapy reduction in seizure frequency after neurofeedback training. However, data on neurofeedback outcomes outside of seizure frequency are limited. Methods: The records for all consecutive patients trained using SMR neurofeedback in the University of Colorado Neurofeedback Clinic prior to March 2015 (n = 9) were retrospectively reviewed, abstracted, and analyzed. Patients completed the Quality of Life in Epilepsy-31 (QOLIE-31) survey as a part of their clinic intake interview and at intervals throughout their training. Results: 214 total training sessions were reviewed. The average total QOLIE-31 baseline score in our patients was 49.3 ± 8.8. Seven patients completed follow-up QOLIE-31 surveys with an average score of 54.9 ± 6.5. Seventy-eight percent of the patients had improvement in their QOLIE-31 scores with training. The largest absolute improvements were in the seizure worry and cognitive subscores of the QOLIE-31. Conclusion: In this small case series, SMR neurofeedback training modestly improved short-term follow-up QOLIE-31 scores in patients with epilepsy.

Couples typically do not seek counseling resources until a crisis occurs. Many times during an intake interview with a counselor, couples report communication issues as a presenting problem. However to date, no best practices or treatment manuals in correspondence with a therapeutic system to improve interpersonal communication skills exist for helping couples recognize the barriers. This article reviews an approach to helping couples understand and make choices about their communication barriers and challenges. An informed philosophical direction, skills, and tools are needed for counselors to navigate the wants, direction, evaluation, and planning (WDEP) along with promoting positive outcomes in couples counseling. This article further outlines an integration of a communication model with the reality therapy WDEP tenets for use in establishing alliances, processing insights, and maintaining a therapeutic environment with couples. Further, counselors may utilize the WDEP method as a brief intervention framework to aid couples who have communication issues with insight acquisition, catharsis, self-disclosure, and goal setting to promote positive outcomes in counseling.

OBJECTIVE We tested the prediction that incremental theorists are more likely to facilitate others' self-disclosure than are entity theorists. METHOD We conducted three studies: (a) a field study that examined client's self-disclosure (N = 122; Mage = 41.9, 67.8% woman; Israelis) during an intake interview with a professional therapist (N = 38; Mage = 46.2, 84.20% woman; Israelis), (b) a survey of adults (N = 120; Mage = 37.14, 57.6% female) who reported self-perceptions and behaviors during conversations and their perceptions of others' self-disclosure. In both studies participants reported their implicit theories, and (c) an experiment (N = 250; Mage = 28.27, 56.6% female) in which participants whose implicit theories were manipulated reported their opening behaviors during a conversation and their perceptions of others' self-disclosure. RESULTS Ones' incremental theory of personality was positively related to another's self-disclosure, to one's opening and disclosure-encouraging behaviors, and was negatively related to one's perceptions of others' self-protection tendency. Furthermore, one's opening behaviors and perceptions of others' self-protection tendencies mediated the effect of one's incremental theory on others' self-disclosure. CONCLUSION Those who believe people can grow and change, can influence others to trust their personal information with them, even when the information is negative.

Community Service Learning (CSL) is a method of teaching where students learn through active participation in thoughtfully organized community service. CSL has emerged as a promising training method to address the changing needs of medical students and to improve their social accountability (1,2). Medical schools are beginning to incorporate community service learning into their curriculums as a way to introduce students to the complicated world of delivering care to vulnerable populations. Mr. A, a refugee from Iraq, immigrated to Canada in June 2015 with his family. Five months later, during a CSL medical intake interview with two medical students and an Arabic interpreter, he revealed to have ongoing suicidal ideation and multiple suicide attempts. Due to significant cultural taboos and stigma around mental illness, Mr. A was initially very hesitant to seek medical help. However, with the help of the CSL program he was able to get much needed medical care.

Contains session preparation items required for treatment including intake interview form, standardize measures, DPICS-T coding sheet, session goals, session outline and clinician integrity checklist.

Many intake interviews begin, explicitly or implicitly, with the expectation that there is something “wrong” with the client. The structure of many psychological assessments supports this dominant pathogenic belief. They are often composed of checklists in which the client is asked to note any past illnesses, addictions, suicidal behavior, and so on. This emphasis on pathology from the beginning may cause an already vulnerable client to feel further destabilized. Moving away from a pathology-focused intake assessment can instead be viewed as an excavation of the client's often problematic dominant story and of the implicit endorsement of the client as “fused” with his or her problem. A narrative approach is uniquely situated to assist the client in excavating hope in the intake interview by inspiring use of questions that are attuned to gathering stories of strength alongside stories of difficulty.