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This article describes how an action research approach was used to involve a community of individuals with mental health issues and their support systems in the development and adoption of a mental health identification (ID) card. The intent of the card was to provide individuals with mental health issues a way to communicate and manage the idiosyncratic nature of their behaviors. A credit card-size ID card was developed that has the individual's picture, address, diagnosis, idiosyncratic behaviors, best approach with the individual when those behaviors are present, medications, allergies, and emergency contact information. Benefits and concerns about the ID system in regard to the cardholder, card recipients, the provision of consent, Health Insurance Portability and Accountability Act compliance, and the balancing of reducing and increasing stigmas and stereotypes emerged throughout the process. In the end, the ID card has come to be seen as a social justice mechanism that allows for communication and awareness for those with mental health issues., (© 2019 National Association of Social Workers.)

Objective: To give a cross-sectional overview of ongoing management of behavioral disorders following traumatic brain injury (TBI) in a region of France, to compare this with recent recommendations from the French Society of Physical Medicine and Rehabilitation (SOFMER), and to evaluate associations between treatments and participant characteristics., Setting: Outpatients referred to medical or community-based facilities in a region of France., Participants: One hundred twenty-nine adults with moderate to severe TBI, in the postacute period (over 3 months postinjury)., Design: Cross-sectional cohort study., Main Measures: Sociodemographic data, ongoing interventions including psychotherapy and medication, behavioral disorders assessed by the Behavioral Dysexecutive Syndrome Inventory (BDSI)., Results: Thirty-three percent of participants received ongoing psychotherapy and 43% were on medication. The most prescribed medications were antidepressants (21%), neuroleptics (18%), anxiolytics (16%), and mood stabilizers (14%). Eighty-five participants (71%) presented a current Behavioral Dysexecutive Syndrome (BDS) according to the BDSI. These participants more frequently received treatment (P = .004), psychotherapy (P = .048), medications (often 2 or more) (P = .007), and particularly antiepileptic mood stabilizers (P = .037) compared with those without BDS., Conclusion: Although recommended as first-line treatment, few participants with BDS received psychotherapy. Medications were overused, especially neuroleptics in view of their potential adverse effects. In contrast, recommended medications, such as mood stabilizers and β-blockers, did not appear to be highly prescribed whatever the evolution. Compliance with recommendations seemed insufficient.

Background: Low- and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice guidelines based on research findings from high-income countries. While the context of health organizations is increasingly recognized as an important consideration when such guidelines are implemented, there is a paucity of studies that have considered local contexts of resource-scarcity against recommended clinical guidelines., Methods: This paper sets out to explore the implementation of the NICE Guideline 11 on family interventions when working with persons with intellectual disability and challenging behavior by a group of psychologists employed in a government health facility in Cape Town, South Africa., Results: In the absence of evidence-based South African research, we argue that aspects of the guidelines, in particular those that informed our ethos and conceptual thinking, could be applied by clinical psychologists in a meaningful manner notwithstanding the relative scarcity of resources., Conclusion: We have argued that where guidelines such as the NICE Guidelines do not apply contextually throughout, it remains important to retain the principles behind these guidelines in local contexts. Limitations of this study exist in that the data were drawn only from the clinical experience of authors. Some of the implications for future research in resource-constrained contexts such as ours are discussed. Smaller descriptive, qualitative studies are necessary to explore the contextual limitations and resource strengths that exist in low- and middle-income settings, and these studies should be more systematic than drawing only on the clinical experience of authors, as has been done in this study.

Primary Objective: Patients with traumatic brain injury (TBI) have difficulty dealing with the social world and may display inappropriate social behavior that negatively affects their social and occupational rehabilitation. This difficulty may be explained by a social problem-solving (SPS) impairment, but little is yet known about the cognitive processes involved in the ability to solve social problems. Several publications have demonstrated that executive functions are related to social problem solving, but the role of social cognition needs to be confirmed. The present pilot study examined the expected relationships between SPS ability and both social cognition and social behavioral skills., Research Design: We compared the performances of 15 patients with TBI on SPS, theory-of-mind and social behavior tasks with those of 25 matched healthy controls., Main Outcomes and Results: Our results showed for the first time that impaired social problem solving is associated with a theory-of-mind deficit, but surprisingly not with executive impairment. There was no evidence that SPS deficits predict social behavioral disorders., Conclusions: Studying social problem solving in patients with TBI may inform the design of more appropriate methods of social rehabilitation.

Background: Children living in low-resource communities are at risk for poorer socio-emotional development and academic performance. Emerging evidence supports use of group music therapy experiences to support social development through community afterschool programming., Objective: To examine the potential benefit of a music therapy social skills development program to improve social skills and academic performance of school-aged children with limited resources in an afterschool program., Method: We used a single-group pre/post-test design, and recruited 20 students (11 females, 9 males), ages 5 to 11 years, from an afterschool program. The music therapy social skills program consisted of eight 50-minute sessions, and we measured social competence and antisocial behavior using the Home & Community Social Behavioral Scale (HCSBS; Merrell & Caldarella, 2008), and social skills, problem behaviors, and academic competence using the Social Skills Improvement System (SSIS; Gresham & Elliot, 2008a, 2008b)., Results: Only students who attended a minimum of six sessions (N = 14) were included in data analysis. Results showed no significant change in individual HBSC subscale scores; however, the total number of low-performance/high-risk skills significantly decreased. SSIS teacher results indicated significant improvement in communication, significant decrease of hyperactivity, autistic behavioral tendencies and overall problem behaviors, and marginal decreases in internalization. Parent ratings mirrored, in part, those of the teacher., Conclusions: Results indicated that music therapy has the potential of being an effective intervention for promoting social competence of school-aged children with limited resources, particularly in the areas of communication and low-performance/high-risk behaviors. Teaching skills through song lyrics and improvisation emerged as salient interventions.

Social behaviour disorders in traumatic brain injury are caused by the dysfunction of cognitive processes involved in social and interpersonal interaction. The concept of social cognition was introduced by authors studying schizophrenia, autism or mental retardation. The boundaries and the content of the concept have not yet been definitively defined, but theory of mind, empathy and emotional processing are included in all the models proposed. The strategies proposed to improve social behaviour focus on the restoration of cognitive processes such as working memory, emotional recognition and processing, and empathy, as well as social skills. To date, there is very little evidence on the efficacy of the aforementioned social cognition strategies., (Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Objective: This pilot study examined the effectiveness of a parent-delivered intervention for improving: the social play skills of children with attention deficit hyperactivity disorder (ADHD) and their typically developing playmates and the empathy of children with ADHD., Methods: Participants were children with ADHD and their typically developing playmates (n = 9/group). The intervention was primarily parent-implemented and involved: parent-training, weekly home-modules, three clinic play-sessions, therapist-parent phone consultations and a one-month follow-up. The Test of Playfulness (ToP) was the primary outcome measure. Cohen's-d and paired sample t-test calculations were used to measure effect., Results: Social play outcomes of children with ADHD improved significantly from: pre- to post-test (t = 3.2; p = 0.02; d = 1.0) and post-test to follow-up intervention (t = 2.7; p = 0.02; d = 1.1). Playmate's improved significantly from pre- to post-intervention (t = 3.9; p = 0.03; d = 1.2). Children with ADHD improved significantly on 4/7 ToP empathy items (t = 2.31-3.16; p = 0.02)., Conclusion: The intervention successfully improved the social play skills of children with ADHD and their playmates.

Individuals with autism spectrum disorder (ASD) have qualitative impairments in social interaction and often prefer food or tangible reinforcement to social reinforcement. Thus, therapists who work with children with ASD often use food or tangible items as reinforcers to increase appropriate behaviors or decrease problem behaviors. The goal of the present study was to shift children's preferences from a highly preferred tangible item to an initially nonpreferred social reinforcer using an observational conditioning procedure. Participants observed a known peer engage in a simple task and select the social reinforcer that was not preferred by the participant. This procedure resulted in a shift of preference toward the social reinforcer by all participants. Maintenance data showed that although the preference change did not maintain for 1 of the participants, it was quickly reestablished with additional observational trials. Results provide further support for the use of observational procedures to alter preferences., (© 2015 Society for the Experimental Analysis of Behavior.)

Purpose: To describe the experience of family caregivers providing care to veterans with traumatic brain injury (TBI)., Design/methods: Using a qualitative design, interviews were conducted with a purposeful sample of women caregivers. Data were analyzed using content analysis procedures., Findings: Findings resulted in the key concept phrased by participants as "He looks normal but." This phrase conceptualizes the participants' description of their experience caring for a brain injured veteran who could appear normal to others but the caregiver's description revealed substantial cognitive, social, and emotional deficits. Concepts include (a) Becoming aware of his disabilities, (b) Observing his troubling symptoms, (c) Dealing with his memory loss, (d) Being fearful of his anger, (e) Sensing his loneliness, (f) Acknowledging the effects on the children, and (g) Managing the best I can., Conclusions/clinical Relevance: A better understanding of the needs of caregivers of veterans with TBI may allow clinicians to better support caregivers., (© 2014 Association of Rehabilitation Nurses.)

The welcomed coeducation of children and adolescents with and without disabilities is going into dangerous territory since it has become burdened with a number of illusionary expectations. The constraints applied by real-life and meaningful circumstances should be taken into account, especially for children with emotional and social behavior disorders. Practicable prevention and intervention measurements cannot be generated without profound knowledge about disorders among this heterogeneous group of people. Abandoning all previously relevant terminology («noncategorization»), demanded by some radical inclusion advocates, leads to a situation that is helplessly confronted with its duties but lacks the basic skills and the necessary support stemming from an interdisciplinary dialogue. The contact with child and adolescent psychiatry is threatened to the disadvantage of the profession.

Parkinson syndromes (PS) represent frequent neurodegenerative disorders. The demographic change suggests an increasing prevalence of PS in the near future. Treatment expenses, early retirement and need of long-term care result in rising public health care expenditures. Standardised concepts of care do not only improve the quality of patient-centered care, but also help to minimize its consequential costs. Their implementation requires profound knowledge of therapeutic strategies and sociomedical regulations. Medical treatment and sociomedical care have to be regularly reevaluated and adapted to the patient's needs and disease severity. An optimal therapy concept guarantees the patient's long term social integration and improves the compliance., (© Georg Thieme Verlag KG Stuttgart · New York.)

The JobFit-Training for adolescents (Petermann u. Petermann, 2010) is a well documented behavioural psychological prevention program for students from the eighth grade and up. The present study examines the results of the evaluation of the practical implementation of the training over the course of two years. Data from 828 students could be collected in two measurements, before and after the intervention, out of which 323 were eighth-graders and 505 were ninth-graders. The analysis showed that eighth-graders profit more with regards to acquiring knowledge through the training than ninth-graders do. However, unlike male eighth-graders, female eighth-graders were unable to furthermore improve their social competences through the training. On the other hand the ninth-graders profit from the training in both groups with regards to their social competences.

The self-regulation model (SRM) is a nine-phase, four-pathway offense process model designed specifically for sexual offenders that is now being applied to the treatment of this group in many settings and jurisdictions. In the present prospective study, we evaluated the validity and utility of the SRM in a sample of 275 adult male sexual offenders treated within the Correctional Service of Canada. Results indicated that participation in treatment resulted in moderate to large sized improvements from pretreatment to posttreatment on a dynamic risk assessment measure and several self-reported treatment targets. These changes were, in some cases, differentially associated with self-regulation pathways, suggesting that offense pathway is a clinically relevant variable when evaluating treatment change and in conceptualizing sexual offender treatment. In terms of outcome, individuals following the approach pathways, particularly the approach-automatic pathway, demonstrated higher failure rates than individuals following avoidant pathways. However, many of these differences were less pronounced when taking risk for recidivism into account. Implications of these findings for the effective assessment and rehabilitation of sexual offenders are discussed., (© The Author(s) 2013.)

We examined the use of risk-change information in sexual offender risk assessments featuring the Violence Risk Scale-Sexual Offender version (VRS-SO), a sex offender risk assessment and treatment planning tool. The study featured a combined international sample of 539 sex offenders followed up an average of 15.5 years post-release. Pre- and posttreatment VRS-SO ratings were amalgamated from two treated samples of sex offenders from Canada and New Zealand. Analyses focused on examinations and applications of change data and its relationship to sexual and violent recidivism. VRS-SO change scores were significantly associated with decreases in these outcome criteria with, and without, controlling for indicators of pretreatment risk (e.g., Static-99R score) and individual differences in follow-up time. Applications of logistic regression using fixed 5-year follow-ups generated estimated rates of sexual and violent recidivism at different VRS-SO score thresholds. The use of logistic regression demonstrated a clinically useful and systematic means of combining risk and change information into posttreatment risk appraisals. Implications for the use of change information in the assessment and management of sexual offender risk are discussed., (© The Author(s) 2013.)

This opinion piece considers my personal experiences of poverty, homelessness, loss, and physical disability in relation to recent discussions of social defeat and resistance among permanent supported housing tenants with physical and mental illnesses. By drawing attention to the onslaught of deprivation and humiliation that generally comes with the territory of poverty and homelessness in the United States, I hope to influence the ways in which clinicians, social service providers, and scholars think about specific instances of social defeat and resistance. My basic point is that any specific experience of resistance or defeat cannot be adequately understood in isolation. Rather, such experiences must be understood in relation to individual life histories of defeat and resistance, and to the symbolic and material sources of success and failure available to citizens who occupy a particular section of social space in a given society.

Objective: Exposure to antisocial others within treatment group sessions may have negative impact. We extend prior research with adolescents by examining rehabilitation group composition among adult male incarcerated offenders., Method: Data were gathered from institution files of rehabilitation completers (N = 1,832; M age = 33.5; 19% Aboriginal, 68% Caucasian), including general, substance, violent, and sex offenders. Capacities for treatment (including motivation, learning ability, and inhibitory control) were gathered from intake assessments. At the beginning and end of rehabilitation, providers rated program performance. Risk for recidivism and postrelease recidivism were gathered from official files, up to 3 years following release., Results: Group effects accounted for up to 40% of variance in program outcomes. Group features (average group participant risk to reoffend and risk score diversity) significantly interacted with treatment capacities to explain program outcomes. Most models revealed a dampening effect whereby the positive association between capacities and outcome was reduced in groups of higher risk and more risk diverse coparticipants. Group composition typically accounted for 30-38% of variance between groups, but total variance in outcome explained was generally small. Higher average group risk predicted postrelease recidivism among family violence offenders., Conclusions: Coparticipants should be considered when researching and providing group programs to adult offenders, with specific attention toward how positive outcomes may be attenuated in the presence of criminogenic coparticipants.

Background and Objectives: Social skills training (SST) intervention has shown its efficacy to improve social dysfunction in patients with psychosis; however the implementation of new skills into patients' everyday functioning is difficult to achieve. In this study, we report results from the application of a virtual reality (VR) integrated program as an adjunct technique to a brief social skills intervention for patients with schizophrenia. It was predicted that the intervention would improve social cognition and performance of patients as well as generalisation of the learned responses into patient's daily life., Methods: Twelve patients with schizophrenia or schizoaffective disorder completed the study. They attended sixteen individual one-hour sessions, and outcome assessments were conducted at pre-treatment, post-treatment and four-month follow-up., Results: The results of a series of repeated measures ANOVA revealed significant improvement in negative symptoms, psychopathology, social anxiety and discomfort, avoidance and social functioning. Objective scores obtained through the use of the VR program showed a pattern of learning in emotion perception, assertive behaviours and time spent in a conversation. Most of these gains were maintained at four-month follow-up., Limitations: The reported results are based on a small, uncontrolled pilot study. Although there was an independent rater for the self-reported and informant questionnaires, assessments were not blinded., Conclusions: The results showed that the intervention may be effective for improving social dysfunction. The use of the VR program contributed to the generalisation of new skills into the patient's everyday functioning., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: A significant number of individuals with brain injury demonstrate behavioral challenges that negatively affect their ability to live successfully in community settings. While there are a number of treatment approaches that have demonstrable effects in well controlled clinical settings, it is very difficult to implement these approaches in natural settings., Objectives: The goal of this study was to report the results of an investigation of the effects of a multicomponent behavioral intervention on the challenging behavior of an adolescent and young adult with growing behavioral concerns after acquired brain injury (TBI)., Methods: The participants were an 16 year old adolescent male and a 24 year old female, with escalating behavior problems after severe TBI. Multiple baseline designs were used to document the effects of an intervention package that integrated cognitive and executive function intervention to address severe challenging behaviors in natural settings. The following dependent variables were used to establish the effectiveness of the interventions: frequency and intensity of aggressive behaviors and participation in scheduled activities. The intervention included integrated components of positive behavior supports, cognitive supports and specific executive function scripts., Results: These single subject experiments demonstrated the effectiveness of a multicomponent intervention on the reduction of the frequency of problem behaviors and the increase of pro-social behaviors., Conclusion: These two successful interventions extended the findings of previously published data for the successful treatment of behavioral challenges using a flexible support-oriented intervention that combines behavioral, cognitive, and executive function components.

Objective: Social cognition is profoundly impaired in patients with schizophrenia. This study describes 'Mental-State Reasoning Training for Social Cognitive Impairment' (SoCog-MSRT), a 5-week program developed to improve social cognition in patients with schizophrenia. We aimed to investigate the feasibility of implementing SoCog-MSRT in a rehabilitation setting and to evaluate whether our training methods produced improvements. METHOD The feasibility and benefits of SoCog-MSRT were evaluated in an open clinical trial with 14 participants with schizophrenia or schizoaffective disorder. Training comprised 10 twice-weekly sessions, for 5 weeks, with a pre- and post-training assessment., Results: There were significant improvements on: (a) a classic false-belief test of Theory of Mind (ToM); (b) inferring complex mental states from the eyes; and (c) a self-reported measure of social understanding. Some of these improvements were associated with baseline levels of working memory and premorbid Intelligence Quotient (IQ). CONCLUSIONS SoCog-MSRT can improve ToM abilities and social understanding, but individuals with poorer working memory and lower premorbid IQ may be less able to benefit from this type of training.

To investigate cerebral reactions to cognitive rehabilitation tasks, oxyhemoglobin changes were compared in 9 patients with cognitive impairments after traumatic brain injury (TBI) and 47 healthy controls using functional near infrared spectroscopy (fNIRS) during nine cognitive rehabilitation tasks employed at Nagoya City Rehabilitation Center. Forty-seven measurement channels were placed on the frontal to temporal cortices, and organized into seven channel regions. Oxyhemoglobin changes were normalized based on the mean oxyhemoglobin value at the resting state, and integrated throughout a task. Statistical analyses of the differences between the TBI patients and controls were performed with the two-sided Mann-Whitney U test. Oxyhemoglobin changes were high for both controls and TBI patients in the lateral frontal regions. Oxyhemoglobin changes in TBI patients tended to be higher than controls in the medial frontal regions for most training tasks, and significant differences (p < 0.05) were seen for two tasks in the medial frontal regions. Different regions were activated during the tasks in TBI patients compared to controls. fNIRS measurement is useful in the evaluation of changes of neuronal activities during rehabilitation tasks in TBI patients.

Objective: To report about existing evidence of effectiveness of social skills training for severely mentally ill adults., Methods: Systematic electronic and manual literature search for systematic reviews and randomized clinical trials (RCTs)., Results: Social skills training is a widely used intervention for people with severe mental illness. We identified four reviews and seven RCTs demonstrating the efficacy and effectiveness of social skills training. Results suggest that patients would benefit from trainings by improving social skills and social functioning. There are ambiguous results regarding other outcomes., Conclusions: People with severe mental illness should be provided with social skills training, if necessary, combined with cognitive remediation. Those techniques are required which actively support the generalization of positive achievements into patients' natural environments., (© Georg Thieme Verlag KG Stuttgart · New York.)

In some neuro-developmental disorders, the combined effect of intellectual disability and atypicalities of social cognition may put individuals at increased vulnerability in their social environment. The neuro-developmental disorders Williams syndrome, characterised by 'hypersociability', and autism spectrum disorders, characterised by 'social withdrawal', are at two extremes of atypical social functioning in humans. In this article, we use Williams syndrome and autism spectrum disorders as exemplars to demonstrate how atypicalities of social cognition may contribute to social vulnerability in these populations. The lives of individuals with both these disorders are marred by an increased risk of social isolation, bullying, unsteady relationships, employment difficulties and abuse. While different behavioural interventions have been tried to improve social functioning in these populations, there has been great variability in their success. Finally, we discuss different issues regarding social independence of these individuals; including employment, safety and decision making., (© 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.)

Objective: Research to establish an evidence-base for the treatment of conduct problems and delinquency in adolescence is well established; however, an evidence-base for interventions with offenders who are diverted from the juvenile justice system has yet to be synthesized. The purpose of this study was to conduct a meta-analysis of experimental studies testing juvenile diversion programs and to examine the moderating effect of program type and implementation quality., Method: A literature search using PsycINFO, Web of Science, and the National Criminal Justice Reference Service data-bases and research institute websites yielded 28 eligible studies involving 57 experimental comparisons and 19,301 youths., Results: Recidivism was the most common outcome reported across all studies. Overall, the effect of diversion programs on recidivism was non-significant (k=45, OR=0.83, 95%CI=0.43-1.58). Of the five program types identified, including case management (k=18, OR=0.78), individual treatment (k=11, OR=0.83), family treatment (k=4, OR=0.57), youth court (k=6, OR=0.93), and restorative justice (k=6, OR=0.87), only family treatment led to a statistically significant reduction in recidivism. Restorative justice studies that were implemented with active involvement of researchers led to statistically significant reductions in recidivism (k=3, OR=0.69). Other outcomes, including frequency of offending, truancy, and psycho-social problems were reported infrequently and were not subjected to meta-analysis., Conclusions: High levels of heterogeneity characterize diversion research. Results of this study recommend against implementation of programs limited to case management and highlight the promise of family interventions and restorative justice., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Therapeutic strategies for improving social cognition in patients with schizophrenia have shown much promise in improving social functioning, as well as remediating core psychotic symptoms. However, the efficacy of previous interventions has often been limited by the ambiguity and inconsistency of the categorized subdomains of social cognition, including theory of mind, emotion processing, social perception and attributional bias. Recent research in social and cognitive neuroscience has revealed many new issues that could contribute to the development of more integrated approaches for improving social functioning. The application of such neuroscientific work to a therapeutic and diagnostic context is likely to encourage more effective transference of learned skills to real-world social functioning. This article seeks to provide a comprehensive review of previous social cognitive interventions for schizophrenia, highlight some crucial limitations of these and present the relevance of recent advances in neuroscientific research in possible future treatment strategies. It is emphasized that a more integrated and naturalistic approach for improving social functioning with greater sensitivity for neuroscientific findings related to the psychopathology of schizophrenia is warranted.

Background: There is not one case report of successful trauma treatment with the use of an evidence-based treatment method in people with substantially limited verbal capacities. This paper assessed the applicability of eye movement desensitisation and reprocessing (EMDR) in two clients with moderate ID, serious behavioural problems, and histories of negative life events., Method: The 8-phase protocol of EMDR, a first-line treatment for psychological trauma, was applied., Results: In both cases, posttraumatic stress disorder (PTSD)-like symptoms decreased in a total of only 6 and 5 sessions, respectively. Gains were maintained at 32 and 10 months' follow-up., Conclusions: EMDR seems to be an applicable psychological trauma treatment for persons with limited verbal capacities. Considering the importance of these findings, further and more rigorous research is required.

Three separate studies were conducted in school, residential and after-school care settings to test the effectiveness of a music therapy-based social skills intervention program on improving social competence in children and adolescents. A total of 45 children (n = 12; n = 13; n = 20) aged 6-17 years with social skills deficits participated in a group-based five session intervention program. The same curriculum, adapted to be age appropriate, was used at all 3 sites. Specific deficits within the social skills areas of peer relations and self-management skills were targeted. Active interventions like music performance, movement to music and improvisation were used. Cognitive-behavioral techniques like modeling, feedback, transfer training and problem solving were also incorporated. Data on social functioning were collected before, during, and after the music therapy intervention from participants, appropriate adult personnel and via behavioral observations. Results indicated that significant improvements in social functioning were found in (a) school participant pre and post self-ratings, (b) researcher pre and post ratings of school participants, (c) case manager's pre and post treatment ratings for the residential participants, (d) after-school care participants' pre and post self-ratings, and (e) behavioral observations at all three settings. Additional changes, although not significant, were noted in teacher ratings, residential participant self- and peer ratings, and after-school case manager ratings. Results from these studies suggest that the music therapy intervention was effective in improving social competence in children and adolescents with social deficits. More research is warranted to provide additional guidance about the use of music therapy interventions to improve social functioning.

Background: The quality of behaviour support plans (BSPs) can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II (BSP-QE II) is one tool that may be useful in assessing the quality of behaviour support plans. It has previously been used to assess BSPs to support children in schools in the USA. In this preliminary study, we examined the utility of the BSP-QE II for assessing behaviour support plans designed for adults with an intellectual disability in community support services in Australia., Method: Experienced practitioners were surveyed concerning the relevance of BSP-QE II components to the evaluation of BSPs in Australia, and an audit was conducted of randomly selected BSPs submitted as a statutory requirement to the Office of the Senior Practitioner., Results: The BSP-QE II showed evidence of acceptable construct validity and interrater reliability. There was evidence of a need for substantial improvement in the quality of BSPs, consistent with previous findings conducted using other audit tools., Conclusions: The findings support the utility of the BSP-QE II, to inform and evaluate service planning in supporting adults with intellectual disability who show challenging behaviour.

Objective: Social psychological theories such as attribution theory have been applied to conditions such as depression and physical disability, but not to traumatic brain injury (TBI). The goal of this paper is to show that that attribution theory and related concepts help to explain the public's misconceptions about TBI and other challenges faced by clinicians and families of persons with TBI., Results: Research shows that misconceptions about brain injury occur because people misattribute the actions of persons with brain injury. These misattributions reflect two features: (a) the absence of visible markers of the injury, and (b) the tendency to compare persons with TBI with their peers rather than their own preinjury performance. These two processes lead to the opposite pattern to the stigma that occurs with visible disabilities: specifically, a failure among members of the public to recognize that problematic behaviors may result from the injury. This analysis suggests several therapeutic strategies for managing public misconceptions in ways that enhance coping and recovery., Conclusion: Clarifying the attribution processes that underpin misconceptions about brain injury provides a framework for enhancing rehabilitation and addressing these misconceptions effectively.

With the rapidly aging population, it is expected that increases in cases of dementia will double over the next 20 years. Currently, there is no cure for diseases such as Alzheimer's disease or frontotemporal dementia (FTD) that cause progressive dementia, and only a few pharmacological interventions that slow the progression of the decline exist. Given that there is no cure available, a rehabilitation approach that emphasizes maintaining existing abilities and removing excess disability (as opposed to emphasizing cure or recovery) for as long as possible is warranted. The current paper proposes that nonpharmacological rehabilitation efforts need to target 5 broad areas/targets: memory enhancement, altering social contingencies and communication styles, improving self-care skills, the arrangement of physical environments to maintain and improve functioning, and increasing physical fitness/physical activity. The purpose of this paper is to review specific behaviorally oriented interventions that target these 5 areas and show promise for inclusion in comprehensive rehabilitation efforts for individuals with dementia., (Copyright © 2010. Published by Elsevier Ltd.)

Social functioning deficits are a prominent feature of many neurological and psychiatric conditions, and may include disruption in the acquisition or application of basic or complex social skills. Such disturbances are often resistant to treatment, and individuals with such conditions are often faced with lifelong difficulties in maintaining personal relationships, employment, and independent living. In recent years, a number of psychosocial treatments have been developed to address this growing problem. In this article, we review studies investigating the use of psychosocial training interventions in individuals with acquired brain injuries, which frequently require intervention for impairments in cognitive and social functioning. We then discuss limitations of these studies and highlight specific areas in which such treatments might be improved in the future.

We compared the efficacy of, and adolescents' preferences for, a Cognitive Behavioural (CBT) and Personal Development (PD) Anger Management (AM) group. The CBT group aimed to help adolescents develop skills to manage predominantly reactive aggression. The PD group aimed to enhance motivation to develop less aggressive identities with less use of proactive aggression. Eighteen adolescents were randomly allocated to a 10-session CBT or PD AM Group; seven additional adolescents formed a control group. They completed pre- and post-intervention questionnaires to assess anger expression and control, use of AM coping skills (also completed by carers) and self-image. Participants were also interviewed pre- and post-intervention; transcripts were subjected to Interpretive Phenomenological Analysis. Both treatment groups demonstrated significant improvements in anger coping and self-esteem, relative to the control group. Participants' age was significantly correlated with self-image and anger control outcomes in the CBT group. Qualitative analysis identified factors associated with improved outcomes, particularly regarding participants' age, motivation and readiness to change, engagement in the therapeutic process, group dynamics and emotional expressiveness. Our ability to interpret data clinically was enhanced by the use of a mixed quantitative-qualitative methodology. The results help us to better match interventions to clients.

Introduction: The psychosocial consequences of psychosis in the youth are educational negligence's, poor peer relations and difficulties in achieving life independency. MORS--the Stationary Model Centre of Sociopsychiatric Rehabilitation was created for overcoming these problems., Aim: To present the programme of rehabilitation and its effects in MORS., Method: The evaluation was performed in 18 of the 26 young persons being admitted to MORS in the years 2006-2008. Structured Questionnaires of past history for the staff and clients, the SOC-29 and KIDscreen -52 scales were used., Results: A significant number of young people from incomplete families, and/or families burdened with parental mental health problems was noticeable. The best effects were achieved in compensating for educational negligence's, and improving the social and life skills. The self estimation of health and life satisfaction was lower in the youth clients on discharge from MORS than in the general population., Conclusions: According to retrospective evaluation, the stationary programme of psychosocial rehabilitation in MORS seems to be effective in youths with psychotic disorders and difficulties in social functioning. Further development, and prospective evaluation of that programme would be valuable. Social support in local communities for the youth being discharged from MORS is needed.

Objective: Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice., Method: The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma., Results: In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection., Conclusions: More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.

Errorless learning (EL) procedures have been shown to be effective in teaching new information and new procedures to individuals with severe memory impairment. The published studies have been based on comparatively short-term interventions delivered to individuals with relatively circumscribed impairments. In this single case study, we explore the usefulness of errorless learning procedures used for seven years with an adult with profound and complicated memory and executive function impairments associated with three distinct aetiologies. In primary functional areas targeted by the intervention, outcome was documented by behavioural descriptions and a frequency rating scale. Caregiver burden was documented with qualitative descriptors. A financial cost-benefit analysis is also provided. In the absence of change in underlying neuropsychological impairments, DI's everyday functioning in critical areas improved substantially, with corresponding reduction in supports and improved quality of life. Caregiver burden was reduced to acceptable levels and cost-benefit analysis demonstrates substantial ongoing cost savings.

Characterising how socio-cognitive abilities develop has been crucial to understanding the wider development of typically developing children. It is equally central to understanding developmental pathways in children with intellectual disabilities such as Down's syndrome. While the process of acquisition of socio-cognitive abilities in typical development and in autism has received considerable attention, socio-cognitive development in Down's syndrome has received far less scrutiny. Initial work in the 1970s and 1980s provided important insights into the emergence of socio-cognitive abilities in the children's early years, and recently there has been a marked revival of interest in this area, with research focusing both on a broader range of abilities and on a wider age range. This annotation reviews some of these more recent findings, identifies outstanding gaps in current understanding, and stresses the importance of the development of theory in advancing research and knowledge in this field. Barriers to theory building are discussed and the potential utility of adopting a transactional approach to theory building illustrated with reference to a model of early socio-cognitive development in Down's syndrome. The need for a more extensive model of social cognition is emphasised, as is the need for larger-scale, finer-grained, longitudinal work which recognises the within-individual and within-group variability which characterises this population. The value of drawing on new technologies and of adapting innovative research paradigms from other areas of typical and atypical child psychology is also highlighted.

Among young people with emotional and behavioral problems (EBP), mutual aid is likely to be valuable in their rehabilitation and deserving of social work support. The benefits of mutual aid stem from the possibility that it prolongs the effective contribution of social work service. Given its potential benefits, it is imperative to clarify the ways in which social work service maximizes these benefits. Such clarification is necessary both to verify untested theories about social work inputs to mutual aid and because the research literature on mutual aid among young people is particularly lacking. Based on data from three focus groups involving social workers in Hong Kong, this study seeks to demonstrate the relevance of theoretically based group work strategies in the mutual aid and rehabilitation of EBP youth. These strategies include identifying commonalities and setting prioritiese, balancing support with demand, optimizing input between social workers and members, and connecting members with relevant others in the community. The research and service implications of the findings of this study for promoting efficient social work input that contributes to the long-term development of young people are discussed.

This study consists of a comparative analysis of patterns of de-escalation between ages 17-18 and 32, based on data from two well-known prospective longitudinal studies, the Cambridge Study in Delinquent Development (a study of 411 working-class males in London) and the Montreal Two Samples Longitudinal Study (a sample of 470 adjudicated French-Canadian males). Analyses focus on within-individual change, with individuals serving as their own controls. In this regard, the magnitude of measured change is relative to the past degree of involvement in offending. These results are contrasted with predictors of between-individual differences in offending behavior at age 32. We investigate the respective roles of cognitive predispositions and social bonds in the prediction of patterns of de-escalation, and assess whether it is possible to make relatively long-term predictions (over a 15-year period) about offending in adulthood. Findings suggest that traditional measures of social bonds and cognitive predispositions measured at age 17-18 are generally weak predictors of de-escalation up to age 32. However, these measures are stronger predictors of between-individual differences in offending gravity. These findings highlight the difficulties in making accurate long-term predictions about changes in individual offending patterns early in the criminal career.

Background: Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long-term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging behaviour and psychotropic drug use in adults with ID following resettlement using a person-centred approach., Method: The Modified Overt Aggression Scale was administered to carers of 49 adults with ID prior to discharge from a long-stay hospital and 6 months and 1 year after community resettlement., Results: All areas of aggressive challenging behaviour reduced significantly between baseline and 6 months following resettlement (P < 0.001). This reduction remained (but did not decrease further) at 1-year follow-up., Conclusions: Further work is needed to evaluate the role of environmental setting on aggressive challenging behaviour in adults with ID.

Lasting socio-emotional behaviour difficulties are common among children who have suffered brain injuries. A proportion of difficulties may be attributed to impaired cognitive and/or executive skills after injury. A recent and rapidly accruing body of literature indicates that deficits in recognizing and responding to the emotions of others are also common. Little is known about the development of these skills after brain injury. In this paper we summarize emotion-processing systems, and review the development of these systems across the span of childhood and adolescence. We describe critical phases in the development of emotion recognition skills and the potential for delayed effects after brain injury in earlier childhood. We argue that it is important to identify the specific nature of deficits in reading and responding to emotions after brain injury, so that assessments and early intervention strategies can be devised.

Background: People with profound and multiple disabilities often display aberrant behaviours (such as stereotypical movements) which can inhibit learning and lead to social stigmatisation. This study was designed to help a man with multiple disabilities increase his object-contact responses and reduce hand stereotypy (in this case, hand/wrist rotation)., Method: An A-B-A-B design with a 3-month post-intervention check was employed. At baseline, a combination of microswitches (or microswitch cluster) was used to monitor the man's object-contact responses and hand stereotypy. During the intervention phases and post-intervention check, the microswitch cluster was combined with preferred stimuli for object-contact responses occurring without hand stereotypy. The stimulation lasted for 8 seconds if the man remained free from hand stereotypy for that time, but was interrupted if the stereotypy appeared., Results: The intervention showed an increase in object-contact responses occurring without hand stereotypy and a reduction in session time with hand stereotypy. These data were maintained at the 3-month post-intervention check., Conclusion: Replication of these findings with other individuals would confirm the utility of this type of intervention for increasing constructive responding and reducing stereotyped behaviours.

Aim: The aim of this study was to provide insight into the adverse effects of neurobehavioral features on the community integration of young adults who have had prior severe traumatic brain injury (TBI) with a positive long-term outcome in either functional or intellectual abilities. TBI subjects were compared with patients suffering from a health condition classified as mild intellectual disability (MID)., Methods: Twenty-five subjects with prior severe TBI, but with substantially normalized perceptual-motor and intellectual functioning, were retrospectively selected according to demographic and clinical admission criteria. The TBI subject group was compared with a selected group of 34 MID subjects. The measures used were: the Wechsler Adult Intelligence Scale-Revised (WAIS-R), Instrumental Activity of Daily Living Scale (IADLS), Community Integration Questionnaire (CIQ), and Social Behaviour Check-list (SBC). The presence/absence of dysfunctional family environment and affective close relationships were also reported., Results: Significant differences between TBI and MID subjects (with greatest scores in TBI group) refer to: WAIS-R Full Scale IQ (FSIQ, indicating an average intellectual level), CIQ-Social integration (indicating a greater level than MID group), and SBC-Defective-type behaviour (indicating a greater level of apathy than MID group)., Conclusion: Defective-type behaviour--synthesized into the term apathy' has the following features: 1) can explain the unsatisfying community integration of TBI subjects with respect to the general population; and 2) best explains the similar CIQ-home integration and CIQ-productive activities compared to subjects presenting a higher intellectual disadvantage (MID patients). The multidisciplinary approach to the complex community integration process of TBI subjects might consider the high frequency of apathy as a primarily target of the community integration management.