American Psychologist

The dissemination and implementation of evidence-based psychological treatments: A review of current efforts.
Recognizing an urgent need for increased access to evidenced-based psychological treatments, public health authorities have recently allocated over $2 billion to better disseminate these interventions. In response, implementation of these programs has begun, some of it on a very large scale, with substantial implications for the science and profession of psychology. But methods to transport treatments to service delivery settings have developed independently without strong evidence for, or even a consensus on, best practices for accomplishing this task or for measuring successful outcomes of training. This article reviews current leading efforts at the national, state, and individual treatment developer levels to integrate evidence-based interventions into service delivery settings. Programs are reviewed in the context of the accumulated wisdom of dissemination and implementation science and of methods for assessment of outcomes for training efforts. Recommendations for future implementation strategies will derive from evaluating outcomes of training procedures and developing a consensus on necessary training elements to be used in these efforts. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
A meta-systems approach to evidence-based practice for children and adolescents.
Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sectors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection services, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the provision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including prevention, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
The efficacy of psychodynamic psychotherapy.
Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Evolutionary psychology: Controversies, questions, prospects, and limitations.
Evolutionary psychology has emerged over the past 15 years as a major theoretical perspective, generating an increasing volume of empirical studies and assuming a larger presence within psychological science. At the same time, it has generated critiques and remains controversial among some psychologists. Some of the controversy stems from hypotheses that go against traditional psychological theories; some from empirical findings that may have disturbing implications; some from misunderstandings about the logic of evolutionary psychology; and some from reasonable scientific concerns about its underlying framework. This article identifies some of the most common concerns and attempts to elucidate evolutionary psychology’s stance pertaining to them. These include issues of testability and falsifiability; the domain specificity versus domain generality of psychological mechanisms; the role of novel environments as they interact with evolved psychological circuits; the role of genes in the conceptual structure of evolutionary psychology; the roles of learning, socialization, and culture in evolutionary psychology; and the practical value of applied evolutionary psychology. The article concludes with a discussion of the limitations of current evolutionary psychology. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Edith Kaplan (1924–2009).
This article honors the life accomplishments of Edith Kaplan. She is widely regarded as the mother of clinical neuropsychology; she passed away on September 3, 2009, at the age of 85. Her modifications to the original Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale led to the development of a new school of clinical neuropsychology known as “the process approach,” of which Kaplan is unequivocally regarded as the pioneer and chief architect. She is best known for her work in test development, and she is the lead or senior author on numerous assessment instruments designed for both children and adults that are used nationally and internationally. At the time of her death, Kaplan was working as a professor of psychology at Suffolk University, an adjunct professor of neurology and psychiatry at Boston University School of Medicine, and an affiliate professor of psychology at Clark University. And, of great importance to the field, she continued to be vigorously involved in her most beloved activity of all, teaching students about neuropsychology. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Imagined interactions.
Social scientists have been studying imagined interactions since the mid-1980s and have measured numerous physiological correlates (Honeycutt, 2010). In this commentary I assess the research reported in Crisp and Turner (May–June 2009) and highlight the underlying mechanisms of imagined interactions that have empirically been laid out across Thailand, Japan, and the United States through confirmatory factor analyses (e.g., McCann & Honeycutt, 2006). The research in imagined interactions has been so extensive that “II” is a common acronym for the construct. Crisp and Turner’s (2009) article is excellent in its premise that prejudice may be ameliorated through IIs. I agree with their contention that “imagined contact is . . . an exciting prospect because it provides a simple, flexible, and effective means of promoting more positive perceptions”. Continued research on IIs is needed to further our understanding of conflict persistence, whether individuals can be taught to utilize IIs in a constructive manner for the purpose of creating quality relationships, and how IIs are used to adjust to life events. Interpersonal communication is informed by a better understanding of intrapersonal processes affecting daily experiences (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Back in the real world.
Comments on Crisp and Turner’s (May–June 2009) research on “imagined intergroup contact” (p. 231). Its goals of reducing prejudice are laudable, especially with a motivation to “prepare people to engage outgroups with an open mind” (p. 231). The method is relatively simple, easy, and inexpensive to use. Consequently, it has a great deal of flexibility and can be fairly easily implemented almost anywhere. It also reflects the widespread tendency of mainstream social psychology to focus almost entirely on individualistic intrapsychic phenomena. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Reasons for skepticism about the efficacy of simulated social contact interventions.
Comments on Crisp and Turner (May–June 2009), who argued that imagining intergroup interactions reduces intergroup prejudice. They argued that the procedure is remarkably effective, with “significant potential application for policymakers and educators seeking to promote tolerance for social diversity” (p. 238). We believe that such interventions, although appealing to many individuals, are problematic and that the authors’ conclusions are overly optimistic. We believe that simulated contact interventions are highly unlikely to produce meaningful attitude change. In sum, we are deeply skeptical about the ability of imagined contact interventions to reduce prejudice. A single, brief, imaginary encounter with an outgroup member is unlikely to reverse or erase the psychological mechanisms that create prejudice. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Have confidence in contact.
In an article in the May–June 2009 American Psychologist, we discussed a new approach to reducing prejudice and encouraging more positive intergroup relations (Crisp & Turner, 2009). We named the approach imagined intergroup contact and defined it as “the mental simulation of a social interaction with a member or members of an outgroup category” (Crisp & Turner, 2009, p. 234). Our proposition is that simply imagining contact with outgroup members can produce more positive perceptions of outgroups. In his commentary, Honeycutt noted that our “article is excellent in its premise” (p. 129), but he was critical of our decision not to discuss his own work in imagined interactions (IIs). Imagined contact is not a magic cure, and it is not a one-shot solution to the problem of prejudice. But as a first step on the road to reduced prejudice and more positive intergroup relations, it may just turn out to be invaluable. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Intergenerational effects of high neuroticism in parents and their public health significance.
The article by Lahey (May–June 2009) provided a timely and important review of a growing body of evidence linking the personality trait of neuroticism to a host of health and psychosocial outcomes with public health significance. Lahey (2009) highlighted the links between high neuroticism and mental health, physical health, and quality of life and described the putative genetic and environmental causes of high neuroticism. He recommended screening for high neuroticism and interventions for those presenting this trait in order to reduce health care costs resulting from the associated conditions. We applaud his treatise but note that it failed to address the impact of high neuroticism among parents on their children’s long-term psychosocial functioning and mental health. In sum, Lahey (2009) provided a compelling argument for considering interventions for persons with high neuroticism as a public health initiative. We strongly support this call for action, as evidence does show that neuroticism adversely affects not only the individual and his or her social environment but the generations to follow. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Prescriptive authority in the face of research revelations.
Fox and his colleagues (May–June 2009) listed three occurrences beginning in the 1980s that have dampened psychologists’ desires to procure the right to prescribe psychotropic medications. That research review highlighted the fact that antidepressants produce a very modest effect at best when compared with placebos. I briefly summarize here some of the important findings that emerged from our original survey and two more recent reviews (Greenberg & Davis Goldman, 2009; Greenberg & Fisher, 1997). (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Effects of an uncertain literature on all facets of clinical decision making.
Greenberg (2010, this issue) is correct in his assertion that the investigational heuristic used to measure the efficacy of antidepressants is flawed. Robust placebo effects are endemic in the psychiatric literature, particularly in studies of antidepressants, and estimates of placebo responding have increased over time (Rief et al., 2009). In the case of established treatments such as antidepressants, the placebo- controlled RCT heuristic is often misapplied (treatments of proven efficacy, no matter how modest, are arguably best understood by comparing their effects with those of other efficacious interventions, not placebos, although we recognize there is not uniformity on this position; see, e.g., Fritze & Möller, 2001). We also agree with Greenberg’s (2010) observation that these points, however valid, do nothing to gainsay the argument that prescriptive authority is an appropriate goal for the profession of psychology. We believe that Greenberg (2010) would likely concur with our observation that the profession of psychology, relatively unburdened by questionable ties to pharmaceutical funding sources or biases toward biological interventions, is best positioned to both investigate and apply treatments for mental disorders that optimally combine both pharmacologic and psychotherapeutic approaches. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

American Psychologist - Vol 65, Iss 2