PsyResearch
ψ   Psychology Research on the Web   



Couples needed for online psychology research


Help us grow:




If you are in NYC and looking for a psychologist, consider NYC Psychological Services.

Journal of Consulting and Clinical Psychology - Vol 82, Iss 2

Random Abstract
Quick Journal Finder:
Journal of Consulting & Clinical Psychology The Journal of Consulting and Clinical Psychology publishes original contributions on the following topics: (a) the development, validity, and use of techniques of diagnosis, treatment, and prevention of disordered behavior; (b) studies of populations of clinical interest, such as hospital patients, individuals who have experienced physical or psychological stressors, adolescents, children, and similar samples; (c) cross-cultural and demographic studies of interest for behavior disorders; (d) studies of personality where these have a clear bearing on problems of clinical dysfunction; (e) studies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, treatment, and prevention.
Copyright 2014 American Psychological Association
  • Efficacy of alcohol interventions for first-year college students: A meta-analytic review of randomized controlled trials.
    Objective: Alcohol use established during the first-year of college can result in adverse consequences during the college years and beyond. In this meta-analysis, we evaluated the efficacy of interventions to prevent alcohol misuse by first-year college students. Method: Studies were included if the study reported an individual- or group-level intervention using a randomized controlled trial, targeted 1st-year college students, and assessed alcohol use. Forty-one studies with 62 separate interventions (N = 24,294; 57% women; 77% White) were included. Independent raters coded sample, design, methodological features, and intervention content. Weighted mean effect sizes, using fixed- and random-effects models, were calculated. Potential moderators, determined a priori, were examined to explain variability in effect sizes. Results: Relative to controls, students receiving an intervention reported lower quantity and frequency of drinking and fewer problems (d+s = 0.07–0.14). These results were more pronounced when the interventions were compared with an assessment-only control group (d+s = 0.11–0.19). Intervention content (e.g., personalized feedback) moderated the efficacy of the intervention. Conclusions: Behavioral interventions for 1st-year college students reduce alcohol consumption and alcohol-related problems. Interventions that include personalized feedback, moderation strategies, expectancy challenge, identification of risky situations, and goal-setting optimize efficacy. Strategies to prevent alcohol misuse among first-year students are recommended. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Randomized controlled trial of a Spring Break intervention to reduce high-risk drinking.
    Objective: Although recent studies have documented high-risk drinking occurring during Spring Break (SB), particularly on SB trips with friends, published intervention studies are few. In the present study, we evaluated the efficacy of event specific prevention strategies for reducing SB drinking among college students, compared to general prevention strategies and an assessment-only control group, as well as evaluated inclusion of peers in interventions and mode of intervention delivery (in-person vs. web). Method: Participants included 783 undergraduates (56.1% women; average age = 20.5 years) intending to go on a SB trip with friends as well as to drink heavily on at least 1 day of SB. Participants completed assessments prior to SB and were randomized to 1 of 5 intervention conditions: SB in-person Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff, Baer, Kivlahan, & Marlatt, 1999), SB web BASICS, SB in-person BASICS with friend, SB web BASICS with friend, general BASICS, or an attention control condition. Follow-up assessment was completed 1 week after SB. Results: Although the SB web BASICS (with and without friends) and general BASICS interventions were not effective at reducing SB drinking, results indicated significant intervention effects for SB in-person BASICS in reducing SB drinking, particularly on trip days. Follow-up analyses indicated that change in descriptive norms mediated treatment effect and reductions in drinking, whereas SB drinking intentions and positive expectancies did not. Conclusions: Overall, results suggest that an in-person SB-specific intervention is effective at reducing SB drinking, especially during trips. In contrast, interventions that contain non-SB-related content, are web-based, or seek to involve friends may be less effective at reducing SB drinking. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Social problem solving among depressed adolescents is enhanced by structured psychotherapies.
    Objective: Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents’ interpersonal behavior. Method: Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% White) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST) and after 12–16 weeks of treatment. Adolescent involvement, problem solving, and dyadic conflict were examined. Results: Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents’ problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents’ problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. Conclusions: Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Predictors and moderators of treatment response in childhood anxiety disorders: Results from the CAMS trial.
    Objective: We sought to examine predictors and moderators of treatment outcomes among 488 youths ages 7–17 years (50% female; 74% ≤ 12 years) meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) criteria for diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavioral therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). Method: Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale–Improvement; CGI–I) outcome measures. Results: Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict Week 12 responder status (CGI–I). Participants’ principal diagnosis moderated treatment outcomes but only on the PARS. No baseline variables were found to moderate treatment outcomes on Week 12 responder status (CGI–I). Discussion: Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Pathways from teacher depression and child-care quality to child behavioral problems.
    Objective: The purpose of this study was to examine the associations among teacher depression, global child-care quality, and child internalizing and externalizing behavioral problems in early child-care settings. Method: We analyzed data from 3-year-old children (N = 761) and their mothers, primarily of disadvantaged socioeconomic status in urban areas, in the late 1990s using the Fragile Families and Child Wellbeing Study. We also had data from the children’s teachers, who reported their own depressed moods. Child behavioral problems were reported by both teachers and parents, and global environmental quality of child care was observed. Path analysis tested direct and indirect effects of teacher depression on children’s behavioral problems via global child-care quality. Results: Teacher depression was directly and indirectly linked to teacher-reported externalizing and internalizing problems through observed global child-care quality, whereas for parent-reported outcomes, teacher depression was only directly related to children’s internalizing problems. Conclusions: Results of this study suggest that teachers’ depressive symptoms can be a contributor to global environmental child-care quality and to child externalizing and internalizing behavioral problems. Practical implications are that programs and policies must take into account effects of teacher depression on child-care quality and young children’s school readiness regarding behavioral problems. Future research should further explore these relationships. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Teacher, parent, and peer reports of early aggression as screening measures for long-term maladaptive outcomes: Who provides the most useful information?
    Objective: This study compared the ability of teacher, parent, and peer reports of aggressive behavior in early childhood to accurately classify cases of maladaptive outcomes in late adolescence and early adulthood. Method: Weighted kappa analyses determined optimal cut points and relative classification accuracy among teacher, parent, and peer reports of aggression assessed for 691 students (54% male; 84% African American and 13% White) in the fall of first grade. Outcomes included antisocial personality, substance use, incarceration history, risky sexual behavior, and failure to graduate from high school on time. Results: Peer reports were the most accurate classifier of all outcomes in the full sample. For most outcomes, the addition of teacher or parent reports did not improve overall classification accuracy once peer reports were accounted for. Additional gender-specific and adjusted kappa analyses supported the superior classification utility of the peer report measure. Conclusion: The results suggest that peer reports provided the most useful classification information of the 3 aggression measures. Implications for targeted intervention efforts in which screening measures are used to identify at-risk children are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Successful emotion regulation skills application predicts subsequent reduction of symptom severity during treatment of major depressive disorder.
    Objective: Deficits in emotion regulation (ER) skills are considered a putative maintaining factor for major depressive disorder (MDD) and hence a promising target in the treatment of MDD. However, to date, the association between the successful application of arguably adaptive ER skills and changes in depressive symptom severity (DSS) has yet to be investigated over the course of treatment. Thus, the primary aim of this study was to clarify reciprocal prospective associations between successful ER skills application and DSS over the course of inpatient cognitive behavioral therapy for MDD. Additionally, we explored whether such associations would differ across specific ER skills. Method: We assessed successful ER skills application and DSS 4 times during the first 3 weeks of treatment in 152 inpatients (62.5% women, average age 45.6 years) meeting criteria for MDD. We first tested whether successful skills application and depression were cross-sectionally associated by computing Pearson’s correlations. Then, we utilized latent curve modeling to test whether changes in successful skills application were negatively associated with changes in DSS during treatment. Finally, we used latent change score models to clarify whether successful skills application would predict subsequent reduction of DSS. Results: Cross-sectionally, successful ER skills application was associated with lower levels of DSS at all assessment times, and an increase of successful skills application during treatment was associated with a decrease of DSS. Moreover, successful overall ER skills application predicted subsequent changes in DSS (but not vice versa). Finally, strength of associations between successful application and DSS differed across specific ER skills. Among a broad range of potentially adaptive skills, only the abilities to tolerate negative emotions and to actively modify undesired emotions were significantly associated with subsequent improvement in DSS. Conclusions: Systematically enhancing health-relevant ER skills with specific interventions may help reduce DSS in patients suffering from MDD. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • An online optimism intervention reduces depression in pessimistic individuals.
    Objective: Interest in online positive psychology interventions (OPPIs) continues to grow. The empirical literature has identified design factors (e.g., variety and duration of activities) and moderators (e.g., personality traits) that can influence their effectiveness. A randomized controlled trial tested an empirically informed OPPI designed to promote self-efficacy and an optimistic outlook. Pessimism was included as a trait moderator. Method: Participants (N = 466) were English-speaking adults interested in becoming happier. They were randomly assigned to complete either an OPPI cultivating optimism or a control condition writing about daily activities for 3 weeks. Follow-up assessments occurred 1 and 2 months following the exercise period. Results: A hierarchical linear model analysis indicated that the optimism intervention increased the pursuit of engagement-related happiness in the short term and reduced dysfunctional attitudes across follow-ups. Pessimistic individuals had more to gain and reported fewer depressive symptoms at post-test. Conclusions: These findings support the conclusion that empirically informed online interventions can improve psychological well-being, at least in the short run, and may be particularly helpful when tailored to the needs of the individual. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Correction to Sibrava et al. (2013).
    Reports an error in "Two-year course of generalized anxiety disorder, social anxiety disorder, and panic disorder in a longitudinal sample of African American adults" by Nicholas J. Sibrava, Courtney Beard, Andri S. Bjornsson, Ethan Moitra, Risa B. Weisberg and Martin B. Keller (Journal of Consulting and Clinical Psychology, 2013[Dec], Vol 81[6], 1052-1062). M. B. Keller's grant information was inadvertently omitted from the author note. It should have been stated that Keller has received grant support from Pfizer, Inc. in the past year. (The following abstract of the original article appeared in record 2013-32698-001.) Objective: Anxiety disorders are the most common group of psychiatric disorders in adults. In addition to high prevalence, anxiety disorders are associated with significant functional impairment, and published research has consistently found them to have a chronic course. To date, very little research has explored the clinical characteristics and prospective course of anxiety disorders in racial and ethnic minority samples. The aims of this article are to present clinical and demographic characteristics at intake and prospective 2-year course findings in a sample of African American adults. Method: Data are presented from 152 African Americans diagnosed with generalized anxiety disorder (GAD, n = 94), social anxiety disorder (SAD, n = 85), and panic disorder with agoraphobia (PDA, n = 77) who are participating in the Harvard/Brown Anxiety Research Project–Phase II (HARP-II). HARP-II is an observational, prospective, longitudinal study of the course of anxiety disorders. Participants were interviewed at intake and annually for 2 years of follow-up. Probabilities of recovery over 2 years of follow-up were calculated using standard survival analysis methods. Results and Conclusions: Survival analyses revealed a chronic course for all anxiety disorders, with rates of recovery of 0.23, 0.07, and 0.00 over 2 years for GAD, SAD, and PDA, respectively. These rates of recovery were lower than those reported in predominantly non-Latino White longitudinal samples, especially for SAD and PDA, suggesting that anxiety disorders may have a more chronic course for African Americans, with increased psychosocial impairment and high rates of comorbid Axis-I disorders. Clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial.
    Objective: We compared mindfulness-based cognitive therapy (MBCT) with both cognitive psychological education (CPE) and treatment as usual (TAU) in preventing relapse to major depressive disorder (MDD) in people currently in remission following at least 3 previous episodes. Method: A randomized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU, CPE plus TAU, and TAU alone, and data were analyzed for the 255 (93%; MBCT = 99, CPE = 103, TAU = 53) retained to follow-up. MBCT was delivered in accordance with its published manual, modified to address suicidal cognitions; CPE was modeled on MBCT, but without training in meditation. Both treatments were delivered through 8 weekly classes. Results: Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up, hazard ratio for MBCT vs. CPE = 0.88, 95% CI [0.58, 1.35]; for MBCT vs. TAU = 0.69, 95% CI [0.42, 1.12]. However, severity of childhood trauma affected relapse, hazard ratio for increase of 1 standard deviation = 1.26 (95% CI [1.05, 1.50]), and significantly interacted with allocated treatment. Among participants above median severity, the hazard ratio was 0.61, 95% CI [0.34, 1.09], for MBCT vs. CPE, and 0.43, 95% CI [0.22, 0.87], for MBCT vs. TAU. For those below median severity, there were no such differences between treatment groups. Conclusion: MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma, but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.
    Objective: Recently, innovative statistical tools have been used to model patterns of change in psychological treatments. These tools can detect patterns of change in patient progress early in treatment and allow for the prediction of treatment outcomes and treatment length. Method: We used growth mixture modeling to identify different latent classes of early change in patients with panic disorder (N = 326) who underwent a manualized cognitive-behavioral treatment. Results: Four latent subgroups were identified, showing clusters of change trajectories over the first 5 sessions. One of the subgroups consisted of patients whose symptoms rapidly decreased and also showed the best outcomes. This information improved treatment prediction by 16.1% over patient intake characteristics. Early change patterns also significantly predicted patients’ early treatment termination. Patient intake characteristics that significantly predicted class membership included functional impairment and separation anxiety. Conclusions: These findings suggest that early treatment changes are uniquely predictive of treatment outcome. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Rehabilitation group coparticipants’ risk levels are associated with offenders’ treatment performance, treatment change, and recidivism.
    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. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • A multisite examination of sexual violence risk and therapeutic change.
    Objective: We conducted a prospective multisite examination of sexual offender risk and treatment change on a large federal Canadian sample of 676 treated sex offenders followed up for an average of 6.31 years post release. Method: The present study featured the clinical application of a risk assessment and treatment planning tool, the Violence Risk Scale–Sexual Offender version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon, 2003). The VRS-SO was rated pre- and posttreatment by sex offender treatment providers on the sample of men who were attending institutionally based sex offender programs across the 5 regions of the Correctional Service of Canada. The Static-99 (Hanson & Thornton, 1999) was also rated as part of routine services, and the Static-99R was used for substantive analyses. Results: The VRS-SO dynamic factors and the Static-99R demonstrated significant predictive accuracy for sexual, violent, and general recidivism (area under the curve = .65 to .78). Significant pre-post changes on the VRS-SO dynamic factors were observed, ranging from small to moderate in magnitude (d = 0.22 to 0.62) across low, moderate, and high intensity programs. The change scores, in turn, were associated with decreases in the 3 recidivism outcomes; the majority of relationships examined attained significance after partialing out of pretreatment scores. Cox regression survival analyses, controlling for pretreatment risk, further demonstrated change scores to have associations with postrelease recidivism outcomes to varying degrees. Conclusions: The results are consistent with the dynamic nature of sexual violence risk and suggest that risk-relevant changes associated with participation in sexual offender treatment are linked to reductions in sexual offender recidivism. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Behavioral activation for depressed breast cancer patients: The impact of therapeutic compliance and quantity of activities completed on symptom reduction.
    Objective: Behavioral activation (BA) is an empirically validated treatment that reduces depression by increasing overt behaviors and exposure to reinforcing environmental contingencies. Although research has identified an inverse correlation between pleasant or rewarding activities and depression, the causal relation between increased structured activities and reduced depression has not directly been studied. Method: In the context of a recent randomized trial (Hopko, Armento, et al., 2011), this study used longitudinal data and growth curve modeling to examine relationships among the quantity of activities completed, proportion of activities completed (i.e., therapeutic compliance), environmental reward, and depression in breast cancer patients treated with BA treatment for depression (n = 23). Results: Therapeutic compliance with assigned activities was causally related to depression reduction, whereas the specific quantity of completed activities was not systematically related. Logistic regression indicated that for patients completing all assigned activities, treatment response and remission were achieved for all patients. Neither therapeutic compliance nor the quantity of completed activities was directly associated with self-reported environmental reward during the BA interval (Session 3 to posttreatment), and environmental reward did not mediate the relation between activation and depression. Conclusions: Patient compliance with BA assignments is causally associated with depression reduction, whereas the quantity of completed activities is less relevant toward conceptualizing positive treatment outcome. Study findings are discussed in the context of behavioral models of depression and BA therapy. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Emergency department predictors of posttraumatic stress reduction for trauma-exposed individuals with and without an early intervention.
    Objective: Recent data have supported the use of an early exposure intervention to promote a reduction in acute stress and posttraumatic stress disorder (PTSD) symptoms after trauma exposure. The present study explored a comprehensive predictive model that included history of trauma exposure, dissociation at the time of the trauma and early intervention, and physiological responses (cortisol and heart rate) to determine which variables were most indicative of reduced PTSD symptoms for an early intervention or treatment as usual. Method: Participants (n = 137) were randomly assigned to the early intervention condition (n = 68) or assessment-only condition (n = 69) while receiving care at the emergency department of a Level 1 trauma center. Follow-up assessments occurred at 4 and 12 weeks posttrauma. Results: Findings suggested that dissociation at the time of the 1st treatment session was associated with reduced response to the early intervention. No other predictors were associated with treatment response. For treatment as usual, cortisol levels at the time of acute care and dissociation at the time of the traumatic event were positively associated with PTSD symptoms. Conclusions: Dissociation at the time at which treatment starts may indicate poorer response to early intervention for PTSD. Similarly, dissociation at the time of the event was positively related to PTSD symptoms in those who received treatment as usual. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Sequenced versus coordinated treatment for adolescents with comorbid depressive and substance use disorders.
    Objective: We evaluated 3 methods of integrating interventions for depression (Adolescent Coping With Depression Course; CWD) and substance use disorders (Functional Family Therapy; FFT), examining (a) treatment sequence effects on substance use and depression outcomes and (b) whether the presence of major depressive disorder (MDD) moderated effects. Method: Participants were 170 adolescents (ages 13–18; 22% female; 61% non-Hispanic White) with comorbid depressive disorder (54% MDD, 18% dysthymia) and substance use disorders who were randomized to (a) FFT followed by CWD (FFT/CWD), (b) CWD followed by FFT (CWD/FFT), or (c) coordinated FFT and CWD (CT). Acute treatment (24 treatment sessions provided over 20 weeks) and 6- and 12-month follow-up effects are presented for substance use (percentage of days of substance use; Timeline Followback) and depression (Children’s Depression Rating Scale–Revised). Results: FFT/CWD achieved better substance use outcomes than CT at posttreatment, and 6- and 12-month follow-ups; substance use effects for CWD/FFT were intermediate. For participants with baseline MDD, the CWD/FFT sequence resulted in lower substance use than either FFT/CWD or CT. Depressive symptoms decreased significantly in all 3 treatment sequences with no evidence of differential effectiveness during or following treatment. Attendance was lower for the second of both sequenced interventions. A large proportion of the sample received treatment outside the study, which predicted better outcomes in the follow-up. Conclusions: Depression reductions occurred early in all 3 treatment sequences. Of the examined treatment sequences, FFT/CWD appeared most efficacious for substance use reductions but addressing depression early in treatment may improve substance use outcomes in the presence of MDD. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Therapeutic alliance in face-to-face and telephone-administered cognitive behavioral therapy.
    Objective: Telephone-administered therapies have emerged as an alternative method of delivery for the treatment of depression, yet concerns persist that the use of the telephone may have a deleterious effect on therapeutic alliance. The purpose of this study was to compare therapeutic alliance in clients receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT). Method: We randomized 325 participants to receive 18 sessions of T-CBT or FtF-CBT. The Working Alliance Inventory (WAI) was administered at Weeks 4 and 14. Depression was measured during treatment and over 1 year posttreatment follow-up using the Hamilton Rating Scale for Depression and Patient Health Questionnaire–9. Results: There were no significant differences in client or therapist WAI between T-CBT or FtF-CBT (Cohen’s f² ranged from 0 to .013, all ps > .05). All WAI scores predicted depression end of treatment outcomes (Cohen’s f² ranged from .009 to .06, all ps f² ranged from 0 to .004, ps > .07). The WAI did not significantly predict depression during posttreatment follow-up (all ps > .12). Conclusions: Results from this analysis do not support the hypothesis that the use of the telephone to provide CBT reduces therapeutic alliance relative to FtF-CBT. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • A 10-year randomized controlled trial of the Early Risers conduct problems preventive intervention: Effects on externalizing and internalizing in late high school.
    Objective: The purpose of this study was to examine the long-term effects of the Early Risers “Skills for Success” Conduct Problems Prevention Program (ER; August, Bloomquist, Realmuto, & Hektner, 2007), a multifaceted program targeting social, emotional, behavioral, and academic risk and protective factors to promote adaptive psychological development. Method: Based on the random assignment of their school, 245 kindergartners (mean age = 6.6 years, SD = 0.57; 68.6% male) with elevated teacher-rated aggressive behavior either participated in ER for 3 intensive years plus 2 booster years or served as controls. Participants were assessed annually during the intervention with teacher and parent reports and at 2 follow-up points. In the current study, 129 of the original participants were reassessed with diagnostic interviews in late high school (mean age = 16.3, SD = 0.52), and multiple imputation was used to deal appropriately with missing data. Results: Program participants had significantly fewer symptoms of conduct disorder, oppositional defiant disorder, and major depressive disorder than did controls. The program’s effect on increasing social skills and parent discipline effectiveness by Grade 3 mediated these effects. Conclusions: The results of this study provide further evidence of the long-term positive effects of multicomponent, elementary-age, targeted conduct problems prevention programs. Training children in social skills and parents in effective discipline are possible mechanisms to divert maladaptive developmental cascades. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Stepped care in the treatment of trichotillomania.
    Objective: There are effective treatments of trichotillomania (TTM), but access to expert providers is limited. This study tested a stepped care model aimed at improving access. Method: Participants were 60 (95% women, 75% Caucasian, 2% Hispanic) adults (M = 33.18 years) with TTM. They were randomly assigned to immediate versus waitlist (WL) conditions for Step 1 (10 weeks of web-based self-help via StopPulling.com). After Step 1, participants chose whether to engage in Step 2 (8 sessions of in-person habit reversal training [HRT]). Results: In Step 1, the immediate condition had a small (d = .21) but significant advantage, relative to WL, in reducing TTM symptom ratings by interviewers (masked to experimental condition but not to assessment point); there were no differences in self-reported TTM symptoms, alopecia, functional impairment, or quality of life. Step 1 was more effective for those who used the site more often. Stepped care was highly acceptable: Motivation did not decrease during Step 1; treatment satisfaction was high, and 76% enrolled in Step 2. More symptomatic patients self-selected into HRT, and on average they improved significantly. Over one third (36%) made clinically significant improvement in self-reported TTM symptoms. Considering the entire stepped care program, participants significantly reduced symptoms, alopecia, and impairment, and increased quality of life. For quality of life and symptom severity, there was some relapse by 3-month follow-up. Conclusions: Stepped care is acceptable, and HRT was associated with improvement. Further work is needed to determine which patients with TTM can benefit from self-help and how to reduce relapse. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Client characteristics as moderators of the relation between the therapeutic alliance and outcome in cognitive therapy for depression.
    Objective: Little is known about the variability of the alliance–outcome correlation across identifiable client subsets. This question was explored in a sample of 60 clients receiving cognitive therapy for depression, from which an overall correlation of .23 was observed between alliance ratings and subsequent symptom change. Method: We examined interactions between the observer-rated version of the Working Alliance Inventory–Short Observer-Rated version (WAI–O; Tracey & Kokotovic, 1989) and client demographics, features of depression, personality, and other clinical features in predicting subsequent symptom change. Results: After correcting for multiple comparisons, interactions between the WAI–O and the number of prior depressive episodes, as well as the severity of baseline anxiety symptoms, were significant predictors of symptom change. When both interactions were controlled for, number of prior depressive episodes emerged as a statistically significant moderator. The alliance predicted outcome in the subgroup of clients with 0–2 prior episodes (r = .52), but not in those with 3 or more prior episodes (r = −.02). These findings were obtained despite similar univariate distributions on the alliance and symptom change in the 2 subgroups. Discussion: Differences that were observed in the predictive relation of alliance to outcome as a function of number of prior episodes suggest that different therapy processes may account for change in these subgroups. If the pattern observed in the present study is replicated, it would suggest that the alliance–outcome association has been both under- and overestimated. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source



Back to top


Back to top