Journal of Consulting & Clinical Psychology

Data-informed psychological therapy, measurement-based care, and precision mental health.
Measurement-based care, that is, incorporating data-informed decision support for therapists into psychological therapy, has undergone significant advancements over the past 2 decades. Technological innovations such as computerized data assessment and feedback tools have facilitated its widespread adoption across various settings. For instance, clinicians can utilize psychometric data to personalize therapeutic approaches, strategies, or modules and track a patient’s response to therapy in real time (e.g., Lutz, Schwartz, & Delgadillo, 2022). Furthermore, new algorithm-based clinical support tools used within measurement-based care can optimize treatment for such patients at risk for treatment failure. Consequently, measurement-based care is evolving into a data-informed and precision psychological therapy concept that can be viewed as a low-intensity transtheoretical adjunct to evidence-based treatments. It can be integrated at multiple care points into clinical practice regardless of the clinical modality, manual, or program used in a given health care system. Therefore, it emerges as an important component of clinical competence, practice, and training, akin to continuous monitoring of physical health indicators (e.g., insulin, fever, or blood pressure). In this viewpoint article, we summarize the core concepts of data-informed psychological therapy that customizes individual psychological interventions to meet specific patient needs. We also explore implications and future steps to integrate this approach into clinical practice and further advance precision mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
School-based organizational skills training for students in grades 3–5: A cluster randomized trial.
Objective: Research has demonstrated the effectiveness of interventions to reduce organizational skills deficits and homework problems, including the clinic-based Organizational Skills Training (OST-C) program (Abikoff et al., 2013). In this study, OST-C was adapted for schools as a small-group (Tier 2) intervention delivered by school partners (OST-T2). Method: The study was conducted in 22 schools serving students from diverse backgrounds. Students (n = 186; 122 male) in Grades 3–5, ages 8–12 (M = 9.7 years; SD = 0.88) with organizational skills deficits referred by teachers were enrolled. Schools were randomly assigned to OST-T2 or treatment as usual with waitlist. OST-T2 consisted of sixteen 35-min child sessions, two caregivers, and two teacher consultations. Outcomes were evaluated with longitudinal mixed effects modeling at posttreatment, 5-month and 12-month follow-up using caregiver and teacher reports of organizational skills, homework, and academic performance. Results: OST-T2 resulted in reductions in organizational skills deficits on caregiver and teacher report (p <.001) at posttreatment and 5-month follow-up (effect sizes [ES], Cohen’s d = 0.96, 1.20). Findings also revealed a reduction in caregiver-reported homework problems at posttreatment and 5-month follow-up (p <.001, ES = 0.60, 0.72), and an improvement in teacher-rated homework at posttreatment (p = .007, ES = 0.64). Effects were attenuated at 12-month follow-up. The effects of OST-T2 on academic measures were not significant. Conclusions: Findings provide evidence for the immediate and short-term effectiveness of OST-T2 delivered by school professionals. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Disruptive child behavior severity and parenting program session attendance: Individual participant data meta-analysis.
Objective: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. Method: We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Child Behavior Inventory scores, we distinguished between trial-level problem severity and child-level problem severity, compared linear and quadratic functional forms at both levels, and considered cross-level interactions, all in a multilevel Poisson regression framework. Results: Drawing on 918 participants in 12 trials, we found that within trials, parents of children with the least and most severe problems attended fewer sessions. Between trials, each additional 10-point increase in the Eyberg Child Behavior Inventory trial mean predicted an 11% increase in attendance. Models including child sex, age, or family low-income did not change coefficients or their interpretation. Conclusions: Our findings suggest that although generally attendance is higher in parents of children with more challenging behavior, it seems difficult for group programs to keep families with the least or most severe problems engaged. Our findings call for the need to better understand the conditions under which lower attendance translates into equivalent or lesser program benefits. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans.
Objective: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care. Method: This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up). Results: Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates. Conclusions: Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Individualized Assessment and Treatment Program (IATP) for alcohol use disorder: Comparison with conventional cognitive-behavioral treatment and examination of coping skills as a mediator of treatment.
Objective: This study tested a highly individualized cognitive-behavioral coping skills treatment for alcohol use disorder (AUD). Recent studies have indicated that coping skills training programs are not always effective. A possible explanation is that the training provided in these programs may not address the specific needs of the patient. The Individualized Assessment and Treatment Program (IATP) was intended to provide a highly individualized approach to the training of skills most relevant for each individual. Method: Men and women with AUD (N = 173) were randomly assigned to one of three, manualized, 12-session treatments: IATP, a conventional (Packaged) cognitive-behavioral program (PCBT), or a Case Management control condition (CaseM). An experience sampling (ES) procedure was employed prior to, and during, treatment to record alcohol use and coping behaviors in all patients. In IATP, this information was used by therapists to plan treatment that would address the specific strengths and weaknesses of each patient in alcohol-use situations. ES data were collected at multiple time points and patients were followed every 3 months out to 21 months posttreatment. Results: Multilevel model analyses indicated that IATP yielded better drinking outcomes than the CaseM or PCBT conditions. Mediation analyses indicated that the effects of IATP versus the other treatments on outcomes were accounted for at least partly by changes in active coping with high-risk situations. Conclusion: Due to the limited diversity of the sample, generalizability of the results may be limited. Results are discussed in terms of the importance of tailoring treatment for the individual patient. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Journal of Consulting and Clinical Psychology - Vol 92, Iss 10