Effects of a Web-based Relationship Program on Co-parenting and Child Functioning

Symposium Title: Novel Preventive Intervention Strategies For Couples and Families: Extending the Reach and Social Impact of CBT to Promote Relationship Quality and Adult and Child Well-being Chair: Allen W. Barton, Ph.D., University of Illinois, Urbana Champaign Discussant: Scott Stanley, Ph.D., University of Denve

Theorizing the Transcendent Persona: Amelia Earhart’s Vision in The Fun of It

In this article, we define and theorize the ‘‘transcendent persona,’’ a discursive strategy in which a rhetor draws from a boundary-breaking accomplishment and utilizes the symbolic capital of that feat to persuasively delineate unconventional ways of communicating and behaving in society. Aviator Amelia Earhart’s autobiography The Fun of It (1932) functions as an instructive representative anecdote of this concept and demonstrates that the transcendent persona’s persuasive force hinges on one’s ability to balance distance from audiences with similarities to them. Striking such a balance creates a platform for rhetors to promote transformative visions of society. Earhart utilized the transcendent persona to illustrate an alternative vocabulary of what contemporary theorists might call feminine gender performativity. The article concludes by exploring the implications of the transcendent persona as an enduring, rhetorical resource for communicators, as well as for scholars of persuasion and social change, religious communication, and communication history

Theorizing the Transcendent Persona: Amelia Earhart’s Vision in The Fun of It

In this article, we define and theorize the ‘‘transcendent persona,’’ a discursive strategy in which a rhetor draws from a boundary-breaking accomplishment and utilizes the symbolic capital of that feat to persuasively delineate unconventional ways of communicating and behaving in society. Aviator Amelia Earhart’s autobiography The Fun of It (1932) functions as an instructive representative anecdote of this concept and demonstrates that the transcendent persona’s persuasive force hinges on one’s ability to balance distance from audiences with similarities to them. Striking such a balance creates a platform for rhetors to promote transformative visions of society. Earhart utilized the transcendent persona to illustrate an alternative vocabulary of what contemporary theorists might call feminine gender performativity. The article concludes by exploring the implications of the transcendent persona as an enduring, rhetorical resource for communicators, as well as for scholars of persuasion and social change, religious communication, and communication history

Barriers to Outdoor Recreation for Marginalized Groups at the University of Montana

Exclusion from outdoor recreation reflects legacies of oppression of marginalized communities and makes access to the outdoors not equally available. In the United States, approximately 38% of Black Americans and 48% of Hispanic Americans participated in outdoor recreation in 2020. This is compared to 55% participation among Caucasian Americans. Many other intersecting identities are actively excluded, including people with disabilities, fat populations, and members of the LGBTQIA2S+ community; furthermore, class-based hierarchies are shown through the restricted outdoor access of low-income populations. While numerous studies show a lack of diversity in outdoor recreation, little to no research has been conducted on the experience of marginalized groups in higher education settings globally and at the University of Montana (UM). The first part of our project includes an event where we invited outdoor community groups within the Missoula and UM community to connect with students and share their resources. We also conducted an anonymous survey of students at the University of Montana to better understand their experiences with outdoor recreation and the barriers in place. Participants were asked a series of questions about their recreation experiences and participation with various outdoor groups within the Missoula community. They were also asked questions relating to the barriers they may face to outdoor participation, with responses including quantitative answers and open-space personal reflections. Respondents reported facing seven key barriers to outdoor recreation: financial, social, lack of information, accessibility, time and money, safety, and transportation. The main objective of our research is to better understand the experience of and identify the barriers to outdoor recreation for various marginalized groups at the University of Montana so that we can better promote community awareness

Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment

The advancement of implementation science is dependent on identifying assessment strategies that can address implementation and clinical outcome variables in ways that are valid, relevant to stakeholders, and scalable. This paper presents a measurement agenda for implementation science that integrates the previously disparate assessment traditions of idiographic and nomothetic approaches. Although idiographic and nomothetic approaches are both used in implementation science, a review of the literature on this topic suggests that their selection can be indiscriminate, driven by convenience, and not explicitly tied to research study design. As a result, they are not typically combined deliberately or effectively. Thoughtful integration may simultaneously enhance both the rigor and relevance of assessments across multiple levels within health service systems. Background on nomothetic and idiographic assessment is provided as well as their potential to support research in implementation science. Drawing from an existing framework, seven structures (of various sequencing and weighting options) and five functions (Convergence, Complementarity, Expansion, Development, Sampling) for integrating conceptually distinct research methods are articulated as they apply to the deliberate, design-driven integration of nomothetic and idiographic assessment approaches. Specific examples and practical guidance are provided to inform research consistent with this framework. Selection and integration of idiographic and nomothetic assessments for implementation science research designs can be improved. The current paper argues for the deliberate application of a clear framework to improve the rigor and relevance of contemporary assessment strategies

Predictors and moderators of agreement between clinical and research diagnoses for children and adolescents.

Diagnoses play an important role in treatment planning and monitoring, but extensive research has shown low agreement between clinician-generated diagnoses and those from structured diagnostic interviews. However, most prior studies of agreement have not used research diagnoses based on gold standard methods, and research needs to identify characteristics of diagnostically challenging clients. This study examined agreement between youth diagnoses generated through the research-based LEAD (Longitudinal, Expert, and All Data) Standard to clinician diagnoses

Patient reported outcome measures in child and adolescent mental health services: Associations between clinician demographic characteristics, attitudes, and efficacy

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. © 2016 Association for Child and Adolescent Mental Health. Published by John Wiley & Sons Ltd.Background Policy recommends using patient reported outcome measures (PROMs), yet their use is persistently low. Our aim was to examine the association between PROM use and clinician demographic characteristics, attitudes and efficacy. Method A sample of N = 109 clinicians completed an online survey. Results Clinicians who reported higher levels of use of cognitive behaviour or humanistic approaches had higher levels of PROM use than clinicians who reported lower levels of use of these approaches. Clinicians who reported having received training had higher levels of self-efficacy regarding PROMs than clinicians who reported not having received training, but the effects of training on PROM attitudes and use were not significant. Still, clinicians with more positive attitudes or self-efficacy regarding PROMs had higher levels of PROM use than clinicians with less positive attitudes or self-efficacy regarding PROMs. Conclusion Clinicians should be supported to have the knowledge, skills and confidence to effectively use PROMs in their clinical practice.Peer reviewedFinal Accepted Versio

Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial

OBJECTIVE: High therapy dropout rates among adolescents have been reported, but little is known about whether dropout is associated with poor outcomes. This study aimed to examine clinical outcomes in adolescents with depression who dropped out of psychological therapy and to determine whether this varied by treatment type. METHOD: Data were drawn from the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study, a randomized controlled trial, comparing a brief psychosocial intervention, cognitive-behavioral therapy, and short-term psychoanalytic psychotherapy in the treatment of adolescent major depression. The sample comprised 406 adolescents with a diagnosis of major depression, 169 of whom dropped out of treatment before the planned end of therapy. Primary outcome was self-report Mood and Feelings Questionnaire (MFQ); secondary outcomes were Health of the Nation Outcome Scale for Children and Adolescents, Revised Children's Manifest Anxiety Scale, Modified Leyton Obsessional Inventory, and clinical diagnosis. RESULTS: During follow-up, there was a nonsignificant trend for dropouts to report higher depressive symptoms than completers. However, modeling showed insufficient evidence for an association between dropout and outcomes. CONCLUSION: In contrast to studies of adult therapy, there was no strong evidence that adolescent patients who dropped out had poorer clinical outcomes compared with those who completed therapy, when dropout was defined as ending treatment without agreement of the therapist. This challenges us to understand why adolescents stop going to therapy, how dropout should be defined, and whether what is prescribed is what is always needed. CLINICAL TRIAL REGISTRATION INFORMATION: Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behavior Therapy; http://www.isrctn.com/; 83033550

Clinician Training, Then What? Randomized Clinical Trial of Child STEPs Psychotherapy Using Lower-Cost Implementation Supports with versus without Expert Consultation

Objective: Implementation of evidence-based treatments in funded trials is often supported by expert case consultation for clinicians; this may be financially and logistically difficult in clinical practice. Might less costly implementation support produce acceptable treatment fidelity and clinical outcomes? Method: To find out, we trained 42 community clinicians from four community clinics in Modular Approach to Therapy for Children (MATCH), then randomly assigned them to receive multiple lower-cost implementation supports (LC) or expert MATCH consultation plus lower-cost supports (CLC). Clinically referred youths (N = 200; ages 7–15 years, M = 10.73; 53.5% male; 32.5% White, 27.5% Black, 24.0% Latinx, 1.0% Asian, 13.5% multiracial, 1.5% other) were randomly assigned to LC (n = 101) or CLC (n = 99) clinicians, and groups were compared on MATCH adherence and competence, as well as on multiple clinical outcomes using standardized measures (e.g., Child Behavior Checklist, Youth Self-Report) and idiographic problem ratings (Top Problems Assessment). Results: Coding of therapy sessions revealed substantial therapist adherence to MATCH in both conditions, with significantly stronger adherence in CLC; however, LC and CLC did not differ significantly in MATCH competence. Trajectories of change on all outcome measures were steep, positive, and highly similar for LC and CLC youths, with no significant differences; a supplemental analysis of posttreatment outcomes also showed similar LC and CLC posttreatment scores, with most LC–CLC differences nonsignificant. Conclusions: The findings suggest that effective implementation of a complex intervention in clinical practice may be supported by procedures that are less costly and logistically challenging than expert consultation

Child and Family Therapy Process: Concordance of Therapist and Observational Perspectives

The objective of this study is to examine the characteristics of outpatient mental health services delivered in community-based outpatient clinics, comparing information obtained from two different sources, therapists serving children and families, and observational coders viewing tapes of the same treatment sessions. Videotaped therapy sessions were rated by therapists and independent coders regarding goals and strategies pursued during each session. Sixty-three sessions were taped of outpatient care provided to 18 children and their caregivers by 11 therapists. Children were 4–13 years old and families were receiving services at least in part due to reported child behavior problems, confirmed by ratings from the Child Behavior Checklist and Conners Parent Rating Scale—Revised. Analyses assessed the frequency, type, and intensity of goals and strategies pursued in therapy sessions from both therapist and observational coders’ perspectives. Reliability of observer ratings and correspondence between therapist and observer reports were also examined. The reliability of observational coding of goals and strategies was moderate to good, with 76% of 39 codes having ICCs of .5 or greater. Therapists reported pursuing 2.5 times more goals and strategies per session, on average, than identified by observational coders. Correspondence between therapists and coders about the occurrence of specific goals and strategies in treatment sessions was low, with 20.5% of codes having a Kappa of .4 or higher. Substantial differences exist in what therapists and independent coders report as occurring in outpatient treatment sessions. Both perspectives suggest major differences between the content of services provided in community-based outpatient clinics and the structure of evidence-based programs, which emphasize intense pursuit of a small number of goals and strategies in each treatment session. Implications of the findings for quality improvement efforts in community-based mental health care settings are discussed