Adapting Psychological Therapies for Autism

BackgroundPsychological interventions informed by cognitive behavioural theory have proven efficacy in treating mild-moderate anxiety and depression. They have been successfully adapted for autistic children and adults who experience disproportionately high rates of co-occurring emotional problems. There has been little research into the perspectives and experience of psychological therapists adapting cognitive behavioural therapy (CBT) as part of routine clinical practice. We surveyed therapist skills, experience and confidence in working psychologically with autistic people, in order to highlight gaps and needs, as well as strengths in terms of therapist skills when working with this group.MethodFifty therapists attending a training event completed a survey about their experience of adapting CBT for autistic clients, alongside a measure of therapist confidence.ResultsAlmost all therapists reported making adaptations to CBT practice when working with autistic clients. Key challenges identified were rigidity in thinking and pacing sessions appropriately. Therapists were relatively confident about core engagement and assessment skills but reported less confidence in using their knowledge to help this group. Therapist confidence was not associated with years of practice or number of adaptations made, but was positively associated with level of therapy training received.ConclusionsThis study highlights a need for training and ongoing supervision to increase therapist confidence in and ability to make appropriate adaptations to CBT treatment protocols for autistic people

'It's always difficult when it's family. . . whereas when you're talking to a therapist. . .': Parents' views of cognitive-behaviour therapy for depressed adolescents

BACKGROUND: Parents are key to helping their adolescent child access psychological therapy for mental health problems such as depression. However, little is known about how parents experience their child's psychological therapy. We aimed to explore parents' experiences of their adolescent child's cognitive behaviour therapy for depression. METHOD: We applied Thematic Analysis (TA) to qualitative data from in-depth interviews with parents (N = 16) whose adolescent child was randomly allocated to CBT in a large multisite RCT for adolescent depression (the IMPACT trial). Interviews were conducted at the end of treatment. RESULTS: We generated two main themes: parents' perceptions of the adolescent's journey through therapy, and parents' perceptions of the therapeutic setting and process. Each included four sub-themes. Parents talked about key factors that impacted on their child's progress through treatment, including the adolescent's readiness for therapy and the adolescent-therapist relationship. CONCLUSION: Parents' insights confirm the foundations of what is considered good clinical practice of CBT for adolescent depression, including tailoring therapy to the adolescent, and establishing a strong adolescent-therapist relationship. Parents recognised that, for CBT to be helpful, their child had to be willing to engage in therapy and able to develop a trusting relationship with their therapist

Effect of root spacing on interpretation of blade penetration tests-full-scale physical modelling

The spatial distribution of plant roots is an important parameter when the stability of vegetated slopes is to be assessed. Previous studies in both laboratory and field conditions have shown that a penetrometer adapted with a blade-shaped tip can be used to detect roots from sudden drops in penetrometer resistance. Such drops can be related to root properties including diameter, stiffness and strength using simpleWinkler foundation models, thereby providing a field instrument for rapid quantification of root properties and distribution. While this approach has proved useful for measuring single widely-spaced roots, it has not previously been determined how the penetrometer response changes as a result of roots being in close proximity. Therefore in this study 1-g physical modelling (at 1:1 scale) was conducted to study the effect of vertical root spacing using horizontal, straight 3D-printed root analogues. Results showthatwhen roots are closely spaced, there is significant interaction between them, resulting in higher apparent root displacements to failure and an increased amount of energy being dissipated. This preliminary work shows that the interpretive models used to analyse the penetrometer trace require further development to account for root-soil-root interactions in densely rooted soil.</p

Quantifying soil reinforcement by fibrous roots

Reinforcement of soil by fibrous roots is crucial for preventing soil erosion and degradation,yet the underlying mechanisms are poorly understood. Without fully understanding root enmeshment within the soil matrix, and root biomechanical properties key for increasing soil shear strength, adoption in main stream civil engineering, understanding of natural systems and implications to agricultural soil management will be limited. Within this thesis theunderlying processes that drive root reinforcement of soils were assessed through a variety oflaboratory and field based experiments. This included recent advances in geotechnical engineering and model plant lines with specific root traits. Plant lines were barley (Hordeum vulgare) from a mapping population where differences in root hairs, tortuosity and lignin biosynthesis were previously identified by screening large numbers of mutants.The initial hypothesis was that root numbers and area would control shear reinforcement, this was tested by altering planting density in both glasshouse and field experiments using one barley variety. After 5 weeks in the field, planting density was related to both reinforcement and root area ratio (RAR), with a 6.7 ?1.40 kPa, or 190%, increase in shear strength between 0 and 950/m2. By 20 weeks in the field shear strength increased by only 29%. The glasshouse study showed an increase of 53%, with a positive correlation to planting density.Relationships between root number and shear strength were not explicit, however, highlighting further possible interactions between soil shear strength and root inclusions. Various underlying processes were then investigated. Barley mutants, with differences in root hairs and tortuosity, were compared to parent lines. Hairless mutants had different root tensile strength characteristics, but experimental difficulties (malfunctioning logging hardware) prohibited detection of impacts on shear strength. A refined study was then performed that also incorporated the influence of abiotic stress from compaction and waterlogging. Barley with down-regulated lignin biosynthesis (Bowman 140) had increased nodalroot tensile strength of 37% compared to the parent line (Bowman Line) under good growth conditions, but this changed to -31% for compacted and 26% for water-logged soil. In addition to abiotic stress, the age of the roots (measured as distance from root tip) type of root (seminal, nodal or lateral) had a large impact on biomechanical behaviour.EThOS - Electronic Theses Online ServiceBBSRC [BBS/S/K/2005/12211A]GBUnited Kingdo

Comparison of new <i>in situ </i>root-reinforcement measuring devices to existing techniques

Mechanical root-reinforcement is difficult to quantify. Existing in-situ methods are cumbersome, while modelling requires parameters which are difficult to acquire. In this paper, two new in-situ measurement devices are introduced ('cork screw' and 'pin vane') and their performance is compared to field vane and laboratory direct shear strength measurements in fallow and rooted soil. Both new methods show a close correlation with field vane readings in fallow soil. Tests in reinforced soil show that both new methods can be installed without significant root disturbance. The simplicity of both new methods allows for practical in-situ use and both can be used to study soil stress-strain behaviour, thus addressing some major limitations in existing methodologies for characterising rooted soil.</p

CAN LINGUISTIC ANALYSIS BE USED TO IDENTIFY WHETHER ADOLESCENTS WITH A CHRONIC ILLNESS ARE DEPRESSED?

Comorbid depression is common in adolescents with chronic illness. We aimed to design and test a linguistic coding scheme for identifying depression in adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), by exploring features of e-consultations within online cognitive behavioural therapy treatment. E-consultations of 16 adolescents (aged 11–17) receiving FITNET-NHS (Fatigue in teenagers on the interNET in the National Health Service) treatment in a national randomized controlled trial were examined. A theoretically driven linguistic coding scheme was developed and used to categorize comorbid depression in e-consultations using computerized content analysis. Linguistic coding scheme categorization was subsequently compared with classification of depression using the Revised Children's Anxiety and Depression Scale published cut-offs (t-scores ≥65, ≥70). Extra linguistic elements identified deductively and inductively were compared with self-reported depressive symptoms after unblinding. The linguistic coding scheme categorized three (19%) of our sample consistently with self-report assessment. Of all 12 identified linguistic features, differences in language use by categorization of self-report assessment were found for “past focus” words (mean rank frequencies: 1.50 for no depression, 5.50 for possible depression, and 10.70 for probable depression; p &lt;.05) and “discrepancy” words (mean rank frequencies: 16.00 for no depression, 11.20 for possible depression, and 6.40 for probable depression; p &lt;.05). The linguistic coding profile developed as a potential tool to support clinicians in identifying comorbid depression in e-consultations showed poor value in this sample of adolescents with CFS/ME. Some promising linguistic features were identified, warranting further research with larger samples.</p

Cross-scale analysis of social-ecological systems:Policy options appraisal for delivering NetZero and other environmental objectives in Scotland

Public policy confronts complex, contested, wicked problems such as climate and biodiversity crises with challenges of how issues are framed, analysed, codified, and interpreted. Social-ecological systems provide an analytical framework that couples the biosphere and technosphere, recognising biophysical limits and emphasising the importance of critical reflection within policy decision-making. Conducting policy-options appraisals is increasingly seen as a transdisciplinary research-policy endeavour with researchers engaging policy actors in an extended peer community (post-normal science). This paper presents a case study of analysis undertaken with researchers, policy analysts, policy makers and other stakeholders to support decisions on how to implement future agriculture support in Scotland, so that the policy programme better delivers across social, economic and environmental objectives. The key change being considered in the future agricultural support programme is Enhanced Conditionality (EC) where the level of financial support provided to farm-businesses will depend on their undertaking agri-environmental measures that deliver against the key priorities of reducing greenhouse gas emissions and reversing biodiversity losses. The paper outlines the policy context within which the EC options appraisal takes place – highlighting how EC is a crucial component in making the wider suite of policy measures work. The transdisciplinary approach, Quantitative Story Telling (QST) is presented, emerging from decision support, participatory research, and post-normal science for policy domains. The stages of QST highlight the importance of analysis that underpins any quantification (decision on how issues are framed and what it included in the analysis) and the expectation that research outputs with be deliberated on with, and interpreted from, stakeholder perspectives. The project specific analyses are outlined, combining top-down options appraisal of how macro-policy decisions could constrain EC and bottom-up analysis of potential uptake and effectiveness of EC measures, undertaken in inter-disciplinary workshops with domain experts from biodiversity, soils and waters. The paper highlights challenges for implementation and evaluation at meso-scale with interactions between farm-businesses and catchment, landscape and regional objectives. The conclusions of the analysis, in policy terms, are that EC presents an opportunity to significantly realign how agricultural land management is conducted in Scotland, so that it is more effective in delivering climate change and biodiversity objectives, but there are formidable challenges in resolving the policy “sudoku”. Meso-scale issues are likely to mean the need to integrate alternative modelling paradigms such as spatial, empirical agent-based modelling (ABM) into policy option appraisals. By taking multi-scale, social-ecological systems perspectives on EC it has been possible to identify key policy decisions at a range of scales on which the success of EC will depend, to have a realistic understanding of how effective the EC measures might be in heterogenous Scottish environments and what are the likely barriers to uptake. The analysis also highlighted where outcomes of the policy change are likely to be challenging to monitor-evaluate; and where there are dependencies between farm-businesses that mean EC measures need to be supplemented with mechanisms that (1) promote cooperation between land managers and (2) identify and respond to agreed local priorities. The value of the participatory QST process was in making sure the analyses being undertaken were salient and the outputs seen as credible – but the challenges of interpreting necessarily complex outputs remain. The greatest value of QST may be that it provides a structured way to navigate complexity with policy makers rather than seeking to control or eliminate it.</p

Cross-scale analysis of social-ecological systems:Policy options appraisal for delivering NetZero and other environmental objectives in Scotland

Public policy confronts complex, contested, wicked problems such as climate and biodiversity crises with challenges of how issues are framed, analysed, codified, and interpreted. Social-ecological systems provide an analytical framework that couples the biosphere and technosphere, recognising biophysical limits and emphasising the importance of critical reflection within policy decision-making. Conducting policy-options appraisals is increasingly seen as a transdisciplinary research-policy endeavour with researchers engaging policy actors in an extended peer community (post-normal science). This paper presents a case study of analysis undertaken with researchers, policy analysts, policy makers and other stakeholders to support decisions on how to implement future agriculture support in Scotland, so that the policy programme better delivers across social, economic and environmental objectives. The key change being considered in the future agricultural support programme is Enhanced Conditionality (EC) where the level of financial support provided to farm-businesses will depend on their undertaking agri-environmental measures that deliver against the key priorities of reducing greenhouse gas emissions and reversing biodiversity losses. The paper outlines the policy context within which the EC options appraisal takes place – highlighting how EC is a crucial component in making the wider suite of policy measures work. The transdisciplinary approach, Quantitative Story Telling (QST) is presented, emerging from decision support, participatory research, and post-normal science for policy domains. The stages of QST highlight the importance of analysis that underpins any quantification (decision on how issues are framed and what it included in the analysis) and the expectation that research outputs with be deliberated on with, and interpreted from, stakeholder perspectives. The project specific analyses are outlined, combining top-down options appraisal of how macro-policy decisions could constrain EC and bottom-up analysis of potential uptake and effectiveness of EC measures, undertaken in inter-disciplinary workshops with domain experts from biodiversity, soils and waters. The paper highlights challenges for implementation and evaluation at meso-scale with interactions between farm-businesses and catchment, landscape and regional objectives. The conclusions of the analysis, in policy terms, are that EC presents an opportunity to significantly realign how agricultural land management is conducted in Scotland, so that it is more effective in delivering climate change and biodiversity objectives, but there are formidable challenges in resolving the policy “sudoku”. Meso-scale issues are likely to mean the need to integrate alternative modelling paradigms such as spatial, empirical agent-based modelling (ABM) into policy option appraisals. By taking multi-scale, social-ecological systems perspectives on EC it has been possible to identify key policy decisions at a range of scales on which the success of EC will depend, to have a realistic understanding of how effective the EC measures might be in heterogenous Scottish environments and what are the likely barriers to uptake. The analysis also highlighted where outcomes of the policy change are likely to be challenging to monitor-evaluate; and where there are dependencies between farm-businesses that mean EC measures need to be supplemented with mechanisms that (1) promote cooperation between land managers and (2) identify and respond to agreed local priorities. The value of the participatory QST process was in making sure the analyses being undertaken were salient and the outputs seen as credible – but the challenges of interpreting necessarily complex outputs remain. The greatest value of QST may be that it provides a structured way to navigate complexity with policy makers rather than seeking to control or eliminate it.</p