Exploring dialectical behaviour therapy clinicians’ experiences of team consultation meetings

Background: This article presents a detailed idiographic analysis of Dialectical Behaviour Therapy (DBT) clinicians’ experiences of team consultation meetings. DBT is an evidence-based psychological intervention with a demonstrated efficacy in the treatment of borderline personality disorder (BPD). Team consultation meetings encompass one of the primary components involved in this treatment model; where DBT clinicians regularly meet to discuss client work and enhance further learning. The present study’s aim was to assess what are DBT clinicians’ experiences of the consultation meeting component and whether it is useful or not. Method: Semi-structured interviews were completed with 11 DBT clinicians (nine females, two males) from three different consultation teams. The research project utilised an interpretative phenomenological analysis (IPA) framework. Audio-recorded interview data was analysed using this framework. Results: Four superordinate themes emerged from the interview data, which included ten subordinate themes. The superordinate themes focused on: (1) the acquisition of DBT technical knowledge and other MDT related expertise (2) participants’ emotional experiences of DBT and consultation meetings, and how this can evolve over time (3) the underlying processes that occur in the consultation team including the development of a team bond and the impact of membership changes and (4) the largely consistent and reliable nature of consultation meetings and how they help maintain clinician motivation. Conclusions: Team consultation meetings were found to be supportive; playing an important role in maintaining clinician motivation through the availability of team support, opportunities to reflect and learn, and assistance in regulating emotions. Challenges arose in relation to team membership changes and acclimatisation to the type of feedback utilised in team consultation. The study’s implications for practise are considered

Contributions of working memory and sustained attention to children’s reading achievement: A commonality analysis approach

We used commonality analysis to explore the unique and overlapping contributions of two closely related executive functions, working memory and sustained attention, to the prediction of children’s reading achievement, over and above age and verbal IQ. Children aged 8–10 years (N = 104) completed measures of working memory capacity, sustained attention capacity, verbal IQ and reading achievement (operationalised as word reading and reading comprehension). We found that working memory capacity explained relatively more unique variance in word reading than in reading comprehension. Working memory capacity also predicted reading achievement through shared variance. In contrast, the capacity to sustain attention did not explain any substantial unique variance in either word reading or reading comprehension. The variance sustained attention capacity explained in reading achievement, albeit small in magnitude, was almost completely from overlapping variance with other predictors. These findings highlight the importance of understanding how executive function components differentially relate to aspects of reading achievement and provide initial evidence that any meaningful contribution sustained attention capacity makes to reading achievement is via shared variance

Unique and overlapping contributions of sustained attention and working memory to parent and teacher ratings of inattentive behavior

Sustained attention and working memory are two closely inter-twined executive functions that may underlie inattentive behavior. However, little research has teased apart their precise contributions in a single study. This study examines the extent to which ratings of children’s inattentive behavior are associated with these executive functions. Specifically, we investigated the unique and overlapping statistical contributions of sustained attention capacity and working memory capacity to parent and teacher ratings of inattentive behavior (operationalized as scores on both the Inattentive and Hyperactive/Impulsive scales of the Conners’ Rating Scale), while controlling for IQ. Children aged 8–11 years completed measures of sustained attention capacity, working memory capacity and IQ. Parents and teachers completed Conners-3 Parent and Teacher Short Forms, as a measure of inattentive behavior. We found that the unique statistical contribution of sustained attention capacity emerged as the most important factor in both parent and teacher ratings of inattentive behavior, with effects of moderate magnitude. In contrast, working memory capacity accounted for a small amount of variance. The overlap between sustained attention and working memory explained a small but substantive amount of variance in inattentive behavior. These findings support the idea that sustained attention and working memory are distinct executive functions that may contribute to goal-directed behavior both uniquely and through their interaction

Popular interventions to enhance sustained attention in children and adolescents: A critical systematic review

There are a myriad of interventions promoting activities designed to help enhance sustained attention in children  and adolescents. In this systematic review, we critically evaluate the evidence behind three popular sustained  attention training approaches – cognitive attention training, meditation, and physical activity. Seven databases  were searched in addition to secondary searches. Cognitive attention training, meditation training or physical  activity intervention studies aimed at improving sustained attention (randomised-controlled or non-randomised controlled designs) in samples of children and adolescents (3–18 years) were included. We screened 3437 unique  articles. Thirty-seven studies satisfied inclusion criteria. In general, cognitive attention training (n = 14) did not  reliably improve sustained attention. Physical activity (n = 15) and meditation interventions (n = 8) demonstrated somewhat more potential in enhancing sustained attention, but these effects should be considered preliminary and need to be replicated with greater methodological rigour. Cognitive attention training  demonstrated very limited transfer to other aspects of attention. Notably, mindfulness training had rather  consistent positive effects on selective attention. Across all three intervention types, there was very weak evidence for transfer to other aspects of cognition, behaviour, and academic achievement. The paper concludes with  methodological recommendations for future studies to strengthen the evidence base. </p

Development and evaluation of an educational intervention in youth mental health for primary care practitioners.

Objectives: Irish adolescents have one of the highest rates of suicide and self-harm in the European Union. Although primary care has been identified as an opportune environment in which to detect and treat mental health problems in adolescents, lack of training among primary care professionals (PCPs) is a barrier to optimum identification and treatment. We describe the development and evaluation of an educational intervention on youth mental health and substance misuse for PCPs. Methods: Thirty general practitioners and other PCPs working in the Mid-West region participated in an educational session on youth-friendly consultations, and identification and treatment of mental ill-health and substance use. Learning objectives were addressed through a presentation, video demonstration, small-group discussions, role play, question-and-answer sessions with clinical experts, and an information pack. Following the session, participants completed an evaluation form assessing knowledge gain and usefulness of different components of the session. Results: 71% of participants were involved in the provision of care to young people. 55% had no previous training in youth mental health or substance abuse. Participants rated knowledge gains as highest with regard to understanding the importance of early intervention, and primary care, in youth mental health. The components rated as most useful were case studies/small group discussion, the ‘question-and-answer session’ with clinical experts, and peer interaction. Conclusions: The educational session outlined in this pilot was feasible and acceptable and may represent an effective way to train professionals to help tackle the current crisis in youth mental health