Client Improvement in a Community-Based Training Clinic: As Indicated by the OQ-45

By reviewing existing data collected at the Texas A&M Counseling and Assessment Clinic (CAC) in Bryan, TX, the present investigator seeks to better understand client response to therapy. Each client receiving services at the clinic completes the Outcome Questionnaire 45 (OQ-45) before every counseling session attended. The OQ-45 consists of 45 questions related to present emotional and psychological distress. The main goal of this study is to provide information regarding clients’ response to therapeutic interventions as measured by their distress levels on the OQ-45. The OQ-45 is an empirically validated measure widely used throughout psychotherapy settings and has been used in the CAC since 2005. Most of the existing research related to dose-response information obtained via the OQ-45 has been implemented at university student counseling centers with a predominantly Caucasian, affluent, and religious population. The present study seeks to expand the knowledge of the field to a more diverse population and unique training setting for budding psychologists. Survival analyses were conducted and results indicate 13 sessions are necessary for a majority of clients from this rural and low-income population to achieve clinically significant change. Additionally, a mere seven sessions are necessary for a majority of clients to achieve reliable improvement. In a country that continues grow in population size and diversity, more information is needed regarding the mental healthcare system and the response of those seeking therapy, this study provides some of that insight

Modeling the Prospective Relationships of Impairment, Injury Severity, and Participation to Quality of Life Following Traumatic Brain Injury

Identifying reliable predictors of positive adjustment following traumatic brain injury (TBI) remains an important area of inquiry. Unfortunately, much of available research examines direct relationships between predictor variables and outcomes without attending to the contextual relationships that can exist between predictor variables. Relying on theoretical models of well-being, we examined a theoretical model of adjustment in which the capacity to engage in intentional activities would be prospectively associated with greater participation, which in turn would predict subsequent life satisfaction and perceived health assessed at a later time. Structural equation modeling of data collected from 312 individuals (226 men, 86 women) with TBI revealed that two elements of participation—mobility and occupational activities—mediated the prospective influence of functional independence and injury severity to optimal adjustment 60 months following medical discharge for TBI. The model accounted for 21% of the variance in life satisfaction and 23% of the variance in self-rated health. Results indicate that the effects of functional independence and injury severity to optimal adjustment over time may be best understood in the context of participation in meaningful, productive activities. Implications for theoretical models of well-being and for clinical interventions that promote adjustmentafter TBI are discussed

Modeling the Prospective Relationships of Impairment, Injury Severity, and Participation to Quality of Life Following Traumatic Brain Injury

Identifying reliable predictors of positive adjustment following traumatic brain injury (TBI) remains an important area of inquiry. Unfortunately, much of available research examines direct relationships between predictor variables and outcomes without attending to the contextual relationships that can exist between predictor variables. Relying on theoretical models of well-being, we examined a theoretical model of adjustment in which the capacity to engage in intentional activities would be prospectively associated with greater participation, which in turn would predict subsequent life satisfaction and perceived health assessed at a later time. Structural equation modeling of data collected from 312 individuals (226 men, 86 women) with TBI revealed that two elements of participation—mobility and occupational activities—mediated the prospective influence of functional independence and injury severity to optimal adjustment 60 months following medical discharge for TBI. The model accounted for 21% of the variance in life satisfaction and 23% of the variance in self-rated health. Results indicate that the effects of functional independence and injury severity to optimal adjustment over time may be best understood in the context of participation in meaningful, productive activities. Implications for theoretical models of well-being and for clinical interventions that promote adjustmentafter TBI are discussed

Predicting smokeless tobacco initiation and re-initiation in the United States Air Force

Introduction: Active Duty United States Air Force (USAF) members have substantially higher rates of smokeless tobacco (ST) use than the general population. Methods: We longitudinally assessed demographics, tobacco use, intrapersonal factors, and interpersonal factors to determine associations with the initiation or re-initiation of ST in the year following a period of forced abstinence among 2188 newly recruited Airmen. Logistic regression analyses were conducted to examine associations between baseline predictors and ST use at one-year follow-up. Results: In the final multivariate models compared to never users, the strongest predictors of ST use initiation after BMT were male gender (adjusted OR 8.93, 95% CI 3.82, 20.88), pre-BMT cigarette and cigar use (adjusted OR 1.60, 95% CI 1.00, 2.57; adjusted OR 2.50, 95% CI 1.66, 3.81 respectively). Compared to former ST users, the strongest predictors of re-initiation were male gender (adjusted OR 10.68, 95% CI 2.25, 50.62) and intentions to use ST (adjusted OR 2.10, 95% CI 1.42, 3.12). Compared to initiators of ST, the strongest predictors of re-initiation were intentions to use ST and peer use (adjusted OR 3.26, 95% CI 1.94, 5.49; OR 2.55, 95% CI 1.92, 3.41 respectively). Conclusions: Our results suggest that initiators may be exploring and viewing ST as a less harmful alternative to cigarette smoking and ST users reporting intentions to use ST in the future often return to use. The development of interventions able to disrupt the link between intentions to use tobacco and future tobacco use in the USAF is vital

Modeling the Prospective Relationships of Impairment, Injury Severity, and Participation to Quality of Life Following Traumatic Brain Injury

Identifying reliable predictors of positive adjustment following traumatic brain injury (TBI) remains an important area of inquiry. Unfortunately, much of available research examines direct relationships between predictor variables and outcomes without attending to the contextual relationships that can exist between predictor variables. Relying on theoretical models of well-being, we examined a theoretical model of adjustment in which the capacity to engage in intentional activities would be prospectively associated with greater participation, which in turn would predict subsequent life satisfaction and perceived health assessed at a later time. Structural equation modeling of data collected from 312 individuals (226 men, 86 women) with TBI revealed that two elements of participation-mobility and occupational activities-mediated the prospective influence of functional independence and injury severity to optimal adjustment 60 months following medical discharge for TBI. The model accounted for 21% of the variance in life satisfaction and 23% of the variance in self-rated health. Results indicate that the effects of functional independence and injury severity to optimal adjustment over time may be best understood in the context of participation in meaningful, productive activities. Implications for theoretical models of well-being and for clinical interventions that promote adjustmentafter TBI are discussed