A Randomized Waitlist-controlled Trial of Voice Over Internet Protocol-delivered Behavior Therapy for Chronic Tic Disorders

Videoconferencing is efficacious, acceptable and equivalent to face to face for a range of psychotherapies, including a Comprehensive Behavioral Interventions for Tics (CBIT), but limited due to lack of portability, and restricted accessibility. An alternative is Voice over Internet Protocol (VoIP) transmission, allowing home delivery of treatment. The present study examined the preliminary efficacy, feasibility, and acceptability of CBIT-VoIP. Twenty youth (8-17) with CTDs participated in a randomized, waitlist-controlled trial of CBIT. Assessments were conducted via VoIP and internet surveys. Significantly greater reductions in total clinician-rated and parent-reported tic severity were found in the CBIT relative to the waitlist-control group, with 33.3% of those in CBIT considered treatment responders. Treatment satisfaction and the therapeutic alliance were high. Higher parent satisfaction with videoconferencing was associated with higher decreases in clinician-rated tic severity. Positive relationships were found between child computer usage at baseline and satisfaction with videoconferencing at post-assessment. VoIP was generally feasible, with some challenges due to audio and visual disruptions

Pilot Open Case Series of Voice over Internet Protocol-Delivered Assessment and Behavior Therapy for Chronic Tic Disorders

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment for children with chronic tic disorders (CTDs). Nevertheless, many families of children with CTDs are unable to access CBIT due to a lack of adequately trained treatment providers, time commitment, and travel distance. This study established the interrater reliability between in-person and Voice over Internet Protocol (VoIP) administrations of the Yale Global Tic Severity Scale (YGTSS), and examined the preliminary efficacy, feasibility, and acceptability of VoIP-delivered CBIT for reducing tics in children with CTDs in an open case series. Across in-person and VoIP administrations of the YGTSS, results showed mean agreement of 91%, 96%, and 95% for motor, phonic, and total tic severity subscales. In the pilot feasibility study, 4 children received 8 weekly sessions of CBIT via VoIP and were assessed at pre- and posttreatment by an independent evaluator. Results showed a 29.44% decrease in clinician-rated tic severity from pre- to posttreatment on the YGTSS. Two of the 4 patients were considered treatment responders at posttreatment, using Clinical Global Impressions–Improvement ratings. Therapeutic alliance, parent and child treatment satisfaction, and videoconferencing satisfaction ratings were high. CBIT was considered feasible to implement via VoIP, although further testing is recommended

Working at the intersection of research and practice:The love to read project

There is growing interest in the use of research-practice partnerships in education, in an attempt to narrow the widely recognized gap between educational research and practice. However, there is a tendency for partnership research to be weighted towards first-person accounts and the majority of literature comes from the US. This article describes the process of researcher-teacher collaboration to co-design an educational program, and teachers’ evaluation of this process, set within the context of a longer-term research-practice partnership in the UK. This paper discusses the benefits, challenges and methodological considerations associated with research-practice partnerships. Implications for future research-practice partnerships are highlighted, as are lessons learnt for those interested in working collaboratively and productively at the intersection of research and practice

Critical Thinking Dispositions of Agricultural Communications Students

Critical thinking, a reasoned, purposive, and introspective approach to solving problems, has received increased attention from agricultural educators. This study of agricultural communications students utilized a directly administered survey to investigate critical thinking dispositions of agricultural communications students at 12 universities. Results indicated that agricultural communications student respondents tend to be highly innovative in their thinking, an important trait in the field of communications. Results also indicated that few agricultural communication students would be classified as having a strong disposition toward critical thinking, while a larger number would be classified as weak in critical thinking dispositions

Optimizing behavior therapy for youth with Tourettes disorder.

Tourettes Disorder (TD) is characterized by tics that cause distress and impairment. While treatment guidelines recommend behavior therapy as a first-line intervention, patients with TD may exhibit limited therapeutic response. Given the need to improve treatment outcomes, this study examined the efficacy of augmenting behavior therapy with D-cycloserine (DCS) to reduce tic severity in a placebo-controlled quick-win/fast-fail trial. Twenty youth with TD completed a baseline assessment to characterize tic severity, premonitory urges, medical history, and psychiatric comorbidity. Youth were randomly assigned to receive a single session of habit reversal training (HRT) augmented by either 50 mg of DCS or placebo. Two bothersome tics on the Hopkins Motor/Vocal Tic Scale (HM/VTS) were targeted for treatment during HRT. One week after the HRT session, youth completed a posttreatment assessment to evaluate change in the severity of bothersome tics. All assessments were completed by independent evaluators masked to treatment group. There was a Treatment Group by Time Interaction in favor of DCS-augmented HRT (p < 0.01), controlling for baseline tic severity, tic medication, and attention deficit hyperactivity disorder. Follow-up comparisons revealed small group differences at the treatment visit (d = 0.27), with the DCS group exhibiting slightly greater severity for targeted tics. There was a large group difference at posttreatment, in which the DCS group exhibited lower severity for targeted tics (d = 1.30, p < 0.001) relative to the placebo group. Findings demonstrate the preliminary enhancement of tic severity reductions by augmenting HRT with DCS compared with placebo augmentation

Pilot Testing Behavior Therapy for Chronic Tic Disorders in Neurology and Developmental Pediatrics Clinics

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment with limited regional availability. As neurology and pediatric clinics are often the first point of therapeutic contact for individuals with tics, the present study assessed preliminary treatment response, acceptability, and feasibility of an abbreviated version, modified for child neurology and developmental pediatrics clinics. Fourteen youth (9-17) with Tourette disorder across 2 child neurology clinics and one developmental pediatrics clinic participated in a small case series. Clinician-rated tic severity (Yale Global Tic Severity Scale) decreased from pre- to posttreatment, z = –2.0, P \u3c .05, r = –.48, as did tic-related impairment, z = –2.4, P \u3c .05, r = –.57. Five of the 9 completers (56%) were classified as treatment responders. Satisfaction ratings were high, and therapeutic alliance ratings were moderately high. Results provide guidance for refinement of this modified CBIT protocol

A Multicenter Examination and Strategic Revisions of the Yale Global Tic Severity Scale

Objective To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. Methods This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Results Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. Conclusions The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed

A Latent Profile Analysis of Age of Onset in Pathological Skin Picking

Background Pathological Skin Picking (PSP) may begin at any age, but the most common age of onset is during adolescence. Age of onset is a potentially useful clinical marker to delineate subtypes of psychiatric disorders. The present study sought to examine empirically defined age of onset groups in adults with PSP and assess whether groups differed on clinical characteristics. Method Participants were 701 adult respondents to an internet survey, who endorsed recurrent skin picking with tissue damage and impairment. Latent profile analysis (LPA) was conducted to identify subtypes of PSP based on age of onset. Then subgroups were compared on demographic and clinical characteristics. Results The best fitting LPA model was a two-class solution comprised of a large group with average age of onset in adolescence (n = 650; 92.9% of the sample; Mean age of onset = 13.6 years) and a small group with average onset in middle adulthood (n = 50; 7.1% of the sample; Mean age of onset = 42.8 years). Relative to the early onset group, the late onset group reported significantly less focused picking, less skin picking-related impairment, lower rates of co-occurring body-focused repetitive behaviors, and trends towards reduced family history of PSP. Individuals in the late onset group also reported increased rates of comorbid depression, anxiety and posttraumatic stress disorder, and were more likely to report that initial picking onset seemed related to or followed depression/anxiety and physical illness. Conclusion Findings suggest the presence of two distinct PSP age of onset groups: (1) an early onset group with average onset in adolescence, clinical characteristics suggestive of greater picking-related burden and familiality, and a profile more representative of the general PSP population; and (2) a late onset group with average onset in middle adulthood, increased co-occurring affective and trauma conditions, and initial onset associated with or following other mental health and physical problems. Future replication is needed to assess the validity and clinical utility of these subgroups

Working at the intersection of research and practice: the love to read project

There is growing interest in the use of research-practice partnerships in education, in an attempt to narrow the widely recognized gap between educational research and practice. However, there is a tendency for partnership research to be weighted towards first-person accounts and the majority of literature comes from the US. This article describes the process of researcher-teacher collaboration to co-design an educational program, and teachers’ evaluation of this process, set within the context of a longer-term research-practice partnership in the UK. This paper discusses the benefits, challenges and methodological considerations associated with research-practice partnerships. Implications for future research-practice partnerships are highlighted, as are lessons learnt for those interested in working collaboratively and productively at the intersection of research and practice

Notes from the field: Lessons learned from using ecosystem service approaches to inform real-world decisions

While there have been rapid advances in assessments of biodiversity and ecosystem services (BES), a critical remaining challenge is how to move from scientific knowledge to real-world decision making. We offer 6 lessons from our experiences applying new approaches and tools for quantifying BES in 20 pilot demonstrations: (1) Applying a BES approach is most effective in leading to policy change as part of an iterative science-policy process; (2) simple ecological production function models have been useful in a diverse set of decision contexts, across a broad range of biophysical, social, and governance systems. Key limitations of simple models arise at very small scales, and in predicting specific future BES values; (3) training local experts in the approaches and tools is important for building local capacity, ownership, trust, and long-term success; (4) decision makers and stakeholders prefer to use a variety of BES value metrics, not only monetary values; (5) an important science gap exists in linking changes in BES to changes in livelihoods, health, cultural values, and other metrics of human wellbeing; and (6) communicating uncertainty in useful and transparent ways remains challenging