Filippo Aschieri

Maximizing the Impact of e-Therapy and Serious Gaming: Time for a Paradigm Shift.

Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives’ paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming.

The effectiveness of therapeutic assessment with an adult client: a single-case study using a time-series design.

This article presents the therapeutic assessment (TA; Finn, 2007) of a traumatized young woman named Claire. Claire reported feeling debilitated by academic demands and the expectations of her parents, and was finding it nearly impossible to progress in her studies. She was also finding it difficult to develop and sustain intimate relationships. The emotional aspects of close relationships were extremely difficult for her and she routinely blamed herself for her struggles in this arena. The assessor utilized the TA model for adults, with the exception of not including an optional intervention session. The steps of TA, particularly the extended inquiry and the discussion of test findings along the way, cultivated a supportive and empathic atmosphere with Claire. By employing the single-case time-series experimental design used in previous TA studies (e.g., Smith, Handler, & Nash, 2010; Smith, Wolf, Handler, & Nash, 2009), the authors demonstrated that Claire experienced statistically significant improvement correlated with the onset of TA. Results indicated that participation in TA coincided with a positive shift in the trajectory of her reported symptoms and with recognizing the affection she held for others in her life. This case illustrates the successful application of case-based time-series methodology in the evaluation of an adult TA. The potential implications for future study are discussed.

Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study

The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including establishing a safe therapeutic environment, reprocessing the trauma, constructing a new narrative, and managing emotional dysregulation. Therapeutic Assessment (TA) is a semistructured, brief intervention that uses psychological testing to promote positive change. The case study of Kelly, a middle-aged woman with a history of repeated interpersonal trauma, illustrates delivery of the TA model for CPTSD. Results of this single-case time-series experiment indicate statistically significant symptom improvement as a result of participating in TA. We discuss the implications of these findings for assessing and treating trauma-related concerns, such as CPTSD.

Epistemological and Ethical Challenges in Standardized Testing and Collaborative Assessment

In this article, the author proposes that although treating clients humanistically may appear to be in conflict with the goal of objectivity in clinical assessment, they are not incompatible; and, indeed, as it is shown, the clinical psychologist has a responsibility to hold both goals in mind in order to achieve the most useful and accurate evaluations. Psychological assessment does not have to aim to remain exclusively in the realm of the “hard” sciences. Nor should assessment be relegated to the realm of pure subjectivity. The triangulation of narratives, particularly in collaborative assessment, provides a means of unifying theories, languages, and ways of producing knowledge and of being professionally responsible.

The Conjoint Rorschach Comprehensive System: Reliability and Validity in Clinical and Nonclinical Couples

This article presents the comparison of 2 paired groups of satisfied (n = 22) and distressed (n = 22) couples using a conjoint version of the Rorschach Comprehensive System (CS; Exner, 2003). The aim of the study was to evaluate if the couples’ verbalizations could be coded reliably using standard CS variables and if the 2 groups of protocols differed on several dimensions hypothesized to reflect relational dissatisfaction. The results showed good to excellent interrater reliability for the selected CS variables. Comparisons revealed expected moderate to large differences between the satisfied and distressed groups with regard to communication (R), some of the affective variables (DEPI%, Afr, SumV%, Col-Shading Blends%), and cognitive variables (X–%, WDA% Sum6%, WSum6%). Among variables connected with aggression, only AgPast% was moderately higher in the distressed group of couples. Overall, the results support the use of the Conjoint Rorschach Comprehensive System (ConRCS) in couples’ assessments.

Exploring Children's Induced Defensiveness to the Tell Me a Story Test (TEMAS)

ABSTRACT This study examined the effect of inducing a defensive attitude (fake good) in children on their responses to the Tell Me a Story test (TEMAS; Costantino, Malgady, & Rogler, 1988). Different story elicitation procedures were employed to explore their efficacy for inducing a defensive response style in children. Eighty-four Italian children aged 8 to 10 years old completed the TEMAS and the L scale of the Behavioral Assessment Scale for Children–2 (BASC–2; Reynolds & Kamphaus, 2004), which were used to detect the adoption of a defensive attitude. Children completed the tests under 1 of 3 conditions: (a) honest condition, (b) fake good with verbal instructions, and (c) fake good with verbal instructions and visual stimuli illustrating what was verbally explained. Using simultaneous verbal instructions and visual stimuli facilitated childrens understanding of the researchers instructions compared to using verbal stimuli alone. Results showed that children instructed to fake good used less time to tell stories and tended to modify the simpler and more face valid aspects of their stories. Still, 29 out of 47 children failed to fake good on the BASC–2 L scale. More complex TEMAS variables showed no significant difference between story elicitation conditions.

Factor structure invariance and discriminant validity of the Self-Curiosity Attitude-Interest scale

This study evaluated the factor structure of the Self-Curiosity Attitude-Interest (SCAI) scale. We conducted analyses of the configural, metric, and scalar factor invariance of the SCAI using data from three groups of participants with varying levels of fluid intelligence. We also explored the relationship between fluid intelligence and self-curiosity. The results provided support for the previously identified two-component factor structure of the SCAI (Aschieri & Durosini, 2015). The factor structure was invariant across the different levels of participant intelligence. Furthermore, as expected, regression analyses did not yield a significant relationship between self-curiosity and fluid intelligence. Limitations of this study and areas for future research are discussed.

Psychological assessment as an intervention with couples: Single case application of collaborative techniques in clinical practice.

Psychological assessment tools yield valid, reliable, and useful data for clinical psychologists. Nonetheless, clients often lack appreciation of their utility to understand and cope with their daily life challenges. Collaborative/Therapeutic Assessment (C/TA) models have shown that assessment results might be used as brief therapeutic interventions through collaboratively sharing testing data with clients. In this article, we focused on two collaborative techniques, namely intervention sessions and summary sessions, as potentially able to increase assessment utility for clients, providing them with life-changing, experience-grounded feedback based on assessment results. The application of these techniques to a clinical case with a couple suggested that both techniques might be beneficially applied to enhance clients’ empathy and compassion, to promote new insights about life challenges, and to sustain the development of new narratives and life meanings. C/TA techniques appear to be effective brief therapeutic interventions and their application in everyday assessment practice may be warranted.

Therapeutic Assessment With a Client With Persistent Complex Bereavement Disorder: A Single-Case Time-Series Design:

This article presents the results of a study into the effectiveness of therapeutic assessment (TA), a brief form of intervention that incorporates the results of assessment findings into psychological treatment. The history of Anthony, a man who reported symptoms of persistent complex bereavement disorder (PCBD), associated with major depression disorder (MDD) and post-traumatic stress disorder (PTSD), is presented. After his parents’ deaths, Anthony became detached from reality, lost all pleasure in his everyday life, and found it impossible to overcome the devastating feelings related to the loss. Following TA principles, the assessor created a supportive and empathic relationship with Anthony and helped him attain his goals for the assessment. The assessment was monitored using a single-case quasi-experimental design with time-series analysis. Results of this study revealed a specific trajectory of Anthony’s self-reported symptoms and a statistically significant trend toward improvement in severity at the end of the TA. This case study highlights the utility and efficacy of TA in helping clients process traumatic losses and complicated bereavements.