Jason F. Jent

The decision to access patient information from a social media site: what would you do?

PURPOSE The current study examined the prevalence with which healthcare providers use a social media site (SMS) account (e.g., Facebook), the extent to which they use SMSs in clinical practice, and their decision-making process after accessing patient information from an SMS. METHODS Pediatric faculty and trainees from a medical school campus were provided a SMS history form and seven fictional SMS adolescent profile vignettes that depicted concerning information. Participants were instructed to rate their personal use and beliefs about SMSs and to report how they would respond if they obtained concerning information about an adolescent patient from their public SMS profile. RESULTS Healthcare providers generally believed it not to be an invasion of privacy to conduct an Internet/SMS search of someone they know. A small percentage of trainees reported a personal history of conducting an Internet search (18%) or an SMS search (14%) for a patient. However, no faculty endorsed a history of conducting searches for patients. Faculty and trainees also differed in how they would respond to concerning SMS adolescent profile information. CONCLUSIONS The findings that trainees are conducting Internet/SMS searches of patients and that faculty and trainees differ in how they would respond to concerning profile information suggest the need for specific guidelines regarding the role of SMSs in clinical practice. Practice, policy, and training implications are discussed.

Cognitive Behavioral Principles Within Group Mentoring: A Randomized Pilot Study.

This study evaluated the effectiveness of a group mentoring program that included components of empirically supported mentoring and cognitive behavioral techniques for children served at a community mental health center. Eighty-six 8- to 12-year-old children were randomly assigned to either group mentoring or a wait-list control group. Group mentoring significantly increased childrens reported social problem-solving skills and decreased parent-reported child externalizing and internalizing behavior problems after controlling for other concurrent mental health services. Attrition from the group mentoring program was notably low (7%) for children. The integration of a cognitive behavioral group mentoring program into childrens existing community mental health services may result in additional reductions in externalizing and internalizing behavior problems.

Successful Therapist–Parent Coaching: How In Vivo Feedback Relates to Parent Engagement in Parent–Child Interaction Therapy

Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. This study investigated how different techniques of therapist in vivo feedback (i.e., coaching) influenced parent attrition and skill acquisition in parent–child interaction therapy (PCIT). Participants included 51 parent–child dyads who participated in PCIT. Children (age: M = 5.03, SD = 1.65) were predominately minorities (63% White Hispanic, 16% African American or Black). Eight families discontinued treatment prematurely. Therapist coaching techniques during the first session of treatment were coded using the Therapist–Parent Interaction Coding System, and parent behaviors were coded with the Dyadic Parent–Child Interaction Coding System, Third Edition. Parents who received more responsive coaching acquired child-centered parenting skills more quickly. Therapists used fewer responsive techniques and more drills with families who dropped out of treatment. A composite of therapist behaviors accurately predicted treatment completion for 86% of families. Although group membership was correctly classified for the treatment completers, only 1 dropout was accurately predicted. Findings suggest that therapist in vivo feedback techniques may impact parents’ success in PCIT and that responsive coaching may be particularly relevant.

No follow-up after positive newborn screening: medical neglect?

The current study examined medical professionals’ behaviors related to reporting medical neglect when a family is noncompliant with follow-up services after a positive newborn screening result. Pediatric medical professionals within an urban medical campus were provided with five case vignettes in relation to different diseases. Medical professionals rated the severity of family noncompliance with follow-up services and indicated whether they would report suspected medical neglect to Child Protective Services (CPS). Physicians were more likely to report medical neglect than the other mandated reporters in the study. Logistic regression analyses found that medical professionals’ perceptions of the severity of family noncompliance with services were significantly predictive of decisions to report medical neglect. Respondent gender and the method by which families were notified of screening results also significantly affected reporting behaviors in certain instances. Although all vignettes included information that met legal statutes for reporting neglect, medical professionals indicated that they would only report neglect 40—61% of the time across vignettes. Continued investigation of the rationale behind medical professionals’ decision-making process and training protocols designed to improve mandated reporter knowledge and reporting behaviors are needed to further reduce bias and improve objectivity when considering ethical and professional obligations to report medical neglect.

Does Practice Make Perfect? The Relationship Between Self-Reported Treatment Homework Completion and Parental Skill Acquisition and Child Behaviors.

The purpose of the current study was to examine whether the rate and type of parent-reported homework completion is associated with parent-report of child behavior outcomes, number of sessions to master parental skills as measured by therapist observation, and length of treatment in Parent-child Interaction Therapy (PCIT). Sixty-two parent-child dyads (primary caregiver: Mage=36.35years, female 95.20%, 81.60% White, 59.57% Hispanic; child Mage=4.22years; child gender male 64.50%) who completed PCIT were included in the study. A within-subjects hierarchical regression statistical design was used to examine the impact of parent report of homework completion on treatment processes and outcomes. A higher rate of self-reported homework completion was predictive of parental mastery of skill acquisition in fewer sessions and treatment completion in fewer sessions. Parent report of homework completion rate was not related to changes in child disruptive behavior after controlling for child behavior at baseline. Current study findings reinforce the importance of having parents regularly practice PCIT skills outside of session in order to decrease treatment length and facilitate the acquisition of parenting skills, which may reduce family burdens associated with attending a weekly treatment.

Improving behavior using child-directed interaction skills: A case study determining cochlear implant candidacy

Abstract Objective and importance Children with hearing loss (HL) are at increased risk of developing externalizing behavior problems (e.g., hyperactivity, attention problems). These problems can lead to cascading effects on childrens overall development. However, few studies have identified evidence-based interventions for this population. Clinical presentation A 6-year-old boy with bilateral HL presented to the clinic with significant behavioral challenges. These challenges (e.g., fatigued quickly, poor attention, and hyperactivity) were affecting the reliability of audiological testing to determine cochlear implant candidacy. Thus, the child was referred for Parent-Child Interaction Therapy (PCIT) to address these behavioral challenges. Intervention and technique PCIT is an evidence-based intervention that has been shown to significantly improve externalizing behavior problems. This study describes how the Child-Directed Interaction phase of PCIT was tailored for a child with bilateral HL. The goal of the intervention was to reduce externalizing behaviors in order to reliably complete a cochlear implant evaluation. Post-intervention, significant improvements were noted in behavior, including a decrease in disruptive behavior to normal levels. This led to completion of previously unsuccessful audiological testing and determination of cochlear implant candidacy. Conclusion This study illustrates how PCIT was successfully tailored to one child with an HL. This is critical as children with HL are at risk for behavior problems, and effective interventions for disruptive behaviors in children with HL may lead to significant improvements in medical and psychosocial outcomes for children with HL and their families.

Handbook of Childhood Psychopathology and Developmental Disabilities: Treatment

Students with disabilities and/or emotional or behavioral problems are at increased risk of poor academic performance, which is linked to a variety of long-term problems. In this overview, the interrelationship between academic success and childhood disorders will be described. Collaborative consultation within academic settings will be reviewed, followed by illustrations about various consultation models. Federal regulations (e.g., Section 504, IEP) for school-aged children with disabilities will be reviewed with an emphasis on understanding these regulations to guide consultative efforts. Examples of positive behavior interventions, accommodations, and modifications will be described and illustrated.