Mary A Peterson

Starting Well: Facilitating the Middle School Transition

School-based mental health programming is a viable intervention because it can provide evidenced-based-treatment (EBT) while avoiding the typical service barriers. In this study, 119 students (ages 10 to 12) were randomly assigned to participate in either a 24-session Coping Power Program (CPP) or a control group. Using the Behavior Assessment Scale for Children-2 (BASC-2), teachers reported significant improvements over time for all students (Attention Problems, Hyperactivity, Externalizing Problems, and Withdrawal, and Study Skills). However, teachers reported that students participating in the CPP showed significantly greater improvement than controls (Learning Problems, School Problems, Behavior Symptom Index, Social Skills, and Adaptive Skills). Effect sizes ranged from small (.19 for Withdrawal) to large (.76 for Adaptive Skills). Teacher reports showed greater improvement by the more experienced group leaders. Results validate the use of this EBT as a viable protocol. The improvement in both groups may suggest a spillover effect for untreated controls. The differential effect of group leader suggests that clinical experience may enhance EBT.

The poverty puzzle: the surprising difference between wealthy and poor students for self-efficacy and academic achievement

Abstract This study explored the relationship between intellectual ability, socioeconomic status (SES), academic achievement and self-efficacy in a cross-cultural sample. Data from 90 students (63 students from Central America and 27 from the US) showed that regardless of culture or IQ, students from low SES families had significantly lower grade point averages than students from medium- or high-SES families. Unexpectedly, data showed that regardless of culture or IQ, students from high-SES families had the lowest self-efficacy, but the highest academic performance. Results suggest that self-efficacy is likely to be related to expectations and self-perception beyond IQ or culture.

Use of technology for note taking and therapeutic alliance.

Is psychotherapeutic alliance helped or harmed by using an iPad or computer during an intake session? Two studies are reported where psychotherapists use one of three different technologies in semistructured initial interviews: paper and pen, iPad, or a computer. The studies were conducted at a Primary Care Clinic and a Community Mental Health Clinic to provide a broader context to account for recent behavioral health integration into medical settings in addition to a traditional psychotherapy setting. The Primary Care Study consisted of 60 participants from a behavioral health service at a primary care clinic. The Community Mental Health Study involved 55 participants from a community mental health clinic in semirural Oregon. No differences were found for the three technologies in either study. Practice and training implications are offered.

The importance of group cohesion in inpatient treatment of combat-related PTSD.

Abstract Post-traumatic stress disorder (PTSD) is the most widespread mental illness resulting from exposure to combat, necessitating an increase in the provision of group therapy. This pilot study examined the efficacy of, and treatment outcome predictors associated with, group inpatient treatment of combat-related PTSD. Participants included 38 active duty military personnel deployed during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), diagnosed with PTSD, and consecutive admissions to an inpatient PTSD treatment facility. A paired samples t-test revealed significant change in symptom severity and global functioning between pre- and post-treatment. Multiple regression analyses supported the predictive utility of baseline symptomatology and group cohesion (> 50% of the variance in treatment outcome), highlighting the importance of group cohesion in the efficacy of group treatment for combat-related PTSD.

Predicting Treatment Response during the Acute Phase of Hospitalization

Objective: This study sought to determine if an initial assessment for an acute inpatient population was able to predict treatment response as measured by progress through clinical pathways. In addition, we sought to analyze the impact of comorbidity on treatment response. Method: A total of 170 adults (18–75 years) admitted for an acute inpatient hospitalization, received a full assessment including the Brief Symptom Inventory. Based on assessment results, patients were placed on one of five clinical pathways. Treatment response was measured by the number of days spent on each level of the clinical pathway. Results: Results revealed an unexpected, significant negative correlation between symptom severity on admission and movement through the clinical pathway; that is, patients with more severe symptomatic presentations at assessment made more rapid progress through the clinical pathways. However, comorbidity showed the strongest relationship with treatment response. Taken together, these variables explained 52% of the variance in treatment response. Conclusions: Responsiveness to antipsychotic medications, as well as high levels of subjective distress and the consequent motivation to achieve relief, may help explain the unexpected relationship between symptom severity and treatment response. Findings also demonstrated the utility of an initial assessment in predicting treatment response.

Reflections on Lothstein's Review

251 Carilyn C. Ellis, Mary Peterson, and Rodger Bufford are affiliated with the Graduate Department of Clinical Psychology at George Fox University in Newberg, Oregon. Jon Benson, a former graduate of George Fox University’s Clinical Psychology Program, provides contract supervision for doctoral students at the inpatient hospital that was the focus of study for this research. ELLIS ET AL. RELPY TO LOTHSTEIN

Homeward Bound: Moving Treatment from the Institution to the Community

This study examined changes in the length of stay, cost savings, recidivism and community access when individuals with serious mental illness who were mandated into extended treatment were moved from a regional center institution to community treatment. Results showed significantly shorter length of stay, cost savings and no increase in recidivism when individuals were treated in the community program.