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Objective: Conduct a meta-analysis of school-based interventions for anxious and depressed youth to evaluate the findings according to QUORUM guidelines. Method: A search of the literature was conducted using PubMed, PsycINFO, and manual searches, supplemented by contact with leading researchers. The present meta-analysis used 63 studies and investigated 8,225 participants receiving CBT and 6,986 participants in comparison conditions. Results: Mean pre-post effect size estimates indicate that anxiety-focused school-based CBT was moderately effective at improving symptomatology of anxiety (Hedge's g = 0.501) and depression-focused school-based CBT was mildly effective at improving depression symptomatology (Hedge's g = 0.298) for youth receiving active interventions as compared to those in anxiety intervention control conditions (Hedge's g = 0.193) and depression intervention controls (Hedge's g = 0.091). Moderators and mediators of treatment outcome were explored. Conclusions: School-based CBT interventions for youth anxiety and for youth depression hold considerable promise, though further investigation is still needed to identify features that optimize service delivery and outcome. / Psychology

Many parent factors have been associated with child anxiety, and researchers have examined how parents may be most beneficially involved in cognitive behavior therapy (CBT) for anxious youth. Results have been mixed as to whether parent CBT, family CBT, and parent interventions addressing parental anxiety or overcontrol have an added benefit over youth-focused CBT. The present study compared (a) a parent group intervention targeting autonomy granting, (b) a parent CBT skills group, and (c) a parent support control group, all provided in conjunction with individual CBT for anxious youth ages 7 to 17. Randomly assigned group conditions, as well as variance in overall parent attendance across conditions, were examined as predictors of change in parenting behaviors and in child anxiety. No significant differences in youth anxiety outcomes were found across parent group conditions, and parental beliefs and involvement improved most for the support control group. However, youth whose parents attended more group sessions showed a significantly greater decrease in anxiety severity than youth whose parents attended fewer (0, 1) sessions, which was mediated by a significantly greater decrease in parental avoidance of child anxiety. The results suggest that additional parent participation in treatment may have an added benefit, even with an unstructured support group format, but do not offer clarity about the benefit of targeted interventions for parents. / Psychology

Two versions of a six month weight control program were developed. A "behavioral" version used traditional behavioral terminology. This program was then modified to produce a "vivid" program using anecdotal material and examples drawn from the community. Terminology in the vividly framed program was reduced to positively framed “common language." For example, "dieting" was replaced by "eating better," and "exercise" by "pleasant physical activity." Seventy-four women then participated in either vividly or behaviorally framed programs. Anthropomorphic and demographic data initially obtained included height and weight, body mass index, weight goals, and marital and employment status. Subjects attended sessions which met at 5 p.m. or 6 p.m. Meetings were held weekly for seven weeks, bi-weekly for a month, and monthly until the end of the six month program. Major variables of interest included attendance, compliance with assignments, changes in total weight and changes in weight reduction quotients. Evaluations of the outcome variables revealed no effect for the verbal framing variable. It is suggested that either verbal framing has little effect in weight control or the level of framing used was ineffective. Other variables, however, appeared to influence outcomes. Self selection took place, with the younger, unmarried women filling the two 6 p.m. groups while older, married women filled the two 5 p.m. groups. Subjects who came closest to achieving their weight goals were the younger, lighter women. Neither attendance nor compliance with assignments were predictive of weight goal attainment. It is suggested that older individuals who have been overfat for many years might best concentrate on healthy eating habits and not set difficult weight goals. Alternatively, younger, less chronically overfat individuals might be better able to benefit from diet-exercise programs and specific weight loss goals. / Ph. D.

In the past decade the push for utilization of evidence-based practice (EBP) in mental health has increased dramatically. Due to managed healthcare, lowered spending on state and federal mental health budgets, and requirements by funding agencies such as Medicaid, it is imperative that mental health clinicians (MHCs) be trained in and utilize EBPs to improve funding and ensure continuity of best practice in clinical interventions with clients. Minimal research exists on MHCs and their knowledge and use of EBPs. The present study examined MHCs' perceptions, knowledge, training, and utilization of EBPs, with a specific focus on Dialectical Behavior Therapy (DBT). To date, it is the most prominent and effective EBP for treating Borderline Personality Disorder (BPD) and associated parasuicidal and suicidal behaviors. Current research supports its effectiveness in treating a myriad of other commonly treated disorders. The exploratory study provides insight into MHCs level of interest in receiving more EBP awareness and DBT training. Results indicate that though clinicians have received training in EBP and DBT, most of that training has been encouraged through career settings. Age of the clinician, years in practice, and type of training background are predictors of level of education, knowledge and training. Results show the majority of clinicians are interested in EBP, aware of the impact EBP can have on treatment effects, and report desire to have more training in EBPs and DBT specifically. These results could provide a necessary bridge between disciplines to allow clinicians, irrespective of training, to provide the most clinically effective treatments to clients. / Ph. D.

Two training procedures (active rehearsal, passive observation) were assessed for relative effectiveness in the acquisition of sequential fire emergency skills, reducing fire-related fears and physiological arousal, and increasing self-efficacy and rationale for fire safety skills. Active subjects imitated videotaped models performing emergency behavior while receiving behavior-contingent feedback. Passive viewers received no practice or feedback. Experimental groups were compared to untrained controls. Active rehearsal was expected to lead to superior skill acquisition, fear-reduction, self-efficacy appraisals, rationale acquisition, and reduction of physiological reactivity (systolic and diastolic blood pressure, pulse rate). Subjects were 52 third-grade children. Dependent measures were assessed at pre-test, post-test, and five-month follow-up. Significant performance gains were found for both experimental groups, but not for controls. Active training produced significantly greater skill acquisition. Skill gains were not maintained at follow-up. All groups showed significant reductions in fear at post-test, but no differences were found between groups. Active training also produced significantly greater self-efficacy appraisals for one emergency situation. Both experimental groups demonstrated significant gains in rationale acquisition relative to controls. Physiological results were confounded by pre-test differences. Correlations between various measures were examined. A significant relationship was found between self-efficacy appraisals and behavioral performance for one emergency situation. The correlation between self-report of fear and self-efficacy was highly significant across time. The implications of active training strategies in fire safety programs are discussed. / Master of Science / incomplete_metadata