Utilizing a sample of community-residing older adults, this pretest-posttest design evaluated the short term (approximately 1 week) impact on everyday functioning of Stress Inoculation (SI) training, a cognitive-behavioral intervention that is essentially a coping skills enhancement program. The targets of training were anxiety and concern about being able to successfully perform everyday living tasks. The training program was contrasted with a no contact (waiting list) control. In an effort to maximize the practical aspects of this study, the assessment battery included the use of two ecologically valid measures of everyday problem solving skills (one self-rated and one interviewer-rated). Also included were a measure of everyday intelligence widely used in gerontological research, two measures of self-efficacy, a geriatric depression scale, a state-trait anxiety scale, and a self-report measure of failures in perception, memory, and motor function. The results suggest that Stress Inoculation training is an effective intervention for improving everyday competence but that personal perceptions of self-efficacy and the emotional states of anxiety and depression mediate treatment effects. In general, only persons with lower levels of self-efficacy and higher levels of anxiety and/or depression saw improvement in their cognitive performance following SI training.

No description available.

No description available.

Bakgrund: Komplexiteten i vård och behandling av personer med substansbrukssyndrom (SUD) är omfattande. Dialektisk beteendeterapi (DBT) syftade initialt till att minska självskadandebeteende hos personer med borderline personlighetssyndrom (BPD) men har på senare år anpassats till andra typer av problem som exempelvis SUD. I Sverige har kommuner och regioner i dagsläget ett delat ansvar i att tillgodose vård och behandling för personer med SUD vilket kan försämra kvaliteten på vård och behandling. Ett nytt förslag att Regionen ska äga huvudmannaskapet ligger idag hos regeringen där en kompetensökning kommer att krävas inom regional verksamhet rörande behandling vid SUD. Som ett led i den kompetensökningen blir syftet med denna examensuppsats att undersöka DBT-terapeuters erfarenheter rörande DBT vid SUD. Metod: Sju DBT-terapeuter rekryterades till studien. Deltagarna intervjuades digitalt med hjälp av en semistrukturerad intervjuguide. Som metod användes reflexiv tematisk analys. Resultat: Upplägg av behandlingen varierade mellan de olika verksamheterna. Viktigt för patientgruppen med SUD var noggrann kartläggning initialt i behandling. Alla DBT-terapeuter var eniga i att DBT var effektiv för patienter med bristande känsloreglering och impulskontroll. Utmaningar att bedriva behandlingen var omgivande faktorer och grupprocesser som kunde ta fokus från behandlingen. Alla DBT-terapeuter var eniga i att det behövdes ett helhetstänk i behandling vid SUD. Samtliga DBT-terapeuter upplevde DBT som hjälpsamt för patientgruppen och majoriteten såg en minskning av återfall och användande av substanser. Slutsats: Författarna drar slutsatsen att DBT och DBT-skill training (DBT-ST) kan vara en bra metod för patienter med SUD. Ett skifte i huvudmannaskap blir viktigt för en mer patientsäker vård. Vidare forskning rekommenderas dock. Nyckelord: Substansbrukssyndrom, Dialektiskt beteendeterapi, erfarenheter, behandling.

Drug addiction is a chronically relapsing disorder that has been characterized by the compulsive use of addictive substances despite adverse consequences to the individual and society. Research has shown various social-psychological factors (e.g., positive affect, self-efficacy, behavioral intentions, beliefs held by others, and ones' perceptions of a behavior) to be essential determinants in recovery. Research has also demonstrated Entrepreneurial Education Programs (EEPs) to improve specific and global self-efficacy and autonomy in adolescent populations. The following study is the first to examine the impact of a therapeutically oriented EEP on entrepreneurial intentions and its antecedents in a population of adolescent males being treated for substance use disorder(s). Findings from the between-subjects analyses show that when compared to those who did not participate in the EEP, program participation increased entrepreneurial intention and its antecedents, entrepreneurial knowledge, emotion regulation, self-efficacy, positive affect, and interest in attending college. When compared to those who did not participate in the EEP, program participation also led to significant reductions in negative affect, anxiety, and stress. Findings from the within-subjects analyses show that participation led to significant increases from time 1 to time 2 in entrepreneurial intention and its antecedents, entrepreneurial knowledge, emotion regulation, self-efficacy, positive affect, and interest in attending college. When compared to time 1 scores, participation led to significant reductions in anxiety and stress. This study identifies the great potential of this therapeutic EEP to reduce behaviors involved in relapse and increase one's engagement with and commitment to antecedents of successful rehabilitation.

The role of the state in land use control was examined in general, and in relation to the land use context of Alaska. The study provides a brief overview of the history of land ownership and land control in Alaska as well as the particular difficulties attendant to the control and management of lands in Alaska. The types of land use control mechanisms and strategies available to Alaska, and their applicability to the Alaska context are examined through case studies of land use programs in Hawaii, Florida, Vermont and Oregon. Finally, the elements of Alaska's land use framework are identified in order to provide insight into the types of land use controls which might form the basis for a state land use control program for Alaska. The study concludes by offering a number of specific recommendations on the actions required to create a viable, comprehensive state land use program for Alaska. / M.S.

Introduction: Understanding the temporal dynamics of mental health conditions, such as suicidal ideation (SI), is critical for advancing research and clinical interventions. Ecological Momentary Assessment (EMA) is a method of increasing relevance for capturing such data over time, within participants daily lives. However, traditional analytical methods often fail to capture the episodic nature and complex temporal dependencies inherent in EMA mental health data. This project investigates the application of recurrent neural networks (RNNs) to EMA data to improve the prediction and understanding of SI, leveraging their ability to model sequential, high-dimensional data. Methods: Data for this study were drawn from a randomized controlled trial examining the effects of dialectical behavioral therapy (DBT) and SSRI medication on SI in individuals with borderline personality disorder. Participants provided EMA responses multiple times per day over a period at baseline and again post-treatment. RNNs were trained on a portion of each participant’s baseline EMA data with EMA as the outcome, using various baseline and time-varying predictors. Predicted EMA SI values were then generated for a baseline EMA testing dataset, and for the post-treatment EMA period, These predicted SI values were examined to assess the accuracy of the RNN modeling. Baseline testing accuracy was compared to traditional mixed-effects models (MEMs) to demonstrate RNNs feasibility as an alternative for learning and predicting SI time series. Additionally, simulated EMA data was generated in order to describe the data conditions under which RNNs are most useful in modeling EMA data. Furthermore, post-treatment EMA SI predictions were explored to assess the long-term predictive capabilities of RNNs and investigate the prospects of using RNNs to draw causal or mechanistic insights. Results: Key findings underscore the potential of RNNs in mental health research. At baseline, RNNs consistently outperformed MEMs in predicting SI, demonstrating their ability to model complex temporal dependencies and account for within- and between-subject variance. The simulated data analysis highlighted conditions under which RNNs excel, including the use of time-varying predictors and the availability of sufficient longitudinal data, offering guidance for future RNN use. The post-treatment analysis revealed that RNNs continued to provide reasonably accurate predictions, showcasing their robustness even when data were temporally distant from the training period, and following treatment interventions. Furthermore, differences in prediction accuracy between the DBT and SSRI treatment groups suggested that these interventions may uniquely influence SI dynamics in ways that RNN predictions may help to illuminate. Variables associated with prediction error differences provided further insight into treatment-specific mechanisms, highlighting the potential for RNNs to uncover nuanced effects not readily captured by traditional methods. Conclusion: This dissertation advances the understanding of SI as a dynamic and context-dependent mental health outcome. By integrating EMA with RNN-based modeling, it addresses critical gaps in the analysis of temporal mental health data, offering novel insights into both the evolution of SI and the effects of therapeutic interventions. These findings underscore the potential of machine learning techniques to enhance EMA's utility, paving the way for future research and clinical applications aimed at improving mental health outcomes.

Assertive training was investigated to determine its usefulness in teaching mildly retarded women to become more assertive. The 10 subjects (ages 18-35, WAIS VIQ 50-75) were randomly assigned to either the assertive training or the control group. Experimental subjects received 5 weeks of daily assertive training sessions which employed modeling, behavior rehearsal, and focused instructions in a group setting. Specific components of assertive behavior were taught in the following order: (a) assertive refusals, (b) assertive requests, (c) posture, (d) eye contact, and (e) loudness, Results of a behavioral role-playing task administered to both groups before and after treatment revealed that assertaive training subjects made significantly greater improvement than controls in their assertive content, Additionally, these subjects manifested significantly more improvement than control subjects on a global assertiveness measure.

Pesquisas de processo em psicoterapia utilizam categorização de sessões como uma maneira de compreender as relações terapeuta-cliente no contexto clínico, sistematizando a descrição da prática terapêutica e identificando variáveis críticas do processo e o impacto sobre sua efetividade. A presente pesquisa buscou relacionar resultados de categorização (molar) de objetivos analítico-comportamentais, estratégias (molares) para atendimento da criança e comportamentos de terapeuta e cliente (molecular), para análise da interação em sessões de atendimento analítico-comportamental. Participaram duas renomadas terapeutas infantis. Foram realizadas filmagens de oito sessões da díade Alice-Alex, seis da díade Bertha-Bia e de entrevistas com as terapeutas doutoras em análise do comportamento com mais de 30 anos de experiência clínica infantil. As sessões foram categorizadas segundo quatro sistemas, os dois primeiros elaborados na presente pesquisa: (1) Sistema de Categorização de Objetivos Terapêuticos (SICOT), (2) Sistema de Estratégias de Conversas e Atividade Terapêuticas (SECAT), (3) Functional Analytic Psychotherapy Rating Scale (FAPRS) e (4) Categorias do terapeuta e do cliente (SMCCIT), além da categorização do foco da fala (dentro ou fora da sessão). Foram obtidos índices Kappa satisfatórios de concordância entre observadores (K>0,630 em três sistemas, p<0,05 em todos) e realizadas análises de associação entre categorias nominais (chi-quadrado), intra e entre sistemas, e análise qualitativa sobre os dados, relacionando-os com os relatos das terapeutas nas entrevistas. Os resultados indicaram que as terapeutas enfatizaram estratégias diferentes, mas coerentes com o perfil das crianças e seus objetivos: no atendimento de Alex, buscou-se ensiná-lo a relatar, engajar-se em tarefas e seguir instruções como alternativa a opor-se e distrair-se; no caso de Bia, visou-se ensiná-la a se expressar de modo assertivo e aprimorar análises. As estratégias de Alice se basearam principalmente em: (1) fazer tarefas terapêuticas, manejando o comportamento de Alex na sessão, para ensino de leitura e escrita e (2) derivar conversas a partir de brincadeiras e fantasias, manejando o controle verbal para ensiná-lo a relatar. As estratégias de Bertha foram: (1) utilizar fantasia, manejando o comportamento de Bia na sessão, para ensino de outras formas de se relacionar com a família e (2) conversar derivado ou paralelo ao brincar e fantasiar, manejando o controle verbal para que as análises suplementassem as contingências fora da sessão. Os dois atendimentos tiveram maior porcentagem de interações com foco dentro da sessão, com ênfase em diferentes atividades para favorecer a adesão, manejar os comportamentos diretamente e conversar com as crianças. Discute-se que: (a) o uso dos diferentes sistemas, molares e moleculares, foi essencial para realizar diferentes níveis de análise e combiná-las entre si; (b) o uso de atividades não é terapêutico em si, mas auxiliar de intervenções com uma população cujo desenvolvimento verbal e seu controle por regras ainda é incipiente, em que as atividades auxiliam o manejo dos comportamentos em sessão e das conversas para a promoção do controle verbal. São apontadas algumas questões de pesquisa decorrentes deste estudo e, considerando a experiência das terapeutas, as implicações e questões práticas para a formação profissional em terapia analítico-comportamental infantil / Research process in psychotherapy use categorization of sessions as a way of understanding the therapist-client relationship in the clinical setting, systematizing description of the therapeutic practice and identifying critical process variables and the impact on their effectiveness. This research related the results of a molar categorization of behavior-analytic objectives, a molar system of strategies for treating the child, and therapist and client behaviors (molecular) for analysis of interaction in behavior analytic sessions. Filming was done in eight sessions of Dyad Alice-Alex and six of Dyad Bertha-Bia and of interviews with therapists, doctors in behavior analysis with more than 30 years of clinical experience with children. The sessions were categorized according to four systems, the first two developed in this research: (1) Categorization System for Therapeutic Objectives (SICOT) (2) System of Strategies of Conversations and Activities (SECAT), (3) Functional Analytic Psychotherapy Rating Scale (FAPRS) and (4) Categories of Therapist and Client Behavior (SMCCIT), besides the categorization of the focus of conversation (in or out of session). Satisfactory Kappa rates of agreement were obtained between observers ((K>0,630 in three of those, with p<0,05 in every system)) and correlation analysis was carried out among nominal categories (Chi-square), within and between systems, as well as qualitative analysis on the data, relating them to reports of therapists during the interviews. Results indicated that therapists have emphasized different strategies, but consistent with the profile of children and their therapeutic goals. In Alex case the therapist attempted to teach him to report, engage and follow instructions as an alternative to opposing and distracting himself. In case Bias case the therapist aimed to teach her to express herself assertively and improve analysis. Alices strategies were based primarily on: (1) assigning therapeutic tasks, managing behavior in the session for teaching to read and write, and (2) deriving conversations from fantasy and games, managing verbal control to teach him to report. The strategies with Bertha were: (1) using fantasy, managing the behavior of Bia in the session for teaching other forms of relationships with family and (2) talking derived from or parallel to playing and make believe, managing verbal control so that the analysis of B would supplement the contingencies out of the session. The two treatments had the highest percentage of interactions with focus on the session, an emphasis on different activities to promote adhesion, to manage behavior directly and converse with children. Conclusions: (a) the use of different systems, molecular and molar, was essential to achieve different levels of analysis and combine them together, (b) the use of activities is not therapeutic in itself, but helps interventions with a population whose verbal development - and its control by rules is still incipient. The activities are important for the management of behaviors in session and conversation for enhancing verbal control. Some research questions are raised considering the experience of participating therapists, and practical implications for professional training in child behavior analytic therapy are discussed

Buscando estabelecer controles públicos e empiricamente indexados para o comportamento verbal clínico do terapeuta de serviços, um modelo de Prática Psicológica por Evidências, chamado Prática Controlada, foi adaptado, testado e explorado quanto a algumas de suas possibilidades, em condições reais de aplicação. Esse modelo se fundamenta num arranjo específico dos procedimentos terapêuticos e em cinco instrumentos utilizados para a coleta de informações qualitativas e quantitativas pré-intervenção e na coleta continuada de dados empíricos referentes ao nível de perturbação psicológica do cliente, à qualidade da relação terapêutica e ao seu nível de engajamento nas tarefas terapêuticas, ao longo das primeiras 20 sessões de tratamentos de orientação analítico-comportamental para 34 clientes (10 homens, 33,3 ± 14,2 anos, e 24 mulheres, 35,6 ± 9,9 anos) em três cidades diferentes. As terapias foram conduzidas por três terapeutas experientes e quatro inexperientes. Os resultados indicaram que esse modelo de prática controlada produz indexadores empíricos que podem ancorar o comportamento verbal do terapeuta de serviços (suas interpretações e julgamentos teóricos e clínicos) e que são sensíveis à evolução de curto, médio e longo prazo da terapia, além de permitir a produção de evidências públicas clínica e socialmente relevantes dos resultados intermediários e finais do tratamento. Através da análise das séries temporais obtidas, os resultados também sugerem que a avaliação do cliente do seu nível de perturbação psicológica, do seu engajamento nas tarefas terapêuticas e na sua apreciação da qualidade da relação terapêutica pode responder a controles independentes e/ou a variáveis idiossincráticas. Apresenta-se uma discussão sobre teoria da mensuração, escalas de medidas e medidas em psicologia e em psicoterapia e algumas sugestões para pesquisas futuras são oferecidas. / Aiming to establish public and empirically based controls for the therapist-practitioner\"s clinical verbal behavior, a model of Evidence Based Psychological Practice, called Controlled Practice, was adapted, tested and explored in real-world conditions of application. This model is based on a specific arrangement of the therapeutic procedures and on five instruments for collecting qualitative and quantitative pre-intervention information and empirical data and for collecting continued empirical data on the client\"s level of psychological distress, on the therapeutic relationship\"s quality and on the client\"s level of performance at therapeutic tasks along the first 20 sessions of behavior-analytic oriented psychological treatments of 34 clients (10 males, 33,3 ± 14,2 yrs., and 24 females, 35,6 ± 9,9 yrs.) in three different towns. The therapies were delivered by three experienced therapists and four inexperienced. Results indicates that this model of controlled practice may anchor the practitioner verbal behavior (his/her clinical and theoretical interpretations and judgments) on empirically based indexers that are, at the same time, sensitive to the short, medium and long-term evolution of the therapy and may provide clinically and socially relevant public evidences of the treatment\"s intermediate and outcome results. Through the analysis of the time-series collected results also suggested that the client\"s evaluation of his/her level of psychological distress, his/her engagement in the therapeutic tasks and his/her appraisal of the therapeutic relationship may respond to independent controls and/or to idiosyncratic variables. A discussion of the theory of measurement, measurement scales and measures in psychology and psychotherapy is presented and some suggestions for future researches are offered.