Background: Eating disorder (ED) researchers continue to explore the effectiveness of e-therapy in improving symptoms and its treatment acceptability, however issues relating to poor uptake, adherence and dropout pose a challenge. Within this portfolio, the systematic review aimed to explore adherence to e-therapy for the treatment of ED, specifically exploring rates and predictors of uptake, completion, and dropout from randomised controlled trials (RCT) of ED e-therapy. The empirical project aimed to explore in-depth symptom change for ED cases engaged in blended internet-based cognitive behavioural therapy (ICBT) and face-to-face ED input. Acceptability of blended input was also explored. Methods: For the systematic review, literature searches were undertaken in March and September 2017 across EMBASE, PsycINFO, MEDLINE, Ovid and Cochrane Central Register of Controlled Trials (CENTRAL) and ProQuest databases. Key papers were assessed against five quality criteria (random assignment to groups, blinding to treatment allocation, quality of content, level of contact, sample size with sufficient power). Using a retrospective case series design, the empirical project explored changes over time of ED, anxiety, depression, quality of life (QoL), motivation for change, overall psychological functioning and clinician-rated/patient-rated improvement. Standardised health assessment measures captured symptoms over multiple time-points, and data was analysed using t-tests, multi-level modelling (MLM) and visual analysis. Acceptability of treatment was tentatively explored using an open feedback questionnaire. Results: Systematic review results identified intervention (content, acceptability, delivery method/location), participant (nature of symptoms, BMI, education, prior therapy, personality, views on e-therapy) and therapist-related factors (therapeutic support) were indicated in predicting uptake, completion and dropout across ED e-therapy. In the empirical project, study findings were inconclusive regarding symptom change attributable to blended input. Model fit improved when severity of ED symptoms predicted overall psychological functioning and patient-rated improvement over time, however findings were non-significant - potentially due to the study being underpowered. Conclusions: Promising evidence exists for ED e-therapy as an acceptable treatment option, however understanding which content nurtures engagement best is needed. Further research is needed into the factors predicting ED blended treatment outcome.

The purpose of this study was to determine if data routinely collected during the kindergarten year and at entry into first grade could be used to predict whether a child would be perceived as successful or not successful by the end of first grade. The need for immediate continued research on this topic was established through the review of literature, which highlighted the extent of the at-risk problem both locally and nationally. The growing number of at-risk students combined with the minimal impact of the educational programs mandates the need to identify these students in time to prevent school failure. However, clear identification procedures are not currently available and previous studies have raised substantial questions regarding the accuracy of early identification procedures. The presenting problem of this study was to determine the sensitivity and specificity of a set of predictor variables, and then to analyze these findings as to whether or not they were accurate enough for use as an initial identification process for subsequent classes. The primary research approach of this study was a longitudinal data collection and correlational analysis, with discriminant analysis techniques used to determine predictive accuracy. The study was limited to data on the class of 2001 from two elementary schools within the Washougal School District. The data collected and the subsequent analysis were used to answer six exploratory research questions. No hypothesis was proposed. This study used ratings and scores obtained from the administration of the Preschool Screening system, kindergarten teacher ratings, the School Success Rating Scale, and the Gates-MacGinitie Reading Readiness Tests as predictor variables. Criterion measures of school success/failure were: placement into special programs or grade retention, and end-of-first-grade evaluations of individual student success (report cards, teacher ratings, Gates-MacGinitie Reading Achievement, and the School Success Ratings Scale). The demographic variables of gender, age, parent marital status, and eligibility for free or reduced lunch were analyzed for their potential to exceed or enhance the accuracy of the predictor variables. Three types of measurement were defined and required in order for a predictor or predictor combination to be considered adequate for use in an identification process. These were overall accuracy, criterion sensitivity and specificity accuracy, and prediction sensitivity and specificity accuracy. An 80 percent accuracy level was desired on all three types of measurement. Findings of this study indicated that no single or combination of predictor, and/or demographic variables produced all three desired levels of accuracy. Various combinations of the predictor and demographic variables produced overall accuracy rates exceeding 80 percent for each of the criterion variables. Criterion measured sensitivity and specificity were found to be adequate for use in the prediction of at-risk students. Prediction measured specificity was also found to be highly accurate. Prediction sensitivity, however, was below the desired 80 percent level, indicating that the predictor variables over identify at-risk students. It was concluded that the predictor variables could be used in an identification process if mild over-identification of at-risk students was acceptable to the district. Any use of these identification procedures is assumed to be in connection with ethical intervention practices. Recommendations from this study included cross validation of the results and continuation of the study regarding the predictive accuracy of the identified variables as the students move through higher grade levels. The study also encouraged the Washougal School District to develop a formal collection and processing procedure for their routinely collected data.

The purpose of this study is to examine a sample of former Utah apprentices who either completed or dropped out of a registered apprenticeship program during the five-year period from 1969 to 1974. Comparisons were made between the dropouts and completers in order to determine how the two groups differed and what factors influenced their decisions to complete or cancel their indentures. Significant differences were found between the two groups with respect to their opinions of the training they received as apprentices. Especially significant differences were seen between the dropouts; and completers' responses to the questions related to their on-the-job training. The study concludes with a discussion of the implications of the findings for the future course of action to be pursued by apprenticeship labor officials in the state.

Given the high prevalence of client unilateral termination from psychotherapeutic services, elucidating client reasons for ending therapy is an important activity for researchers. Three studies were designed to shed light on reasons for both premature and appropriate termination from the perspective of adult clients and therapists: 1) In Study 1, I examined data from the Canadian Community Health Survey, Cycle 1.2, to establish base rates of client reasons for psychotherapy termination in Canada, along with their demographic and clinical correlates, 2) In Study 2, I used training clinic data to examine client and therapist perspectives of reasons for termination, working alliance, and barriers to treatment participation in mutual versus unilateral terminators, and 3) In Study 3, I collected data from Canadian clinical psychologists to examine their perspectives of client reasons for early versus later termination, and their use of engagement strategies to reduce client-initiated unilateral termination. In Study 1, 43.1 percent of respondents reported terminating therapy for reasons other than feeling better or completing treatment. In general, individuals with low income and diagnosable mental disorders had significantly increased odds of premature termination. Study 2 revealed that when clients made unilateral decisions to end therapy, therapists were only partially aware of either the extent of clients’ perceptions of their success in therapy or with their dissatisfaction with therapy. Although working alliance and barriers to treatment participation were rated as lower in the context of unilateral termination by both clients and therapists than in the context of mutual decisions to terminate therapy, all clients, in general, rated the early alliance and barriers to treatment as higher than did their therapists. In Study 3 psychologists assigned differential importance to reasons for termination depending on whether termination was before versus after the third session. Theoretical orientation (CBT versus other) did not influence views of reasons for termination, but influenced use of some engagement strategies. Results are discussed in terms of research and clinical implications.

Given the high prevalence of client unilateral termination from psychotherapeutic services, elucidating client reasons for ending therapy is an important activity for researchers. Three studies were designed to shed light on reasons for both premature and appropriate termination from the perspective of adult clients and therapists: 1) In Study 1, I examined data from the Canadian Community Health Survey, Cycle 1.2, to establish base rates of client reasons for psychotherapy termination in Canada, along with their demographic and clinical correlates, 2) In Study 2, I used training clinic data to examine client and therapist perspectives of reasons for termination, working alliance, and barriers to treatment participation in mutual versus unilateral terminators, and 3) In Study 3, I collected data from Canadian clinical psychologists to examine their perspectives of client reasons for early versus later termination, and their use of engagement strategies to reduce client-initiated unilateral termination. In Study 1, 43.1 percent of respondents reported terminating therapy for reasons other than feeling better or completing treatment. In general, individuals with low income and diagnosable mental disorders had significantly increased odds of premature termination. Study 2 revealed that when clients made unilateral decisions to end therapy, therapists were only partially aware of either the extent of clients’ perceptions of their success in therapy or with their dissatisfaction with therapy. Although working alliance and barriers to treatment participation were rated as lower in the context of unilateral termination by both clients and therapists than in the context of mutual decisions to terminate therapy, all clients, in general, rated the early alliance and barriers to treatment as higher than did their therapists. In Study 3 psychologists assigned differential importance to reasons for termination depending on whether termination was before versus after the third session. Theoretical orientation (CBT versus other) did not influence views of reasons for termination, but influenced use of some engagement strategies. Results are discussed in terms of research and clinical implications.

Thesis (Ph. D.)--University of North Texas, 2003. / Includes bibliographical references (p. 166-179).

No description available.

Why do seventy percent of Canadian Aboriginal students drop out of school? Although the literature focuses on reform to schools, school systems, and to the formal relationships that govern Aboriginal education, there is, as yet, a lack of empirically-based evidence from the perspectives of the people who have dropped out. The research was conducted in an adult education centre located in Winnipeg, Manitoba, Canada, and combines semi-structured interviews with an innovative Bead Workshop field-tested in other areas of identity conflict. The study asked 22 Aboriginal people how they make sense of their education experiences, inquired about why they dropped out of school, and invited them to share their hopes for the future. The trans-disciplinary nature of peace and conflict studies offers a new analysis when data were applied to Lederach’s (2003) conflict transformation framework. The findings showed that the participants quit school in the midst of very difficult and strikingly similar life circumstances, and they did not attribute dropping out to inadequacies in education or schooling, or to the effects of colonialism. The study expands the peace and conflict literature into the Canadian Aboriginal context while establishing a new research design and methodology. The study respects Indigenous research principles and combines them with conflict transformation principles to provide empirical evidence about why Aboriginal students drop out of school, and then extends the theoretical literature with a framework for exploring the role of deeper beliefs like love, courage, and hope in personal conflict transformation. Future research can be undertaken with larger groups of Aboriginal people to better understand their experiences in education and in other important areas of life, and to inform and advise Aboriginal policy and practice.

This thesis examines demographic data from 1358 clients from a mental health center in Anderson, Indiana in terms of the client's discharge record. It was hypothesized that there would be demographic data identified that would increase the therapist's ability to predict those most likely to drop from therapy. Support was obtained for this hypothesis, suggesting the client's socioeconomic status as the most reliable source of dropout identification.It was also hoped that by incorporating the cooperation of therapists in completing a questionnaire, particular therapist behaviors would be identified as effective tools in returning a dropout back to therapy. Therapist's demographic data were also to be examined in an attempt to suggest characteristics that may dispose a client toward premature termination. Unfortunately, obtaining the cooperation of the therapists proved more difficult than anticipated. Possible explanations were discussed in the transcript. Future research directions are also discussed.

Why do seventy percent of Canadian Aboriginal students drop out of school? Although the literature focuses on reform to schools, school systems, and to the formal relationships that govern Aboriginal education, there is, as yet, a lack of empirically-based evidence from the perspectives of the people who have dropped out. The research was conducted in an adult education centre located in Winnipeg, Manitoba, Canada, and combines semi-structured interviews with an innovative Bead Workshop field-tested in other areas of identity conflict. The study asked 22 Aboriginal people how they make sense of their education experiences, inquired about why they dropped out of school, and invited them to share their hopes for the future. The trans-disciplinary nature of peace and conflict studies offers a new analysis when data were applied to Lederach’s (2003) conflict transformation framework. The findings showed that the participants quit school in the midst of very difficult and strikingly similar life circumstances, and they did not attribute dropping out to inadequacies in education or schooling, or to the effects of colonialism. The study expands the peace and conflict literature into the Canadian Aboriginal context while establishing a new research design and methodology. The study respects Indigenous research principles and combines them with conflict transformation principles to provide empirical evidence about why Aboriginal students drop out of school, and then extends the theoretical literature with a framework for exploring the role of deeper beliefs like love, courage, and hope in personal conflict transformation. Future research can be undertaken with larger groups of Aboriginal people to better understand their experiences in education and in other important areas of life, and to inform and advise Aboriginal policy and practice.