Objectives: To show forgiveness to be a central component in substance abuse and recovery and to encourage the empirical investigation of such realtionships. Methods: Literature reviewed and synthesized to support the role of forgiveness in addiction and recovery and to justify its empirical investigation. Results: The construct and process of forgiveness are present in 12-Step Facilitation Therapy, Motivational Enhancement Therapy, and Cognitive Behavioral Coping Skills Therapy, and other psychotherapies applicable to the treatment of substance abuse. Nevertheless, few studies exist to provide empirical support for these relationships. Conclusions: Religion and spirituality can have a salutary effect on substance use disorders. However, little is known regarding the effects of specific manifestations of religiosity and spirituality. Forgiveness, decreasing negative responses to offense irrespective of interaction with the offender, has been argued to be highly relevant to problematic substance use. Although the process of forgiveness is conceptually found in empirically validated forms of treatment for alcohol problems, little quantitative evidence exists to verify and illuminate the relationships between forgiveness and substance abuse. Empirical investigation into the basic, indirect, contextual, and interventional relationships between forgiveness and substance use disorders, including development, maintenance, and recovery, is warranted and encouraged.

Since it was first articulated, the Risk-Need-Responsivity model (RNR; Andrews, Bonta, & Hoge, 1990) has been extensively researched and is regarded as an empirically supported model for providing effective correctional treatment. It is comprised of three core principles: the risk principle, which provides direction for who should receive treatment; the need principle, which identifies intermediate treatment targets; and the responsivity principle, which states how treatment programs should be structured. The RNR model is purported to be relevant for all offender populations, including female offenders (Dowden & Andrews, 1999a), juvenile offenders (Dowden & Andrews, 1999b), violent offenders (Dowden & Andrews, 2000), and sexual offenders (Hanson, Bourgon, Helmus, & Hogdson, 2009). Yet, the majority of RNR research has examined the risk and need principles, and the responsivity principle remains understudied. The responsivity principle includes two sub-principles: general and specific (Andrews, & Bonta, 2010). The current research explored the general responsivity principle, which states that programs should use theoretically relevant models for individual change, specifically cognitive-behavioral and cognitive-social learning models (Andrews & Bonta, 2010). The following techniques are consistent with these models: "role-playing, modeling, repeated practice of alternative behaviors, cognitive restructuring to modify thoughts/emotions, skills building, or reinforcement" (Andrews & Bonta, 2010, p. 50). Despite empirical support, the RNR model has received minimal application to juveniles, and it has not been widely tested in the substance abuse treatment context. Additionally, it is not clear whether adherence to the RNR model is relevant for reducing substance use outcomes in youth. Adolescent substance abuse treatment programs were designed to address substance use among juveniles, and have been widely researched to determine their effectiveness; yet their effectiveness remains understudied among juvenile offenders. These studies include examinations of specific treatment interventions used, such as Multisystemic Therapy. Many of these interventions are considered to be "evidence-based treatment" (EBT), but there is a wide variety of repositories that classify interventions as "evidence-based" with varying criteria used to classify them. The juvenile drug treatment court model (JDTC) was specifically developed to address substance use and crime among juvenile offenders; however, findings from empirical studies have not demonstrated a strong treatment effect. To address these gaps in the literature, secondary analyses were conducted on data collected from 132 adolescent outpatient substance abuse treatment programs (AOPs) and 10 juvenile drug treatment courts nationwide. This research was an application of the general responsivity principle in the AOP and JDTC context to determine the impact of responsivity adherence on the odds of rearrest and substance use severity. The analyses also included an examination of evidence-based treatment (EBT) in both samples to determine the influence of EBT use scores on the odds of rearrests and substance use severity scores. To examine the AOP sample, multilevel models were used to examine the individual- and program-level impact of responsivity adherence and EBT use. To examine the JDTC sample, multivariate analyses were used to examine the individual-level impact of responsivity adherence and EBT use. Overall, responsivity adherence was not significantly associated with rearrests among AOP participants, nor was it significantly associated with substance use severity scores. Additionally, the odds of rearrest were significantly greater among individuals who received interventions with a higher EBT use score; though, there was no association between the average EBT use scores across programs and the odds of rearrest. There was no significant association between individual- and program-level EBT use scores and substance use severity. Among JDTC participants, an increase in responsivity adherence was associated with an increase in the odds of rearrest and substance use severity. A similar association emerged between EBT use scores and both outcomes, wherein increases in EBT use scores were significantly associated with an increase in the odds of rearrest and substance use severity. The results of the analyses suggest the need for further specification of both general responsivity adherence and "evidence-based" treatment for use in future research and theory; specifically, further elaboration of the general responsivity-adherent techniques and clear criteria for classifying interventions as "evidence-based treatment." The findings also imply that certain types of treatment interventions are more compatible with the JDTC model than other interventions. Additional analyses suggest the possibility that general responsivity adherence and evidence-based treatment may not be unique constructs. Future research may benefit through exploring evidence-based treatment as a criterion for adherence to the general responsivity principle. / Criminal Justice

The goal of the current study was to develop and test a rigorous measure of therapist adherence to a cognitive-behavioral, manual-based treatment for childhood and adolescent depression. This project employed data from the recently completed UCLAYouth Anxiety and Depression Treatment study. This study aimed to advance the literature by devoting the full focus of the project to the development of a manual-based measure that would demonstrate interrater reliability across multiple raters. This study reported on the psychometric development of the PASCET Manual Adherence Scale (PMAS) (e.g. scoring strategy, item development, reliability), a unique measure of therapist adherence that represents the content of the treatment manual for the "Primary and Secondary Control Enhancement Training" program (PASCET; Weisz et al., 1999). In sum, the P-MAS showed strong interrater reliability for most items of the scale. The items with poorer ICCs may have been influenced by instrumentation problems, small sample size, and range restriction. Some session content showed evidence that more meetings may be required to sufficiently cover the material, particularly for those that involve heavy in-vivo content, require the use of technology, or involve cognitive interventions which may be challenging for children and young teenagers. The results indicated that therapists adhered to slightly more than half of the prescribed manual content overall. The variability in adherence appeared greater for session-specific content than for standard session items, reflecting the variability within that content and the myriad of factors which may have influenced adherence to diverse material. Adherence for session-specific content demonstrated a slightly downward trend over time, with a significant drop off between the first and second phases of treatment and a leveling off between second and third phases. For all but two relevant sessions, therapist adherence to didactic content was significantly higher than adherence to in-vivo content, highlighting the challenges of engaging depressed youth in active learning. As this active involvement is theorized to be an essential component in addressing depressive symptoms, the challenges in implementation of this content may represent the most significant barrier to therapist adherence with this manual.

Autism spectrum disorder (ASD) presents with difficulties in social communication, repetitive and/or restricted behaviors, as well as variable language development. Individuals with suspected ASD ideally participate in assessments which include measures of cognitive abilities, adaptive functioning, language functioning, and ASD specific measures (i.e., ADOS, ADI-R). Diagnosis of ASD can occur confidently at 2 years of age, however, the mean age at diagnosis is 4-5 years old. Delays in diagnosis are accounted for by lacking professionals and centers with the capabilities to assess ASD, as well as long waitlists for assessments. Early identification and intervention have been shown to provide the best improvements in ASD symptomology. The aim of the current study was to conduct a program evaluation of an autism treatment center that was designed to provide high quality evidence-based interventions. The study determined if treatment-as-usual in that center yields the expected gains in adaptive functioning and corresponding decreases in barriers to learning. Results indicated improvement in scores on standardized direct assessment of milestone achievement and barriers to learning, but no significant improvement in adaptive skills via secondary informant questionnaire measures following 6 months of treatment. The overall sample size was small due to COVID-19 complications, lack of institutional procedures, and limited client pool. Further investigation into the treatment practices and reevaluation strategies for individuals with ASD is required.

For over 75 years the process of (un)forgiveness has been anecdotally understood to play an important role in the Twelve-Step Model of addiction and recovery. However, only very recently have scholars begun to examine the empirical evidence in support thereof. Multiple dimensions and aspects of forgivingness (trait), state forgiveness, and problematic substance use are relevant to one another in the context of addiction and recovery. Models of the association between forgiveness and problematic substance use have been developed, including the conceptual identification of the process of (un)forgiveness as inherent to and/or consistent with evidence-based treatment modalities. Relevant empirical evidence is reviewed and of the 21 empirical studies in the published scientific literature, 90 % show a salutary association. Indeed, forgivingness of self may be the most important dimension of forgiveness for recovery. A future research agenda is proposed and implications for individual, public, and societal health are discussed.

The early identification of non-responding psychotherapy clients and reducing their treatment failure rates are the principal functions of Clinical Support Tools (CST). Nearly two decades of patient-focused research have produced several "evidence-based treatment monitoring" (EBTM) practices, that measure individual patients' responses to theory-guided treatments and alert therapists of clients who are at risk of eventual treatment failure. Clinical Support Tools are a quality management program that bundle several EBTM practices, and have been shown to improve outcomes in failing clients (Shimokawa, Lambert & Smart, 2010). Appropriately, EBTM has generated significant interest as it expands notions of what constitutes evidence-based practice with non-responding patients (APA, 2006). There is a practical need to disseminate Clinical Support Tools to a wider audience of clinicians and practice environments. The current study was designed to advance understanding of CST mechanisms by providing detailed, qualitative data that demonstrate how CST procedures are utilized in routine practice. Eleven doctoral-level psychologists experienced in using Clinical Support Tools at a university counseling center were interviewed about their use of Clinical Support Tools with a recent non-responding client and about their general experiences with past non-responding clients. Clinicians' responses were categorized as Actions, Decisions, or Attitudes, and were subjected to inductive, thematic content analysis. Results were interpreted to indicate which CST functions were active or inactive in the therapists' routine care. Findings indicated that therapists utilized CST resources to monitor patient status, to identify problems that may have explained therapy non-response, and to initiate corrective interventions. Although it was clear that therapists used the CST signal-alarm system to initiate a problem assessment and corrective intervention, it was less clear whether therapists used CST's to determine significance of client change or to determine the client's prognosis. This observation needs to be confirmed through further investigation. Future research that quantifies CST utilization and investigates implementation-outcome relationships is recommended. Finally, practical avenues for increasing the influence and prevalence of EBTM practices in behavioral healthcare are discussed.

PURPOSE: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has not yet been systematically evaluated in the Caribbean context, particularly with Hispanic youth exposed to multiple disasters. The objective of this project was twofold: 1) to train mental health providers in Puerto Rico in TF-CBT as part of a clinical implementation project within the largest managed behavioral health organization (MBHO) on the island, and 2) to conduct a program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. METHOD: Fifteen psychologists were trained in TF-CBT. These psychologists then provided TF-CBT to 56 children and adolescents, ages 5-18, in community-based mental health clinics and one primary care clinic with a co-located psychologist in Puerto Rico. The mean number of traumatic events reported by youth referred for TF-CBT was 4.11. RESULTS: Thirty-six out of 56 children enrolled in the project (64.3%) successfully completed all components of TF-CBT. Results demonstrated large effect sizes for reduction in youth-reported posttraumatic stress symptoms (PTSS) (Cohen's d = 1.32), depressive symptoms (Cohen's d = 1.32), and anxiety symptoms (Cohen's d = 1.18). CONCLUSIONS: These results suggest that it was feasible to train providers in TF-CBT, that providers were able to deliver TF-CBT in community-based settings both in person and via telehealth (due to the COVID-19 pandemic), and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in Puerto Rico in a post-disaster context. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for Hispanic youth and disaster-affected youth in the Caribbean.

No description available.

This single-case design study examined the effectiveness of adapting evidence-based treatments (EBTs) for children in a community clinic through a university-community partnership. Community clinic therapists treated eight youths (five males), ages 10 to 14, of whom four were Caucasian, two were Latino, one was African-American, and one was Caucasian/African-American. Youths presented with a primary diagnosis of a DSM-IV (American Psychiatric Association, 1994) internalizing disorder (plus multiple comorbidities). An adapted treatment combining multiple elements based on two primary treatment manuals: Coping Cat (Kendall et al., 1990) and PASCET (Weisz et al., 1999) was used. Youths with comorbid externalizing symptoms were also treated with elements from a parent-training manual (Barkley, 1997). Results of visual and clinical significance analysis demonstrated mixed support for the adapted treatment in a community clinic setting. The findings support further efforts to test the effectiveness of adapted EBTs in a community clinic setting and population.

No description available.