The present study investigated the effects of progressive relaxation training using an abridged form of Jacobson's (1938) relaxation exercises on the mean number of nocturnal sleep disturbances in a group of psychiatric inpatients. Nocturnal time-sampling observations were made during a 14 day base line to select Ss who averaged 1.5 sleep disturbances per night. Six women, ranging in age from 23 to 56 years, were classified as problem sleepers and were moved to a common bedroom, where a second 16 day base line was taken to control for changes in the nocturnal environment. After a brief introduction and demonstration, a tape recording of the relaxation exercises was played each night of the 20 day experimental period. Results indicate a statistically significant decrease (p < .05) in the mean number of sleep disturbances as compared to base line levels. Caution was suggested in interpreting the results due to the possibility of interaction between the performance of the relaxation exercises, alteration of the nocturnal environment, and Ss' hypnotic drug medication.

Female adolescents are increasingly being charged with crimes of violence, and the literature is lacking as to how best to reduce their aggressive tendencies. In the past, girls represented a small portion of all youths involved in criminal justice systems, and studies involving effective treatment options for them were rarely conducted. Aggression Replacement Training® is a 10-week, evidence-based, group treatment intervention designed to advance moral reasoning, improve social skills, and manage angry feelings. Numerous outcome studies of Aggression Replacement Training® with both offending and non-offending male adolescents and with male and female adolescents together have yielded mixed results. The question remains whether or not positive results can be obtained when Aggression Replacement Training® is provided to only female adolescents in a group setting. This quasi-experimental study examined if there were significant decreases in aggressive tendencies and increases in pro-social behaviors among female juvenile offenders in a residential commitment program in the state of Florida who participated in an Aggression Replacement Training® group intervention versus those who did not participate. Due to the exceptionally high degree of exposure to traumatic life events commonly reported by this population, this study also hoped to ascertain whether or not the level of traumatic distress mattered as to the efficacy of the intervention for the girls who participated. The results of repeated measures 2 X 2 (time X group) ANOVA tests indicated no significant mean differences in rule-breaking or aggressive behaviors pre- to posttest between the 30 experimental and 30 comparison group members in this quasi-experimental study, although only a large anticipated effect could have been observed with a sample this size. The degree of trauma (covariate), also, had no significant impact on intervention efficacy for those girls who participated in the Aggression Replacement Training® group treatment. Mean negative behaviors were reduced for all study participants during the 12-week study time frame while in the commitment program, however, and both groups exhibited a mean increase in positive behaviors. Additional studies with larger samples may reveal a clearer picture of the benefits this intervention may provide to girls in juvenile justice commitment settings.

Although group treatment is often advocated for survivors of childhood sexual abuse (CSA), few studies have examined the effects of such treatments, particularly with adolescents. Yet adolescence is an important time for survivors of CSA as this is when they may truly begin to process what it means to have been sexually abused as a child (Berliner, 1991; Thun, Sims, Adams, & Webb, 2002). Consequently, this study sought to evaluate and develop best practice evidence for group treatment of adolescent girls who have experienced sexual abuse. The study used both a developmental intervention research approach to guide the development of a best practice intervention; and an action research, mixed methods program evaluation to achieve detailed examination of a small number of client cases so as to ethically assess the effectiveness of the intervention. In keeping with the intervention research approach and with the aim of providing specific knowledge about treatment for CSA survivors that was unattainable through reviewing treatment outcome studies, an initial study was undertaken which retrospectively and prospectively assessed a locally available treatment program for adolescent girls. This study found the locally available treatment approach was unlikely to have been effective at alleviating distress associated with CSA but that past participants and their mothers felt that such a program is important. Recommendations were made on the elements necessary to construct a more clinically responsive and effective treatment. A 16 week Trauma Focused Cognitive Behavioural group treatment program was then developed. This pilot treatment program was evaluated in Study 2, using both formative and summative program evaluation methods with four adolescent girls (aged 13-18). The summative findings support the utility of the treatment program and positive benefits were noted for each group participant, including reductions in symptoms of depression, anxiety and PTSD. The formative findings indicated that the treatment program was in need of further refinement. This included altering some session content, placing more focus on group process and including parents in the treatment. The recommendations of Study 2 were subsequently implemented and the revised treatment program was evaluated by experts in the field to enhance its content validity. The treatment program was then further evaluated in Study 3 using similar evaluation methods with five girls aged 12-15. Clinically significant changes were obtained for four of these five participants, as indicated by triangulation of data from the participants, their parents and group facilitators. Formative findings indicated that the program used in Study 3 was a significant improvement on the program used in Study 2. The major curative factor for participants appeared to lie in the group process and attendance at the program. Treatment was found to have a high degree of acceptability according to participants, parents and facilitators and was implemented with integrity, although flexibility and individualisation were important. The benefits of the research approach in terms of critical reflection, functionally relevant data, within and across case analysis and contextualisation are discussed. As the findings of this series of studies highlight, positive benefits were apparent for each participant and thus it is concluded that group treatment is a viable option for adolescent survivors of CSA.

Acquired Brain Injury (ABI) can cause balance and mobility deficits with activity and participation limitations. Repetitive Functional Task Practice (RFTP), currently best practice to promote recovery, is often not delivered at an adequate volume due to limited resources. This case series looked at the feasibility of treating community-dwelling people with ABI, in a group format, thus allowing economical, intense rehabilitation. Four participants attended for four weeks, three days/week, 4.25 hours/day. One-to-one and semi-supervised therapy was delivered with one therapist and one assistant. 89.51 minutes of RFTP and 134.82 minutes of total physical therapeutic activity was delivered per day. Participant satisfaction was good. All participants improved on some clinical measures. Three participants improved single and dual-task balance measures. This project established feasibility, allowed the formation of guiding principles for and supported the value of future research and development of this ABI Boot Camp model. / February 2016

OBJECTIVE: This study will explore the effects that an online support group can have on traumatic brain injury (TBI) caregiver burden. BACKGROUND: TBI is a public health concern that affects the lives of both patients and their caregivers. Caregivers often take responsibility for significant elements of TBI patients’ lives and, over time, this role takes a mental and physical toll on a caregiver’s own life. To date, there is limited research on the success of interventions, such as support groups and telehealth, in mitigating caregiver burden. There is much research that remains to be done. It is crucial that new and innovative support groups and telehealth interventions, such as the one outlined in this thesis, are trialed and analyzed by participants, in order to understand what methods are most effective in supporting these caregivers. DESIGN: One-group before-after non-randomized innovative intervention study. PARTICIPANTS: Eighty-five adult primary caregivers of TBI patients, recruited through the Brain Injury Association of America (BIAA). INTERVENTION: Sixteen sessions of mindfulness-based cognitive behavioral therapy (CBT) led by trained clinical psychologists and delivered via group videoconference. MAIN OUTCOME MEASURES: Zarit Interview Burden (ZBI); Brief Symptom Inventory (BSI). DATA ANALYSIS: Descriptive demographics. Unadjusted effect size and score descriptive for ZBI and BSI. Paired t-tests to compare mean ZBI and mean BSI at pre-intervention and post-intervention. Stratify by baseline BSI score to determine if baseline BSI score predicts decrease in ZBI score over the course of the intervention. CONCLUSIONS: The proposed study provides an innovative way to reduce burden on TBI caregivers and to analyze the feasibility and acceptance of the intervention. The study does, however, present limitations and, thus, outlines areas for future research. These limitations include the lack of a control group, the use of multiple clinical psychologists as group leaders, and the recruitment of only BIAA members who are comfortable using technology.

Introduction: Nearly 19.3% of children in the United States have obesity. There are several behavioral weight loss (BWL) programs available for children and adolescents that have proven effective in managing weight. Many of these treatments are delivered to groups of children rather than to individual youth. However, previous reviews of the literature have not explored the unique effects of group treatment modalities. Research has shown that social ties, particularly with peers, have an impact on adolescents' physical activity engagement and dietary habits. Therefore, it is important to explore how the interaction component of group delivered BWL treatments contributes to their success. This study sought to aggregate efficacy findings across published studies examining both group treatments and standard BWL care. Method: This meta-analytic review of the literature adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) as well as the Cochrane Handbook for Systematic Reviews of Interventions. Literature searches for relevant studies were conducted using electronic databases such as PsychINFO, PubMed, and Web of Science. Randomized clinical trials of interventions for overweight or obese youth aged 3-18 conducted between 1990-2020 which tested behavioral weight-loss interventions published in English were included. Three reviewers read titles and abstracts and code studies using the eligibility criteria. Cohen's d determined if an effect size was small (0.1), medium (0.3), or large (0.5). Results: Eight studies were included in the preliminary analysis. An omnibus weighted mean effect size for all group BWL treatment showed a small, but significant effect size (mean d = 0.121, 95% CI = 0.008 - 0.234), indicating that group treatments are more efficacious in pediatric weight loss and weight management at the end of treatment compared to individual or standard BWL treatment. Conclusion: Previous reviews and meta-analyses on BWL in children and adolescents have not addressed the contribution group therapy has on treatment outcomes. Results from this study may aid the development of future youth BWL treatments as group treatment is shown to be as effective or more effective than individual treatment. Group-delivered BWL programs could prove to be more cost-effective and improve access to care relative to individual interventions

No description available.

Nonclinical panic attacks have been defined as "panic reported by individuals not seeking treatment" (Norton, Cox, & Malan, 1992). The purpose of this study was to assess the prevalence of nonclinical panic attacks and associated symptomatology in a university sample of 576 late adolescents (ages 18-19), and to compare the effectiveness of two group treatments [Education/Support (ES) and Cognitive-Behavioral (CBT)] and a self-monitoring Waitlist (WL) condition in reducing the frequency and severity of nonclinical panic attacks, daily anxiety, and associated symptomatology. Nonpanickers (71.4% of the sample) reported no history of panic on the Panic Attack Questionnaire (PAQ; Cox, Norton, & Swinson, 1992). Past Panickers (16.5%) reported at least one panic attack prior to the past month. Recent Panickers (12.2%) reported at least one panic attack in the past month. Recent Panickers evidenced higher levels of trait anxiety, state anxiety, and depression, with a trend toward higher levels of anxiety sensitivity and internal negative attributions, relative to both Past Panickers and Nonpanickers, who did not differ. Thirty-four Recent Panickers were randomly assigned to the WL, ES, or CBT conditions. The entire sample, regardless of condition, showed a reduction in frequency of panic attacks, as well as their associated symptoms and cognitions, severity of daily anxiety, and three measures of general psychopathology (Le., depression, trait anxiety, and state anxiety). However, both active treatment groups were superior to the waitlist in producing improvement in panic-related self-efficacy, avoidance, and anxiety sensitivity. There was evidence that ES was slightly more effective than CBT in improving panicrelated self-efficacy, while CBT was somewhat more effective in reducing avoidance. Finally, while both treatment conditions combined fared significantly better than the waidist in producing high endstate functioning, assessed via a constellation of variables conceptually related to panic (i.e., panic-free status, high panic-related self-efficacy, low avoidance, low anxiety sensitivity), ES appeared most effective in promoting high ends tate functioning at Post-Treatment and Follow-Up (two months following treatment). Implications of these findings for the treatment of nonclinical panic attacks in late adolescence are discussed. / Ph. D.

Anxiety and depressive disorders are prevalent among youth and are often experienced concurrently or sequentially during development (Kroes et al., 2001; Costello, Erklani, & Angold, 2006). These disorders are also associated with weaker cognitive behavioral treatment (CBT) outcomes when experienced simultaneously in youth (e.g. Berman, Weems, Silverman, & Kurtines, 2000). Treatment research has begun to investigate the feasibility and efficacy of treating comorbid emotional disorders using transdiagnostic treatment approaches (Barlow et al., 2010; Ehrenreich et al., 2008). Evidence from adult and adolescent populations indicates that these more broadly focused treatment programs may offer benefits above and beyond disorder- and domain-specific protocols, leading to improvements in diagnostic severity and emotion regulation across a range of disorders and emotions (Ellard, Fairholme, Boisseau, Farchione, & Barlow, 2010; Ehrenreich-May & Remmes, 2010). The current study extends transdiagnostic treatment research to school-age children, ages 7-12, in a mental health clinic setting by investigating preliminary post-treatment outcomes and treatment acceptability in a recent open trial (N enrolled= 16; N completed treatment=13) of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Laird, 2009). Results revealed that participants experienced significant improvements in clinical severity ratings of principal and all related diagnoses, as well as in parent reported anxious and parent and child reported depressive symptoms at the post-treatment assessment. Additionally, parents reported gains in child coping and improvements in dysregulation across emotional domains (including worry, sadness, and anger). The EDTP had good retention rates, moderately good attendance, and parents and children reported high levels of treatment satisfaction. The results of this open trial provide preliminary evidence for the utility and acceptability of a transdiagnostic group protocol to treat both clinical anxiety disorders, as well as self- and parent-reported anxious and depressive symptoms for youth within a mental health setting. These results suggest that children may uniquely benefit from a more generalized, emotion-focused treatment modality, such as the EDTP, that can offer flexibility in its treatment targets to families as well as mental health clinicians.

Typical symptoms of aphasia such as comprehension problems and expressive language difficulties may affect the ability to take part in social contexts. Therefore, it is important to find ways to facilitate communication for people with aphasia. CIRCA is a communicationpromoting web service, designed for people with dementia and healthcare providers. Since people with aphasia show similar linguistic and communicative difficulties as people with dementia, it is possible that CIRCA would work as a communication support for people with aphasia as well. The aim of the present study was to investigate CIRCA as group activity for people with aphasia, in comparison to traditional group activities. Five participants with aphasia were recruited. The data collection involved four sessions with the use of CIRCA and four sessions where traditional activities were conducted, each session lasting for about 30 minutes. The sessions were videotaped, transcribed and analyzed according to methods inspired by Conversation Analysis, CA. The authors of this study chose to analyze the use of gestures, laughter, communication supporting behaviour and utilization of the available material in the various activities. The selected sections consisted of commonly used conversational phenomena that were considered to shape and characterize the conversations during traditional group activities, and when using CIRCA. Interviews about the participants' experiences of the conversations were conducted during the various activities. The selected conversational phenomena occurred frequently during all sessions as a type of interactive resources. What primarily characterized CIRCA as a group activity, in comparison to the traditional group activities, was that both pointing and iconic gestures were used to convey or clarify a message; that laughter served as a way of expressing mutual understanding about the material in CIRCA; that guesses in conversations when using CIRCA more often succeeded as communicative help behaviour; and that the images and music in CIRCA were used as a support for expression and understanding in conversation. All participants had a positive attitude toward the use of CIRCA.