Hydrocephalus can impact all areas of health, including physical, cognitive, and social-emotional functioning. The social-emotional health of children who have had surgery for their hydrocephalus is not well characterized. This study examined social-emotional and behavioral functioning using the Behavioral Assessment System for Children, Third Edition (BASC-3) and the Hydrocephalus Outcome Questionnaire (HOQ) in children aged 5-17 years old. BASC-3 parent report scores were compared to the BASC-3 normative sample using one-sample t-tests to evaluate overall social-emotional functioning. BASC-3 scores were correlated with the social-emotional domain of the HOQ using Pearson's r to determine if the HOQ accurately captures the social-emotional functioning of children with hydrocephalus in a neurosurgery setting. BASC-3 and HOQ scores of children with different etiologies of hydrocephalus were compared using one-way ANOVAs. Children with hydrocephalus of all etiologies had more difficulties with social-emotional functioning compared to normative populations, but there were no differences in functioning between etiologies. The social-emotional domain of the HOQ correlated more strongly with the BASC-3 than did the physical and cognitive domains. These results provide evidence that children who have had surgery for their hydrocephalus may be at increased risk of social-emotional and behavioral difficulties, but etiology may not be particularly helpful in predicting what kinds or degree of difficulty. This study also supports the content and divergent validity of the social-emotional domain of the HOQ.

The OQ-45.2 (Outcome Questionnaire-45.2) is a measure of psychological distress that examines patients' emotional states and level of functioning in society. This measure was administered at admission and discharge to inpatients at a level II trauma center with in- and outpatient populations in addition to the BBHI-2 (Brief Battery for Health Improvement-2) and FIM (Functional Independence Measure). Results suggested that patients demonstrated psychological improvements from admission to discharge. In addition, the OQ-45.2 was found to correlate with nearly all subtests of the BBHI-2. Finally, diagnosis, length of stay, and number of psychotherapy sessions were not predictive of improvements on the OQ-45.2 total score, suggesting that this measure can be appropriately used on a heterogeneous medical population.

Research investigating clinical versus actuarial prediction and judgment has consistently demonstrated the superiority of actuarial (statistical) methods. Little research to date has directly compared clinical and actuarial predictions in the context of patient-focused psychotherapy outcomes. The most relevant study on this issue was completed with an adult population and results indicated that the actuarial method was significantly more accurate at predicting client treatment failure compared to clinician’s predictions. This study examined clinical versus actuarial prediction of client deterioration in a sample of children and adolescents receiving treatment in a managed care and community mental health setting. Predictions of treatment failure made by the actuarial method were found to be significantly more accurate than predictions of treatment failure made by clinicians. More specifically, participating clinicians did not make a single prediction of treatment failure. These findings add further evidence to support the use of actuarial methods in enhancing clinical decision-making in community-based mental health services for children and adolescents.

The need for psychotherapy outcome research is growing in Japan as the societal demands for psychotherapy have increased in recent years. Although researchers in Japan recognize the importance of integrating clinical practice and empirical research in evaluating psychotherapy outcome, most Japanese studies to date have relied heavily on qualitative case studies (Haebara, 1997; Kanazawa, 2004; Tanno, 2001). With the help of six translators and 116 native Japanese pilot respondents, this study adapted the Outcome Questionnaire (OQ; Lambert et al., 1996), one of the most common quantitative measures of clinical outcome, for use in Japan. The translation of the original OQ into Japanese followed Beaton et al. (2000) to include forward translation, synthesis, back translation, and expert committee meetings. The study produced 4 pre-final versions, 2 pretests, and a pilot. With permission from the original questionnaire developers, a few items were modified to achieve cultural equivalence. The rigorous translation and adaptation processes, evaluated through the Translation Validity Index (Tang & Dixon, 2002) and Content Validity Index (Polit et al., 2007), sought semantic, content, and conceptual equivalence between the English and Japanese versions of the OQ. Study limitations and suggestions for further development of the Japanese OQ are discussed.

This correlational study attempted to determine if the Outcome Questionnaire can be used to collect the same information as the Revised Dyadic Adjustment scale in marital assessment. Both measures are common pretreatment assessments and have relational components. The study used secondary data from the Utah State University Marriage and Family Therapy Clinic. Reliability and correlational tests were performed and the results indicate that the assessments measure different constructs. There also were no statistically significant correlations when comparing the measures by gender, marital distress, and marital satisfaction. Implications are discussed including the formulation of new clinical cut-off scores and the importance of using both measures to perform better assessments.

<p>SAMMANFATTNING</p><p>Under 2006 påbörjades arbetet med att nationellt höja kvaliteten på praktiskt socialt arbete. Socialstyrelsen gav då ut nya råd och riktlinjer för hur socialtjänsten kan stärka och utveckla sitt behandlingsarbete. Utifrån detta blir det allt vanligare att mer strukturerade manualer och behandlingsinstrument införs i arbetet. Ett sådant instrument är Youth Outcome Questionnaire, som under hösten 2007 implementeras i en kommunal behandlingsverksamhet i Örebro. Syftet med studien är att undersöka hindrande och möjliggörande faktorer som omgärdar implementeringen av ett behandlingsinstrument i en behandlingsverksamhet för ungdomar på institution. Syftet preciseras genom följande frågeställningar: Hur följdes det behandlingsarbetet upp innan implementeringen av instrumentet? Vad har föranlett att enheten beslutat att införa det nya behandlingsinstrumentet Y-OQ 2.0? Vilka möjliggörande eller hindrande faktorer har föregått implementeringsarbetet av instrumentet? Vilka negativa eller positiva faktorer framkommer i det praktiska handhavandet och tillämpningen av instrumentet? Studien har en kvalitativ ansats och bygger på semistrukturerade intervjuer med sex personer ur personalgruppen i den aktuella verksamheten. Tolkningsramen utgörs i huvudsak av implementeringsteori. Resultatet visar att personalen har en positiv inställning till arbetet med instrumentet. Man har inte tidigare arbetat utifrån strukturerade utvärderingsmetoder i form av instrument eller manualer och en majoritet av respondenterna ser behovet av utvärdering i verksamheten. Hindrande faktorer under implementeringen visar sig främst i att man upplever utbildningen som något bristfällig och att man inte heller fått någon handledning kring instrumentet. Detta har lett till osäkerhet kring användandet av detta liksom hur man ska använda de resultat som framkommer, vilket också visar på de praktiska svårigheter detta medfört. De möjliggörande faktorerna handlar till stor del om personalens positiva attityd och vilja att använda sig av det nya verktyget. I diskussionen förs resonemang kring implementeringens effekter på behandlingsverksamheten och instrumentets tillämpningsområde inom behandlingsarbetet.</p><p>Nyckelord: Implementering, implementeringsteori, behandlingsinstrument, Youth Outcome Questionnaire (Y-OQ 2.0), institutionsbehandling</p>

SAMMANFATTNING Under 2006 påbörjades arbetet med att nationellt höja kvaliteten på praktiskt socialt arbete. Socialstyrelsen gav då ut nya råd och riktlinjer för hur socialtjänsten kan stärka och utveckla sitt behandlingsarbete. Utifrån detta blir det allt vanligare att mer strukturerade manualer och behandlingsinstrument införs i arbetet. Ett sådant instrument är Youth Outcome Questionnaire, som under hösten 2007 implementeras i en kommunal behandlingsverksamhet i Örebro. Syftet med studien är att undersöka hindrande och möjliggörande faktorer som omgärdar implementeringen av ett behandlingsinstrument i en behandlingsverksamhet för ungdomar på institution. Syftet preciseras genom följande frågeställningar: Hur följdes det behandlingsarbetet upp innan implementeringen av instrumentet? Vad har föranlett att enheten beslutat att införa det nya behandlingsinstrumentet Y-OQ 2.0? Vilka möjliggörande eller hindrande faktorer har föregått implementeringsarbetet av instrumentet? Vilka negativa eller positiva faktorer framkommer i det praktiska handhavandet och tillämpningen av instrumentet? Studien har en kvalitativ ansats och bygger på semistrukturerade intervjuer med sex personer ur personalgruppen i den aktuella verksamheten. Tolkningsramen utgörs i huvudsak av implementeringsteori. Resultatet visar att personalen har en positiv inställning till arbetet med instrumentet. Man har inte tidigare arbetat utifrån strukturerade utvärderingsmetoder i form av instrument eller manualer och en majoritet av respondenterna ser behovet av utvärdering i verksamheten. Hindrande faktorer under implementeringen visar sig främst i att man upplever utbildningen som något bristfällig och att man inte heller fått någon handledning kring instrumentet. Detta har lett till osäkerhet kring användandet av detta liksom hur man ska använda de resultat som framkommer, vilket också visar på de praktiska svårigheter detta medfört. De möjliggörande faktorerna handlar till stor del om personalens positiva attityd och vilja att använda sig av det nya verktyget. I diskussionen förs resonemang kring implementeringens effekter på behandlingsverksamheten och instrumentets tillämpningsområde inom behandlingsarbetet. Nyckelord: Implementering, implementeringsteori, behandlingsinstrument, Youth Outcome Questionnaire (Y-OQ 2.0), institutionsbehandling

Background: Mental health issues and harmful substance use are problems that affect many Canadian youth. Wilderness therapy (WT) is a residential adventure-based therapy modality shown to have some success in treating these issues. Further research is needed regarding the ways that participants change, and if there are certain individuals that benefit more from this treatment than others. Purpose: The purpose of this study is to explore the changes in presenting problems and trait emotional intelligence of participants at one WT organization in Ontario, Canada. The working alliance - shown to have a positive impact on therapeutic treatment - along with sex and age, were examined to determine if these elements moderate outcomes. Methodology: Two separate samples were created from archival data provided by the participating organization. The first sample includes pre and post Youth Outcome Questionnaires (N=30, 14 to 18 year olds). The second sample includes pre and post Trait-Emotional Intelligence Questionnaires (N=68 youth, 16 to 20 year olds). All participants in both groups completed one Working Alliance Inventory post-WT. Descriptive statistics were calculated, paired t-tests were run, and Pearson correlation matrices and visualizations were created. Findings/Conclusions: Findings indicate that older male individuals report greater reductions in presenting problems as a result of their participation in WT. Trait emotional intelligence did not seem to change, and the working alliance did not seem to moderate any of these outcomes. / Graduate

Many college counseling centers use outcome measures to track therapeutic change for their clientele. These questionnaires have traditionally looked primarily at a client's symptom distress (e.g. depression, anxiety, suicidality, etc.) and are used to detect changes in the client's life that are due to therapy. Unfortunately, there is no measure that has been exclusively created and validated for use with college students. The College Adjustment Scales (CAS) form a multidimensional psychological measure designed specifically for use in college and university settings. Even though the CAS was created as a screening tool, it contains items that provide insight into changes that are possibly taking place for college students in therapy that are not measured by current outcome questionnaires. The purpose of this study was to determine which items and scales on the CAS were sensitive to therapeutic change for college students, thus assessing the validity of the test as an outcome measure and providing data for the development of future college counseling specific outcome questionnaires. This study used hierarchical linear modeling (HLM) to generate slopes that represent change over time for treatment and control groups. These slopes were compared to each other in order to determine whether each item and scale was sensitive to therapeutic change. The control sample consisted of 127 student participants that were not in therapy. The treatment sample was archival and consisted of 409 student clients. Seven of the nine scales were found to be sensitive to therapeutic change. However, 45 of the 108 individual items did not meet the set criteria. Because of these findings, the creators of the CAS are encouraged to revise the measure if it is to be used as an outcome questionnaire. In addition, researchers and clinicians should consider these results and take care not to treat this measure as an instrument that is wholly sensitive to therapeutic change for the college population. Items found to be sensitive to therapeutic change can be used to create a new outcome measure specifically for counseling centers.

A prominent need in the youth psychotherapy literature includes the examination of mechanisms of change within the context of "real world" clinical settings, where the practice of psychotherapy differs significantly from that in controlled clinical trials. In examining mechanisms of change in youth psychotherapy, variables related to parent functioning may be among the most important factors to consider in predicting and promoting good child outcomes. The purpose of the present study was to evaluate three important aspects of parent functioning—psychological symptom distress, interpersonal relations, and social role performance—as potential predictors of successful treatment outcomes in a traditional community outpatient treatment setting for children and adolescents. Further, this study examined whether parents indirectly benefited from their children receiving services, expanding our view on the scope and benefits inherent in youth psychotherapy. Parent Symptom Distress, Interpersonal Relations, and Social Role performance were measured using the domains of the Outcome Questionnaire 45 (OQ-45; Lambert et al., 2004), and youth treatment outcomes were measured using the parent and self-report versions of the Youth-Outcome Questionnaire (Y-OQ; Burlingame, Wells, Lambert, & Cox, 2004; Y-OQ-SR; Wells, Burlingame & Rose, 2003). Using Hierarchical Linear Modeling with this sample of 339 youth, aged 4-17 and their parents, this study examined the relationship between these parent domains and youth progress in therapy. Results revealed that parent Symptom Distress and Social Role performance improved significantly over the course of youth treatment. Further, Social Role performance at intake significantly predicted the rate of change in parent-reported youth outcome; and Interpersonal Relations at intake significantly predicted rate of change in youth-reported outcome. Finally, changes in parent Social Role performance were associated with changes in youth symptoms over the course of treatment. Examining the associations between these variables is an important step toward identifying potential mechanisms of change in youth mental health treatment. The results of this study provide valuable information on the importance of attending to parent functioning in the assessment and treatment of youth mental health issues.