Thesis (M.A.). / Written for the Dept. of Educational and Counselling Psychology. Title from title page of PDF (viewed 2009/06/12). Includes bibliographical references.

Habilitationsschrift--Bonn. / Bibliography: p. [121]-127.

Zugl. teilw.: São Paulo, Univ., Diss., 1999.

Bibliography: pages 143-152. / This study explores brief dynamic psychotherapy as a model of intervention with the individual adult client. The rationale for examining this area emanated from a few aspects. Firstly, increasing numbers of research studies indicated that the median length of psychotherapy, whether in private practice, or in community mental health centres, was actually of brief duration, whether planned or not; secondly, emerging studies indicated the proven effectiveness of brief intervention; and thirdly, the current emphasis on practice accountability with a more conscious use of time and outcome, were motivating factors to explore this model in practice. In addition, the study aimed to explore elements from the broader psychoanalytic tradition, which could be shaped and offered within a brief dynamic model of therapy.

Sleep disorders are highly prevalent in children and adolescents, affecting approximately 25-40% of this population. Questions about sleep are among the most frequent concerns that parents raise to their child’s pediatric medical provider. Behavioral treatments are the empirically supported treatments for addressing behavioral disordered sleep, and pediatric medical providers often endorse using such strategies. However, given the time constraints of primary care visits, such strategies are delivered in a very brief format. Whether or not these recommendations result in a change in the child’s disordered sleep symptoms has not been explored. Further, it is likely that this brief recommendation format is effective for some patients but not others. For example, children with comorbid neurodevelopmental conditions, severe sleep problems, and anxiety are less likely to respond to brief sleep interventions, and, therefore, may require a more comprehensive, time-intensive behavioral intervention. The current study aimed to explore factors related to the efficacy of a brief behavioral intervention provided via telehealth. Thirteen parents completed all portions of the study. Three were parents of children between the ages of 8 to 15 years and 10 were parents of children between the ages of 4 to 7 years (M = 6.8; SD = 2.7). All parents identified as White mothers. All children were also identified as White with 38.5% being female. Due to small sample size, quantitative analyses were not appropriate, so a qualitative examination of the data was conducted to explore relationships among participant demographics, sleep hygiene behaviors, sleep knowledge, sleep symptom severity, anxiety symptoms, and effects of the intervention. Results indicated that 37.50% of parents accurately assessed whether their child had problematic sleep. Minor variations in sleep knowledge were observed between parents who accurately identified their child’s sleep problems and those who did not (7.67 and 6.40 out of 10, respectively). Overall, participants had an average initial sleep knowledge score of 6.68, an average follow up sleep knowledge score of 7.31, and an average change in knowledge score of 0.62. Regarding effects of the intervention on sleep symptom severity, the average initial sleep symptom severity score was 50.25, the average follow up sleep severity score was 48.77, and the average change in sleep severity score was -2.00. An examination of sleep hygiene characteristics highlighted that while 81.25% of participants endorsed having a bedtime routine, almost 70% reported that the routine included an electronic device. Differences in initial sleep symptom severity and sleep knowledge scores were noted between participants who did and did not include electronic devices in their bedtime routines. The clinical implications of these findings are discussed further. Differences in intervention efficacy between participants with and without ADHD was also examined, but differences were not apparent. Intervention acceptability and feasibility were also examined. The current study demonstrated that the intervention was feasible to deliver for most participants within 10 minutes and, therefore, would be conducive to a primary care setting. Additionally, parents reported high levels of satisfaction with the content, understandability, and comprehensiveness of the treatment, which is encouraging for parents’ willingness to utilize the intervention if it was available to them. This study acted as an important initial step to determining the feasibility and acceptability of a brief behavioral sleep intervention. Clinical implications and future directions are discussed.

Motives for alcohol use are associated with distinct antecedents and consequences. Drinking alcohol to cope with negative affect is consistently associated with the most problematic patterns of use. Interventions targeting drinking to cope are needed. This randomized controlled treatment trial evaluated the impact of a brief coping motive feedback-based intervention on motives and problematic outcomes associated with drinking. In addition, a more comprehensive model of the antecedents and consequences of drinking to cope was tested. The study randomized 170 participants to receive either a brief Standard Feedback Condition (SFC; n = 83) or a Motives Feedback Condition (MFC; n = 87) that added education and feedback on drinking to cope as well as alternate coping strategies. Significant reductions in drinking to cope with depression were greater in the MFC at the 2-month follow-up, but the intervention's effect on drinking to cope with anxiety did not reach conventional levels of statistical significance. Significant reductions in drinking and negative consequences were observed but did not differ significantly by condition. Change in coping with depression motives mediated the effect of the intervention on outcomes of drinking and negative consequences. Partial support was found for a structural model linking antecedents of use, coping motives, and consequences associated with substance use. This study is a promising new direction in motives research, providing support for brief interventions incorporating motives-related feedback and for furthering our understanding of the origins and consequences of drinking to cope with negative affect. / Ph. D.

Hemispherectomy has gained widespread endorsement as a useful technique for treating seizures in patients with cerebral hemispheric dysfunction. Following this procedure, most patients experience seizure-freedom or a substantial decrease in the number of seizures occurring. Regarding other areas of functioning, patients generally maintain the same level of intelligence, language abilities, motor functioning, and visual ability, and experience improvements in behavioral disturbances and social skills. However, the current outcome literature lacks information regarding the effect of hemispherectomy on executive function. The purpose of this study is to evaluate executive function in pediatric patients with intractable epilepsy following a hemispherectomy. The parents of children who had undergone this surgical intervention completed the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, and Kenworthy, 2002) and their children's scores were compared to those of children with epilepsy treated with anticonvulsant medications (AEDs) only. The impact of clinical variables (i.e. age at time of surgery, lateralization of hemispherectomy, and amount of time since surgery) on BRIEF scores were also examined. Results indicated that children undergoing a hemispherectomy produced lower scores (less impaired) on several of the BRIEF scales as compared to those taking AEDs only. The left and right hemispherectomy group differed only on a subscale measuring behavioral inhibition, with the right hemispherectomy group producing a higher mean (meaning more impairment). Several BRIEF scores in the aggregate hemispherectomy group were positively correlated with time since surgery, such that longer post-operative periods were associated with poorer performances on the BRIEF. Several BRIEF measures were negatively correlated with age at time of surgery, suggesting that younger patients fared worse on the BRIEF than older patients.

This study examined the effect of the use of Brief-Solution Focused Therapy procedures on a young adolescent male, whose history suggested alcohol involvement on a daily basis. The data given during the baseline, intervention and follow-up phases, were obtained using the index of alcohol involvement scale, developed by Hudson. The A-B-A single system research design was used to analyze the data in all three phases. The conclusion drawn from the findings suggests that a series of brief –solution focused therapy reduced the alcohol involvement of the young adolescent male. The result of a student t statistic test also showed that there was a statistical significance between the baseline phase and the intervention phase, thereby supporting the conclusion of this study.

Thesis (Ph. D.)--University of Oregon, 2003. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 98-103). Also available for download via the World Wide Web; free to University of Oregon users.

Those who misuse alcohol in the United States do not regularly seek treatment on their own to reduce use and avoid consequences of misuse. Because of the association between alcohol misuse, alcohol-related risk behaviors, and injury; alcohol misuse in the United States has serious societal and individual repercussions. To alleviate these problems, health care professionals; including doctors, nurses, and social workers; have an opportunity to screen injured patients for alcohol misuse and provide brief interventions. Although some brief intervention research has demonstrated reductions in alcohol misuse and other injury-related behaviors, other evidence indicates that brief alcohol interventions are not equally effective for all injured patients. Moreover, screening and brief alcohol interventions are not reimbursed in most states, leaving providers and medical centers uncompensated for providing services. A possible way to address these challenges is to target intervention services to patients who are most likely to make positive changes. Therefore, this dissertation used mixture modeling to identify subclasses of injured patients based on their past injury-related consequences and risks of alcohol misuse in order to describe which subgroups made the greatest reductions in drinking in the year following discharge from a Level-1 trauma center. This dissertation also identified which subclasses of patients made the greatest behavioral improvements for injury-related consequences and risks of alcohol misuse during the year following discharge from the trauma center. Patients with profiles that contained high probabilities of multiple consequences and risks and those with histories of alcohol-related accidents and injuries reported some of the largest improvements in drinking and injury-related consequences and risks following discharge. Those classes that made the fewest changes had profiles that consisted of fighting and taking foolish risks while drinking or that consisted of low probabilities of risks or consequences of alcohol misuse. This dissertation provides tentative evidence for targeting intervention services to injured patients. Further research should verify which subclasses of patients are most likely to reduce alcohol misuse and other alcohol-related risk behaviors in order to more effectively target brief alcohol interventions, increase cost savings, and improve the health and behavioral health outcomes for injured patients who misuse alcohol. / text