Behavioral Treatment Program Research Articles

Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland – Protocol for the Making MECC Work research programme

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

School-based cognitive behavioural intervention programme for addressing anxiety in 10- to 11-year-olds using short classroom activities in Japan: a quasi-experimental study

BackgroundAlthough several school-based cognitive behavioural intervention programmes have been developed in Japan to prevent and improve children’s anxiety disorders, the substantial time required for their completion remains a problem.MethodsA brief version of the cognitive behavioural programme called ‘Journey of the Brave’, developed for Japanese children was conducted among 90 children aged 10‒11 years using 20-min short classroom activities, and its effectiveness was examined. The children were divided into two groups: the intervention (n = 31) and control groups (n = 59). The control group did not attend any programme sessions and followed regular school curriculum. We conducted 14 weekly programme sessions and assessed children at pre-intervention, post-intervention, and 2-month follow-up (6 months after the beginning). The primary and secondary outcome measures were the Spence Children’s Anxiety Scale (SCAS) to assess children’s anxiety symptoms and the Strengths and Difficulties Questionnaire (SDQ) to measure behaviour problems, respectively.ResultsA statistically significant reduction in the SCAS score in the intervention group was found at 2-month follow-up compared with the control group. A significant reduction was also observed in the SDQ score.ConclusionsOur findings suggested that the ‘Journey of the Brave’ programme, which requires only 5 h of short classroom activities, demonstrates promising results compared with previous programmes. A larger randomised control trial would be desirable.Trial registrationUMIN, UMIN000009021, Registered 10 March 2012.

Systems training for emotional predictability and problem solving in older adults with personality disorders: a pilot study.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a cognitive behavioural therapy-based group treatment programme for patients with borderline personality disorder (BPD). STEPPS has demonstrated its effectiveness for (younger) adults. However, there are no studies into the effects of STEPPS for older adults. The aim was to explore the outcome of STEPPS in older adults with personality disorders. In this naturalistic pre- vs post-treatment study, older patients with a personality disorder, reporting emotion regulation difficulties, were included. The primary outcome was BPD symptoms. Secondary outcomes included psychological distress and maladaptive personality functioning. Twenty-four patients, with a mean age of 63.9 years (SD=4.6), completed the 19-week programme. Nine patients (23.1%) did not complete the treatment. There were no significant differences in age, gender or global severity between completers and patients dropping out. There was a significant pre- vs post-treatment decrease of BPD symptoms, with a large effect size (Cohen's d=1.577). Self-control improved significantly and demonstrated a large effect size (r=.576). Furthermore, identity integration improved significantly, with a medium effect size (Cohen's d=.509). No significant differences were reported for most domains of psychological distress and maladaptive interpersonal personality functioning. The findings in this pilot study suggest STEPPS is a feasible treatment programme for older adults with personality disorders and emotion regulation difficulties. Adaptations to the program, for a better fit for older adults, however, might be needed.

Psychological factors predicting self-reported and observed aggression in male forensic psychiatric inpatients

The present study examined the psychological determinants of self-reported and observed aggression in male violent forensic psychiatric inpatients. Baseline data came from 232 inpatients referred to a cognitive–behavioral treatment program. Linear regression models were used to assess the relationship between the patients’ psychological characteristics and aggressive behavior. Self-reported aggression was studied with cross-sectional data, while the inpatients’ observed aggression in the ward was investigated with prospective data. The main factors contributing to the prediction of self-reported aggression were state anger, antisocial lifestyle and agreeableness, while the main factors contributing to the prediction of observed aggression were trait anger and agreeableness. The findings support the focus of treatment programs for forensic psychiatric inpatients on anger management.

Application of computerized cognitive behavioral therapy in patients with persistent postural-perceptual dizziness

Objective:A computerized cognitive behavioral therapy intervention program was constructed for patients with persistent postural-perception dizziness（PPPD） and its effects on dizziness symptoms, negative emotions and balance function were investigated. Methods:A randomized controlled trial design was used to select 86 patients with PPPD who were seen in the Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University from July 2020 to July 2021. Randomly assigned to the control group（43 patients） and the experimental group（43 patients）. The control group was routinely treated with medication and vestibular rehabilitation, while the experimental group underwent computerized cognitive behavioral therapy for a total of 9 sessions over 8 weeks; their dizziness symptoms（DHI）, negative affect（GAD-7, PHQ-9） and balance function（BBS） were compared at baseline, 4 and 8 weeks later. Results:After 4 and 8 weeks of intervention, the improvement of dizziness symptoms and negative mood in both groups had a between-group effect, time effect, and interaction effect（P<0.05）. The improvement of balance function had only a time effect and interaction effect（P<0.05）, and no difference in between-group effect was seen（P>0.05）. Conclusion:Computerized cognitive behavioral therapy can be used as an adjunctive treatment to alleviate patients' dizziness, negative affect, and balance function, but no additional benefit has been seen in terms of balance function improvement.

Development of the motivational thought frequency scale for alcohol abstinence (MTF-A).

For most treatment-seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non-specific about treatment consumption goals, which limit their effectiveness. Desires and mental imagery are relevant in the motivation for AUD treatment engagement. The Motivational Thought Frequency Scale for an abstinence goal (MTF-A) was adapted from the MTF for controlled drinking (MTF-CD). This study psychometrically evaluated the MTF-A in an alcohol-dependent sample engaged in treatment with a goal of abstinence. To enhance the clinical utility of the scale, a secondary aim was to evaluate a psychometrically equivalent short version of the MTF-A. A sample N of 329 treatment-seeking patients with AUD (mean age of 44.44 years, SD=11.89 years, 72% male) who were undertaking a cognitive behavioral treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF-A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF-A measured motivation for abstinence through four factors: intensity, self-efficacy imagery, incentives imagery, and availability. Confirmatory factor analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first-session treatment non-attendance and alcohol consumption between baseline assessment andcommencement of treatment, controlling for potential confounds. A four-factor structure provided the best fit for the MTF-A, compared with one- and three-factor models. A shortened 9-item MTF-A scale (S-MTF-A) provided better fit than the 13-item MTF-A scale. Both MTF-A and S-MTF-A displayed good internal consistency. Although both MTF-A and S-MTF-A successfully predicted first-session treatment non-attendance, neither predicted alcohol consumption between the baseline assessment and commencement of treatment. The model fit of the four-factor, 9-item S-MTF-A was superior to the original 13-item MTF-A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation.

LET’S GO OUT! A GROUP-BASED INTERVENTION IN OUTDOOR ADVENTURE EDUCATION AS A SPECIAL EDUCATIONAL SUPPORT

&lt;p&gt;This article deals with the group-based behavioral, cognitive, and skill-training intervention program &lt;em&gt;Maltti &lt;/em&gt;as a special educational support action applied with outdoor adventure education at the primary school level. The need to apply the group-based intervention arose from the special education teachers’ (N=2) desire to reinforce and expand their pedagogical methods in order to improve the students' development in special education. The special education teachers had a group of pupils with special educational needs, aged from 10 to 11 (5th graders in Finland). These pupils faced challenges in social and emotional development, for example, in the areas of psychological regulation, self-regulation, and emotional regulation. This article is a case study which presents how outdoor adventure education can be implemented in special education. It also describes how special education teachers experienced the group-based intervention intersecting with outdoor adventure education. The research findings indicate that together, the intervention and the outdoor adventure education encouraged pupils’ emotional and social development, well-being, relaxation, a sense of belonging, successful experiences, positive group experiences, and strengthened executive functions. The findings promote the use of outdoor adventure education methods in the group-based intervention &lt;em&gt;Maltti&lt;/em&gt; with children with special needs.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0958/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

A Brief History and Future of the Traffic Light Diet

Abstract The Traffic Light Diet is a commonly used component of many behavioral treatment programs for pediatric obesity. Vorland, Brown, Cardel and Brown (1) raise some interesting and important issues related to the Traffic Light Diet. This commentary is designed to provide a background on the history and purpose of the Traffic Light Diet, to indicate the Traffic Light Diet is only one component of effective Family-Based Behavioral Treatments for pediatric obesity, and to support an idea for future directions for the Traffic Light Diet based on unique dietary and nutritional requirements for specific diseases.

Evaluation of an interprofessional collaborative practice training module for the management of children with autism spectrum disorder

BackgroundProtocols instituted for behavioral treatment and skills training programs for the management of autism spectrum disorder (ASD) suffer from lack of collaborative approaches. The tenets of interprofessional collaborative practice (IPCP) focus on preparing a panel of health care professionals (HCPs) from different professions who can work together to enable the common goal of ensuring that children with ASD can participate in society. This study was designed to pilot this approach through an IPCP training module on ASD for care providers from multiple professions. MethodsAn interventional study with pre-post analysis began with formation of the interprofessional (IP) team, who developed an IPCP module, addressing the knowledge and skills needed for the collaborative management of neurodevelopmental issues of children with ASD. This module was delivered through an online training workshop using various teaching learning methods to the participants from seven different health professions after obtaining informed consent. Perceptions of interprofessional collaboration and competencies of IPCP were assessed using standard IP tools and reflective summaries and analyzed through a mixed-methods approach. ResultsA total of 42 HCPs from seven professions, including speech and hearing, occupational therapy, clinical psychology, physiotherapy, pediatrics, nursing, and pedodontics, participated in the study. Pre-post analysis of PINCOM-Q and Dow-IPEC data and thematic analysis revealed a significant difference in the perceptions of interprofessional collaboration and competencies’ levels of IPCP. ConclusionThis study suggests that use of IPCP principles in the training of professionals working with ASD is a promising and feasible option to develop more competent health professionals. The training enhanced the abilities of professionals to work in field of ASD as conveyed by the participants. They also expressed confidence in the knowledge of IP core competencies after the completion of the module.

Meeting the Needs of a Culturally Diverse Nation: An Evaluation of a Behavioural Program Adapted to Treat Vietnamese Australians Experiencing Gambling Problems

Equity is an important principle of health care in Australia, and redesigning health services to meet the needs of culturally marginalised groups has the potential to improve accessibility to psychotherapy. This paper describes the collaborative efforts of an ethno-specific service and a specialist treatment service to provide an evidence-informed intervention to treat Vietnamese Australian individuals experiencing gambling problems. Employing a clinical case audit tool and drawing on the evidence of 33 participants, the study identified which features of therapeutic practice had the most impact on retention and treatment completion. Moderate but influential adjustments to the delivery of a standard behavioural treatment program improved access, treatment adherence, and success for Vietnamese Australians experiencing gambling problems. These findings have significant implications for health care provision in a culturally diverse nation. Results highlight the importance of service adaptation to address under-utilisation and under-representation of psychotherapy services by culturally marginalised groups due to language and cultural barriers.

Become your own SLEEPexpert: design, development and evaluation of a pragmatic behavioral treatment program for insomnia in inpatient psychiatric care

Become your own SLEEPexpert: design, development and evaluation of a pragmatic behavioral treatment program for insomnia in inpatient psychiatric care

OCD and Comorbid Depression: Assessment, Conceptualization, and Cognitive Behavioral Treatment.

Many individuals with obsessive-compulsive disorder (OCD) also meet criteria for additional diagnoses. Among the most common co-occurring diagnoses are mood disorders-especially depression. This article focuses on the comorbidity between OCD and major depression. After discussing nature of OCD and depression, the rates and clinical impact of depression on OCD, the conceptualization, assessment, and treatment of OCD when it appears along with depression is covered in detail. The derivation and implementation of a cognitive behavioral treatment program specifically for depressed OCD patients is described and illustrated using a case example.

Smokeless Tobacco: Pattern and Awareness in a Rural Area of Bangladesh

Background: Smokeless tobacco consumption has contributed nothing except diseases, disability and death. But assessment of awareness and knowledge regarding its use has less been studied to the extent as that of smoking. The study was undertaken to assess the pattern of use and awareness of smokeless tobacco among rural community.&#x0D; Materials and methods: This descriptive cross-sectional study was conducted among 310 respondents selected through systemic sampling method, aged 18 years, residing at least for 10 years in Noakhali district in Bangladesh. This study was conducted from May to November 2013. Data were collected with a pretested questionnaire through face-to-face interview. &#x0D; Results: Smokeless Tobacco (SLT) use was prevalent among 45.8% of respondents. Higher proportion of females than males used SLT. Zarda was the common form in more than half of the users. Among daily users, self-interest was the main factor for initiation and mean age of starting was 35 years. Per day frequency of SLT use for 1-8 times was in two-thirds of the daily users. Most of the respondents knew that SLT is injurious to health. About two-thirds of them mentioned SLT as addictive. More than one-thirds of the respondents had knowledge that smoking is more injurious than SLT. However, 30% of the respondents knew that both smoking and SLT were equally addictive. Excluding the former users, majority of the respondents knew that SLT might be quitted. &#x0D; Conclusion: Multistage effective behavioral change intervention programs are the preferable way to overcome this lifestyle-related health problem.&#x0D; JCMCTA 2022 ; 33 (1) : 166-172

Noncommunicable diseases risk factors and the risk of COVID-19 among university employees in Indonesia.

IntroductionNoncommunicable diseases (NCDs) are still a major public health problem in Indonesia. Studies have shown that risk factors of NCDs are associated with coronavirus disease 2019 (COVID-19) severity and mortality. However, it is unclear whether NCD risk factors are also risks for new COVID-19 cases. This study aimed to obtain an NCD risk profile among university employees and its associations with contracting COVID-19.MethodsA cross-sectional study was conducted in October 2021. Participants were administrative employees of Universitas Indonesia (UI), Depok City, West Java. Assessment of NCD risk factors was based on the World Health Organization STEPwise approach to NCD risk factor surveillance (WHO STEPS). Demographic, working, and medical-history data were obtained electronically by using a Google Form. Physical and laboratory examinations were done in the Integrated Post for NCDs. Risks were expressed as adjusted odds ratio (ORadj) and 95% confidence interval (CI) in multivariate analyses.ResultsA total of 613 employees were enrolled. Men were predominant (54.8%), and about 36% of them work in shift as security personnel. About 66.7% were overweight or obese and 77.8% had hypertension. There were 138 (22.8%) employees who had COVID-19. Nearly all (95.6%) had been fully vaccinated against COVID-19. At-risk waist circumference (ORadj 1.72, 95% CI 1.15–2.56, p = 0.008) and total cholesterol level of 200–239 mg/dL (ORadj 2.30, 95% CI 1.19–4.44, p = 0.013) were independent risk factors, but shift work (ORadj 0.52, 95% CI 0.34–0.80, p = 0.003) was protective against COVID-19.ConclusionThe prevalence of NCD risk factors among university administrative employees was high, increasing the risk of contracting COVID-19. A behavioral intervention program to manage NCD risk factors at the university level is urgently needed according to the Health Promoting University framework.

Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members

BackgroundOver the past 10 years, incidence of sexually transmitted infections (STIs) has increased to record numbers in the United States, with the most significant increases observed among adolescents and young adults. The US military, where the majority of active duty personnel are 18–30 years old, has seen similar increases. However, the US military does not yet have a standardized, service-wide program for STI education and prevention.MethodsThe KISS intervention (Knocking out Infections through Safer-sex and Screening) was adapted from an evidence-based intervention endorsed by the US Centers for Disease Control and Prevention and consisted of a one-time, small group session. Content included STI/HIV knowledge and prevention, condom use skills, and interpersonal communication techniques. The intervention was pilot tested for feasibility and acceptability among a population of service members and medical beneficiaries at Joint Base Lewis-McChord in Washington state.ResultsA total of 79 participants aged 18–30 years were consented to participate in the pilot study and met entry criteria, 66/79 (82.5%) attended the intervention session, and 46/66 (69.7%) returned at 3 months for the final follow-up assessment. The intervention sessions included 31 male (47.0%) and 35 female (53.0%) participants. Almost all participants felt comfortable discussing sexual issues in the group sessions, reported that they intended to practice safer sex after the intervention, and would also recommend the intervention to friends. Knowledge about STI/HIV prevention significantly increased after the intervention, and intervention effects were maintained at 3 months. About one-fifth of participants tested positive for N. gonorrhea or C. trachomatis infection at enrollment, while none had recurrent STIs at the final visit. Use of both male and female condoms increased after the intervention.ConclusionsThe KISS intervention was feasible to implement in the military setting and was acceptable to the active duty service members and other medical beneficiaries who participated in the pilot project. Further studies are needed to determine if the KISS intervention, or others, effectively decrease STI incidence in active duty personnel and would be appropriate for more widespread implementation.Trial RegistrationRetrospectively registered as the pilot phase of clinicaltrials.gov NCT04547413, “Prospective Cohort Trial to Assess Acceptability and Efficacy of an Adapted STI/HIV Intervention Behavioral Intervention Program in a Population of US Army Personnel and Their Medical Beneficiaries—Execution Phase.”

Instructing Parents to Deliver Discrete Trial Teaching to Their Children with Autism Spectrum Disorder in Korea

The purpose of this study was to evaluate the effects a parent training programin Korea using the Teacher Performance Rate Accuracy Scale (TPRA)during training and video self-monitoring on the rates of accurate discretetrial Teaching (DTT) and children’s correct responses. The study was conductedin an early intensive behavior intervention (EIBI) program of a publicchildren’s hospital in Korea. Two mothers who had children enrolled in theEIBI services participated in the study. A delayed multiple baseline acrossparticipants design was used. The training program consisted of individualcoaching with therapist-conducted TPRAs and group instruction on parentself-monitoring using TPRA for self-evaluations. Results indicated thateach parent’s average rates of accurate DTT presentations increased and therates of error presentation decreased after the intervention. As a result, theirchildren’s average percentage of correct responses increased during interventionand maintained after intervention. Results of this study suggest that thistraining program is promising and has potential for a large-scale implicationin Korea.

A person-centred, theory-based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study.

AimTo test the effectiveness of a person‐centred and theory‐based educational intervention to increase adolescents′ adherence to adequate oral hygiene behaviour, that is, self‐performed periodontal infection control.Materials and MethodsData were derived from a prospective, multi‐centred, two‐arm, quasi‐randomized field study in which treatment was performed by dental hygienists (DHs) within the Public Dental Service, Västra Götaland, Sweden. Adolescents with poor oral hygiene conditions were invited to participate. The test intervention was based on cognitive behavioural theory and principles, and the DHs used a collaborative communicative approach, inspired by motivational interviewing. The control intervention consisted of conventional information/instruction. Clinical assessments and oral hygiene behaviours were evaluated at 6 months.ResultsThree‐hundred and twelve adolescents were enrolled, of whom 274 followed the treatment to 6‐month follow‐up. There were significant improvements in gingival bleeding and plaque scores for both treatment groups at 6 months, with significantly greater improvements in the test group. Adolescents in the test group brushed their teeth and used interdental cleaning aids more frequently compared to participants in the control group at 6 months.ConclusionA person‐centred and theory‐based oral health education programme is more effective than conventional oral health education in improving adolescents' oral hygiene behaviour and periodontal infection control. ClinicalTrials.gov (NCT02906098).

Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study.

BackgroundDespite the efficacy of psychosocial interventions in minimizing psychosocial morbidity in breast cancer survivors (BCSs), intervention delivery across survivorship is limited by physical, organizational, and attitudinal barriers, which contribute to a mental health care treatment gap in cancer settings.ObjectiveThe aim of this study is to develop iNNOV Breast Cancer (iNNOVBC), a guided, internet-delivered, individually tailored, acceptance and commitment therapy–influenced cognitive behavioral intervention program aiming to treat mild to moderate anxiety and depression in BCSs as well as to improve fatigue, insomnia, sexual dysfunction, and health-related quality of life in this group. This study also aims to evaluate the usefulness, usability, and preliminary feasibility of iNNOVBC.MethodsiNNOVBC was developed using a user-centered design approach involving its primary and secondary end users, that is, BCSs (11/24, 46%) and mental health professionals (13/24, 54%). We used mixed methods, namely in-depth semistructured interviews, laboratory-based usability tests, short-term field trials, and surveys, to assess iNNOVBC’s usefulness, usability, and preliminary feasibility among these target users. Descriptive statistics were used to characterize the study sample, evaluate performance data, and assess survey responses. Qualitative data were recorded, transcribed verbatim, and thematically analyzed.ResultsOverall, participants considered iNNOVBC highly useful, with most participants reporting on the pertinence of its scope, the digital format, the relevant content, and the appropriate features. However, various usability issues were identified, and participants suggested that the program should be refined by simplifying navigation paths, using a more dynamic color scheme, including more icons and images, displaying information in different formats and versions, and developing smartphone and tablet versions. In addition, participants suggested that tables should be converted into plain textboxes and data visualization dashboards should be included to facilitate the tracking of progress. The possibility of using iNNOVBC in a flexible manner, tailoring it according to BCSs’ changing needs and along the cancer care continuum, was another suggestion that was identified.ConclusionsThe study results suggest that iNNOVBC is considered useful by both BCSs and mental health professionals, configuring a promising point-of-need solution to bridge the psychological supportive care gap experienced by BCSs across the survivorship trajectory. We believe that our results may be applicable to other similar programs. However, to fulfill their full supportive role, such programs should be comprehensive, highly usable, and tailorable and must adopt a flexible yet integrated structure capable of evolving in accordance with survivors’ changing needs and the cancer continuum.

Oppositional defiant disorder: Evidence-based review of behavioral treatment programs.

Oppositional defiant disorder (ODD) is a common clinical condition seen among children and adolescents in behavioral health settings. In this article, we review behavioral treatment programs and their clinical use in managing ODD. We searched PubMed, PsycInfo, and Scopus from 2000 to 2020 using the terms "oppositional defiant disorder" and "treatment." We found 1,665 articles, including clinical trials, review articles, and case control studies of evidence-based ODD treatments in patients age <18. Articles were screened to identify literature focusing on evidence-based behavioral treatment programs for ODD. The literature search revealed abundant evidence supporting the role of behavioral treatment programs for managing ODD and other disruptive behavior disorders. In this review, we discuss the most recent findings on established and effective strategies, including Parent Management Training, Parent-Child Interaction Therapy, Collaborative Problem Solving, Incredible Years program, Triple-P Positive Parenting Program, Start Now and Plan program, and Coping Power Program. ODD can cause significant distress to patients and their caregivers. Familiarity with behavioral treatment programs provides clinicians with tools for managing this condition in clinical settings.

Group cognitive behavioural therapy with virtual reality exposure versus group cognitive behavioural therapy with in vivo exposure for social anxiety disorder and agoraphobia: a protocol for a randomised clinical trial

IntroductionAnxiety disorders have a high lifetime prevalence, early-onset and long duration or chronicity. Exposure therapy is considered one of the most effective elements in cognitive behavioural therapy (CBT) for anxiety,...