Number Of Counseling Sessions Research Articles

우울에 대한 모래놀이치료 연구동향 : 2007년에서 2023년까지 학위 및 학술지를 중심으로

The purpose of this study is to analyze trends in sandplay therapy research for depression conducted in Korea, seek research directions for sandplay therapy related to depression improvement, and provide basic data necessary for therapeutic research. The papers included in the study include 58 domestic studies conducted from 2007 to 2023. As a result of the study, an average of 3.4 studies on depression and sandplay therapy were continuously conducted each year. Additionally, 53.1% of the research subjects were degree theses and 46.5% were academic theses. In the case of academic papers, 44.4% of studies were published in general academic journals, 40.8% were studies published in registered journals, and 12.8% were studies published in candidate journals. In order to verify the effectiveness of depression in research, Beck's depression scale was used most often, and pre- and post-test was used in 43 studies. The subjects of the study were diverse, including children, adolescents, and adults, but the proportion of adults was high at 32%. The average number of study participants was 10, and the number of counseling sessions was 15 on average. Based on these research results, implications such as points to be considered when conducting sandplay therapy research related to depression and discussions on follow-up research were presented.

Effect of a Best-Practice Alert on the Rate of Smoking Cessation among Pregnant Women.

This study aimed to determine if a best-practice alert (BPA) implementation increases the rate of smoking cessation during pregnancy and affects pregnancy outcomes associated with smoking. This was a pretest-posttest study design where a BPA was added to electronic medical records (EMR) of pregnant persons who reported active smoking. The BPA provided the 5A's method to conduct counseling on smoking cessation. The rates of smoking cessation during pregnancy were compared 1.5 years before and after implementation of the BPA. Secondary outcomes examined whether counseling on smoking cessation was done, the number of the counseling sessions during pregnancy, and obstetric outcomes associated with maternal smoking. After implementation of the BPA, the rate of smoking cessation in pregnancy increased from 17.5% prior to BPA implementation to 54.9% after BPA implementation (p < 0.001). The rate of counseling on smoking cessation increased from 66.6% prior to BPA implementation to 95.6% after BPA implementation, with an increase noted also in the number of smoking cessation counseling sessions. In multivariate analyses, after controlling for maternal demographic and clinical factors, BPA implementation was significantly associated with higher rates of smoking cessation (adjusted odds ratio [aOR]: 3.44, 95% confidence interval [CI]: 2.17-5.51), higher rates of documented smoking cessation counseling in the EMR (aOR: 12.44, 95% CI: 6.06-25.64), and higher odds of conducting the counseling more than once (aOR: 6.90 95% CI: 4.45-10.88). The rate of smoking cessation and number of times pregnant persons were counseled increased after implementation of a BPA. The BPA could be a useful EMR tool to increase smoking cessation rates during pregnancy. · Smoking during pregnancy is a maternal and fetal concern.. · Prenatal care offers the chance to address smoking.. · BPA increases rates of smoking counseling and cessation..

Smoking cessation strategies for women: An analysis of smoking cessation determinants among Korean female smokers participating in a smoking cessation outreach program.

Background: Although there is strong evidence that behavioral counseling improves quit rates, limited data are available on individualized smoking cessation counseling provided to female smokers because they often are hesitant to identify as smokers. This study aimed to elucidate factors related to smoking cessation among Korean women who participated in the smoking cessation outreach program. Methods: This retrospective descriptive study used data retrieved from the Korea Health Promotion Institute. The data included individual participant characteristics, supportive services received, and self-reported smoking cessation outcomes from June 1, 2015, to December 31, 2017. Results: Data from 709 women were analyzed. We found cessation rates of 43.3% (confidence interval [CI]=0.40, 0.47) at four weeks, 28.6% (CI=0.25, 0.32) at 12 weeks, and 21.6% (CI=0.19, 0.25) at six months. Significant determinants of quitting at six months were regular exercise (odds ratio [OR]=3.02; 95% CI=1.28, 3.29; P=0.009) and the number of counseling sessions during the first four weeks of the program (OR=1.26; 95% CI=1.04, 1.82; P=0.041). Conclusion: Providing intensive counseling during initial phase of smoking cessation program and regular exercise would be effective strategies for smoking cessation programs for women smokers to promote their health.

Effects of a supportive workplace environment on the success rate for smoking cessation camp.

This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation. In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time. The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08-12.38). At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers' health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.

패널자료를 활용한 대학생 중도탈락 결정요인 분석

Purpose - This paper analyzes the student determinants of college non-completion and estimates the effects of each determinant on college non-completion. Design/methodology/approach – We use student panel data from a large Korean university from 2011 to 2021. Our results are from estimation of fixed-effects logit model. Findings – The results show that grade point average, participation in extracurricular activities, the number of counseling sessions with teachers, and financial aid are the main determinants of college non-completion. Academic probation, which is defined as any person who has a cumulative grade point average below a one point seven five, increases the non-completion rate by 2.6 percentage points and an one-point rise in extracurricular activities index reduces the rate by 0.1 percentage points. The effects of each determinant are heterogeneous across student sub-groups which are separated by gender, nationality, and academic discipline. Research implications or Originality - Tailored support programs for academically discouraged students that incorporate student characteristics and backgrounds are necessary to increase college completion rates and degree attainment.

Relationship between Health Counselor Characteristics and Counseling Impact on Individuals at High-Risk for Lifestyle-Related Disease: Sub-Analysis of the J-HARP Cluster-Randomized Controlled Trial.

Early diagnosis and treatment are necessary to prevent lifestyle-related diseases among high-risk individuals. This study aimed to examine the impact of counselor characteristics on clinic visits among individuals at high risk for lifestyle-related diseases. A total of 8975 patients aged 40 to 74 years with lifestyle-related comorbidities, who underwent an annual health checkup and received health counseling, were included in this study. Data intervention timing, mode of counseling, number of counseling sessions, and explanation methods were collected. We assessed the impact of counselor characteristics, including profession (public health nurse, clinical nurse, and nutritionist), age, and years of counseling experience, on counseling outcomes. The probability ratios (95% confidence intervals) of clinic visits were 1.22 (1.11–1.35) for public health nurses and 1.04 (0.90–1.20) for nurses compared with nutritionists. After adjustment for participant and counselor characteristics and initial timing, mode, and number of counseling sessions, the corresponding probability ratios (95% confidence intervals) were 1.16 (1.05–1.29) and 1.12 (0.95–1.31), respectively. Counselor age and years of experience did not influence clinic visits of the target population. Public health nurses were more effective in increasing clinic visits among the target population owing to their profession-specific knowledge, skills, and experience.

Maintenance of smoking cessation in Korean single mothers

BackgroundSingle mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the general and smoking-related characteristics of single mothers registered with the Visiting a Smoking Cessation Service in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4 weeks and 24 weeks after they initially quit smoking.MethodsThe participants were 77 single mothers registered in the Smoking Cessation Service Program. Data were included from a three-year span (January 2017–December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4 weeks and 24 weeks.ResultsMost participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4 and 18% at 4 weeks and 24 weeks, respectively. The higher the number of counseling sessions, the higher the participants’ chances of maintaining smoking in all non-smoking periods, and whether pregnancy, CO level, and drinking were significant only in a short-term non-smoking period (4 weeks).ConclusionsOur results suggest that the number of smoking cessation counseling sessions is important for long-term smoking cessation beyond short-term cessation in single mothers. To increase the smoking cessation rate of single mothers, it is important to conduct customized smoking cessation counseling at the time of smoking cessation and continue such counseling in the long term.

Success Factors for Tobacco Smoking Cessation Among Korean Female College Student Smokers.

The purpose of this study was to identify factors that successfully influence to quit smoking in female college students. The study was conducted from September 1, 2015 to December 31, 2017. Participants included 477 female student smokers, the average age was 20.87 years. The participants received smoking cessation counseling over the course of nine visits and via telephone calls for a period of 6 months. Follow-up assessments were conducted at 4, 6, 12, and 24 weeks. The factors significantly associated with successful smoking cessation included the average number of cigarettes smoked per day, age of first smoking experience, nicotine dependency, number of counseling sessions, confidence, and readiness. The most influential factor was the number of counseling sessions. Hence, this study suggested to promote continuous counseling and to introduce counseling programs tailored to female students, which might increase their success rate of quitting.

The Impact of Teachers' Guidance and Counseling Role on Students' Discipline in Private Schools: أثر إرشاد المعلمين ودورهم الإرشادي على انضباط الطلاب في المدارس الخاصة

This study aims to investigate the impact and extent of applying teachers' guidance and counseling on students’ discipline in private school. It attempts to answer these questions: what is the allocated time in counseling? What are the required skills of teachers? And what are the most important approaches of counseling? A questionnaire survey was used to obtain the results by distributing it to a sample of 150 private school teachers. Also, the open-end questions are preferred in the questionnaire survey. Validity and reliability test of the instruments was conducted; data was analyzed using percentages and descriptive analysis in SPSS Software. The results showed that there is an impact of guidance and counseling on student' discipline in private schools. There is a lack on the number of counseling sessions and the teachers tend to use individual counseling, group counseling, and nondirective counseling approaches. However, the study's recommendations included: the importance of increasing guidance and counseling awareness, holding more counseling sessions and training programs for the teacher to improve the students' skills. أثر إرشاد المعلمين ودورهم الإرشادي على انضباط الطلاب في المدارس الخاصة The Impact of Teachers' Guidance and Counseling Role on Students' Discipline in Private Schools Nader Fahmi Alzyoud Faculty of Educational Sciences || The Hashemite University || Jordan This study aims to investigate the impact and extent of applying teachers' guidance and counseling on students’ discipline in private school. It attempts to answer these questions: what is the allocated time in counseling? What are the required skills of teachers? And what are the most important approaches of counseling? A questionnaire survey was used to obtain the results by distributing it to a sample of 150 private school teachers. Also, the open-end questions are preferred in the questionnaire survey. Validity and reliability test of the instruments was conducted; data was analyzed using percentages and descriptive analysis in SPSS Software. The results showed that there is an impact of guidance and counseling on student' discipline in private schools. There is a lack on the number of counseling sessions and the teachers tend to use individual counseling, group counseling, and nondirective counseling approaches. However, the study's recommendations included: the importance of increasing guidance and counseling awareness, holding more counseling sessions and training programs for the teacher to improve the students' skills.

Factors Affecting Smoking Cessation Success of Heavy Smokers Registered in the Intensive Care Smoking Cessation Camp (Data from the National Tobacco Control Center).

ObjectivesThe purpose of this study was to investigate the factors involved in the success of smoking cessation in heavy smokers enrolled in an intensive care smoking cessation camp program.MethodsHeavy smokers enrolled in the program were classified into a success (n = 69) or failure (n = 29) group, according to whether they maintained smoking cessation for 6 months after the end of the program. Demographics, smoking behaviors, and smoking cessation-related characteristics were analyzed.ResultsStatistically significantly more participants in the success group had a spouse (98.6%; p = 0.008) compared with participants in the failure group (82.8%). However, multivariate logistic regression analysis indicated that having a spouse was not an independent factor in smoking cessation (p = 0.349). A significant difference in the frequency of counseling between the success and failure groups was observed (p = 0.001), with 72.5% of those who received counseling on 3–5 occasions for 6 months after the end of program successfully quit smoking, indicating that those who received more counseling had a higher likelihood of smoking cessation success. This was confirmed as an independent factor by multivariate logistic regression (p < 0.005). Furthermore, a graduate school level of education or higher, indicated a statistically greater success rate compared to those that were less well educated (p = 0.043). This was also observed as a significant independent factor using multivariate logistic regression (p = 0.046).ConclusionEducation level, marital status, and the number of counseling sessions were significant factors contributing to smoking cessation success.

The effects of client–counselor racial matching on therapeutic outcome

This study explored the effects of ethnic/racial matching on psychotherapy outcomes via the number of counseling sessions attended by clients, using clinical data collected from a university’s counseling center. A total sample of 644 clients (193 men, 448 women) was selected and the ethnic/racial distribution of the sample comprised 499 White/European American (77.5%), 81 African American (12.6%), 33 Asian American (5.1%), and 31 Hispanic clients (4.8%). As a result of a multilevel mediation analysis, it was found that the clients working with counselors of matching ethnicity/race attended more number of counseling sessions than those with counselors of different ethnicity/race. Moreover, the ethnic/racial matching between clients and counselors led to a higher improvement of global assessment of function (GAF). The analysis also revealed that the client–counselor ethic/racial matching showed significant, direct effects on the improvement of GAF. The effects of ethnic/racial matching on the number of counseling sessions and GAF improvement significantly differed at the counselor-level. Clinical implications to multicultural counseling and training are provided.

A Fully Automated Conversational Artificial Intelligence for Weight Loss: Longitudinal Observational Study Among Overweight and Obese Adults.

BackgroundType 2 diabetes is the most expensive chronic disease in the United States. Two-thirds of US adults have prediabetes or are overweight and at risk for type 2 diabetes. Intensive in-person behavioral counseling can help patients lose weight and make healthy behavior changes to improve their health outcomes. However, with the shortage of health care providers and associated costs, such programs do not adequately service all patients who could benefit. The health care system needs effective and cost-effective interventions that can lead to positive health outcomes as scale. This study investigated the ability of conversational artificial intelligence (AI), in the form of a standalone, fully automated text-based mobile coaching service, to promote weight loss and other health behaviors related to diabetes prevention. This study also measured user acceptability of AI coaches as alternatives to live health care professionals.ObjectiveThe objective of this study was to evaluate weight loss, changes in meal quality, and app acceptability among users of the Lark Weight Loss Health Coach AI (HCAI), with the overarching goal of increasing access to compassionate health care via mobile health. Lessons learned in this study can be applied when planning future clinical trials to evaluate HCAI and when designing AI to promote weight loss, healthy behavior change, and prevention and self-management of chronic diseases.MethodsThis was a longitudinal observational study among overweight and obese (body mass index ≥25) participants who used HCAI, which encourages weight loss and healthy diet choices through elements of cognitive behavioral therapy. Weight loss, meal quality, physical activity, and sleep data were collected through user input and, for sleep and physical activity, partly through automatic detection by the user’s mobile phone. User engagement was assessed by duration and amount of app use. A 4-question in-app user trust survey assessed app usability and acceptability.ResultsData were analyzed for participants (N=70) who met engagement standards set forth by the Centers for Disease Control and Prevention criteria for Diabetes Prevention Program, a clinically proven weight loss program focused on preventing diabetes. Weight loss (standard error of the mean) was 2.38% (0.69%) of baseline weight. The average duration of app use was 15 (SD 1.0) weeks, and users averaged 103 sessions each. Predictors of weight loss included duration of AI use, number of counseling sessions, and number of meals logged. Percentage of healthy meals increased by 31%. The in-app user trust survey had a 100% response rate and positive results, with a satisfaction score of 87 out of 100 and net promoter score of 47.ConclusionsThis study showed that use of an AI health coach is associated with weight loss comparable to in-person lifestyle interventions. It can also encourage behavior changes and have high user acceptability. Research into AI and its application in telemedicine should be pursued, with clinical trials investigating effects on weight, health behaviors, and user engagement and acceptability.

"AMPQ-II 및 관리 매뉴얼"에 따른 학교 상담의 효과: 상담자 요인 및 회기 수를 중심으로

The Korean government has administered the 'AMPQ-II' to all middle school students to prevent psychological problems and make immediate interventions when necessary. On the other hand, there has been a paucity of studies of the effectiveness of this governmental policy, or the factors influencing the effectiveness of the intervention. Using the data from 48 counselees from two middle schools, the present study examined the effectiveness of the intervention programs, and whether the counselor's characteristics and the number of counseling sessions might matter in the effect. The results suggested that most students reported improvements after the interventions. The intervention effect was less pronounced when the counselors had governmental certification. The number of counseling sessions was not a significant factor for predicting the effectiveness of the interventions. Interpretations of the present study should be made cautiously because of the small sample size. The present results, however, suggest that efforts to improve the quality of the counseling teachers are necessary. In addition, increasing the number of counseling sessions is not necessarily effective.

Current psychotherapy supervision conditions among mental health practitioners in China

Objective: To investigate the psychotherapy supervision conditions and related factors among mental health practitioners in China. Methods: A total of 291 mental health practitioners completed a 43-item self-administered questionnaire about the current state of mental health practitioners' supervision. Results: The percentage of supervision among mental health practitioners was 54.6% and 97% wanted to be supervised. About one-third of practitioners had not been supervised regularly, and 38.5% of supervision was conducted through peer discussion. Verbal reporting was used for 60.3% of supervision. Factors significantly related to mental health practitioners' acceptance of supervision included the average number of counseling sessions and the source of the training fee. Conclusion: Mental health practitioners in China require much more supervision than they currently receive. The setting and methods of supervision should also be improved.

Disclosure of HIV status outcome of regular counseling in a cohort of patients attending HIV clinics

Background The African continent bears the greatest burden of HIV/AIDS in the world. Efforts by scientists to find a vaccine for curing the pandemic have proved futile to date. The prevalence in Uganda stands at 6.4%in Adults and 0.7 % in Children, and about 1.1 million Ugandans are living with HIV/AIDS. The AIDS Support Organization started in 1987. Non disclosure of HIV sero status affects uptake of HIV/AIDS health services, increases stigma and discrimination. Methodology A retrospective cohort study was done to review records of patients newly registered between January and December 2007 from Management Information System. We analyzed records of patients who had not previously disclosed their HIV/AIDS Sero status at the time of entry into TASO HIV/AIDS clinic. These patients routinely received counseling services for a period of 36 months to assess their disclosure status. Results Out of 1413 patients counseled, 117(8.3%) patients had not disclosed their HIV sero status, 27(23%) patients were sexually active. During the first individual counselling sessions, patients were given information on condom use 19%, septrine prophylaxis 18%, sexually transmitted infections 15%, family planning 12%, and antiretroviral therapy 9%, safe water 8%, abstinence 5%, life skills 4%, prevention of mother to child transmission 4%, Tuberculosis 4%, voluntary counselling and testing 2%, and faithfulness 1%. Significant number of these sessions focused on opportunistic infections 39%, disclosure 15%, antiretroviral therapy 14%, drug therapy 9%, STD and HIV prevention 5%, nutrition 4% and welfare 4%, discordance 2%, sexuality and abstinence 3%. Other indirect interventions included HIV prevention sensitization through formation of peer support groups, drama sensitizations, group counseling and health talks during clinics. After 36 months of follow-up, 65-56% of 117 patients had disclosed their HIV sero status. Disclosure of HIV status is statistically associated with the number of counseling sessions (p=0.008). Average number of counseling sessions was 6 sessions. Patients who had not disclose after 36months recorded an average of 3 counselling sessions. Revealing of HIV sero status is statistically associated by sex, more female reveal their HIV Sero status in as short life span compared to males (p=0.002).

Does motivational interviewing counseling time influence HIV-positive persons’ self-efficacy to practice safer sex?

ObjectiveThis study examined the impact of motivational interviewing (MI) counseling time on self-efficacy to practice safer sex for people living with HIV/AIDS (PLWHA). MethodsIn 4 month intervals we followed a cohort of 490 PLWHA for 12 months.We conducted hierarchical linear regression models to examine changes in safer sex self-efficacy when participants received zero, low to moderate (5–131min) and high (132–320min) doses of MI time. We conducted a similar analysis using number of counseling sessions as the predictor variable. ResultsParticipants with low to moderate doses of MI counseling had 0.26 higher self-efficacy scores than participants with zero MI time (p=0.01). Also, they had 0.26 lower self-efficacy scores than participants with high amounts of MI time (p=0.04). Participants with high doses of MI had a 0.5 higher self-efficacy score than participants with zero amount of MI time (p<0.0001). Participants who received 3–4 counseling sessions had 0.41 greater self-efficacy scores than participants who did not receive any sessions (p<0.0001) but did not differ from participants receiving 1–2 sessions. ConclusionMI time is a key to enhancing safer sex self-efficacy among PLWHA. Practice implicationsSafer sex self-efficacy improves the more MI counseling time and sessions PLWHA receive.

Quality Assessment of Genetic Counseling Process in the Context of Presymptomatic Testing for Late-Onset Disorders: A Thematic Analysis of Three Review Articles

Presymptomatic testing (PST) is available for a range of late-onset disorders. Health practitioners generally follow guidelines regarding appropriate number of counseling sessions, involvement of multidisciplinary teams, topics for pretest discussion, and follow-up sessions; however, more understanding is needed about what helps consultands effectively and the impact of amount and quality of genetic counseling on the psychosocial sequelae of PST for late-onset disorders. We conducted a thematic analysis of three review articles on quality of the genetic counseling process, aiming at (1) exploring current evidence; (2) identifying quality assessment indicators; and (3) making recommendations for genetic counseling practice in late-onset disorders. We undertook a systematic search of 6 relevant databases: 38 articles were identified and 3 fitted our inclusion criteria; after quality appraisal, all were included in the review. The number of sessions, time spent, consultation environment, follow-up, and multidisciplinarity were identified as variables for quality assessment. Research on counseling in the context of genetic testing in familial cancer tends to be related to outcomes and indicators for quality assessment, while research concerning other late-onset diseases is mainly focused on the psychological impact of the test results. The quality and content of the overall process in noncancer late-onset diseases is insufficiently articulated. Despite the fact that PST for Huntington disease and other degenerative conditions has been offered for more than 20 years, good methodological approaches to assess quality of genetic counseling in that context remain elusive. This restricts improvement of the protocols for genetic services and, in general, healthcare for the at-risk population.

African American Participation and Success in Telephone Counseling for Smoking Cessation

Quitlines that provide telephone counseling for smoking cessation have been proved to be effective. All 50 states currently provide free quitline access to their residents; however, little research has been published on African American utilization of quitlines or their success rates. This study evaluated how effectively African Americans are served by telephone counseling (quitline) for smoking cessation based on empirical data from 45,510 callers from Texas, Louisiana, Washington, and District of Columbia and randomized clinical trial data from 3,522 participants. African Americans tended to use a quitline in proportions greater than their proportional representation in the smoking communities in both states and the District. African American quit rates were equivalent to those of non-Hispanic "Whites" as were their levels of satisfaction with the service and the number of counseling sessions they completed. African Americans were more likely to request counseling than non-Hispanic Whites. This study demonstrates that telephone counseling is a promising tool for addressing health disparities related to smoking among African Americans.

Self-Administered Cognitive Behavior Therapy for Moderate to Severe Irritable Bowel Syndrome: Clinical Efficacy, Tolerability, Feasibility

Given the limitations of conventional therapies and restrictions imposed on newer pharmacologic agents, there is an urgent need to develop efficacious and efficient treatments that teach patients behavioral self-management skills for relieving irritable bowel syndrome (IBS) symptoms and associated problems. Seventy-five Rome II diagnosed IBS patients (86% female) without comorbid gastrointestinal disease were recruited from local physicians and the community and randomized to either 2 versions of cognitive behavior therapy (CBT) (10-session, therapist-administered CBT vs 4-session, patient-administered CBT) or a wait list control (WLC) that controlled for threats to internal validity. Final assessment occurred 2 weeks after the 10-week treatment phase ended. Outcome measures included adequate relief from pain and bowel symptoms, global improvement of IBS symptoms (CGI-Improvement Scale), IBS symptom severity scale (IBS SSS), quality of life (IBSQOL), psychological distress (Brief Symptom Inventory), and patient satisfaction (Client Satisfaction Scale). At week 12, both CBT versions were significantly (P < .05) superior to WLC in the percentage of participants reporting adequate relief (eg, minimal contact CBT, 72%; standard CBT, 60.9%; WLC, 7.4%) and improvement of symptoms. CBT-treated patients reported significantly improved quality of life and IBS symptom severity but not psychological distress relative to WLC patients (P < .0001). Data from this pilot study lend preliminary empirical support to a brief patient-administered CBT regimen capable of providing short-term relief from IBS symptoms largely unresponsive to conventional therapies.

ElderLynk: A Community Outreach Model for the Integrated Treatment of Mental Health Problems in the Rural Elderly

In 2000, a rural consortium of health care education and service providers established a geriatric mental health outreach program (ElderLynk) for the underserved elderly (aged 65 and older) in ten rural counties in northeast Missouri. ElderLynk evaluated the efficacy of an integrated community-based treatment model through the creation and evaluation of a clinical database. Ten rural counties in northeast Missouri were chosen because they were designated as mental health shortage areas (MHSAs) and because their elderly population approximates the projected level of elderly in the USA in 2020. All patients were managed by a geriatric nurse with treatment planning and oversight provided by a community-based interdisciplinary team which included a psychiatrist, geriatrician, psychologist, and social worker. Using the Geriatric Depression Scale (GDS); the Government Performance and Results Act data (GPRA) to assess life satisfaction, independence/autonomy, psychosocial functioning, and overall health; the Instrumental Activities of Daily Living (IADL); the Mini-Mental Status Examination (MMSE); and patterns of service usage (number of hours of case management and number of counseling sessions), ElderLynk patients improved significantly in overall psychological functioning, level of depression, and reported life satisfaction despite significant declines in mental status, daily function, and overall health.