Self-management Skills Training Research Articles

Primary Prevention of Sexually Transmitted HIV Infections: Transferring Behavioral Research Technology to Community Programs

Behavioral research to prevent the spread of human immunodeficiency virus (HIV) infection has made significant progress over the past decade. Most importantly, studies have repeatedly shown that theory-based prevention interventions that build self-efficacy through self-management and communication skills training successfully reduce HIV risk behaviors. Simultaneously, communities have mobilized to develop programs that assist persons in reducing their risk for HIV infection. The degree to which behavioral sciences have contributed to community-based HIV prevention programming is examined in this paper through a systematic assessment of technology transfer in the area of sexual risk behavior reduction. We analyzed the content of twelve community-based HIV risk-reduction programs targeting gay and bisexual men developed by seven of the nation's largest AIDS service organizations. Telephone interviews were conducted with community program developers to determine the source of their programs and whether they had been influenced by behavioral sciences. Evidence was mixed with respect to the degree to which behavioral sciences have contributed to the development of community-based programs. Program elements often reflected research-based models but with questionable fidelity. Evidence for diffusion of research-based information occurred most often when community organizations received direct consultation from behavioral scientists. We suggest that technology transfer in HIV prevention requires behavioral scientists working in communities to serve as translators of theoretical constructs for practical applications. Preventing the spread of HIV could therefore be improved through partnerships between behavioral researchers and communities.

A Self-Management Approach to Reducing Aids Risk in Sexually Active Heterosexual College Students

This study investigated the effectiveness of a self-management skills training (SMST) program in modifying at-risk sexual behaviors among a group of 51 college-aged heterosexual, sexually active, males and females. The frequency of condom use and related responses were self-monitored before, during, and after participation. In addition, pre- and post-test treatment measures were used to analyze attitudes and beliefs related to issues such as risk of HTV and AIDS, sexual communication skills, and condoms. The SMST program focused on identifying antecedent variables, planning appropriate response sequences, and arranging positive consequences. These skills were then practiced in the program sessions and via home work assignments. Results showed significant increases in reported condom use, condom purchase.and in condom-use dialogue with sexual partners. The findings of this study may be useful in developing effective intervention programs to reduce the risk of AIDS on college campuses.

Psychoeducation in first-episode psychosis: a therapeutic process.

THE importance of psychoeducational work with the relatives of patients with psychotic illness has been increasingly emphasized in recent years (Anderson et al. 1986). This has resulted partly from research showing that providing support and information for families is of value in reducing relapse rates as well as assisting relatives directly, and partly from the emergence of highly effective organizations of relatives advocating on behalf of the families of the severely mentally ill (Sokas 1986). A puzzling aspect of this development is the relative lack of interest in the psychoeducational needs of the patients themselves. As Smith et al. (1992) point out, few researches or clinicians have focused on this issue and only one controlled study has been carried out (Goldman and Quinn 1988). Eckman et al. (1992) reported the results of a controlled trial of modularized illness self-management skills training versus supportive group psychotherapy and found some advantage for the former intervention, which involved some elements of psychoeducation. However, the patients were suffering from well-established schizophrenia and had been ill for many years, so the timing of the interventions was less than optimal.

A Descriptive Analysis of Disruptive Behavior During Pre- and Post-Unsupervised Self-Management by Students with Serious Emotional Disturbance

A descriptive analysis of disruptive behavior was generated from filmed observations prior to and following training in self-management skills. Two junior high students with serious emotional disturbance (SED) were covertly videotaped during in-classroom and between-classroom performance in the absence of supervision. Videotapes were analyzed by descriptive analysis of conditions associated with disruptive/off-task behaviors. Descriptive analysis revealed that maladaptive behaviors were self-initiated in unsupervised settings. It also is apparent from this analysis that maladaptive behaviors were correlated with provocation by peers and with continuing disruptive interaction between students once an off-task/disruptive episode had begun. Treatment procedures were applied by way of a multiple baseline across settings design and included instruction, modeling, rehearsal, and rehearsal in the apparent absence of supervision. Self-management training features included self-assessment, self-recording, and self-reinforcement for correct approximations of on-task and socially appropriate behavior. Outcomes suggest that the descriptive analysis was predictive of the conditions correlated with problem behaviors and that on-task/socially appropriate behaviors were transferred and sustained while operating under the influence of self-management in the absence of supervision.

The impact of community-based groups to help persons reduce HIV infection risk behaviours

In addition to widescale AIDS education campaigns, interventions are also needed which can directly assist in the development of skills to reduce HIV infection. Cognitive-behavioural and skills training approaches have long been used to help individuals learn to change other behaviour patterns related to health and can be applied to AIDS. Several approaches (self-management skills training, assertiveness training, and problem-solving) are discussed in relation to HIV risk reduction counselling. Examples and outcome data from prior risk reduction groups for gay men are summarised. Involvement in multiple-session group intervention can produce rapid and clinically meaningful changes in high-risk behaviour patterns. Issues pertinent to the field implementation of such interventions are discussed.

Self-Management and Social Skills Training

In a multiple baseline design across groups study, ten predelinquent and delinquent youths were given behavior modification, social skills, and self-management training. The youths were also required to conduct one behavior modification project on another person and one self-management project. Measures of the youths' behavior included parent and teacher rating scales, court records, and school attendance and grades. Parents, youths, and the referring community agencies also filled out program evaluation questionnaires. The youths demonstrated a decrease in the number of problem behaviors exhibited at home and in school. The results of the consumer evaluations also indicated the program was judged effective. The benefits of a self-management approach to juvenile offenders are discussed.