Wait-list Group Research Articles

Positive behaviour support for adults with acquired brain injury and challenging behaviour: A randomised controlled trial.

Challenging behaviours are common and disabling consequences of acquired brain injury (ABI), causing stress for close-others and disrupting community integration. Positive Behaviour Support (PBS) interventions have support from case studies as a means of reducing these behaviours, but controlled trials are lacking. This study aimed to evaluate, with a randomised waitlist-controlled trial, the efficacy of a 12-month PBS intervention, termed PBS+PLUS, in reducing challenging behaviours after ABI. Participants included 49 individuals with ABI (PBS+PLUS Intervention and Waitlist Treatment-as-usual groups) and their close-others. The design was a randomised waitlist-controlled trial with 12-month follow-up. PBS+PLUS involved setting collaborative goals toward a more meaningful life with the individual with ABI and addressing barriers to achieving these, including challenging behaviours, through skill-building, restructuring environments and executive strategies. The primary outcome measure was the Overt Behaviour Scale (OBS). The Challenging Behaviour Self-Efficacy Scale (CBSES) was a secondary outcome, assessing close-others' self-efficacy in addressing challenging behaviour. Measures were completed at baseline and every 4 months. Data analyses involved mixed-effects and negative binomial regressions examining change over time by group. The PBS+PLUS Intervention group included 24 participants and the Waitlist group 25 participants. On the OBS, the Intervention group showed a significant reduction in challenging behaviour over the 12-month intervention. However, the Waitlist group showed similar improvement on the OBS over the 12-month waitlist period. The Waitlist group was not denied an intervention from other providers during this period. Gains continued for 8 months post-intervention. The PBS+PLUS intervention resulted in significantly greater gains in close-others' confidence in addressing challenging behaviours on the CBSES, relative to those in the Waitlist group, who showed no such gains. Although we cannot say this intervention is more effective than any other, the study did show that PBS+PLUS can result in significant and sustained reductions in challenging behaviour in individuals with severe ABI and increased confidence of close-others in addressing these difficult behaviours. #ACTRN12616001704482.

The efficacy and optimal matching of an Internet-based acceptance and commitment therapy intervention for depressive symptoms among university students: A randomized controlled trial in China.

The present study tested the efficacy of an unguided internet-based Acceptance and Commitment Therapy (iACT) program for depression, and identified the psychological characteristics of participants who benefitted the most from the program. Undergraduate students with mild to severe symptoms of depression were randomized to the iACT group (n = 95) or the waiting-list group (WLC group; n = 87). Depressive symptoms and positive mental health were assessed at baseline (T0 ), at the end of the 6-week program (T1 ), and at a 3-month follow-up (T2 ). Compared with the WLC group, the iACT group showed significantly more improvement in depressive symptoms (d = 1.27) and positive mental health (d = 0.59), both at T1 and T2 . Latent Profile Analysis identified three classes of participants: Sensitive-to-Relationship, Low-Reactive-Depression, and Endogenous-Depression group. In general, the treatment was particularly suitable for the Sensitive-to-Relationship class. The iACT was effective in treating the depressive symptoms of undergraduates, especially suitable for the clients with high baseline depression, high externality, high resistance, and high sensitivity to relationships.

Internet-based psychotherapy in children with obsessive-compulsive disorder (OCD): protocol of a randomized controlled trial

BackgroundObsessive-compulsive disorder (OCD) in children can lead to a huge burden on the concerned patients and their family members. While successful state-of-the art cognitive behavioral interventions exist, there is still a lack of available experts for treatment at home, where most symptoms manifest. Internet-based cognitive behavioral therapy (iCBT) could overcome these restrictions; however, studies about iCBT in children with OCD are rare and mostly target computerized self-help resources and only email contact with the therapist. Therefore, we intended to build up and to evaluate an iCBT approach for children with OCD, replacing successful elements of traditional in-office face-to-face CBT, with face-to-face teleconferences, online materials, and apps.MethodsWith the help of a pilot feasibility study, we developed the iCBT consisting of 14 teleconference sessions with the child and parents. The sessions are supported by an app assessing daily and weekly symptoms and treatment course completed by children and parents. Additionally, we obtain heart rate and activity scores from the child via wristbands during several days and exposure sessions. Using a waiting list randomized control trial design, we aim to treat and analyze 20 children with OCD immediately after a diagnostic session whereas the control group of another set of 20 OCD patients will be treated after waiting period of 16 weeks. We will recruit 30 patients in each group to take account for potential dropouts. Outcomes for the treatment group are evaluated before randomization (baseline, t0), 16 weeks (end of treatment, t1), 32 weeks (follow-up 1, t2), and 48 weeks after randomization (follow-up 2, t3). For the waiting list group, outcomes are measured before the first randomization (baseline), at 16 weeks (waiting list period), 32 weeks (end of treatment), 48 weeks after the first randomization (follow-up I), and 64 weeks after the first randomization (follow-up II).DiscussionBased on our experience of feasibility during the pilot study, we were able to develop the iCBT approach and the current study will investigate treatment effectiveness. Building up an iCBT approach, resembling traditional in-office face-to-face therapy, may ensure the achievement of well-known therapy effect factors, the acceptance in both patients and clinicians, and the wide distribution within the health system.Trial registrationClinicalTrials.govNCT05037344. Registered May 2019, last release August 13th, 2021.

An internet-based treatment for flying phobia using 360° images: A feasibility pilot study

BackgroundMore research is needed in the field of Internet-delivered Cognitive Behavioral Treatments (ICBTs) for specific phobia in order to understand which characteristics are important in online exposure scenarios. The aim of the present work was to conduct a feasibility pilot study to explore participants' opinions, preferences, and acceptability ratings of two types of images (still images vs 360° navigable images) in an ICBT for Flying Phobia (FP). A secondary aim was to test the potential effectiveness of the two active treatment arms compared to a waiting list control group. An exploratory aim was to compare the role of navigable images vs. still images in the level of sense of presence and reality judgment and explore their possible mediation in treatment effectiveness. MethodsParticipants were randomly allocated to three conditions: NO-FEAR Airlines with still images (n = 26), NO-FEAR Airlines with still and navigable images (n = 26), and a waiting list group (n = 26). Primary outcome measures were participants' opinions, preferences, satisfaction, and acceptance regarding the images used in the exposure scenarios. Secondary outcome measures included FP symptomatology outcomes and measures of sense of presence and reality judgment. ResultsParticipants in the study preferred navigable images over still images before and after treatment (over 84%), and they considered them more effective and logical for the treatment of their problem. However, adherence in the experimental conditions was low (42.3% dropout rate), and more participants withdrew from the group that included navigable images compared to the group that only included still images (14 vs. 8), with no statistical differences in attrition between the two conditions. NO-FEAR Airlines proved to be effective in reducing FP symptomatology compared to the control group, with large between-group effect sizes on all FP measures (ranging from 0.76 to 2.79). No significant mediation effect was found for sense of presence or reality judgment in treatment effectiveness. DiscussionThe results of the current study suggest that participants prefer more immersive images in exposure scenarios, providing data that can help to design useful exposure scenarios to treat specific phobias in the future. They also provide evidence supporting the effectiveness of an ICBT for FP. Trial registrationRegistered at Clinicaltrials.gov (NCT03900559) on April 9, 2019. Retrospectively registered.

Effects of Combing Group Executive Functioning and Online Parent Training on School-Aged Children With ADHD: A Randomized Controlled Trial.

ObjectiveThe acceptance of drug treatment for younger children with attention-deficit/hyperactivity disorder (ADHD) in China remains low. Here, we explored the clinical benefits of a non-pharmaceutical intervention method combining a group and executive function training and an online parent training program, termed group executive functioning and online parent training (GEF-OPT), for school-aged students with ADHD through a randomized controlled trial.MethodA total of 145 children (aged 6–8 years) were formally registered and randomized to the intervention group (n = 73) and waitlist group (n = 72). The enrolled children received eight sessions of GEF-OPT treatment, which consists of a hospital-based children executive function (EF) training program and an online parent training program. Treatment outcome was assessed by a parent/teacher report questionnaire and neurophysiological experiment.ResultsAfter eight sessions of intervention, children in the intervention group showed a significant improvement in inattentive symptom compared to the waitlist group (14.70 ± 4.35 vs. 16.03 ± 2.93; p = 0.024), but an insignificant difference in hyperactive-impulsivity (9.85 ± 5.30 vs. 10.69 ± 5.10; p = 0.913). Comorbid oppositional defiant disorder was significantly reduced in the intervention group (7.03 ± 4.39 vs. 8.53 ± 4.41; p = 0.035). Children in the intervention group had greater reduction in the scores of behavioral regulation index (inhibition, emotional control) and metacognition index (working memory, planning/organization, monitoring) in executive function than those in the waitlist group (p < 0.05). Significant effects were also found in learning problem of Weiss Functional Impairment Scale–Parent form and parental distress between two groups at post-treatment (p < 0.05). In line with this, the result of go/no-go task showed significant improvements in accuracy change (4.45 ± 5.50% vs. 1.76 ± 3.35%; p = 0.001) and reaction time change (47.45 ± 62.25 s vs. 16.19 ± 72.22 s; p = 0.007) in the intervention group compared with the waitlist group.ConclusionWe conclude that participants in the GEF-OPT program improved outcomes for inattentive symptom, executive function, learning problems, and parental distress. GEF-OPT is a promising non-pharmaceutical therapeutic option for younger children.Trial RegistrationChiCTR2100052803.

Effectiveness of a Multicomponent Parenting Intervention for Promoting Social-Emotional School Readiness Among Children From Low-Income Families in Hong Kong

Most parenting programs target parents of children with severe behavioral problems. There is limited evidence on the effectiveness of universal parenting programs, especially for families with low income. To evaluate the effectiveness of the KeySteps@JC Parent-Child Interaction Program for low-income families in Hong Kong. A parallel, unblinded, cluster, randomized clinical trial was conducted from September 2018 to June 2019. Eight participating preschools in Hong Kong were randomly assigned (1:1) using an online randomization plan generator into intervention (immediate) and waiting list control (delayed) groups. Intervention participants included the parents of children in kindergarten grade 1. The results were processed by an intention-to-treat analysis. KeySteps@JC Parent-Child Interaction program. The primary outcome was child behavioral problems, which were assessed using the Strength and Difficulties Questionnaire. Secondary outcomes were parental emotion coaching, involvement in child reading and play, and parent stress levels, which were assessed using Chinese-validated versions of the Parent Reading Belief Inventory, the Chinese Parent-Child Interaction Scale, the Emotion-Related Parenting Styles, and the Parental Stress Scale questionnaires. Parents in the intervention group participated in a training program consisting of 20 weekly 1.5-hour sessions on child behavior management, emotion coaching, dialogic reading, and interactive play. The primary hypothesis was that child behavior problems would be reduced after the intervention. The main analysis was a mixed-method regression with group status as the independent variable. A total of 267 parents (mean age, intervention group: 33.8 years; 95% CI, 32.9-34.7 years; waiting list group: 35.7 years; 95% CI, 34.5-36.9 years) participated in the program. The intervention group included 153 participants (57.3%), and the waiting list group included 114 participants (42.7%). Among the target children (mean age, intervention group: 3.5 years; 95% CI, 3.4-3.5 years; waiting list group: 3.4 years; 95% CI, 3.4-3.5 years), there were 88 boys (57.5%) in the intervention group and 59 boys (51.8%) in the waiting list group. At postintervention, the intervention group reported a statistically significant improvement in children's behavior (Cohen d, 0.29; 95% CI, 0.04-0.53); parents' use of emotion-coaching strategies, including feelings of uncertainty or ineffectiveness in emotion socialization (Cohen d, 0.26; 95% CI, 0.01-0.50) and parental rejection of negative emotion (Cohen d, 0.33; 95% CI, 0.08-0.57); and involvement in child reading (Cohen d, 0.17; 95% CI, -0.07 to 0.41). The results of this randomized clinical trial provide promising evidence on the effectiveness of a multicomponent parenting intervention in preparing children from low-income families to be more socially and emotionally ready for school. ClinicalTrials.gov Identifier: NCT03615937.

Efficacy of Email-delivered Versus Face-to-face Group Cognitive Behavioral Therapy for Insomnia in Youths: A Randomized Controlled Trial

PurposeThe purpose of the study was to compare the efficacy of group-based therapy (GT) and email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I) with the wait-list (WL) control group in youths. MethodsThe study involved an assessor-blind, parallel group randomized controlled trial in youths meeting the diagnostic criteria for insomnia disorder. Participants were randomized to one of the three groups (8-week GT, 8-week ESH, or WL). Participants in all three groups were assessed at baseline and after treatment (week 9 for the WL group). The two treatment groups were additionally assessed at one month and six months after the intervention. Treatment effects were examined using linear mixed models. ResultsA total of 135 youths (mean age: 20.0 ± 2.5 years, female: 67.4%) were recruited. After treatment, both active treatment groups showed significant improvements in insomnia symptoms (GT vs. WL: Cohen's d = −1.03, ESH vs. WL: d = −.63), less presleep arousal (d = −.52 to −1.47), less sleep-related dysfunctional belief (d = −.88 to −1.78), better sleep hygiene practice (d = −.79 to −.84), and improved daytime functioning (d = −.56 to −.96) compared with the WL group. In addition, GT outperformed ESH in improving maladaptive sleep-related beliefs and mood symptoms at post-treatment and 6-month follow-up. A reduction of suicidality with moderate effect size favoring GT emerged at 6-month follow-up. DiscussionOur findings suggested that both group-based and email-delivered CBT-I were effective in treating youth insomnia, but group-based CBT-I showed superior effects on reducing maladaptive beliefs and mood symptoms.

Preliminary Evidence on the Association of Complementary and Integrative Health Care Program Participation and Medical Cost in Veterans.

Transforming Health and Resilience through Integration of Values-based Experiences (THRIVE) is a complimentary and integrative health program. THRIVE is delivered through shared medical appointments where participants engage in provider-led education and group discussion on wellness-related topics. THRIVE has been associated with improved patient-reported outcomes in a female veteran cohort. This quality improvement study evaluated the association between THRIVE participation and Veterans Health Administration (VHA) healthcare costs across a 1 year period. A cohort study design (n = 184) used VHA administrative data to estimate the cost difference between 1 year pre- and post-THRIVE participation. The 1 year post-cost of the THRIVE cohort was then compared to the 1 year cost of a quasi-experimental waitlist control group (n = 156). Data sources included VHA administrative and electronic health records. Patients were roughly 51 years old, were typically White/Caucasian, and had a service priority level representing catastrophic disability. The adjusted post-THRIVE cost was $26,291 [95% confidence interval (CI): $23,014-29,015]; $1,720 higher than the previous year's cost but was not statistically significant (P = 0.289). However, a comparison between the THRIVE cohort and a group of waitlist THRIVE patients (n = 156) the intervention group on average was $8,108 more than the waitlist group (95% CI: $3,194-14,005; P < 0.01). In summary, data analysis of veterans' annual healthcare cost trajectories were inconclusive. This preliminary study produced mixed results requiring more research with larger samples and randomized control trial methodology. Evidence of whether the THRIVE intervention can maintain cost effectiveness while maintaining its supported evidence of healthcare quality is needed.

The Effect of Calligraphy as an Art Therapy Intervention Containing Religious Motifs, on the Anxiety and Depression in Adolescent Psychiatric Patients.

This research was conducted to determine the effect of calligraphy on the anxiety and depression levels of adolescent psychiatric patients. It was conducted with adolescent psychiatric patients ages 14-17 in Turkey's Eastern Anatolia Region. They were allocated a calligraphy (n = 40) or a wait-list (n = 39) group. Those in the calligraphy group participated in 60-min calligraphy sessions for three weeks. The state anxiety levels of adolescents who applied calligraphy decreased gradually when compared with adolescents in the control group. The difference between the third-week mean post-test state anxiety scores of the adolescents in the calligraphy and control groups was significant (t = 2.34, p = .02). The trait anxiety scale and depression scale mean post-test scores of the adolescents in the calligraphy group were lower than in the control group. The difference between two groups was significant. Calligraphy can be potentially used as a beneficial method for reducing anxiety and depression.

Improved Sobriety Rates After Brain-Computer Interface-Based Cognitive Remediation Training.

Up to 80% of individuals seeking treatment fail in their attempts at sobriety. This study investigated whether 1) a cognitive remediation therapy (CRT) program augmented with a brain-computer interface (BCI) to influence brain performance metrics would increase participants' self-agency by restoring cognitive control performance; and 2) that ability increase would produce increased sobriety rates, greater than published treatment rates. The study employed a retrospective chart review structured to replicate a switching replication methodology (i.e., waitlist group) using a pre-test and post-test profile analysis quasi-experimental design. Participants' records were organized into treatment and non-treatment groups. Adult poly-substance users were recruited from alcohol and other drugs (AOD) use outpatient programs and AOD use treatment centers in the United States. Participants volunteered for pre- and post-testing without treatment (n = 121) or chose to enter the treatment program (n = 200). The treatment group engaged in a 48-session BCI/CRT augmented treatment program. Pre- and post-treatment measures comprised 14 areas from the Woodcock-Johnson Cognitive Abilities III Assessment Battery. An 18-month follow-up assessment measured maintenance of sobriety. After testing the difference for all variables across time between test groups, a significant multivariate effect was found. In addition, at 18 months post-treatment, 89% of the treatment group maintained sobriety, compared to 31% of the non-treatment group. Consistent with addiction neurobehavioral imbalance models, traditional treatment programs augmented with BCI/CRT training, focused on improving cognitive control abilities, may strengthen self-control and improve sobriety rates.

Testing the Impact of a Peer-Delivered Family Support Program: A Randomized Clinical Effectiveness Trial.

The effectiveness of NAMI Basics, a peer-led family support program for caregivers of children with mental health concerns, was tested in a sample of caregivers referred to five National Alliance on Mental Illness (NAMI) affiliates in a large southwestern state. Caregivers of children with mental health concerns (N=111; 69% biological mothers, 45% Hispanic/Latinx, 33% Caucasian, and 12% African American) were randomly assigned to a six-class NAMI Basics course led by peer parents or an 8-week waitlist condition. At baseline and 8 weeks after the course began, all caregivers completed measures assessing services engagement and activation, attitudes toward mental health services, parenting stress, and youth symptoms. Data were analyzed by using linear regression. Compared with caregivers in the waitlist condition, NAMI Basics participants reported significant increases in parent engagement and activation, as well as intentions to engage with mental health services. NAMI Basics participants also reported significant decreases in their child's intrapersonal and interpersonal distress, compared with those in the waitlist group. No significant differences were noted on measures of parenting stress, attitudes toward mental health services, or stigma. NAMI Basics affected caregiver outcomes and youth symptoms, as measured by caregiver report, compared with a waitlist control group. Peer-led services, such as NAMI Basics, may increase engagement with effective mental health services for youths and families.

Videoconference-delivered Mind-Body Resiliency Training in Adults with congenital heart disease: A pilot feasibility trial

IntroductionAdults with congenital heart disease (ACHD) often experience elevated health anxiety. The SMART-3RP is an eight-week, mind-body group resiliency intervention with evidence to reduce health anxiety in other medical populations. The aims of this waitlist-controlled, randomized pilot feasibility trial were to explore (1) feasibility and acceptability of videoconference-delivered SMART-3RP, (2) feasibility and acceptability of remote blood pressure monitoring, and (3) changes in health anxiety, mindfulness, and resiliency. MethodsParticipants (N ​= ​12 adults with CHD; Mean age ​= ​41.2 years, SD ​= ​13.8, 100% white, and 75% female) were 1:1 randomized into a pilot from July 2020 to September 2020. Participants completed surveys at baseline, three-month, and six-month follow-up; recorded their blood pressure via a digital health platform four times per week for eight weeks post-randomization (n ​= ​32 total recordings); and completed individual exit interviews. Results91% (29/32) of patients screened were eligible; of those, 41% (12/29) enrolled. 83% were retained at three-month follow-up (10/12) and 90% of those (9/10) were retained at six months. Average adherence to blood pressure monitoring was 70% (22/32 recordings completed; SD ​= ​31.9). Effect sizes from baseline to three months suggested greater improvement in the immediate group compared to the waitlist group for health anxiety (Cohen's r ​= ​−.59), mindfulness (r ​= ​−0.44), and resiliency (r ​= ​−0.49). Exit interviews revealed positive experiences with the intervention, benefits of mindfulness skills for coping with anxiety, and suggestions for improvement including further targeting ACHD-specific needs. ConclusionsThese findings support the feasibility of conducting a randomized controlled efficacy trial of SMART-3RP for ACHD, and the acceptability and potential utility of SMART-3RP for emotional health in ACHD.

The Effectiveness of Positive Psychotherapy on Life Expectancy and Psychological Well-Being in Women with Breast Cancer

Aim: The aim of this study was to determine the effectiveness of positive psychotherapy on life expectancy and psychological well-being in women with breast cancer. Method: The research method was semi-experimental with pre-test-post-test design and follow-up with the control group. The statistical population consisted of all female patients between the ages of 20 and 45 with breast cancer who received a definitive diagnosis of breast cancer according to clinical and laboratory examinations by a specialist. Among them, 30 subjects were selected by available non-random sampling method and were randomly assigned to two experimental groups (positive-oriented psychotherapy) and control (15 in each group). Then, the experimental group was treated with positive psychotherapy methods based on Seligman’s (2006) protocol in 10 sessions of 90 minutes (one session per week) and the waiting list group did not undergo any intervention until the end of the follow-up. Data were collected using Snyder's Life Expectancy Questionnaire (2000) and Ryff Psychological Well-Being Questionnaire (1989) and analyzed by repeated measure analysis of variance using SPSS-22 software. Results: The results showed that positive-oriented psychotherapy affected life expectancy (F=36.35, P&gt;0.001) and psychological well-being (F=13.54, P&lt;0.001) in women with breast cancer. Conclusion: As a result, health professionals can use any method along with other treatment methods to improve life expectancy, psychological well-being of vulnerable groups, including breast cancer patients.

Supporting Weight Management during COVID-19: A Randomized Controlled Trial of a Web-Based, ACT-Based, Guided Self-Help Intervention

Introduction: Adults with overweight and obesity are vulnerable to weight gain and mental health deterioration during the COVID-19 pandemic. We developed a web-based, guided self-help intervention based on Acceptance and Commitment Therapy (ACT) that aims to support adults with overweight and obesity to prevent weight gain by helping them to manage their eating behaviours, be more physically active, and protect their emotional wellbeing (“SWiM-C”). SWiM-C is a guided self-help programme using non-specialist guides to enhance scalability and population reach while minimizing cost. This study evaluated the effect of SWiM-C on bodyweight, eating behaviour, physical activity, and mental wellbeing in adults with overweight and obesity over 4 months during the COVID-19 pandemic in the UK. Methods: We randomized adults (BMI ≥25 kg/m²) to SWiM-C or to a wait-list standard advice group. Participants completed outcome assessments online at baseline and 4 months. The primary outcome was self-measured weight; secondary outcomes were eating behaviour, physical activity, experiential avoidance/psychological flexibility, depression, anxiety, stress, and wellbeing. We estimated differences between study groups in change in outcomes from baseline to 4 months using linear regression, adjusted for outcome at baseline and the randomization stratifiers (BMI, sex). The trial was pre-registered (ISRCTN12107048). Results: 486 participants were assessed for eligibility; 388 participants were randomized (196 standard advice, 192 SWiM-C), and 324 were analysed. The adjusted difference in weight between SWiM-C and standard advice was −0.60 kg (−1.67 to 0.47, p = 0.27). SWiM-C led to improvements in uncontrolled eating (−3.61 [−5.94 to −1.28]), cognitive restraint (5.28 [2.81–7.75]), experiential avoidance (−3.39 [−5.55 to −1.23]), and wellbeing (0.13 [0.07–0.18]). Conclusions: SWiM-C improved several psychological determinants of successful weight management and had a protective effect on wellbeing during the pandemic. However, differences in weight and some other outcomes were compatible with no effect of the intervention, suggesting further refinement of the intervention is needed.

Randomized controlled trial of occupation performance coaching for families of children with autism spectrum disorder by means of telerehabilitation

Introduction This study examined the effectiveness of occupational performance coaching, which was delivered through telerehabilitation, in improving children with autism spectrum disorders (ASD) occupational performance, behavior problems, and prosocial behavior in addition to parental self-efficacy and quality of life. Method Forty-three children were matched and randomized to occupational performance coaching or waitlist groups. Occupational performance, parental self-efficacy, behavioral problems, and prosocial behaviors were assessed using the Canadian Occupational Performance Measure, Child adjustment and parent efficacy scale-developmental disability (CAPES-DD), the Short-Form Health Survey, and goal attainment scale. Results The intervention group showed greater improvement on occupational performance, specified goals, and behavioral problems. No progress was seen on the CAPES-DD prosocial behavior subscale. In addition, parental quality of life improvement was not maintained after the follow-up phase. Conclusion Occupation performance coaching, which was delivered through telerehabilitation, was effective on children with ASD occupational performance and parental self-efficacy, but it was not effective on the prosocial behaviors of these children.

Feasibility, Effectiveness, and Mechanisms of a Brief Mindfulness- and Compassion-Based Program to Reduce Stress in University Students: A Pilot Randomized Controlled Trial.

The mental health of university students is a public health concern, as psychopathology has significantly risen among this population. Mindfulness-based programs may support their mental health, though more research is needed. We used a two-armed pilot randomized controlled trial to study the feasibility, preliminary effectiveness, and potential mechanisms of a brief 6-week instructor-led mindfulness- and compassion-based program (MCBP for University Life) on perceived stress and psychological distress. Thirty undergraduate psychology students participated (15 in the intervention group, and 15 as wait-list controls). Those in the intervention arm engaged well with the course and formal at-home practice, attending at least five sessions and meditating between 4–6 days per week. Significant improvements in perceived stress, psychological distress, mindfulness skills, decentering, self-compassion, and experiential avoidance were found at the end of the intervention, while the wait-list group remained unchanged. There were significant differences between the two groups in those variables at post-test, favoring the intervention arm with major effects. Reductions in stress were mediated by improvements in mindfulness skills, decentering, and self-compassion; meanwhile reductions in psychological distress were mediated by improvements in decentering. These results suggest that this intervention might be feasible and effective for university students, but more high-quality research is needed.

Social relationships in children: favourable influence of activities promoting self-awareness and empathic interaction

Abstract Embodied and intersubjective experience is crucial to the social cognition processes on which interpersonal relationships are based. We assessed whether promoting these processes through participation in self-awareness and empathic interaction activities can influence social integration among peers in 7- to 8-year-old children. The intervention, conducted in a school context, included mindfulness-based practices (favouring self-awareness), empathic collaboration activities and perspective-taking instances (promoting other-oriented awareness). To evaluate social integration levels, children were asked to complete a sociometric questionnaire, each listing the peers they would choose to play with (positive ties) and those they would prefer not to play with (negative ties). Based on this relational data, two types of directed networks were constructed: positive networks (PN) and negative networks (NN), in two temporal instances (pre- and post-intervention). In both the experimental and waitlist groups, pre–post intervention changes in the topology of peer social networks were evaluated by analysing global network properties such as connectivity, degree distribution, density, reciprocity, transitivity and modular structure. Our findings showed that after participating in the intervention social integration was improved, reflected in increased general interconnection of positive ties: greater average connectivity and density in PN, more equitably distributed choices (no evident leadership), greater cohesion and an increase in the number of reciprocal interactions. Additionally, we found a lower level of social rejection; that is, lower average connectivity and density in NN, the persistence of only mutual negative choices and negative ties confined to small groups. These findings were not observed in the waitlist group. This study demonstrates how participation in an intervention that promotes social cognition processes can influence the structure of peer social networks, favouring social integration. The social network analysis provides quantitative evidence of the plasticity of social relationships in children, constituting a valuable tool for the assessment of this kind of intervention at a group level.

Effectiveness of narrative therapy on adult attachment styles and expressivity in women experiencing low marital satisfaction

AbstractThe present study investigates the effectiveness of narrative therapy on adult attachment styles and expressivity in women experiencing low marital satisfaction. This study was quasi‐experimental. Participants consist of 30 women experiencing low marital satisfaction. They were selected based on availability and randomly designated to an intervention or waiting list group. Narrative therapy was accomplished individually in six 45‐min sessions for the intervention group. Results based on repeated‐measures analysis of variance showed no significant improvement in the intervention group for expressivity and adult attachment. Still, it revealed a considerable improvement during follow‐up in expressivity. Consequently, results indicate that narrative therapy cannot influence adult attachment and expressivity, but a 2‐month follow‐up questionnaire administered indicates improvement in expressivity with a large effect size.

Evaluation of a Web-Based Stress Management Program for Persons Experiencing Work-Related Stress in Sweden (My Stress Control): Randomized Controlled Trial.

BackgroundStress is one of the most common reasons for sick leave. Web-based interventions have the potential to reach an unlimited number of users at a low cost and have been shown to be effective in addressing several health-related problems. Handling stress on an individual level is related to behavior change. To support behavioral changes in stress management, My Stress Control (MSC) was developed. The development of MSC was based on several health psychology theories and models; however, central in the development were Social Cognitive Theory, Theory of Reasoned Action, Theory of Planned Behavior, Transactional Theory of Stress and Coping, and the Transtheoretical Model and Stages of Change. MSC is a fully automated program. The program is tailored to the user’s specific needs for stress management and behavior change.ObjectiveIn this study, we aim to conduct a randomized controlled trial to evaluate the extent to which MSC affects perceived stress in persons experiencing work-related stress.MethodsThis was a randomized controlled trial with 2 arms. Study participants were recruited by visiting the worksites and workplace meetings. Participants were assigned to the intervention or wait-list group. Web-based questionnaires were used before and after the intervention to collect data. Perceived stress measured using the Perceived Stress Scale-14 was the primary outcome measurement. Analyses were conducted for both between-group and within-group changes.ResultsA total of 92 participants were included in this study: 48 (52%) in the intervention group and 44 (48%) in the wait-list group. Overall, 25% (12/48) of participants in the intervention group and 43% (19/44) of participants in the wait-list group completed the postintervention assessment. There were no significant effects on perceived stress between the intervention and wait-list groups or within the groups. A small effect size (Cohen d=0.25) was found when comparing mean change over time on the primary outcome measure between the intervention and wait-list groups. In addition, a small effect size was found between pre- and postintervention assessments within the intervention group (Cohen d=0.38) as well as within the wait-list group (Cohen d=0.25).ConclusionsThe effect of MSC on perceived stress remains uncertain. As adherence was low in the intervention group, elements or features that facilitate adherence and engagement must be further developed before firmer conclusions regarding the effect of MSC can be made.Trial RegistrationClinicalTrials.gov NCT03077568; https://clinicaltrials.gov/ct2/show/NCT03077568

A Randomized Control Trial of a Brief Self-Compassion Intervention for Perfectionism, Anxiety, Depression, and Body Image.

Objective: Due to a rise in perfectionistic tendencies and growing concerns about the increase in mental health conditions among students this study aimed to examine the effects of a brief intervention in self-compassion on maladaptive perfectionism, anxiety, depression, and body image.Methods: The intervention consisted of four seminars and a silent half-day retreat with short lectures and relevant experiential practices from Mindful Self-Compassion (MSC) and Mindfulness Based Stress Reduction (MBSR). This randomized wait-list control trial was pre-registered at Clinicaltrials.gov (ID: NCT03453437, Unique Protocol ID: UiBMSC2018). University students were randomly assigned to the intervention group and wait-list control group and filled out surveys weekly. A repeated measures analysis of variance (ANOVA) was used to compare the groups pre- and post-treatment. Mixed level modeling was used to analyze changes in all outcome measures over time.Results: Eighty-nine participants completed the intervention. Results of the ANOVA showed significant post-intervention reductions in maladaptive perfectionistic tendencies and symptoms of depression and anxiety, in addition to increased self-compassion and improved body image in the intervention group as compared to the wait-list group. Mixed level modeling showed statistically significant changes in self-compassion, maladaptive perfectionism, adaptive perfectionism, anxiety, and depression but not body image. Only the mixed level modeling showed small but significant changes to adaptive perfectionism, also called strivings. Implications of different changes to maladaptive perfectionism than adaptive perfectionism are discussed.