Pragmatic fidelity measurement in youth service settings.

Background: Fidelity measurement is critical for developing, evaluating, and implementing evidence-based treatments (EBTs). However, traditional fidelity measurement tools are often not feasible for community-based settings. We developed a short fidelity rating form for the Collaborative Problem Solving (CPS) approach from an existing manualized coding system that requires extensive training.

An open trial of Collaborative Problem Solving in a naturalistic outpatient setting.

Collaborative Problem Solving (CPS) is an intervention for reducing children's challenging behaviors. The aim of the present study was to evaluate the effects of family therapy using CPS in an outpatient clinic that specializes in treating children with challenging behaviors. One hundred and twenty families presented for treatment.

The value of implementation frameworks: Using the active implementation frameworks to guide system-wide implementation of Collaborative Problem Solving.

In the last decade, many implementation frameworks have emerged that consolidate the research on implementation science, guiding purveyors and service agencies in improving implementation of evidence-based practices (EBPs). In this paper, we describe how the purveyor of one EBP utilized the active implementation frameworks (AIFs) to define and standardize strategies for site-wide implementation. We illustrate what implementation looked like before and after using AIFs to understand implementation, as well as some ways in which using the AIFs helped the purveyor identify, and then overcome, barriers to implementation.

Reliability and validity of the Thinking Skills Inventory, a screening tool for cross-diagnostic skill deficits underlying youth behavioral challenges.

Deficits in a range of skill domains (including executive functioning, emotion regulation, social cognition and language/communication) are associated with disrupted youth behavior and functioning across mental health diagnoses. The identification of skill deficits are important for effective treatment planning, particularly for personalized interventions. While there are multiple ways to assess these skills, parent/caregiver reports represent an important information source.

Developing a prototype for short-term psychodynamic (supportive-expressive) therapy: An empirical study with the psychotherapy process Q-set.

Objective: A Psychotherapy Process Q-set (PQS) prototype characteristic of short-term psychodynamic therapy (STPP) does not yet exist.

Method: Experts in supportive-expressive (SE) therapy used the 100-Item PQS questionnaire to rate an ideal short-term SE therapy.

Results: Agreement between raters was high (Cronbach's alpha = 0.

The Collaborative Problem Solving approach: outcomes across settings.

In the last decade, Collaborative Problem Solving (CPS) has become a popular approach to managing the challenging behaviors of children and adolescents, and has established a growing evidence base for reducing oppositional behavior and related outcomes. In contrast with standard behavioral methods that provide incentives for meeting adult expectations, CPS focuses on identifying and treating lagging cognitive skills that interfere with children's ability to meet these expectations. Since the majority of CPS outcomes have been evaluated in clinical and educational settings as part of internal quality-improvement efforts, only a small proportion of these findings has been published in peer-reviewed academic journals.

Can two psychotherapy process measures be dependably rated simultaneously? A generalizability study.

Observer ratings in psychotherapy are a common way of collecting information in psychotherapy research. However, human observers are imperfect instruments, and their ratings may be subject to variability from several sources. One source of variability can be raters' assessing more than 1 instrument at a time.

Patient and practitioner influences on the placebo effect in irritable bowel syndrome.

Objective: To determine whether placebo responses can be explained by characteristics of the patient, the practitioner, or their interpersonal interaction.

Methods: We performed an analysis of videotape and psychometric data from a clinical trial of patients with irritable bowel syndrome who were treated with placebo acupuncture in either a warm empathic interaction (Augmented, n = 96), a neutral interaction (Limited, n = 97), or a waitlist control (Waitlist, n = 96). We examined the relationships between the placebo response and a) patient personality and demographics; b) treating practitioner; and c) the patient-practitioner interaction as captured on videotape and rated by the Psychotherapy Process Q-Set.

Measuring psychotherapy process with the Adolescent Psychotherapy Q-set (APQ): Development and applications for training.

This study presents the initial findings from the development of an adolescent version of the Child Psychotherapy Q-set (CPQ, Schneider, 2003). The CPQ is a psychotherapy process measure that utilizes Q-methodology to define psychotherapy process in an empirical form suitable for quantitative analysis. This new instrument, the Adolescent Psychotherapy Process Q-set (APQ), was developed to be pantheoretical in assessing the process of psychotherapy with adolescents.

Psychoanalysis with avoidant personality disorder: A systematic case study.

This case study of process and outcome is based upon data obtained during a 5-year psychoanalysis of an adult male with avoidant personality disorder (AVPD). To date, no known systematic case studies, effectiveness studies, or randomized control trials exist for psychoanalysis in the treatment of AVPD. In this study, self-reported symptoms and observer-rated personality disorder (PD), global functioning, object relations, and psychological health were gathered at intake, after each year of treatment, and at 1-year follow-up.

The relationship among patient contemplation, early alliance, and continuation in psychotherapy.

The present study examined the relationship among contemplation stage of readiness to change, formation of an early therapeutic alliance, and psychological distress following the first session of psychotherapy. Significant correlations between the contemplation scores and the therapeutic alliance were found for patients in the contemplation stage. Although contemplation scores were not a factor in return for a second session of psychotherapy, the bond subscale of the alliance inventory did significantly contribute to whether patients returned for therapy.

Beyond brand names of psychotherapy: Identifying empirically supported change processes.

There is considerable debate about which empirical research methods best advance clinical outcomes in psychotherapy. The prevailing tendency has been to test treatment packages using randomized, controlled clinical trials. Recently, focus has shifted to considering how studying the process of change in naturalistic treatments can be a useful complement to controlled trials.

Innovations: child & adolescent psychiatry: use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units.

The authors describe "collaborative problem solving," a cognitive-behavioral approach for working with aggressive children and adolescents. The model conceptualizes aggressive behavior as the byproduct of lagging cognitive skills in the domains of flexibility, frustration tolerance, and problem solving. The goal is to train staff to assess specific cognitive skills that may be contributing to challenging behavior and to teach children new skills through collaborative problem solving.

On analytic process.

An innovative methodology is presented for identifying and assessing change process in psychoanalytic treatments. Using the Psychotherapy Process Q-set (PQS), a panel of experienced psychoanalysts developed a prototype of an ideal psychoanalytic hour. This prototype was then applied to verbatim transcripts of three archived treatment samples: psychoanalyses, long-term analytic therapies, and brief psychodynamic therapies.

Effectiveness of collaborative problem solving in affectively dysregulated children with oppositional-defiant disorder: initial findings.

Oppositional-defiant disorder (ODD) refers to a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures. Research has shown that children with ODD and comorbid mood disorders may be at particular risk for long-term adverse outcomes, including conduct disorder. In this study, the authors examined the effectiveness of a cognitive-behavioral model of intervention--called collaborative problem solving (CPS)--in comparison with parent training (PT) in 47 affectively dysregulated children with ODD.

Psychotherapy process: the missing link: comment on Westen, Novotny, and Thompson-Brenner (2004).

In this comment, J. S. Ablon and C.

A transactional model of oppositional behavior: underpinnings of the Collaborative Problem Solving approach.

Oppositional defiant disorder (ODD) refers to a recurrent pattern of developmentally inappropriate levels of negativistic, defiant, disobedient, and hostile behavior toward authority figures. ODD is one of the most common (and debilitating) comorbid disorders within Tourette's disorder (TD). Diverse psychosocial treatment approaches have been applied to children's ODD-related behaviors.

Validity of controlled clinical trials of psychotherapy: findings from the NIMH Treatment of Depression Collaborative Research Program.

Objective: This research extends a series of studies that have examined the process of psychotherapy. The authors hypothesized that manual regimens of psychotherapy compared in a controlled clinical trial would overlap considerably in process and technique and that intervention strategies common to both treatments would be responsible for promoting patient change.

Method: Expert therapists developed prototypes of the ideal regimens of brief interpersonal psychotherapy and cognitive behavior therapy using the Psychotherapy Process Q-Set, an instrument designed to provide a standard language for describing treatment processes.