Ethical and Legal Guidance for Mental Health Practitioners Who Wish to Conduct Research in a Private Practice Setting.

Mental health practitioners, even when they have research training, rarely contribute to the scientific literature. One reason for this may be that they need help addressing the ethical and legal issues they encounter as they contemplate undertaking research in a clinical practice setting. To address that need, we offer several types of guidance for conducting research in a private practice setting in a way that meets high ethical and legal standards.

Targeting Co-Sleeping in Children With Anxiety Disorders Using a Modified Bedtime Pass Intervention: A Case Series Using a Changing Criterion Design.

Children with anxiety disorders experience high rates of sleep-related problems, with co-sleeping and resistance to sleeping independently being among the more frequent problems reported. Although extinction-based behavioral sleep interventions have repeatedly been shown to be highly effective for treating bedtime resistance, the primary obstacle to their implementation is parent discomfort with these procedures. The bedtime pass intervention was developed to minimize extinction bursts when implementing extinction procedures for childhood sleep problems.

Overcoming a primary barrier to practice-based research: Access to an institutional review board (IRB) for independent ethics review.

Practice-based research is an important means of bridging the gap between the science and practice of psychotherapy. Unfortunately, numerous barriers exist for clinicians who want to conduct research in practice settings. One specific barrier that has received minimal attention in the literature-lack of access to institutional review board (IRB) oversight for independent ethics review-can impede the ability to carry out and disseminate research projects.

Cross-Sectional Examination of the Associations Between Symptoms, Community Integration, and Mental Health in Multiple Sclerosis.

Objective: To determine the frequency and severity of 8 symptoms in persons with multiple sclerosis (MS) and to examine the association between these symptoms and community integration and mental health.

Design: Cross-sectional survey that assessed 8 symptoms (pain, fatigue, imbalance, numbness, weakness, shortness of breath, vision loss, and memory loss), disease progression (self-report version of the Expanded Disability Status Scale), community integration, and mental health.

Setting: Community.

Preoperative state anxiety, acute postoperative pain, and analgesic use in persons undergoing lower limb amputation.

Objectives: The current study examined the relationship between preoperative anxiety and acute postoperative phantom limb pain (PLP), residual limb pain (RLP), and analgesic medication use in a sample of persons undergoing lower limb amputation.

Materials And Methods: Participants included 69 adults admitted to a large level 1 trauma hospital for lower limb amputation. Participants' average pain and anxiety during the previous week were assessed before amputation surgery.

Utilization and patients' perceptions of the effectiveness of pain treatments in multiple sclerosis: A cross-sectional survey.

Background: Although chronic pain is common among persons with multiple sclerosis (MS), little is known about the utilization and patients' perception of the effectiveness of pain treatments in MS.

Objectives: The objectives were to: (1) identify specific treatments currently used for pain relief by adults with MS; (2) examine patients' perceptions of the effectiveness of each of these treatments; and (3) examine rates of health care utilization, specifically provider and emergency department visits, for pain.

Design: Cross-sectional survey.

Psychometric evaluation of the Overall Anxiety Severity And Impairment Scale (OASIS) in individuals seeking outpatient specialty treatment for anxiety-related disorders.

Background: Comorbidity among anxiety-related diagnoses is common, highlighting the need for brief, meaningful measures of anxiety that cut across diagnoses.

Methods: The current study examined the psychometric properties of one such measure, the Overall Anxiety Severity and Impairment Scale (OASIS) (Norman et al., 2006), in a naturalistic sample of individuals seeking treatment at an outpatient anxiety treatment center.

Psychosocial factors in chronic pain in the dysvascular and diabetic patient.

Dysvascular and diabetic patients are faced with high rates of chronic pain as a consequence of numerous secondary sequelae, including diabetic neuropathy and limb loss. Researchers and scientists have put forth a tremendous amount of effort to understand the complex nature of pain in this population of individuals, as well as others with chronic pain secondary to illness and injury. The emergent understanding of anatomy and sensory physiology within the past century has fueled an initial focus of understanding pain from a purely neurologic and biochemical perspective.

Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury.

Thirty-seven adults with spinal-cord injury and chronic pain were randomly assigned to receive 10 sessions of self-hypnosis (HYP) or EMG biofeedback relaxation (BIO) training for pain management. Participants in both treatment conditions reported substantial, but similar, decreases in pain intensity from before to after the treatment sessions. However, participants in the HYP condition, but not the BIO condition, reported statistically significant decreases in daily average pain pre- to posttreatment.

A comparison of self-hypnosis versus progressive muscle relaxation in patients with multiple sclerosis and chronic pain.

Twenty-two patients with multiple sclerosis (MS) and chronic pain we recruited into a quasi-experimental trial comparing the effects of self-hypnosis training (HYP) with progressive muscle relaxation (PMR) on pain intensity and pain interference; 8 received HYP and the remaining 14 participants were randomly assigned to receive either HYP or PMR. HYP-condition participants reported significantly greater pre- to postsession as well as pre- to posttreatment decreases in pain and pain interference than PMR-condition participants, and gains were maintained at 3-month follow-up. Most of the participants in both conditions reported that they continued to use the skills they learned in treatment and experienced pain relief when they did so.

Psychosocial factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain.

Biopsychosocial models of chronic pain that recognize psychological and environmental factors as important aspects of adjustment to pain have been proposed for understanding chronic pain and related suffering in persons with multiple sclerosis (MS), but such models have not been empirically tested. The objective of this study was to test such a model by evaluating the associations of several psychosocial variables (i.e.

The reliability and validity of pain interference measures in persons with multiple sclerosis.

Valid measures of pain-related interference with functioning could serve as useful outcome measures in much needed clinical trials of pain treatments for persons with multiple sclerosis (MS). The purpose of this study was to examine the psychometric properties of two pain interference measures in persons with MS and chronic pain. Modified versions of the Interference scale of the Brief Pain Inventory (BPI) and the Disability scale of the Graded Chronic Pain Scale were administered via a mailed survey to 187 community-dwelling persons with MS.

Psychologic interventions for chronic pain.

As a biopsychosocial understanding of chronic pain has become more sophisticated during recent decades, a variety of psychologically based treatment approaches have been developed and empirically validated for helping people better manage their pain. These approaches to pain management have much to offer persons with chronic pain in terms of enhancing quality of life and pain-related coping, as well as reducing disability and pain-related interference with functioning. Although some treatments, like hypnotic analgesia, may require referral to a specialized provider, several of the principles of other psychologically based treatment approaches for pain management (eg, operant behavioral therapy, cognitive-behavioral therapy, motivational interviewing) can easily be integrated into work with persons with pain in a rehabilitation setting.

The reliability and validity of pain interference measures in persons with spinal cord injury.

Unlabelled: The current study compared the psychometric properties of 2 commonly used measures of pain-related interference, the Graded Chronic Pain (GCP) Disability scale and 3 modified versions of the Brief Pain Inventory (BPI) Interference scale. Participants were 127 persons with spinal cord injury (SCI) who reported pain on a survey. The results suggest that the GCP Disability scale and 3 versions of the BPI Interference scale are reliable and valid measures of pain-related interference in persons with SCI and pain.

Chronic pain in persons with multiple sclerosis.

The MS literature clearly indicates that chronic pain is a significant problem for many, although not all, persons with MS. The rates of pain have been found to vary in different studies, from 44% to 80%, depending on the sample and the specific questions used to assess the incidence and severity of pain. What is not clear is the proportion of persons who have acute pain relative to chronic pain.