What Is Working for Practitioners: A Mixed Method Analysis Using the Collaborative Practice Assessment Tool.

Interprofessional practice (IPP) is thought to increase coordination of care and provide numerous benefits for clients and practitioners. While the importance of interprofessional education and practice has been emphasized in the literature and by numerous organizations including the World Health Organization, understanding what is working for practitioners is still elusive. Using the World Health Organization's framework regarding IPP and the Interprofessional Education Collaborative (IPEC) guidelines and competencies, this research attempted to identify what is working for practitioners when it comes to IPP and where opportunities for growth are still evident. The Collaborative Practice Assessment Tool was distributed to practitioners across disciplines, with a focus on speech-language pathologists and behavior analysts, and both qualitative and quantitative measures were analyzed to determine what reported IPP strategies are in use. Results indicated that practitioners are more similar than they are different when it comes to what is working with regard to the IPEC competencies (i.e., values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teams and teamwork) and where change is needed. Discussion and suggestions relevant to clinical practice were identified and a call for development of IPP training across and within disciplines based on IPEC competencies is recommended.

Online ACT Matrix Parent Training for Japanese-Speaking Mothers with Distress in the United States.

Cultural stigma, shame, self-concealment, and language and socio-economic barriers often keep Asian immigrant parents and children away from mental and behavioral services in the United States. Research shows that increased levels of parent distress suggest a negative impact on parenting practices and correlate child-maltreatment. Therefore, this study aimed to test one functionally contextual strategy to address such issues. The current study evaluated the effects of an online Acceptance and Commitment Training (ACT) Matrix for Japanese-speaking mothers living the United States. A nonconcurrent multiple baseline single-subject design across four mothers was used to assess the effect of ACT Matrix on value-driven behaviors, parental engagement (session attendance and daily assignment completion), parental distress, and psychological flexibility. The study consisted of a baseline, treatment (three ACT Matrix treatment sessions adapted from the six-step protocol), maintenance, and follow-up phases. A visual analysis reporting level, trend, variability, immediacy of change and overlap was used to identify a functional relation between the treatment and observable overt behaviors of value-driven behaviors and daily assignment completion. In addition, a non-overlap of all pairs was used to measure effect sizes for these behaviors. For psychological flexibility and parental distress, we used the reliable change index to assess whether clinically significant improvement occurred or not. The results revealed that the online ACT Matrix parent training program was effective in improving all four dependent variables. Mothers reported that the training was culturally sensitive, effective, and acceptable. The details of findings and the implications for future research as preventive science are discussed.

Effects of the COVID-19 Pandemic on Parental Burnout and Parenting Practices: Analyses Using a Retrospective Pretest.

Background: Many of the conditions of the COVID-19 pandemic were consistent with factors shown to be predictive of parental stress and burnout. The purpose of the current study was to use a retrospective pretest method to gain an understanding of the effects of the COVID-19 pandemic on levels of parental burnout and on parenting practices. Method: A brief survey was conducted using a retrospective pretest method to examine parental burnout (The Parental Burnout Assessment, Roskam et al, 2018) and parenting practices (The Alabama Parenting Questionnaire, Frick, 1991). The survey asked parent participants to answer questions about their experiences before and during the pandemic. Results: Findings indicated that the pandemic had a significant impact on parents, increasing overall levels of parental burnout and impacting parenting practices by reducing use of positive parenting strategies and increasing use of inconsistent discipline and corporal punishment. These changes in parenting practices were even more pronounced for parents whose levels of parental burnout moved from "normal" levels before the pandemic to clinical levels during the pandemic. Conclusion: The findings of the current study suggest that the COVID-19 pandemic has had a negative impact on levels of parental burnout and parenting practices. Although additional research is needed, the results suggest that there is a need for clinicians to understand the effects that the pandemic may have had on parents and families with an understanding that families may be at ongoing risk despite a relaxation of COVID-19 restrictions.

Parental Burnout and Child Maltreatment During the COVID-19 Pandemic.

The novel coronavirus (COVID-19) has spread across the United States, resulting in significant changes in almost all aspects daily life. These changes place parents at increased risk for parental burnout. Parental burnout is a chronic condition resulting from high levels of parenting-related stress due to a mismatch between the demands of parenting and the resources available for parents to meet those demands. Research on parental burnout has suggested that parents who experience burnout are more likely to engage in child abuse and neglect, placing children at risk for detrimental short- and long-term outcomes. The purpose of this paper is to review the concept of parental burnout, discuss parental burnout in the context of the current COVID-19 pandemic, and focus specifically on the effects of child maltreatment. Implications for practitioners will be discussed.

Anger, Fear, and Sadness: How Emotions Could Help Us End a Pandemic of Racism.

Racism, recently referred to as another kind of pandemic, affects the health and safety of diverse individuals within the United States and around the world. Emotions are a powerful and integral aspect of the experience of racism; however, within the field of behavior analysis, we have been hesitant to acknowledge emotion or explore how it relates to behavior and behavioral contingencies. As a result, the scope of our understanding of emotion is limited. To better understand the current experience and perception of practitioners in the field of behavior analysis, as they relate to emotion and racism, a brief survey was conducted. Findings indicated that although many may be comfortable discussing emotion and displaying emotions for themselves and others, this was not the case for everyone. Further, many were uncomfortable discussing racism. Although participants believed that emotions of racism are important and should be addressed by the field of behavior analysis, they think the field has not done enough work in this area. The results of the study lead to several recommendations, including additional antiracism research and the acknowledgment of emotional experience, as well as for how individuals can better understand, and maybe reduce, the negative emotions associated with oppression.

Ending the School-to-Prison Pipeline: Perception and Experience with Zero-Tolerance Policies and Interventions to Address Racial Inequality.

This study expands the current research on anti-Black racism and student discipline in schools. It examines perception, experiences, and alternatives of zero-tolerance policies in education, in relation to the call for action by Black Lives Matter at Schools. Black, Indigenous, and People of Color (BIPOC) students are affected at a disproportionate rate when it comes to school discipline, leading to high, inequitable incarceration rates. However, behavior analysis already has powerful tools and interventions that can stop this "school-to-prison pipeline" effect. A survey of school professionals investigated awareness of adverse outcomes from zero-tolerance policies and the use of effective, behavioral alternatives to exclusionary disciplinary practices. Results confirmed zero-tolerance policies still exist in North American schools, but that school professionals, including behavior analysts, support Black Lives Matter at School's call to end such practices. It is important to note that participants report already having the necessary skills to combat zero-tolerance; however, many still feel uncomfortable or ill-prepared to implement interventions specifically intended to decrease anti-Black racism in schools.

A Comparison of Modeling, Prompting, and a Multi-component Intervention for Teaching Play Skills to Children with Developmental Disabilities.

Play skills are an essential component of a learner's repertoire, allowing access to social interactions with peers and adults. Children with developmental disabilities frequently require explicit teaching to acquire play skills rather than acquiring them through natural learning opportunities. Without targeted practice, these deficits could continue to expand, separating the children from their typically developing peers. This study aimed to teach three children with developmental disabilities independent play skills in the form of building blocks with a diagram. We evaluated three methods of teaching play skills, prompting, modeling, and a multi-component approach, within an alternating treatment design to determine which, if any, is most effective. Each teaching strategy included a three-step prompting hierarchy and was paired with an edible reinforcer delivered following independence. Successful responses at the targeted prompt level resulted in verbal praise. Following intervention, the rate of successful responses and independent responses increased across all three participants.

Prevalence of physical health problems among youth entering residential treatment.

OBJECTIVE: To examine the prevalence of physical health problems among youth entering residential treatment. PATIENTS AND METHODS: The sample included 1744 youth (mean age: 14.6 ± 1.8 years) entering a large residential treatment program between 2000 and 2010. Youth received an intake medical evaluation, including a review of available records, detailed medical history, and physical examination. Medical conditions present at the time of the evaluation were recorded by the examining physician and later coded by the research team. Only diagnoses recognized by the International Classification of Diseases, 10th Revision, were included in the analyses. To maintain the focus on physical health problems, behavioral and emotional disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision were excluded. Obesity, acne, and allergies were also excluded. RESULTS: Approximately one-third (33.7%) of youth had a physical health diagnosis at the time of intake. Asthma was the most prevalent condition diagnosed (15.3% of the sample). Girls were significantly more likely to have a diagnosis than were boys (37.1% vs 31.5%). Age was not associated with diagnostic status. Rates of physical health conditions differed significantly by ethnicity: black (36.4%) and white (35.4%) youth had the highest rates, and Hispanic youth (23.2%) had the lowest. CONCLUSIONS: Youth who enter residential treatment have high rates of physical health conditions. These problems could complicate mental health treatment and should be considered in multidisciplinary treatment planning.

Psychotropic medication management in a residential group care program.

This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically, and based on behavioral data, it is possible to make changes to psychotropic treatment that have a positive effect on youth behavior and psychological well-being.