ABSTRACT
Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder in children, characterized by social interaction, communication difficulties, and repetitive and stereotyped behaviors. Existing intervention methods have limitations, such as requiring long treatment periods and needing to be more convenient to implement. Extended Reality (XR) technology offers a virtual environment to enhance children's social, communication, and self-regulation skills. This paper compares XR theoretical models, application examples, and intervention effects. The study reveals that XR intervention therapy is mainly based on cognitive rehabilitation, teaching, and social-emotional learning theories. It utilizes algorithms, models, artificial intelligence (AI), eye-tracking, and other technologies for interaction, achieving diverse intervention outcomes. Participants showed effective improvement in competency barriers using XR-based multimodal interactive platforms. However, Mixed Reality (MR) technology still requires further development. Future research should explore multimsodal interaction technologies combining XR and AI, optimize models, prioritize the development of MR intervention scenarios, and sustain an optimal intervention level.
Subject(s)
Autism Spectrum Disorder , Humans , Autism Spectrum Disorder/therapy , Child , Virtual Reality , Artificial IntelligenceABSTRACT
Online programs that reduce relationship distress fill a critical need; however, their scalability is limited by their reliance on coach calls. To determine the effectiveness of the online OurRelationship program with varying levels of coach support, we conducted a comparative effectiveness trial with 740 low-income couples in the United States. Couples were randomly assigned to full-coach (ncouples = 226; program as originally designed), automated-coach (ncouples = 145; as a stand-alone program with tailored automated emails only), contingent-coach (ncouples = 145; as an adaptive program where tailored automated emails are followed by more coaching if couples did not meet progress milestones), or a waitlist control condition (ncouples = 224). All analyses were conducted within a Bayesian framework. Completion rates were comparable across conditions (full-coach: 65 %, automated-coach: 59 %, contingent-coach: 54 %). All intervention couples reported reliable pre-post gains in relationship satisfaction compared to waitlist control couples (dfull = 0.46, dcontingent = 0.47, and dautomated = 0.40) with no reliable differences across intervention conditions. Over four-month follow-up, couples in full- and contingent-coach conditions maintained gains in relationship satisfaction and couples in the automated-coach condition continued to improve. Given the comparable completion rates and minimal differences in effect sizes across intervention conditions, all three coaching models appear viable; therefore, the choice of model can vary depending on available resources as well as couple or stakeholder preferences. This study was preregistered (ClinicalTrials.govNCT03568565).
ABSTRACT
BACKGROUND: Bereavement due to cancer increases the risk of prolonged grief disorder. However, specialized treatment options for prolonged grief after a loss due to illness are still scarce. OBJECTIVE: The aim of this study is to extend previous findings by evaluating a web-based cognitive behavioral intervention with asynchronous therapist support, consisting of structured writing tasks adapted specifically for prolonged grief after cancer bereavement. METHODS: The intervention was evaluated in a purely web-based randomized waitlist-controlled trial. Open-access recruitment of participants was conducted on the web. Prolonged grief (Inventory of Complicated Grief), depression, anxiety, posttraumatic stress, posttraumatic growth, somatization, sleep quality, and mental and physical health were assessed on the web via validated self-report measures. RESULTS: A total of 87 participants were randomized into the intervention group (IG; 44/87, 51%) or the waitlist control group (43/87, 49%). Of the participants, 7% (6/87) dropped out of the study (5/44, 11%, in the IG). Of the 39 completers in the IG, 37 (95%) completed all intervention tasks. The intervention reduced symptoms of prolonged grief (intention-to-treat: P<.001; η2=0.34; Cohen d=0.80) to a clinically significant extent. It had favorable effects on depression, anxiety, posttraumatic stress, posttraumatic growth, and overall mental health but not on somatization, sleep quality, or physical health. CONCLUSIONS: The web-based intervention for prolonged grief after cancer bereavement is effective in reducing symptoms of prolonged grief disorder and accompanying syndromes in a timely, easily realizable manner and addresses specific challenges of bereavement to illness. Considering web-based approaches in future mental health care policy and practice can reduce health care gaps for those who are bereaved to cancer. TRIAL REGISTRATION: German Clinical Trial Register U1111-1186-6255; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011001.
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Resumen El propósito de este artículo es contribuir a la discusión del tipo de intervenciones que podrían ser más eficaces para la protección de los menores. Para lograrlo, se analizan las características de algunos de los programas mejor valorados en las clasificaciones de las intervenciones basadas en la evidencia: los tipos de intervenciones realizadas, sus formatos de ejecución y su efectividad. En la discusión, se plantean tres posibles factores que podrían estar relacionados con la eficacia de estos programas: la interacción entre la utilización de técnicas basadas en la evidencia y la adaptación de la intervención a las necesidades de cada familia, los efectos sobre la motivación y las expectativas de autoeficacia de los participantes y las características de los profesionales. Palabra clave: protección al menor; intervenciones basadas en la evidencia; evaluación de la eficacia.
Abstract The purpose of this article is to contribute to the discussion of the kind of interventions that could be most effective for child protection. To achieve this, the characteristics of some of the most highly valued programmes for evidence-based practice are analysed: the type of intervention used, their implementation formats and their effectiveness results. In the discussion, three possible factors that could be related to the effectiveness of these programmes are considered: the interaction between the use of evidence-based techniques and adaptation of the intervention to the needs of each family, the effects on motivation and the expectations of self-efficacy by the participants and the characteristics of the practitioners.
Subject(s)
Humans , Child Welfare , Treatment Outcome , Evidence-Based PracticeABSTRACT
Abstract Background In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention) had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254) from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66); receiving individual psychiatric counseling (n = 68); receiving both individual psychological and psychiatric counseling (n = 102); and receiving not only individual counseling (i.e., psychology or psychiatry), but also attending group therapy (n = 18). Results Using MANOVA and Wilks's multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603) = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual's probability to remain abstinent.
ABSTRACT
This paper presents the development and preliminary evaluation of an integrated group cognitive-behavioral treatment (CBT) for comorbid mood, anxiety, and substance use disorders. The 12-session, manualized treatment was developed collaboratively by a mental health program in a teaching hospital and a community-based addictions service and administered in both settings. Results from an uncontrolled effectiveness trial of 29 treatment completers suggest that integrated group CBT may reduce stress and alcohol use symptoms and improve substance refusal self-efficacy. Changes in symptoms of anxiety, depression, and drug use were not significant, although the effect size for anxiety reduction was in the medium range. Nonetheless, the clinical significance of treatment effects on mood, anxiety, and substance use symptoms was modest. Changes in coping skills and quality of life were not significant, although medium-to-large effects were observed for changes in several coping skills. Participants reported being highly satisfied with treatment, found the treatment strategies to be useful, and noted an improvement in their functioning, particularly socially. Methodological and sample size limitations warrant more rigorous follow-up investigations of this treatment. Results are considered in the context of the current literature on integrated psychological treatments for these common comorbidities.
Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy/methods , Depressive Disorder/therapy , Psychotherapy, Group/methods , Substance-Related Disorders/therapy , Adaptation, Psychological , Adult , Anxiety Disorders/complications , Anxiety Disorders/psychology , Cognition , Depressive Disorder/complications , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Pilot Projects , Quality of Life , Substance-Related Disorders/complications , Substance-Related Disorders/psychology , Treatment Outcome , Young AdultABSTRACT
O estudo das reações humanas ao trauma tem crescido substancialmente nos últimos anos englobando, não apenas as Histéricas de Freud, mas também os combatentes de guerras, sobreviventes de tragédias naturais e as vítimas de abuso infantil e violência doméstica. Surgiram, pela ampliação do campo de trabalho, inúmeras terapias novas, cada uma reclamando maior eficiência e rapidez que a outra, fazendo com que os terapeutas das velhas escolas psicodinâmicas pareçam dinossauros antiquados e sem recursos úteis no tratamento destas questões. Este artigo visa mostrar as contribuições contemporâneas de colegas psicodramatistas internacionais para lidar com situações de Estresse pós-traumático, bem como estimular o desenvolvimento de estudos controlados estatisticamente que possam mostrar a riqueza do nosso instrumental teórico e prático.
The study of Trauma has grown substantially in recent years covering not only Freud and his hysterics but also for combatants of war, survivors of natural disasters, and victims of child abuse and domestic violence. Inumerous new therapies have emerged, each more efficient and faster than the other, making the old school psychodynamic therapists appear like antiquated dinosaurs with no useful resources to deal with these issues. This article aims to show the contemporary contributions of international psychodramatists to deal with post-traumatic stress disorder, and encourage the development of controlled studies to show statistically the richness of our theoretical and practical body of knowledge.
El estudio de las reacciones humanas a un trauma ha crecido considerablemente en los últimos años, incluyendo no sólo las pacientes histéricas de Freud, sino también los combatientes de la guerra, los sobrevivientes de desastres naturales y las víctimas de abuso infantil y violencia doméstica. La ampliación del campo de trabajo ha estimulado numerosas terapias nuevas, cada una reclamando ser más eficiente y más rápida que la otra, de forma que las viejas escuelas psicodinámicas se parezcan dinosaurios anticuados, sin recursos útiles en el tratamiento de estos temas. Este artículo tiene como objetivo mostrar las contribuciones contemporáneas del Psicodrama para trabajar con situaciones de estrés postraumático, y fomentar el desarrollo de los estudios controlados para mostrar estadísticamente la riqueza de nuestras herramientas teóricas y prácticas.
ABSTRACT
Motivational Interviewing (MI) is a treatment method that has proven effective for increasing motivation to change and decreasing the consumption of different drugs. However, the results of studies examining the impact of MI on tobacco consumption are contradictory. Moreover, evidence of the effectiveness of MI for modifying well-validated psychophysiological indices of motivational change is still lacking. The aim of the present study was to use the startle probe paradigm and self-report measures of motivational change to assess the effectiveness of MI, compared to Prescriptive Advice (PA) and no treatment, in a sample of 53 smokers (28 male) who were not ready to quit smoking. After the intervention, the MI group reported increased motivation to change compared to both the PA and control groups. MI participants also had a potentiated startle reflex in response to tobacco-related pictures compared to the other two groups. These findings provide evidence that MI reverses the underlying motivational system activated by tobacco related cues.
Subject(s)
Motivation/physiology , Motivational Interviewing , Reflex, Startle/physiology , Smoking Cessation/psychology , Smoking/psychology , Adult , Cues , Female , Humans , Male , Smoking/physiopathology , Young AdultABSTRACT
A psicoterapia pela internet é uma prática que, no Brasil, só é permitida aos psicólogos na forma de pesquisa. O objetivo do presente artigo foi realizar uma revisão dos estudos em psicoterapia pela internet, discorrendo sobre os recursos e os limites desse atendimento psicológico e suas implicações para a relação terapêutica e para a efetividade do tratamento. São apresentadas questões legais e éticas concernentes à prática. Os resultados apontaram similaridades entre a relação terapêutica online e a presencial, mostrando-se a psicoterapia pela internet efetiva nas mais distintas modalidades, embora a maioria dos estudos seja sobre intervenções cognitivo-comportamentais. As questões legais e éticas podem ser parcialmente solucionadas com diretrizes claras das organizações profissionais e com o treino de terapeutas na modalidade online. Concluímos que a psicoterapia pela internet, embora requeira maiores estudos, anuncia-se como uma prática viável e promissora...
The practice of online therapy is only allowed to psychologists in Brazil for research. The aim of this paper was to review studies on online therapy, discussing the features and limits of this type of psychological treatment and its implications for the therapeutic relationship and treatment effectiveness. Legal and ethical issues concerning the practice are presented. The results pointed to similarities between the therapeutic relationship online and face-to-face therapy, showing that online therapy is effective in its different modalities, although most studies deal with cognitive-behavioral interventions. Legal and ethical issues can be partially solved with clear guidelines of professional organizations and training of therapists in online mode. We conclude that online therapy requires more study, but already presents itself as a viable and promising practice...
La psicoterapia a través de Internet en Brasil sólo está permitida a los psicólogos en la forma de investigación. El objetivo de este trabajo fue revisar los estudios de la psicoterapia a través de Internet, hablando de las características y los límites de esto tratamiento psicológico y sus implicaciones para la relación terapéutica y la efectividad del tratamiento. Se muestran problemas legales y éticos relacionados con la práctica. Los resultados apuntaron a las similitudes entre la relación terapéutica online y cara a cara, muestrando que la psicoterapia a través de Internet es efectiva en sus más distintas modalidades, aunque la mayoría de los estudios se trata de intervenciones cognitivo-conductuales. Las cuestiones jurídicas y éticas pueden ser parcialmente resueltas con claras diretrices de las organizaciones profesionales y formación de los terapeutas en la modalidade online. Concluimos que la psicoterapia a través de Internet, aunque requiere más estudio, se anuncia como una práctica viable y prometedora...
Subject(s)
Humans , Internet , Psychotherapy , CounselingABSTRACT
A psicoterapia pela internet é uma prática que, no Brasil, só é permitida aos psicólogos na forma de pesquisa. O objetivo do presente artigo foi realizar uma revisão dos estudos em psicoterapia pela internet, discorrendo sobre os recursos e os limites desse atendimento psicológico e suas implicações para a relação terapêutica e para a efetividade do tratamento. São apresentadas questões legais e éticas concernentes à prática. Os resultados apontaram similaridades entre a relação terapêutica online e a presencial, mostrando-se a psicoterapia pela internet efetiva nas mais distintas modalidades, embora a maioria dos estudos seja sobre intervenções cognitivo-comportamentais. As questões legais e éticas podem ser parcialmente solucionadas com diretrizes claras das organizações profissionais e com o treino de terapeutas na modalidade online. Concluímos que a psicoterapia pela internet, embora requeira maiores estudos, anuncia-se como uma prática viável e promissora.(AU)
The practice of online therapy is only allowed to psychologists in Brazil for research. The aim of this paper was to review studies on online therapy, discussing the features and limits of this type of psychological treatment and its implications for the therapeutic relationship and treatment effectiveness. Legal and ethical issues concerning the practice are presented. The results pointed to similarities between the therapeutic relationship online and face-to-face therapy, showing that online therapy is effective in its different modalities, although most studies deal with cognitive-behavioral interventions. Legal and ethical issues can be partially solved with clear guidelines of professional organizations and training of therapists in online mode. We conclude that online therapy requires more study, but already presents itself as a viable and promising practice.(AU)
La psicoterapia a través de Internet en Brasil sólo está permitida a los psicólogos en la forma de investigación. El objetivo de este trabajo fue revisar los estudios de la psicoterapia a través de Internet, hablando de las características y los límites de esto tratamiento psicológico y sus implicaciones para la relación terapéutica y la efectividad del tratamiento. Se muestran problemas legales y éticos relacionados con la práctica. Los resultados apuntaron a las similitudes entre la relación terapéutica online y cara a cara, muestrando que la psicoterapia a través de Internet es efectiva en sus más distintas modalidades, aunque la mayoría de los estudios se trata de intervenciones cognitivo-conductuales. Las cuestiones jurídicas y éticas pueden ser parcialmente resueltas con claras diretrices de las organizaciones profesionales y formación de los terapeutas en la modalidade online. Concluimos que la psicoterapia a través de Internet, aunque requiere más estudio, se anuncia como una práctica viable y prometedora.(AU)
Subject(s)
Humans , Psychotherapy , Internet , CounselingABSTRACT
O objetivo deste estudo foi oferecer orientações quanto ao uso de medidas quantitativas para verificar a eficácia da reabilitação neuropsicológica, apresentando os pressupostos para emprego de medidas de magnitude de efeito. O método utilizado foi a revisão bibliográfica, baseada na escolha arbitrária de artigos em periódicos científicos e livros que tratem do tema. A partir desta revisão, recomendamos o uso de medidas de magnitude de efeito na mensuração da eficácia de intervenções em reabilitação neuropsicológica, com especial atenção para o uso do d de Cohen e delta de Cliff, bem como a descrição do poder estatístico dos testes utilizados e seus respectivos intervalos de confiança.
The aim of this study was to offer guidelines on the use of quantitative measures to verify the neuropsychological rehabilitation effectiveness, presenting the assumptions for the use of effect size measures. The method was literature review, based on the arbitrary choice of articles in scientific journals and books that addressed the topic. From this review, we recommend the use of effect size measures in the mensuration of the treatment effectiveness in neuropsychological rehabilitation, with special attention to Cohen's d and Cliff's delta usage, as well as the description of the statistical power of the applied tests and their respective confidence intervals.
Subject(s)
Child , Adult , Therapeutics/statistics & numerical dataABSTRACT
Although researchers have identified many promising teaching strategies and intervention programs for children with autism spectrum disorder, research on implementation of these interventions in school settings has lagged. Barriers to implementation include incompletely developed interventions, limited evidence of their utility in promoting long-term and meaningful change, and poor fit with school environments. To overcome these barriers, interventions need to be detailed in manuals that identify key components yet allow for flexibility, and studies need to evaluate long-term, real-life outcomes. Innovative research strategies also may be important, particularly carrying out research on new interventions in school settings from the outset, conducting partial effectiveness trials in which study personnel administer interventions in school settings, using community-partnered participatory research approaches, and redesigning interventions in a modular format.
Subject(s)
Child Development Disorders, Pervasive/therapy , School Health Services , Child , Community-Based Participatory Research/methods , HumansABSTRACT
Although applied behavior analysts often say they engage in evidence-based practice, they express differing views on what constitutes "evidence" and "practice." This article describes a practice as a service offered by a provider to help solve a problem presented by a consumer. Solving most problems (e.g., increasing or decreasing a behavior and maintaining this change) requires multiple intervention procedures (i.e., a package). Single-subject studies are invaluable in investigating individual procedures, but researchers still need to integrate the procedures into a package. The package must be standardized enough for independent providers to replicate yet flexible enough to allow individualization; intervention manuals are the primary technology for achieving this balance. To test whether the package is effective in solving consumers' problems, researchers must evaluate outcomes of the package as a whole, usually in group studies such as randomized controlled trials. From this perspective, establishing an evidence-based practice involves more than analyzing the effects of discrete intervention procedures on behavior; it requires synthesizing information so as to offer thorough solutions to problems. Recognizing the need for synthesis offers behavior analysts many promising opportunities to build on their existing research to increase the quality and quantity of evidence-based practices.
ABSTRACT
A maior parte dos estudos, sobre a importância do ambiente familiar no desenvolvimento emocional e no tratamento psicológico de crianças, busca associar as características da mãe à patologia da criança, em detrimento da figura do pai. Tendo isso em vista, este estudo teve como objetivo investigar as características de personalidade de pais de crianças com tendência antissocial, submetidas ao psicodiagnóstico interventivo, e sua possível relação com os resultados terapêuticos dos filhos. Seis pais de sete crianças foram avaliados pelo Teste de Rorschach, e o follow-up dos casos indicou a ocorrência de cinco sucessos e dois fracassos terapêuticos. As características paternas associadas ao sucesso foram ausência de comprometimentos severos no teste da realidade, controle pulsional e relacionamentos interpessoais, além de uma organização neurótica de personalidade. Sendo assim, os resultados mostram a importância de incluir informações sobre a personalidade paterna na realização de indicação terapêutica de crianças e na proposição de prognósticos.
Most studies addressing the importance of the family environment on childrens emotional development and psychological treatment associate the characteristics of the mothers personality with the childs pathology, disregarding the characteristics of the fathers personality. Therefore, this studys objective was to investigate the personality characteristics of fathers of children with antisocial tendencies by means of the psychodiagnosis interventive method and to investigate the potential relationship of such characteristics to the treatment results obtained for children. Six fathers of seven children were evaluated by the Rorschach test. Follow-up of the cases indicated five therapeutic successes and two failures. The paternal personality characteristics associated with success included the absence of severe impairment in the test of reality, control of impulses, and interpersonal relationships, in addition to a neurotic organization of personality. The results show the importance of including information concerning the fathers personality when prescribing therapies and establishing prognoses.
La mayoría de los estudios sobre la importancia del ambiente familiar en el desarrollo emocional y en el tratamiento psicológico de niños busca asociar las características de la madre a la patología del niño, en detrimento del padre. Así, la finalidad de esta investigación fue analizar las características de personalidad de padres de niños con tendencia antisocial, sometidos al psicodiagnóstico de intervención, y su relación con los resultados terapéuticos de los hijos. Se evaluó a seis padres de siete niños por el Test de Rorschach. El seguimiento indicó la ocurrencia de cinco éxitos y dos fracasos terapéuticos. Las características paternas asociadas al éxito fueron ausencia de compromisos severos en el test de la realidad, control pulsional y relaciones interpersonales y una organización neurótica de personalidad. Los resultados muestran la importancia de incluir informaciones sobre la personalidad paterna en la realización de indicación terapéutica para niños y en la proposición de pronósticos.
Subject(s)
Humans , Male , Female , Child , Antisocial Personality Disorder , Diagnostic Techniques and Procedures , Fathers , Rorschach TestABSTRACT
A maior parte dos estudos, sobre a importância do ambiente familiar no desenvolvimento emocional e no tratamento psicológico de crianças, busca associar as características da mãe à patologia da criança, em detrimento da figura do pai. Tendo isso em vista, este estudo teve como objetivo investigar as características de personalidade de pais de crianças com tendência antissocial, submetidas ao psicodiagnóstico interventivo, e sua possível relação com os resultados terapêuticos dos filhos. Seis pais de sete crianças foram avaliados pelo Teste de Rorschach, e o follow-up dos casos indicou a ocorrência de cinco sucessos e dois fracassos terapêuticos. As características paternas associadas ao sucesso foram ausência de comprometimentos severos no teste da realidade, controle pulsional e relacionamentos interpessoais, além de uma organização neurótica de personalidade. Sendo assim, os resultados mostram a importância de incluir informações sobre a personalidade paterna na realização de indicação terapêutica de crianças e na proposição de prognósticos.(AU)
Most studies addressing the importance of the family environment on childrens emotional development and psychological treatment associate the characteristics of the mothers personality with the childs pathology, disregarding the characteristics of the fathers personality. Therefore, this studys objective was to investigate the personality characteristics of fathers of children with antisocial tendencies by means of the psychodiagnosis interventive method and to investigate the potential relationship of such characteristics to the treatment results obtained for children. Six fathers of seven children were evaluated by the Rorschach test. Follow-up of the cases indicated five therapeutic successes and two failures. The paternal personality characteristics associated with success included the absence of severe impairment in the test of reality, control of impulses, and interpersonal relationships, in addition to a neurotic organization of personality. The results show the importance of including information concerning the fathers personality when prescribing therapies and establishing prognoses.(AU)
La mayoría de los estudios sobre la importancia del ambiente familiar en el desarrollo emocional y en el tratamiento psicológico de niños busca asociar las características de la madre a la patología del niño, en detrimento del padre. Así, la finalidad de esta investigación fue analizar las características de personalidad de padres de niños con tendencia antisocial, sometidos al psicodiagnóstico de intervención, y su relación con los resultados terapéuticos de los hijos. Se evaluó a seis padres de siete niños por el Test de Rorschach. El seguimiento indicó la ocurrencia de cinco éxitos y dos fracasos terapéuticos. Las características paternas asociadas al éxito fueron ausencia de compromisos severos en el test de la realidad, control pulsional y relaciones interpersonales y una organización neurótica de personalidad. Los resultados muestran la importancia de incluir informaciones sobre la personalidad paterna en la realización de indicación terapéutica para niños y en la proposición de pronósticos.(AU)