Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Objective Contemporary research demonstrates the feasibility of assessing therapeutic performance of trainee-therapists through the use of objective measures of client treatment outcome. Further, significant variation between individual therapists based on their client treatment outcomes has been demonstrated. This study sets out to determine whether a reliable composite measure of therapeutic efficiency, effectiveness and early dropout can be developed and used to objectively compare trainee-therapists against each other. Design and methods Treatment outcomes of 611 clients receiving treatment from 58 trainee-therapists enrolled in a professional training programme were tracked with the OQ-45.2 over a 6-year period to assess therapeutic efficiency, therapeutic effectiveness and early client dropout. Results Significant variation between trainee-therapists was observed for each index. Findings of a moderately strong correlation between therapeutic efficiency and effectiveness enabled the ranking of trainee-therapists based upon a composite measure of these indexes. A non-significant correlation was found between early client dropout and measures of therapeutic effectiveness and efficiency. Conclusions The findings stress the importance of utilizing objective measures to track the treatment outcomes. Despite all trainee-therapists being enrolled in the same training programme, significant variation between trainee-therapists' therapeutic efficiency and effectiveness was found to exist. Practitioner points Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development. Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change. Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme. Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Adding paths to resilience and daily accounts to an already rich field of inquiry: A brief commentary on James Jackson's "Social structure and health disparities"

In absolute terms, there have been improvements in social resources for all racial and ethnic groups in the United States. The rise in education levels among blacks and Hispanics, for instance, suggests a lessening of the gap between classes, beginning in the later part of the 1960’s (Kao & Thompson, 2003). Yet the divide in income and to a lesser extent education between peoples who differ in gender, skin color and ethnic origin continues and in many ways is greater now than ever (Danziger & Gottschalk, 1997); (Gottschalk, 1997). The psychological distance between those high and those low in social-economic status continues unabated and threatens to undermine the capacity of communities to foster the positive architecture of hope, optimism and equal opportunity that holds us together as a nation...

Diagnosing adult Attention Deficit Hyperactivity Disorder: Are late onset and subthreshold ciagnoses valid?

Objective Diagnosing attention deficit hyperactivity disorder (ADHD) in adults is difficult when diagnosticians cannot establish an onset before the DSM-IV criterion of age 7 or if the number of symptoms recalled does not achieve DSM’s diagnosis threshold. Method The authors addressed the validity of DSM-IV’s age-at-onset and symptom threshold criteria by comparing four groups of adults: 127 subjects with full ADHD who met all DSM-IV criteria for childhood-onset ADHD, 79 subjects with late-onset ADHD who met all criteria except the age-at-onset criterion, 41 subjects with subthreshold ADHD who did not meet full symptom criteria for ADHD, and 123 subjects without ADHD who did not meet any criteria. The authors hypothesized that subjects with late-onset and subthreshold ADHD would show patterns of psychiatric comorbidity, functional impairment, and familial transmission similar to those seen in subjects with full ADHD. Result Subjects with late-onset and full ADHD had similar patterns of psychiatric comorbidity, functional impairment, and familial transmission. Most children with late onset of ADHD (83%) were younger than 12. Subthreshold ADHD was milder and showed a different pattern of familial transmission than the other forms of ADHD. Conclusions The data about the clinical features of probands and the pattern of transmission of ADHD among relatives found little evidence for the validity of subthreshold ADHD among such subjects, who reported a lifetime history of some symptoms that never met DSM-IV’s threshold for diagnosis. In contrast, the results suggested that late-onset adult ADHD is valid and that DSM-IV’s age-at-onset criterion is too stringent.

Neuropsychological studies of late onset and subthreshold diagnoses of adult Attention-Deficit/Hyperactivity Disorder

Background Diagnosing attention-deficit/hyperactivity disorder (ADHD) in adults is difficult when the diagnostician cannot establish an onset prior to the DSM-IV criterion of age 7 or if the number of symptoms recalled does not achieve the DSM-IV threshold for diagnosis. Because neuropsychological deficits are associated with ADHD, we addressed the validity of the DSM-IV age at onset and symptom threshold criteria by using neuropsychological test scores as external validators. Methods We compared four groups of adults: 1) full ADHD subjects met all DSM-IV criteria for childhood-onset ADHD; 2) late-onset ADHD subjects met all criteria except the age at onset criterion; 3) subthreshold ADHD subjects did not meet full symptom criteria; and 4) non-ADHD subjects did not meet any of the above criteria. Results Late-onset and full ADHD subjects had similar patterns of neuropsychological dysfunction. By comparison, subthreshold ADHD subjects showed few neuropsychological differences with non-ADHD subjects. Conclusions Our results showing similar neuropsychological underpinning in subjects with late-onset ADHD suggest that the DSM-IV age at onset criterion may be too stringent. Our data also suggest that ADHD subjects who failed to ever meet the DSM-IV threshold for diagnosis have a milder form of the disorder.

The modern day bystander: Online and face-to-face bystander actions of adolescents in traditional bullying and cyberbullying

This study investigated whether bystanders of traditional bullying and cyberbullying used face-to-face methods, online methods or both methods when reporting, discouraging and providing support to the victims of traditional bullying and cyberbullying. A questionnaire was completed by 348 high school students (Years 7 – 12) from seven independent schools in Australia. Overall, students predominantly utilized face-to-face methods when reporting to others for both types of bullying. Older students were more likely to use online methods to discourage the traditional bully (i.e., asking the bully to stop). Males and older students were more likely to use online methods to support victims of traditional bullying. Females were more likely to use face-to-face methods to support victims of cyberbullying. Implications for practice and future research are discussed.

Development of the dimensions of adult mastery motivation questionnaire

Mastery motivation is an important developmental construct that has implications for development across the lifespan. Research to date has focused predominantly on infants and children, with the Dimensions of Mastery Questionnaire (DMQ) being the most widely used measure of mastery motivation. This paper reports on the development and initial validation of an adult measure: the Dimensions of Adult Mastery Motivation Questionnaire (DAMMQ). Six hundred and twenty-eight adults (68 % female) aged 18 to 90 years completed the questionnaire. Factor analysis produced 24 items that represented five factors: task persistence, preference for challenge, task related pleasure, task absorption and competence/self-efficacy. The DAMMQ was found to have good internal consistency, test-retest reliability and concurrent validity. Within group differences for age, gender and education are reported. The development of the DAMMQ paves the way for future research about mastery motivation in adult populations.

A global perspective on psycho-educational assessment

For psychologists in less developed countries, psycho-educational assessment is often challenging due to a lack of specialist training and a scarcity of appropriate, psychometrically robust instruments. This paper focuses on school psychology and psycho-educational assessment in three countries: Bangladesh, China and Iran. Despite differences in demographic and cultural features, these countries share similar issues that restrict the practice of psycho-educational assessment. We conclude that it is important for psychologists in western countries to support professional training and testing practices in less developed countries.

Is stereotype threat a useful construct for organizational psychology research and practice?

Stereotypes about different groups persist in organizations. Employees from such groups may experience stereotype threat, or the concern that they are being judged on the basis of demeaning stereotypes about groups to which they belong. The goal of this focal article is to discuss whether stereotype threat is a useful construct for organizational psychology research and practice. To this end, we focus on consequences other than acute performance deficits in laboratory settings. In particular, we examine studies that highlight the effects of stereotype threat on intrapersonal outcomes (e.g., job attitudes), interpersonal outcomes (e.g., negotiation), and on the relationship between employees and their organization. The research reviewed suggests that stereotype threat is a potentially important phenomenon in organizations, but it also highlights the paucity of research in an organizational context. We provide suggestions for future research directions as well as for the prevention and amelioration of stereotype threat in the workplace.

Influences on novice drivers' speed selection - a systematic review: Application and limitations of theory and methodology

Background Excessive speed is a primary contributing factor to young novice road trauma, including intentional and unintentional speeds above posted limits or too fast for conditions. The objective of this research was to conduct a systematic review of recent investigations into novice drivers’ speed selection, with particular attention to applications and limitations of theory and methodology. Method Systematic searches of peer-reviewed and grey literature were conducted during September 2014. Abstract reviews identified 71 references potentially meeting selection criteria of investigations since the year 2000 into factors that influence (directly or indirectly) actual speed (i.e., behaviour or performance) of young (age <25 years) and/or novice (recently-licensed) drivers. Results Full paper reviews resulted in 30 final references: 15 focused on intentional speeding and 15 on broader speed selection investigations. Both sets identified a range of individual (e.g., beliefs, personality) and social (e.g., peer, adult) influences, were predominantly theory-driven and applied cross-sectional designs. Intentional speed investigations largely utilised self-reports while other investigations more often included actual driving (simulated or ‘real world’). The latter also identified cognitive workload and external environment influences, as well as targeted interventions. Discussion and implications Applications of theory have shifted the novice speed-related literature beyond a simplistic focus on intentional speeding as human error. The potential to develop a ‘grand theory’ of intentional speeding emerged and to fill gaps to understand broader speed selection influences. This includes need for future investigations of vehicle-related and physical environment-related influences and methodologies that move beyond cross-sectional designs and rely less on self-reports.

Openness to experience as a predictor and outcome of upward job changes into managerial and professional positions

In industrial and organizational psychology, there is a long tradition of studying personality as an antecedent of work outcomes. Recently, however, scholars have suggested that personality characteristics may not only predict, but also change due to certain work experiences, a notion that is depicted in the dynamic developmental model (DDM) of personality and work. Upward job changes are an important part of employees’ careers and career success in particular, and we argue that these career transitions can shape personality over time. In this study, we investigate the Big Five personality characteristics as both predictors and outcomes of upward job changes into managerial and professional positions. We tested our hypotheses by applying event history analyses and propensity score matching to a longitudinal dataset collected over five years from employees in Australia. Results indicated that participants’ openness to experience not only predicted, but that changes in openness to experience also followed from upward job changes into managerial and professional positions. Our findings thus provide support for a dynamic perspective on personality characteristics in the context of work and careers.

Sleep and self-regulation from birth to 7 years: A retrospective study of children with and without ADHD at 8-9 years

Objective To examine mean level differences, and longitudinal and reciprocal relations among behavioral sleep problems, emotional dysregulation, and attentional regulation across early childhood for children with and without ADHD at 8-9 years. Method This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) – Infant Cohort (n = 4109 analyzed). Children with and without ADHD were identified at age 8-9 years via parent-report of ADHD diagnosis and the 5-item Inattention-Hyperactivity subscale from the Strengths and Difficulties Questionnaire. Maternal report of child sleep problems and self-regulation was collected at 0-1, 2-3, 4-5 and 6-7 years of age. ANOVA was used to compare mean level differences in sleep problems, emotional and attentional regulation by ADHD group. Longitudinal structural equation modeling examined the relations among sleep and self-regulation across time in children with and without ADHD. Results Children with ADHD had persistently elevated levels of sleep problems (from infancy) and emotional and attentional dysregulation compared to controls (from 2-3 years of age). Sleep problems, emotional dysregulation, and attentional regulation were stable over time for both groups. Sleep problems were associated with greater emotional dysregulation two years later from 2-3 years of age for both groups, which in turn was associated with poorer attentional regulation. There was no direct relationship between sleep problems and later attentional regulation. Conclusion Sleep problems in children with and without ADHD are associated with emotional dysregulation, which in turn contributes to poorer attentional functioning. This study highlights the importance of assessing and managing sleep problems in young children.

Rethinking Early Childhood Education and Care: Implications for Research and Evaluation

Research in disadvantaged populations demonstrates that the effect of Early Childhood Education and Care (ECEC) programs can reach into adulthood and influence a wide range of achievement and social well-being outcomes. In English-speaking developed economies, these findings have sparked new perceptions of the role ECEC programs play in both the public and private sphere. Programs that achieve improved learning and social well-being for children are seen as an investment for both individuals and society. Yet, the empirical understanding of what programs best deliver positive outcomes across the diversity of social contexts is limited. A key research task is to identify the forms of ECEC that are most effective in delivering enduring and broad positive outcomes for all children. This article explores changing policy conceptualizations of ECEC, the outcome goals of ECEC, and directions for research in identifying quality in ECEC programs.

Web-based active learning and frequent feedback: Engaging first-year university students

Web-based technology is particularly well-suited to promoting active student involvement in the processes of learning. All students enrolled in a first-year educational psychology unit were required to complete ten weekly online quizzes, ten weekly student-generated questions and ten weekly student answers to those questions. Results of an online survey of participating students strongly support the viability and perceived benefits of such an instructional approach. Although students reported that the 30 assessments were useful and reasonable, the most common theme to emerge from the professional reflections of participating lecturers was that the marking of questions and answers was unmanageable.

Seeking continuity: Educational strategy in and for mobile ADF families

This report shares findings and insights from an interview study conducted in 2009, with 34 ADF families. These families were identified in the communities of primary schools in both state and Catholic systems with high ADF family enrolments in 3 towns across 2 states, with the assistance of the DCO and their embedded Defence School Transition Aides (DSTAs). In the interviews the parents were invited to describe their history of ADF relocations, and how they managed transitions for each member in terms of school choice, child care arrangements, spouse employment, and educational transitions. Parallel interviews were conducted with 12 teachers and 6 DSTAs across the identified schools to describe how schools cater for mobile ADF families flowing through their classes. Parents were invited to tell the story of their family’s sequence of moves and how each member made the transition, then reflect more generally on what advice they’d give other mobile families. Teachers were asked to describe how they respond to the mobile families in their school community, and to illustrate some of the issues and challenges from the institutional perspective. By offering perspectives from both parents and teachers, the report hopes to facilitate a dialogue between parties to address their common goal – promoting productive continuities in education for children in mobile families.