Parental involvement and group cognitive behavioral treatment for anxiety disorders in children and adolescents: Treatment specificity and mediation effects of parent and peer variables

Phobic and anxiety disorders are one of the most common, if not the most common and debilitating psychopathological conditions found among children and adolescents. As a result, a treatment research literature has accumulated showing the efficacy of cognitive behavioral treatment (CBT) for reducing anxiety disorders in youth. This dissertation study compared a CBT with parent and child (i.e., PCBT) and child group CBT (i.e., GCBT). These two treatment approaches were compared due to the recognition that a child’s context has an effect on the development, course, and outcome of childhood psychopathology and functional status. The specific aims of this dissertation were to examine treatment specificity and mediation effects of parent and peer contextual variables. The sample consisted of 183 youth and their mothers. Research questions were analyzed using analysis of variance for treatment outcome, and structural equation modeling, accounting for clustering effects, for treatment specificity and mediation effects. Results indicated that both PCBT and GCBT produced positive treatment outcomes across all indices of change (i.e., clinically significant improvement, anxiety symptom reduction) and across all informants (i.e., youths and parents) with no significant differences between treatment conditions. Results also showed partial treatment specific effects of positive peer relationships in GCBT. PCBT also showed partial treatment specific effects of parental psychological control. Mediation effects were only observed in GCBT; positive peer interactions mediated treatment response. The results support the use CBT with parents and peers for treating childhood anxiety. The findings’ implications are further discussed in terms of the need to conduct further meditational treatment outcome designs in order to continue to advance theory and research in child and anxiety treatment.

The effects of parental nurturance and involvement on peer relationships and psychosocial functioning of young adults

This study examined peer relationships and psychosocial functioning as a function of maternal and paternal involvement and nurturance along with the moderating effects of gender, family form, and ethnicity. Prior research has shown the influence of mother’s involvement on peer relationship quality but not of fathers. Further, previous studies did not examine moderation by family form, gender, or ethnicity. The sample consisted of 1359 students who identified their biological mother and father as the most influential parental figures in their lives. Their ages ranged from 18 to 26; Sixty-one percent of the sample was Hispanic, 13% non-Hispanic Black, 25% non-Hispanic White; 76% female and 70% from intact families. The analytical strategy included using bivariate correlations and structural equation modeling to examine these relationships. ^ All dimensions of maternal and paternal nurturing and involvement were positively related to positive characteristics of peer relationships, self-esteem and life satisfaction consistent with the multicultural findings of PARTheory (Rohner, Khalique, & Cournoyer, 2005). A structural model was developed that was able to adequately account for the relationship between parental influence, peer relationships, and psychosocial functioning. These effects of both maternal and paternal influence were strongly moderated by culture, family form, and gender. Finally, a differential effect was found among parental influence with fathers having a greater influence on friendship quality and importance than mothers, despite greater maternal involvement. ^ These findings have theoretical, clinical, and social implications as they call for a socially based theoretical perspective within which to study these relationships. Such a perspective would better inform clinicians when using impaired social functioning as indicative of axial diagnosis, and for the implementation of social policy to encourage paternal involvement. ^

Professional Ethics and Welfare Reform: The Importance of Ethical Competence

This paper explores the professional ethics of welfare reform providers and its influence in the achievement of welfare reform goals. Four themes address the professional ethics and ethical competence of welfare reform providers.

Intercultural Education and Intercultural Competence in Higher Education in Ukraine

The establishment of independent Ukraine in 1991 created a political and social climate that entailed a need and possibility for democratic educational reforms in Ukraine. An integration of Ukraine in multicultural European and global society can be supported academically by infusing intercultural education in primary, secondary, and higher education curricula.

Cultural Competence in Health Care: Implications for Human Resource Development

This paper reviews the need for cultural competence in health care, the barriers faced by health care professionals as they attempt to deliver culturally competent care, and the implications for human resource development initiatives.

Cognitive competence and life course change in multi-problem adolescents

The dissertation reports on two studies. The purpose of Study I was to develop and evaluate a measure of cognitive competence (the Critical Problem Solving Skills Scale – Qualitative Extension) using Relational Data Analysis (RDA) with a multi-ethnic, adolescent sample. My study builds on previous work that has been conducted to provide evidence for the reliability and validity of the RDA framework in evaluating youth development programs (Kurtines et al., 2008). Inter-coder percent agreement among the TOC and TCC coders for each of the category levels was moderate to high, with a range of .76 to .94. The Fleiss' kappa across all category levels was from substantial agreement to almost perfect agreement, with a range of .72 to .91. The correlation between the TOC and the TCC demonstrated medium to high correlation, with a range of r(40)=.68, p<.001 to r(40)=.79, p<.001. Study II reports an investigation of a positive youth development program using an Outcome Mediation Cascade (OMC) evaluation model, an integrated model for evaluating the empirical intersection between intervention and developmental processes. The Changing Lives Program (CLP) is a community supported positive youth development intervention implemented in a practice setting as a selective/indicated program for multi-ethnic, multi-problem at risk youth in urban alternative high schools in the Miami Dade County Public Schools (M-DCPS). The 259 participants for this study were drawn from the CLP's archival data file. The study used a structural equation modeling approach to construct and evaluate the hypothesized model. Findings indicated that the hypothesized model fit the data (χ2 (7) = 5.651, p = .83; RMSEA = .00; CFI = 1.00; WRMR = .319). My study built on previous research using the OMC evaluation model (Eichas, 2010), and the findings are consistent with the hypothesis that in addition to having effects on targeted positive outcomes, PYD interventions are likely to have progressive cascading effects on untargeted problem outcomes that operate through effects on positive outcomes.

The effects of cross -age peer tutoring on writing and reading comprehension skills and attitudes and self -perceptions as writers of third and fourth grade students

The purpose of this study was to investigate the effects of cross-age peer writing response groups on the writing and reading achievement of third and fourth grade students. Students' attitudes about writing and their perceptions of themselves as writers were also measured at the end of the study. ^ One hundred and twenty-two third and fourth grade students enrolled in a public school in a middle-class, multi-cultural neighborhood participated in the study. Four existing classes of students were randomly assigned to either the experimental condition (EC) or the control condition (CC). Both groups were pretested and posttested for writing and reading achievement. The intervention, cross-age peer writing groups, met for eleven weeks. ^ Three hypotheses were examined in this study: (a) writing improvement score, (b) reading comprehension improvement score, and (c) students' attitudes toward writing and their perception of themselves as writers based on the five scales measured on the Writer Self-Perception Scale. ^ ANOVAs were done on the pretests and posttests for writing and the Stanford Achievement Test reading comprehension subtest scores for the year of the study and the previous year. ANOVAs were also done for the five areas of the Writer Self-Perception Scale. Cross-tabulations were also used to compare improvement level verses treatment group, and grade level. ^ Analysis of the data revealed that there was no evidence that the tutoring (EC) groups made more progress than the non-tutoring (CC) groups in writing and reading. There was evidence of growth in writing, especially by the fourth graders. Most importantly, the fourth grade tutors, the experimental group, had the most positive feelings about writing and themselves as writers. ^

Compensatory effects of parent and peer support on well -being and achievement during pre- and early adolescence

The current study was designed to explore the salience of parent and peer support in middle childhood and early adolescence across two time periods as indicated by measures of achievement (grade point average (GPA), Stanford Achievement Test (SAT) scores and teacher rated school adaptation) and well-being (loneliness, depression, self-concept and teacher-rated internalizing behaviors). ^ Participants were part of an initial study on social network relations and school adaptation in middle childhood and early adolescence. Participants at Time 1 (in the spring of 1997) included 782 children in grades 4 and 6 of eight lower and middle income public elementary schools. Participants (N = 694) were reinterviewed two years later in the spring of 1999 (Time 2). ^ Multivariate analyses of variance (MANOVA) were used to investigate the change in salience of parent and peer support from Time 1 to Time 2. In addition, Tukey-HSD (Honestly Significant Difference) post hoc tests were used to test the significance of the differences among the means of four support categories: (1) low parent-low friend, (2) low parent-high friend, (3) high parent-low friend, and (4) high parent-high friend. ^ Compensatory effects were observed for loneliness and self-concept at Time 1, as well as for SAT scores, self-concept and overall achievement at Time 2. Results were consistent with existing findings that suggest a competitive model of parent/peer influence on achievement during adolescence. This study affirms the need for a more contextual approach to research examining competing and compensatory effects on adolescent development. ^

Subject -centered and problem -based approaches to teaching clinical competence in physical therapy

Physical therapy students must apply the relevant information learned in their academic and clinical experience to problem solve in treating patients. I compared the clinical cognitive competence in patient care of second-year masters students enrolled in two different curricular programs: modified problem-based (M P-B; n = 27) and subject-centered (S-C; n = 41). Main features of S-C learning include lecture and demonstration as the major teaching strategies and no exposure to patients or problem solving learning until the sciences (knowledge) have been taught. Comparatively, main features of M P-B learning include case study in small student groups as the main teaching strategy, early and frequent exposure to patients, and knowledge and problem solving skills learned together for each specific case. Basic and clinical orthopedic knowledge was measured with a written test with open-ended items. Problem solving skills were measured with a written case study patient problem test yielding three subscores: assessment, problem identification, and treatment planning. ^ Results indicated that among the demographic and educational characteristics analyzed, there was a significant difference between groups on ethnicity, bachelor degree type, admission GPA, and current GPA, but there was no significant difference on gender, age, possession of a physical therapy assistant license, and GRE score. In addition, the M P-B group achieved a significantly higher adjusted mean score on the orthopedic knowledge test after controlling for GRE scores. The S-C group achieved a significantly higher adjusted mean total score and treatment management subscore on the case study test after controlling for orthopedic knowledge test scores. These findings did not support their respective research hypotheses. There was no significant difference between groups on the assessment and problem identification subscores of the case study test. The integrated M P-B approach promoted superior retention of basic and clinical science knowledge. The results on problem solving skills were mixed. The S-C approach facilitated superior treatment planning skills, but equivalent patient assessment and problem identification skills by emphasizing all equally and exposing the students to more patients with a wider variety of orthopedic physical therapy needs than in the M P-B approach. ^

Positive Effects of Peer Modeling and Positive Reinforcement on Healthy Food Intake in Elementary School Children

The current study aims to discover the effects of “Food Dudes” peer modeling videos and positive reinforcement on vegetable consumption using a delayed multiple baseline design across subjects. Results suggest peer modeling and positive reinforcement as effective means to increase vegetable intake.

Peer Support: An Intervention To Facilitate Second Language Acquisition In Students With Asperger Syndrome And Primary Language Deficits

This is a study of a peer support program to aid students in secondary school struggling to learn a second language (for college entrance requirements) who have Asperger Syndrone and primary language deficits.

Establishing a baseline of psychometric estimates of measurement of intercultural competence of Ukrainian faculty: Setting the stage for domestic and global intercultural understanding

Post-Soviet Ukraine is in a time of upheaval and transition. Internal relations between pro-Western and pro-Russian supporters have deteriorated in the light of recent political events of Euro Revolution, Russia's occupation of the Crimean peninsula, and the militant confrontations in the southeastern regions of the country. In the light of these developments, intercultural competence is greatly needed to alleviate domestic tensions and enable effective intercultural communication with the representatives of different cultures within the country and beyond its borders.^ This study established a baseline of psychometric estimates of intercultural competence of Ukrainian higher education faculty. A sample of 276 professors of different academic majors from one university in Western Ukraine participated in the research. The Global Perspective Inventory (GPI; Merrill, Braskamp, & Braskamp, 2012) was chosen as a research instrument to measure intercultural competence of the faculty members. The GPI takes into account cognitive, intrapersonal, and interpersonal domains, each of which contains two scales reflective of theories of cultural development and intercultural communication – Cognitive-Knowing, Cognitive-Knowledge, Intrapersonal-Identity, Intrapersonal-Affect, Interpersonal-Social Responsibility, and Interpersonal-Social Interaction. Because the research instrument has neither been previously used as a measure of intercultural competence, nor administered in Ukraine, it was cross-validated using a Table of Specification (Newman, Lim, & Pineda, 2013) and two sets of factor analyses. As a result, a modified version of the GPI was created for use in Ukraine.^ Multiple linear regression analyses were used to test relationships between the participants' GPI scores on intercultural competence, and several independent variables that consisted of academic discipline, intercultural experience, and how long the participants taught at the university. The analyses determined a positive relationship between the scores on three out of six scales of the original version and two out of five scales of the modified version of the GPI and all the independent variables simultaneously. The relationship between the faculty responses on the six scales of both GPI versions and the independent variables controlling for each other produced mixed results. A unique role of intercultural professional development in predicting intercultural competence was discussed.^

The Effects of Peer Teaching of Infant Massage on General Self-Efficacy and Mother Infant Attachment Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Peer Leaders’ Perceptions of Learning Experiences

Peer-Led Team Learning (PLTL) at Florida International University maintains a large volume of student and Peer Leader (PL) participation. Students, who participate in PLTL, on average, perform a letter grade better than their peers who do not participate in PLTL. To analyze PL perspectives on learning, a survey was conducted. The survey had a series of Likert scale statements and free response questions on learning. The nature of the questions are regarding barriers in education, individual learning strengths and weaknesses, and the perception that PLTL improved the learner’s capabilities to overcome these obstacles. Based on the survey responses, PLs perceive an improvement in the way they learn during and/or after becoming a PL. Students participating in PLTL exhibited an increase in course content retention and perceived improvement in study skills. Students in PLTL also perceived the PLTL workshop environment to be comfortable enough to address questions and misconceptions.

The influence of a peer mentor program for international students on domestic peer mentors and their intercultural development

In this study, a mixed method approach was used to examine the experience of 43 domestic peer mentors who participated in a peer mentoring program for international students offered at Memorial University of Newfoundland, St. John’s, Canada. The study aimed to answer the following questions: 1) does participating in a mentorship program for international students result in change in the intercultural development for domestic peer mentors as measured by the Intercultural Development Inventory (IDI)? 2) what were the experiences of domestic peer mentors participating in a peer mentoring program for international students? Following the Developmental Model of Intercultural Sensitivity (Bennett, 1998) as a guide, this study used the scores from the Intercultural Development Inventory (IDI) to gain an understanding of the influence of the program. The scores obtained pre and post mentorship experiences were compared and a significant difference was found. Reflections from 120 monthly reports and seven individual semi-structured interviews were also conducted to gain a deeper understanding of the mentorship experience and the influence it had on the mentors’ intercultural development. The benefits of intercultural peer mentoring on student development of skills such as leadership, communication and empathy are also discussed. The study echoes previous research that calls for an increased amount of facilitated intercultural program within university campuses. The study also advocates for further implementation of programs that provide opportunities for intercultural learning between domestic and international students in order for intercultural development to improve in higher educational settings.