|Implementing Empirically Supported Treatments with Novel Populations: Children, Adolescents, and Young Adults
|Saturday, May 28, 2005
|1:00 PM–2:20 PM
|Private Dining Room 1 (3rd floor)
|Area: CBM; Domain: Service Delivery
|Chair: Scott T. Gaynor (Western Michigan University)
|Abstract: There is a strong empirical database supporting the use of behavior therapy techniques with adults suffering with depressive symptoms. There is far less efficacy data with children and adolescents, groups for whom the rates of depression are on the rise. Eckshtain and Gaynor will present single-subject data (from 6 children) on the efficacy of Primary and Secondary Control Enhancement Training with added parent training for children with depressive symptoms. Harris and Gaynor will then present single-subject data (from 5-6 teens) who received Values-based Behavioral Activation for depressive symptoms. The growing prevalence of depressive symptoms, low self-esteem, and impaired psychosocial functioning on college campuses has recently received national (including Congressional) attention. Clore and Gaynor present data from an idiographic assessment technique for identifying fluency with positive and negative self-talk. They then present results of a study comparing the effects of teaching college students with depressive symptoms and low self-esteem skills for disputing negative self-talk (n=9) or increasing positive self-talk (n=9). Finally, Dore et al. present psychosocial and academic outcome data from a study comparing Acceptance and Commitment Therapy (n=10) to a control condition (n=10) for college students who are at risk for becoming or are currently academically probated.
|Primary and Secondary Control Enhancement Training for Children Displaying Depressive Symptoms
|DIKLA ECKSHTAIN (Western Michigan University), Scott T. Gaynor (Western Michigan University)
|Abstract: Primary and Secondary Control Enhancement Training (PASCET) involves teaching children strategies to improve skills deficits (primary control) and to better cope with adversity (secondary control). The coping strategies address both private and public behaviors of the child. The present study evaluated the efficacy of PASCET plus parent training sessions. Treatment was administered twice a week and included up to 13 individual sessions and 7 sessions with the parents. Six children (average age 10 yrs, 5 females and 1 male), who met inclusion criterion based on a standardized measure of depression, were enrolled. Time-series and pre-, mid-, and post-treatment assessments suggested substantial decreases in depressive symptoms according to both parent and child report. Global measures of social skills, family functioning, and child behavior, were less consistent. Parents reported high satisfaction with the treatment. Results provide support for the efficacy of PASCET and preliminary support for the inclusion of parents to promote generalization and practice of skills that directly improve parent-child relationships and indirectly decrease depressive symptoms.
|Values-based Behavioral Activation for Adolescents with Depressive Symptoms
|AMANDA M. HARRIS (Western Michigan University), Scott T. Gaynor (Western Michigan University)
|Abstract: Studies investigating cognitive behavior therapy (CBT) have reported it to be more effective than control conditions in the treatment of adolescent depression. However, there is a continuing debate about whether the cognitive components of CBT are actually necessary for producing therapeutic change. Behavioral activation therapy, a treatment that focuses on reducing avoidance and bringing individuals into contact with important sources of reinforcement, has shown encouraging results with depressed adults (see Jacobson et al., 1996). The present study is an investigation of a values-based behavioral activation therapy for adolescents experiencing symptoms of depression. Adolescents between the ages of 13 and 18 who met inclusion criteria based on an elevated score on a standardized measure of depression were offered 12 sessions of behavioral activation. Repeated measures of depression, cognitive distortions, and active versus disengaged coping were taken at several pretreatment assessment sessions, prior to each treatment session, at the end of the treatment, and at follow-up. Preliminary data indicate that the adolescents demonstrated a decrease in depressive symptoms while showing an increase in values-focused behaviors and active coping. These results may help extend the efficacy of behavioral activation to depressed adolescents, while also providing additional data relevant to the question of whether activation is sufficient to produce change.
|Fluency Versus Thought Record Training with College Students Reporting Low Self-Esteem
|JAY CLORE (Western Michigan University), Scott T. Gaynor (Western Michigan University)
|Abstract: In precision teaching, fluency is defined as fast, well-practiced, and accurate performance. According to cognitive theory, the self-tacts (self-thoughts) of depressed individuals are automatic, but distorted, suggesting a type of fluency in negative, but not adaptive, self-tacting. This notion was tested using a self-thought fluency assessment. Participants wrote as many positive or negative self-thoughts as s/he could in one minute intervals. For non-distressed college students (n=60) the ratio of positive to negative thoughts was 1.5:1, while for distressed college students reporting low self-esteem (n=18) the ratio was less than 1:1. The distressed students were then randomized to 3 training sessions in either (a) evaluating and disputing negative self-thoughts using the thought record, a hallmark technique used in cognitive-behavior therapy or (b) developing fluency with positive self-thoughts using daily 1-min timings with increasing numbers of positive self-thoughts. Both groups showed significant improvements in self-esteem, distess, and depression. The Fluency group showed a significant increase in positive self-thoughts compared to those in the Thought Record condition, while negative self-thoughts slightly decreased across groups. Statistical trends suggested that positive thoughts became more believable and negative thoughts less believable across treatments. Fluency training appears as effective as the technique drawn from the empirically supported cognitive-behavior therapy.
|Acceptance and Commitment Therapy for Academically Struggling College Students
|DAWN J. DORE (Western Michigan University), R. Wayne Fuqua (Western Michigan University), Amy E. Naugle (Western Michigan University), Scott T. Gaynor (Western Michigan University)
|Abstract: The transition to college is often rich with stress from social, academic and emotional sources. Difficulty managing these stressors is evident in student reports of depression, anxiety and isolation. As emotional factors are correlated with poorer academic performance, it is hypothesized that the academic struggles of some college students may reflect psychological distress. As such, interventions for this population may need to target distress rather than exclusively targeting academic skills. Data from a previous study by Wilson et al (2001) using Acceptance and Commitment Therapy (ACT) showed promising results with this population. The current study uses a similar protocol and attempts to extend the previous research by utilizing a larger treatment sample (N=10) and a control group (N=10). Participants (20% male; mean age 19.3 years) completed three assessment batteries including measures of academic skills and psychological symptoms. GPA was compared at post-treatment and one semester follow-up. Results suggest modest differences between groups, primarily on measures of motivation. The need for improved treatment integrity measures as well as suggestions about the focus and components of treatment for academically struggling college students will be discussed.