Coping, Attributions, and Health Functioning Among Adolescents with Chronic Illness and Their Parents: Reciprocal Relations Over Time Abstract The purpose of the study was to identify bidirectional and longitudinal links between attributions, coping, and health functioning among adolescents with chronic illness and their parents. Religious/spiritual coping, attributional styles, and health functioning were assessed among adolescents with chronic illness at two time points approximately 21 months apart. Parental coping and attributions at both time points were also measured. Longitudinal links between variables were tested using an autoregressive cross-lagged path model; adolescent age and disease differences were evaluated via multigroup modeling. Poorer adolescent health functioning at baseline predicted higher use of parent optimistic attributional style at follow-up. Adolescent optimistic attributional style at baseline predicted more positive and less negative religious/spiritual coping at follow-up; adolescent negative religious/spiritual coping at baseline predicted more positive religious/spiritual coping at follow-up. Parent optimistic attributional style and positive religious/spiritual coping at baseline predicted the same constructs among adolescents at follow-up. With respect to age differences, parental negative religious/spiritual coping at baseline was associated with poorer health functioning among younger, but not older, adolescents at follow-up. There were no disease differences in the model. Important links were identified in this family-based model of coping, attributions, and health functioning. The results highlight specific targets for interventions to improve health functioning and coping among adolescents with chronic illness, including parental religious/spiritual coping and adolescent attributional style.

Psychosocial Intervention Programs for Parents of Children with Cancer: A Systematic Review and Critical Comparison of Programs’ Models and Development Abstract Intervention programs have been developed to help parents cope with their child’s cancer. Despite some studies reporting a high level of evidence, it is unclear how these programs build on each other. Appraising models of change is critical to advance scientific knowledge and provide evidence-based interventions. This review aims to identify existing programs, explicitly formulate their underlying models, evaluate how they translate into concrete activities, as well as identify and discuss their development process. Eleven programs based on models of change from cognitive-behavioral, systemic and counselling theories were identified. Many models included a sound theoretical framework, targeted outcomes, as well as implementation strategies. In most cases, preliminary development studies were conducted, but details were rarely provided on how development stages informed the redesign of intervention programs. Acceptability and treatment fidelity were not available for one-third of the programs. Future reports should document the development and design redesign stages prior to conducting efficacy trials, as this step would provide crucial details to critically appraise programs.

When Words Fail: Providing Effective Psychological Treatment for Depression in Persons with Aphasia Abstract More than 2 million people in the United States are living with some form of aphasia, a communication disorder that has been associated with high incidence of clinical depression. Despite their large numbers, persons with aphasia have received little clinical attention from psychologists and other mental health providers. The life participation interventions and supported communication methods developed and routinely employed by speech–language pathologists could assist mental health professionals in addressing the needs of this underserved population. This paper examines the psychological challenges facing individuals living with aphasia and the factors contributing to depressive symptoms among those with significant communication loss. In addition, it explores the potential compatibility between life participation interventions developed by speech–language pathologists and evidence-based cognitive–behavioral interventions for depression, such as behavioral activation. Specific adaptations to behavioral activation for individuals experiencing aphasia-related depressive symptoms are explored, along with strategies for integrating supported communication in the provision of mental health treatment.

Brief Behavioral Intervention for Disruptive Behavior in a Child with a Hypothalamic Hamartoma: A Case Report Abstract Most children with hypothalamic hamartoma (HH) manifest symptoms of epilepsy and associated cognitive deficits and behavioral difficulties as well as central precocious puberty (CPP). However, there is little to no research examining behavioral difficulties in children with HH without epilepsy, nor is there research examining treatments to address the behavioral difficulties of patients with HH without epilepsy. In the current case report, the authors implemented a validated parent management training program [the Brief Behavioral Intervention (BBI)], to treat symptoms of ADHD and disruptive behavior in a 6-year-old female patient with HH and CPP. The family participated in six BBI sessions over a period of 8 weeks. Parent behavioral ratings suggested significant reductions of symptoms of ADHD and disruptive behaviors to the normal range. The current case report demonstrates the effectiveness of the BBI program in the treatment of behavioral difficulties in a patient with HH and CPP. Further, the present study explores behavioral manifestations rarely explored in patients with HH without epilepsy.

Theoretical Rationale and Case Illustration of Mindfulness-Based Cognitive Therapy for Fear of Cancer Recurrence Abstract Fear of cancer recurrence (FCR) is a common problem among cancer survivors and evidence-based interventions grounded in theoretical models are needed. Mindfulness-Based Cognitive Therapy (MBCT) is an evidence-based intervention for reducing health anxiety that could be useful to apply to FCR. However, there has only been one study of MBCT for FCR to date, and the theoretical rationale and practical application of MBCT for FCR has not been described. The purpose of this paper is to offer an evidence-based rationale for MBCT to treat FCR based on a health anxiety model; describe the process of adapting MBCT to target FCR; and present a case study of the adapted protocol for treating FCR in a young adult breast cancer survivor to illustrate its delivery, feasibility, acceptability, and associated changes in outcomes. Clinical implications and directions for future research are discussed.

Long-Term Posttraumatic Stress Following Accidental Injury in Children and Adolescents: Results of a 2–4-Year Follow-Up Study Abstract In this study, we determined the long-term prevalence of posttraumatic stress disorder (PTSD) in children and adolescents after accidental injury and gained insight into factors that may be associated with the occurrence of PTSD. In a prospective longitudinal study, we assessed diagnosed PTSD and clinically significant self-reported posttraumatic stress symptoms (PTSS) in 90 children (11–22 years of age, 60% boys), 2–4 years after their accident (mean number of months 32.9, SD 6.6). The outcome was compared to the first assessment 3 months after the accident in 147 children, 8–18 years of age. The prevalence of PTSD was 11.6% at first assessment and 11.4% at follow-up. Children with PTSD or PTSS reported significantly more permanent physical impairment than children without. Children who completed psychotherapy had no symptoms or low levels of symptoms at follow-up. Given the long-term prevalence of PTSD in children following accidents, we recommend systematic monitoring of injured children. The role of possible associated factors in long-term PTSS needs further study.

Acceptability of the Stepped Care Model of Depression Treatment in Primary Care Patients and Providers Abstract Primary care has become the first and only point of contact for a majority of individuals experiencing depressive symptoms. One alternative model of care that has been adopted in international primary care settings as an alternative to standard care is the stepped care model. Emerging evidence suggests that the stepped care model is at least as effective as standard care for depression; however, little is known about attitudes of patients and providers regarding this model, especially within the US. The current study utilized a cross-sectional survey to inquire about general attitudes towards the stepped care model, the individual steps, and the treatments offered within each step. We also examined the step that participants would prefer if prescribing or seeking help and the strength of those preferences. Descriptive and inferential statistics indicated that participants view the stepped care model as an acceptable form of treatment for depression and it is an improvement upon standard care. Results also indicated that our patient sample generally preferred self-help interventions over other treatment options, while most of our provider sample would prefer to treat patients in a manner consistent with the stepped care model. These results highlight the importance of collaboration and assessing preferences for treatment choices.

You Can Only Go Full Speed for So Long : The Career Development of Psychologists Working in Psychosocial Oncology Settings Abstract Cancer centers have adopted a holistic approach to cancer treatment to better meet the psychosocial needs of cancer survivors. However, the current number of psychosocial providers in oncology is inadequate to meet the growing demand and psychosocial providers may face barriers in accessing oncology-specific training. The current study aims to explore the career development of psychologists working in oncology to inform training and workplace supports, as well as to inform training for health psychologists interested in other sub-specialties. Interviews were conducted with 20 psychologists with oncology work experience. Data were analyzed using the consensual qualitative research method. Results indicated three primary domains: (a) factors influencing entry into the field, (b) factors influencing ongoing career decision-making, and (c) factors influencing success in psychosocial oncology. The complexities of these domains are discussed; suggestions for supporting psychologists interested in psychosocial oncology at individual as well as systemic levels are provided.

Reflections on a Health Psychology Service for Patients with Uveal Melanoma: The Challenge of Psychological Screening and Intervention When Distress is ‘Normal’ Abstract We appraise the role of screening for distress as part of health psychology assessment of patients newly diagnosed with cancer. We reviewed records of consecutive patients who accepted a health psychologist’s assessment over 4 years, examining convergence and divergence of the result of screening (whether patients reached threshold as ‘cases’) with the psychologist’s clinical judgment of need for intervention. Of 261 patients, 88 (33.7%) were ‘cases’. Of these, need for psychological intervention was identified in 70 (79.5%). Of the 173 (66.3%) ‘non-cases’, need was identified in 59 (34.1%). Examination of cases where the psychologist’s judgment diverged from screening showed that ‘caseness’ can arise from distress that patients can manage themselves and, conversely, that psychological needs arise in the absence of overt distress. Formal screening may not identify need for psychological intervention. The psychologist’s role is to make expert judgments of patients’ current and future needs. Dialogue with patients should be the vehicle for assessment.

The Impact of Deep Brain Stimulation for Parkinson’s Disease on Couple Satisfaction: An 18-Month Longitudinal Study Abstract Patients with Parkinson’s disease (PD) may benefit from deep brain stimulation (DBS) to improve motor and medication-induced symptoms. Yet mixed evidence regarding the outcome of successful DBS on couple satisfaction has been highlighted in the literature. Thirty patients diagnosed with PD were included in a study investigating couple satisfaction (MSS-14), depression (HAD-D) and anxiety (HAD-A) at four measurement times: before DBS and 6, 12, and 18 months post-surgically. Sixteen spouses/partners were included as well. Couple satisfaction from the patient perspective was never associated with depression or anxiety. However, poor marital adjustment (i.e., difference and absolute difference between patients and spouses/partners MSS-14 scores) predicted patients’ pre-operative depressive mood. Longitudinal analyses showed that couple satisfaction (n = 9) worsened at 12 months and 18 months compared to pre-DBS scores, F(2.047, 16.378) = 8.723, p = .003, and despite concomitant motor improvement. Growth curve analyses showed that couple satisfaction worsening occurred between 6 and 12 months post-operatively (b = 2.938, p < .001). Thus, couple satisfaction did not increase along with motor improvement and deteriorated after the adjustment period following DBS.