Using reliable change to calculate clinically significant progress in children with EBD: A BHRS program evaluation.

Purpose The purpose of this single-case experimental design paper is to examine the efficacy of the high-dosage Life Minus Violence – Enhanced (LMV-E) programme with a small sample of four violent women in custody. All participants were undertaking LMV-E as one component of their treatment pathway in an Offender Personality Disorder (OPD) treatment service for women with personality disorder. The methodology employed an AB baseline design with a six-month baseline period, nine-month treatment period and six-month follow-up. Levels of direct and indirect aggression were recorded throughout the baseline, intervention, and follow-up period. In the follow-up period, women were engaging in further treatment. Psychometric measures linked to treatment domains were used to explore clinically significant and reliable change following the intervention. Clinical and reliable change was indicated in some treatment domains for each participant following the intervention. The pattern of these reductions varied between the women. The patterns of findings are discussed and recommendations presented. Design/methodology/approach The methodology employed an AB baseline design with a six-month baseline period, nine-month treatment period and six-month follow-up. Levels of direct and indirect aggression were recorded throughout the baseline, intervention and follow-up period. In the follow-up period, women were engaging in further treatment. Psychometric measures linked to treatment domains were used to explore clinically significant and reliable change following the intervention. Findings Clinical and reliable change was indicated in some treatment domains for each participant following the intervention. The pattern of these reductions varied between the female offenders. The patterns of findings are discussed and recommendations presented. Practical implications The LMV-E programme was associated with some positive improvements in treatment domains measured in a small sample of female violent offenders. Improvements to some degree were most commonly found in the domains of anger, emotional control and components of criminal thinking. It would be clinically useful to examine characteristics of individuals that appear to benefit most from particular interventions. Originality/value There are no existing published findings related to the implementation of LMV-E with females. Therefore, this paper provides preliminary contribution to the evidence base in this area.

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Nostalgic conversations: The co-production of an intervention package for people living with dementia and their spouse

Dementia ◽

10.1177/14713012211047350 ◽

2021 ◽

pp. 147130122110473

Author(s):

Emily Dodd ◽

Sanda Ismail ◽

Gary Christopher ◽

Tim Wildschut ◽

Constantine Sedikides ◽

...

Keyword(s):

Meaning In Life ◽

Social Connectedness ◽

Self Esteem ◽

Reliable Change Index ◽

Psychological Benefits ◽

Intervention Package ◽

Post Intervention ◽

Reliable Change ◽

Clinically Significant ◽

Clinical Potential

Objectives Nostalgic memories are more social than other forms of autobiographical recall, often refer to atypical events, express more positive affect and reflect life as meaningful. Recalling a nostalgic (compared to ordinary) memory increases self-esteem, self-growth, meaning in life and social connectedness for people living with dementia. We set two objectives: to work with people living with dementia to develop an intervention based on nostalgia, and to assess whether couples could engage in nostalgic conversations. Method Our research fell into three phases. Initially, we consulted with people living with dementia and with carers to identify the parameters for a nostalgic intervention. From this, we drafted a workbook that contained triggers for nostalgic conversations, which we then took back to the public contributors for refinement. Finally, we trialled the workbook over 5 weeks with six couples, each of which included a person living with dementia. We assessed pre- and post-intervention self-esteem, self-growth, meaning in life and social connectedness for participants with dementia and social connectedness for carers. We then calculated Reliable Change Index scores and established levels of clinically significant change. We also interviewed couples at the end of the intervention to explore its implementation and acceptability. Results All six couples could identify nostalgic memories, with five couples successfully integrating the nostalgic conversations into their day-to-day lives. A sixth couple found it difficult to engage fully with the intervention, but still considered it useful. All six couples manifested a reliable change in at least one outcome, with one couple showing reliable change across three outcomes. Conclusion The psychological benefits of nostalgia have been robustly demonstrated in laboratory-based studies. This co-production of an intervention that sets nostalgic recall into the context of a conversation has clinical potential but requires further investigation through a larger study.

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Evaluating a person-centred chronic pain service using indices of reliable and clinically significant change

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v3i1.855 ◽

2015 ◽

Vol 3 (1) ◽

pp. 19 ◽

Cited By ~ 2

Author(s):

Katherine Macey ◽

Simon Clarke ◽

Nima Golijani-Moghaddam ◽

Roshan Das Nair

Keyword(s):

Chronic Pain ◽

Outcome Data ◽

Service Planning ◽

Published Data ◽

Traditional Group ◽

Reliable Change ◽

Clinically Significant Change ◽

Individual Level ◽

Significant Change ◽

Clinically Significant

Background: Psychological interventions for chronic pain often require substantial individualisation, which can undermine links with the research evidence on which treatment is based. To ensure clients receive effective therapy, evaluation is needed. This paper demonstrates the use of individual level change indices, which may be more appropriate for assessing effectiveness of person-centred treatment than traditional group-level statistics.Aims: To evaluate the efficacy of a psychological chronic pain service at individual level and to recommend improvements for future service evaluation.Method: Indices of reliable and clinically significant change were used to assess outcomes on the HADS, CORE-10, and PSEQ.Results: 56 out of 83 clients had usable outcome data. On the most widely administered outcome measure, the CORE-10, n=15 met reliable change and n=22 met clinically significant change criteria. 18 showed no reliable change. Only one person deteriorated.Conclusions: The person-centred treatment provided by this service was effective and achieved outcomes similar to published data from a structured group programme. However, missing data reduces the reliability of these conclusions and led to reduced usefulness of the evaluation for service planning. Recommendations for future evaluation are made.

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Feasibility of a virtual reality program to treat children with fear of darkness with nonexpert therapists

Revista de Psicología Clínica con Niños y Adolescentes ◽

10.21134/rpcna.2020.07.2.2 ◽

2020 ◽

Vol 7 (2) ◽

Author(s):

Mateu Servera ◽

Belén Sáez ◽

Joan Miquel Gelabert Mir

Keyword(s):

Experimental Study ◽

Virtual Reality ◽

Experimental Studies ◽

The Other ◽

Reliable Change Index ◽

Reliable Change ◽

Clinically Significant Change ◽

Significant Change ◽

Clinically Significant

Fear of darkness is highly prevalent and stable in children and often ends up becoming a specific situational phobia. The aim of this study is to analyze the feasibility of adapting and applying it through a Virtual Reality (VR) tool by nonexpert therapists. A pre-experimental study was carried out with six participants between the ages of 8 and 12 years old using pre- and posttreatment scales for assessing the fear of darkness. Statistically significant differences with large effects were found in all posttreatment measures: EMO (Roshenthal’s r = 0.64), WCDAN (r = 0.52), and Global item of current fear of darkness (r = 0.59). Using the Reliable Change Index (RCI) as a measure of clinically significant change, four participants improved satisfactorily, one acceptably, and the other did not improve. The results support the feasibility of using an adapted VR program to treat fear of darkness without being an expert therapist. However, more detailed experimental studies need to be carried out in order to analyze its efficacy.

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Assessing Clinically Significant Change: Application to the SCL-90–R

Psychological Reports ◽

10.2466/pr0.2000.86.1.263 ◽

2000 ◽

Vol 86 (1) ◽

pp. 263-274 ◽

Cited By ~ 52

Author(s):

Norbert Schmitz ◽

Norbert Hartkamp ◽

Gabriele H. Franke

Keyword(s):

Clinical Significance ◽

Psychotherapy Research ◽

Outcome Data ◽

Outcome Study ◽

Symptom Checklist ◽

Reliable Change ◽

Psychotherapeutic Process ◽

Clinically Significant Change ◽

Process And Outcome ◽

Clinically Significant

A Symptom Checklist (SCL-90–R) is a potentially useful measure of psychological distress; it is frequently used in psychotherapy research and clinical practice. The purpose of this study was to illustrate the use of the SCL-90–R for determining statistically reliable change and clinical significance outlined by Jacobson and Truax in 1991. This paper describes the concepts of statistical and clinical significance of change. A proposal for obtaining and characterizing samples is made. Then a clinician's perspective is taken. Reliable change estimates and cut-off scores are chosen based on outcome data. Selected data from a single psychotherapeutic process and outcome study then were used to test the estimates of change and cut-off scores.

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Clinically Significant and Reliable Change: Comparing an Evidence-based Intervention to Usual Care

Journal of Child and Family Studies ◽

10.1007/s10826-019-01621-3 ◽

2019 ◽

Vol 29 (4) ◽

pp. 921-933

Author(s):

Maria Michelle Vardanian ◽

Amrita Ramakrishnan ◽

Sarah Peralta ◽

Yasmin Siddiqui ◽

Suniti P. Shah ◽

...

Keyword(s):

Usual Care ◽

Evidence Based ◽

Reliable Change ◽

Clinically Significant

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Measuring clinically significant outcomes – LDQ, CORE-10 and SSQ as dimension measures of addiction

Psychiatric Bulletin ◽

10.1192/pb.bp.112.041301 ◽

2014 ◽

Vol 38 (3) ◽

pp. 112-115 ◽

Cited By ~ 5

Author(s):

Duncan Raistrick ◽

Gillian Tober ◽

Jenny Sweetman ◽

Sally Unsworth ◽

Helen Crosby ◽

...

Keyword(s):

Mental Health Problems ◽

Clinical Implications ◽

Three Dimension ◽

Reliable Change ◽

Clinically Significant Change ◽

Social Satisfaction ◽

The Core ◽

Two Measures ◽

Significant Change ◽

Clinically Significant

Aims and methodTo determine values for reliable change and clinically significant change for the Leeds Dependence Questionnaire (LDQ) and Social Satisfaction Questionnaire (SSQ). The performance of these two measures with the Clinical Outcomes in Routine Evaluation (CORE-10) as three dimension measures of addiction was then explored.ResultsThe reliable change statistic for both LDQ and SSQ was ≥4; the cut-offs for clinically significant change were LDQ 410 males, ≤5 females, and SSQ ≥16. There was no overlap of 95% CIs for means by gender between ‘well-functioning’ and pre- and post-treatment populations.Clinical implicationsThese data enable the measurement of clinically significant change using the LDQ and SSQ and add to the evidence for the performance of the LDQ, CORE-10 and SSQ as dimension measures of addiction. The CORE-10 and SSQ can be used as treatment outcome measures for mental health problems other than addiction.

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EM of human atherosclerosis: Aortic fatty streaks with transitional lesion features

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123519 ◽

1992 ◽

Vol 50 (1) ◽

pp. 622-623

Author(s):

K. Florian Klemp ◽

J.R. Guyton

Keyword(s):

Foam Cell ◽

Cell Formation ◽

Processing Technique ◽

Foam Cell Formation ◽

Tissue Preparation ◽

Electron Microscopic ◽

Extracellular Lipid ◽

Electron Microscopic Cytochemistry ◽

Human Atherosclerosis ◽

Clinically Significant

The earliest distinctive lesions in human atherosclerosis are fatty streaks (FS), characterized initially by lipid-laden foam cell formation. Fibrous plaques (FP), the clinically significant lesions, differ from FS in several respects. In addition to foam cells, the FP also exhibit fibromuscular proliferation and a necrotic core region rich in extracellular lipid. The possible transition of FS into mature FP has long been debated, however. A subset of FS described by Katz etal., was intermediate in lipid composition between ordinary FS and FP. We investigated this hypothesis by electron microscopic cytochemistry by employing a tissue processing technique previously described by our laboratory. Osmium-tannic acid-paraphenylenediamine (OTAP) tissue preparation enabled ultrastructural analysis of lipid deposits to discern features characteristic of mature fibrous plaques.

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Toward quantitative defect analysis using HREM

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100171304 ◽

1994 ◽

Vol 52 ◽

pp. 714-715

Author(s):

David J. Smith

Keyword(s):

Electron Microscope ◽

Unit Cell ◽

Defect Analysis ◽

Significant Progress ◽

Detailed Characterization ◽

Small Unit ◽

Resolution Electron ◽

High Resolution Electron Microscope ◽

Large Unit Cell ◽

Made In

The electron microscope has evolved to the level where it is now straightforward to record highresolution images from thin samples (t∼10 to 20nm) that are directly interpretable in terms of atomic arrangements. Whilst recorded images necessarily represent two-dimensional projections of the structure, many defects such as dislocations and interfaces may be linear or planar in nature and thus might be expected to be amenable to detailed characterization. In this review, we briefly consider the recent significant progress that has been made in quantitative defect analysis using the high-resolution electron microscope and then discuss some drawbacks to the technique as well as potential scope for further improvements. Surveys of defect modelling for some small-unit-cell materials and interfaces have recently been published, and reference should be made to other papers in this symposium for further examples.The technique of structure imaging originated in the early '70s with observations of large-unit-cell block oxides.

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