Goodness of Fit

Disorder (HD) is a complex mental health problem defined by an overabundance of clutter, difficulty with organization and discarding, and problems regulating acquisition. This chapter describes the features of HD, evidence-based intervention approaches and outcomes, and the elements of a manualized treatment approach with emphasis on flexible delivery to meet clients’ needs. Opportunities to flexibly implement cognitive and behavioral treatments (CBT) for HD include modification of assessment methods, the order of therapy components, treatment timing and focus, responsiveness to client comorbidity and context, consideration of treatment planning, and approaches to increasing motivation and building skills. Also covered are supports for cognitive and behavioral changes in acquisition/organizing/discarding, assessing the appropriateness of a home cleanout, and determining “flexibility within fidelity” (Kendall & Frank, 2018) for group HD treatments and online interventions.

Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic

Type 1 diabetes management can be challenging for children and their families. To address psychosocial concerns for parents of youth with type 1 diabetes, we developed two parent-focused interventions to reduce their diabetes distress and fear of hypoglycemia. Our team conducted several of these interventions during the early stages of the COVID-19 pandemic and recognized a need to make timely adjustments to our interventions. In this viewpoint article, we describe our experience conducting these manualized treatment groups during the pandemic, the range of challenges and concerns specific to COVID-19 that parents expressed, and how we adjusted our approach to better address parents’ treatment needs.

Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic (Preprint)

UNSTRUCTURED Type 1 diabetes management can be challenging for children and their families. To address psychosocial concerns for parents of youth with type 1 diabetes, we developed two parent-focused interventions to reduce their diabetes distress and fear of hypoglycemia. Our team conducted several of these interventions during the early stages of the COVID-19 pandemic and recognized a need to make timely adjustments to our interventions. In this viewpoint article, we describe our experience conducting these manualized treatment groups during the pandemic, the range of challenges and concerns specific to COVID-19 that parents expressed, and how we adjusted our approach to better address parents’ treatment needs.

Mechanical/Algorithmic Versus Flexible/Creative Clinical Practice: How Underlying Principles Bridge the Gap

In the case of "Hiro" (Lichtman, 2017) I described the successful use of Comprehensive Behavioral Intervention for Tics (CBIT) in a young boy with Tourette Syndrome (TS). In three different commentaries on this case, authors noted important concepts regarding the use of manuals in treating TS; how an understanding of underlying principles is important in flexible use of manuals; and how training impacts the treatment of TS. In my response to these commentaries, I hope to continue the conversation of how to use manuals in psychotherapy in general as well as in the treatment of TS in particular. Specifically, I hope to address the seeming dichotomy between a mechanical, algorithmic approach to treatment versus a flexible, creative approach, and to ultimately show that an understanding of the underlying principles guiding manualized treatment provides room for ingenuity that proves this dichotomy false.

Trauma-Focused Cognitive–Behavioral Therapy

Trauma-focused cognitive–behavioral therapy (TF-CBT) is a manualized treatment for children 3–17 years old who have posttraumatic stress symptomology as a result of experiencing a traumatic event or series of events. This evidence-based practice allows for practitioner expertise in adapting the order and time spent on each of the treatment components to best meet the individual needs of the child and his or her caretaker. This article provides an overview of the treatment components of TF-CBT, its application across various settings, use with diverse populations, and effectiveness.