The Flash Technique as an Effective Low-Intensity Intervention for Migrants at the U.S. Point of Entry

There are not enough psychotherapists to offer individual trauma intervention to the tens of millions of people traumatized around the world. Eye movement desensitization and reprocessing (EMDR) is a proven trauma treatment but requires substantial time and financial resources for training. One solution may be low-intensity intervention with the flash technique (FT) offered one-on-one online and based on highly scripted instructions in which participants can work on their distressing memories independently. The FT is a protocol that was originally developed for the preparation phase of EMDR and only requires a few hours of training. In this study, we aim to explore whether a scripted FT protocol used by inexperienced student clinicians might be effective. Nine master-level social work students, trained in FT and under licensed supervision, offered individual FT treatment online using a scripted protocol. Participants were admitted to the study with an Impact of Event Scale—Revised (IES-R) score of >24. Pre- and posttreatment surveys were collected from 30 participants who each received 6 sessions of individual therapy. No follow-up study data was collected. The IES-R data dropped from a pretreatment mean of 45.97 ( SD = 14.5, 95% CI = [40.78, 51.16]) to posttreatment mean of 25.33 ( SD = 14.92, 95% CI = [19.99, 30.67]), with a p -value of <.00001 and a Cohen’s d = 1.4, showed a large effect size. Interpretation of the study results is limited due to a lack of a control group and a relatively small sample size ( n = 30). Furthermore, since we did not follow participants posttreatment, the impact of the intervention over time is unknown for this study. Even so, the data suggested that the scripted FT protocol might be usable even by inexperienced student clinicians, paving the way for its use as a low-intensity trauma intervention.

The Flash Technique (FT) is a low-intensity individual or group intervention, which was shown to reduce the distress of disturbing and traumatic memories rapidly. For this reason, the purpose of the study was to examine the effect of the Flash Technique on childhood trauma, dissociation, and Post-Traumatic Stress Symptoms. The Quantitative Study Method was used in the study with the single-group pre-test post-test control group design, which is one of the semi-experimental designs. The childhood Traumas Scale, PTSD Checklist Scale, and Dissociation Questionnaire (DIS-Q) were used in the study. The study is an individual intervention application that consisted of six case series. The duration of the intervention for memories varies according to the intensity of the client's problem. But in general, interventions for memories lasted an average of 35-55 minutes. Compared to other therapies, this is shorter in terms of time. The Non-parametric Friedman Test was used for the difference between the measurements because the study group was very small. These repeated measurements are the equivalent of the One-Way Analysis of Variance. As a result of the data obtained in the study, the dissociation levels of university students (χ2 (2) = 10.33; p < .05), childhood trauma symptoms (χ2 (2) = 12.00; p < .05), and post- traumatic stress symptoms (χ2 (2) = 12.00; p < .05).It was determined that the Flash Technique is an effective technique for reducing and/or improving the dissociation levels, childhood trauma symptoms, and post-traumatic stress symptoms of university students.

Effectiveness of Brief and Standard School-Based Cognitive-Behavioral Interventions for Adolescents With Anxiety: A Randomized Noninferiority Study

America, all things not being equal

The paper gives an overview of the limited evidence in England and Wales. The paper shows which therapies have been measured. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Larger studies are needed across all types of patient wards in England and Wales with random allocation to types of therapy and longer-term follow-up. More studies are needed where researchers are not aware of the therapy being delivered. More studies need to use a mixture of patient and clinician outcome measures. Outcomes should also measure incident, readmission and reoffending rates. More evidence is needed from patients who are female, non-white and who are diagnosed with depression and anxiety. INTRODUCTION: The efficacy of psychological interventions delivered under the Mental Health Act (1983) (MHA) in England and Wales is unclear. While meta-analyses have reviewed acute and forensic psychological interventions in wider geographical areas, there has been no review specifically in the unique MHA context. A systematic review was conducted of psychological outcomes for inpatients detained under the MHA in England and Wales. Diagnoses and type of psychological intervention were not restricted, provided a psychological outcome measure was used. Studies were identified through APA PsychInfo, MEDLINE, CINAHL and Academic Search using a combination of key terms. Data extraction included effect direction, statistical significance, intervention type, format and duration, study size, inpatient setting, control group and study quality. High-quality evidence was sparse. Some improvements were found in overall well-being, self-esteem, social functioning, problem-solving, substance use, anger, offending attitudes, fire-setting, violence, anxiety, depression, personality disorder and psychosis. However, the overall evidence base is lacking. Larger-scale randomized controlled trials are needed across secure, acute and learning disability inpatient settings in England and Wales with longer term follow-up, blind assessors and both self-report and clinician-rated measures, as well as incident, readmission and reoffending rates. Greater representation is needed of females, non-white groups and affective disorders. The efficacy of psychological interventions for inpatients detained under the MHA in England and Wales remains unclear. Clinicians are encouraged to use relevant outcome measures in relation to treatment goals, to monitor the efficacy of interventions being offered to this client group. This paper highlights the current body of evidence for psychological interventions in inpatient settings within England and Wales, which is an environment in which mental health nursing plays an important role in patients' recovery. This evidence is also particularly important as there is a shift in clinical practice to training nursing staff to deliver some of the low-intensity psychological interventions, such as behavioural activation, solution-focussed therapy and motivational interviewing.

BackgroundCigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD), and it contributes to the development of many other serious diseases. Smoking cessation in COPD patients is known to improve survival and reduce the number of hospitalization-requiring acute exacerbations of COPD. However, smoking cessation interventions in these patients have only been successful for approximately 15–20% for consistent smoking abstinence in 12 months. Thus, more effective interventions are needed for this patient group. The aim of this study is to determine whether a high-intensity intervention compared to a low-intensity intervention can increase the proportion of persistent (> 12 months) anamnestic and biochemical smoking cessation in active smokers with COPD.MethodsThis study is a randomized controlled trial. A total of 600 active smokers with COPD will be randomly assigned 1:1 to either a standard treatment (guideline-based municipal smoking cessation program, “low intensity” group) or an intervention (“high-intensity” group) group, which consists of group sessions, telephone consultations, behavior design, hotline, and “buddy-matching” (smoker matched with COPD patient who has ceased smoking). Both groups will receive pharmacological smoking cessation. The primary endpoint is anamnestic and biochemical (cotinine analysis in urine) validated smoking cessation after 12 months.DiscussionThe potential benefit of this project is to improve smoking cessation rates and thereby reduce smoking-related exacerbations of COPD. In addition, the project can potentially benefit from increasing the quality of life and longevity of COPD patients and reducing the risk of other smoking-related diseases.Trial registrationClinicalTrials.gov NCT04088942. Registered on 13 September 2019

High probability request (high-p) sequences, based on the momentum of behavior principle, have been an effective intervention for improving compliance and work completion for students who display challenging behaviors. They have been portrayed as a low-intensity intervention because of being perceived as simple, clear, and easy for any teacher to implement as compared to developing a token economy, behavioral contract, or conducting a functional behavioral assessment which are intensive and require expertise in applied behavior analysis. However, high-p request sequences may not be as low-intensity as has been depicted. There are several subtleties for implementing them effectively that teachers would not automatically understand. Also, an examination of the research may raise concerns how well this intervention translates into practice. The purpose of this articles is to provide foundational and theoretical information that is often overlooked when researching and implementing high-p request sequences, describe different techniques for building behavioral momentum, address issues translating research into practice, discuss problems in following published implementation steps, and offering an alternative approach for engendering student compliance.

Smoking cessation is an important goal for smokers with coronary artery disease (CAD) because it reduces cardiac morbidity and mortality. Effective interventions for cigarette smokers with CAD exist, but they often are considered to be intensive and expensive. Stepped-care interventions have been proposed as a promising way to allocate smoking cessation treatments in a cost-effective manner. Stepped care refers to the practice of initiating treatment with low-intensity intervention and then exposing treatment failures to successively more intense interventions. To address the efficacy of this approach, 254 cigarette smokers hospitalized with CAD were provided a brief cessation intervention. The participants then were assigned randomly to either a more intensive stepped-care treatment (counseling and nicotine patch therapy) or no additional treatment. Outcomes were point-prevalent abstinence measured 3 months and 1 year after hospital discharge. Stepped-care treatment increased smoking cessation rates from 42% to 53% during a 3-month follow-up period (P =.05), but showed little effect at the 1-year follow-up assessment, as evidenced by a cessation rate for the minimal intervention group of 36% versus 39% for the stepped-care group (P =.36). A stepped-care approach to smoking cessation increased short-but not long-term point-prevalent abstinence in patients with CAD. For improvement of long-term effectiveness, refinement of the timing and content of stepped-care interventions needs to occur.