Abstract: School refusal behavior is a common problem seen by mental health professionals and by educators but little consensus is available as to its classification, assessment, and treatment. This study assessed 143 youth with primary school refusal behavior and their parents to examine diagnoses that are most commonly associated with proposed functions of school refusal behavior. As expected, results indicated that great heterogeneity in diagnoses marks this population. In general, anxiety-related diagnoses were associated more with negatively reinforced school refusal behavior; separation anxiety disorder was associated more with attention-seeking behavior; and oppositional defiant disorder and conduct disorder were associated more with pursuit of tangible reinforcement outside of school. These results are discussed within the context of classification, assessment, and treatment of this population.

Abstract: Thirty-one community-residing older adults age 60 or over either received 16 sessions of individual cognitive psychotherapy (Beck, Rush, Shaw, & Emery, 1979) or read Feeling Good (Burns, 1980) for bibliotherapy. Posttreatment comparisons with the delayed-treatment control indicated that both treatments were superior to a delayed-treatment control. Individual psychotherapy was superior to bibliotherapy at posttreatment on self-reported depression, but there were no differences on clinician-rated depression. Further, bibliotherapy participants continued to improve after posttreatment, and there were no differences between treatments at 3-month follow-up. Results suggest that bibliotherapy and that individual psychotherapy are both viable treatment options for depression in older adults.

Abstract: The effects of a set of behavioral and educational interventions provided in a middle-school-based mental health program on the behavior and academic performance of 7 students diagnosed with attention-deficit/hyperactivity disorder (ADHD) were studied. The treatments included educational, social skills and family interventions designed to target school functioning, peer relations, and family functioning. Dependent measures included parent and teacher ratings of ADHD symptoms, daily functioning, and academic grades. Large effect sizes were found on measures of inattention and school functioning. Grades and measures of family functioning and peer relations yielded small to moderate effect sizes. Description of the procedures is provided and implications for advancing school-based mental health care for adolescents with a diagnosis of ADHD are discussed.

Abstract: Inner-city youth are at high risk for dropping out of high school. Within this article, risk factors associated with dropout and strategies for effective prevention and intervention are reviewed. An example of a school-based drop-out prevention program is highlighted. The FUTURES Program is a school-based drop-out prevention program designed to address the needs of high-risk youth through smaller classes, character development, career preparation, case management/mentoring, positive incentives, and access to mental health services. Components of the program are described in detail and data evaluating the effectiveness of the program are presented. Directions for the future development of programs and conducting research to prevent dropout by inner-city youth are discussed.

Abstract: This article assesses the relation between health risk behaviors and varying levels of exposure to violence in an effort to inform assessment and intervention efforts of a school-based mental health program serving inner-city youth. Health risk behaviors such as involvement in violence, risky sexual behavior, and substance use are clearly associated, both with each other and with violence exposure. However, differential relationships were observed depending on the nature of violence exposure. Knowledge of violence was associated with substance use and sexual behavior variables. Witnessing violence was associated with violence involvement, substance use, and exercise variables. Finally, violent victimization was associated with violence involvement and sexual behavior variables. A more complete understanding of the associations among health risk factors and violence exposure variables has the potential to improve implementation of school mental health services for urban youth.

Abstract: The consumption of nonfood items (i.e., pica) frequently occurs in persons with developmental disabilities. Pica may result in the puncture or blockage of the digestive tract, infestation by gastrointestinal parasites, and can interfere with an individual's daily learning, occupational performance, and quality of life. Twenty-six published studies have examined the efficacy of behavioral-intervention packages (e.g., differential reinforcement of other behavior, noncontingent attention, or overcorrection) on the pica of persons with developmental disabilities. This article reviews those studies and discusses the effectiveness, generality, and acceptability of the various intervention packages used to reduce pica. Additionally, this article highlights the recent clinical advancements that have been made in the treatment of the pica of persons with developmental disabilities.

Abstract: Current research supports the effectiveness of self-monitoring strategies for addressing academic and behavioral challenges within educational settings. Although variations in procedures exist, frequently implementation of self-monitoring involves some form of adult feedback as a method of establishing accurate self-monitoring. To date, however, researchers have not systematically evaluated whether adult feedback is a necessary component for self-monitoring to be effective. In the current investigation, the influence of adult feedback on the effectiveness of self-monitoring was analyzed. The participant was a 13-year-old student receiving educational services in a special education school at a residential facility for youth with conduct problems. The effectiveness of self-monitoring with and without adult feedback was compared. Results suggest that adult feedback may be an important component for establishing self-monitoring as an effective intervention for behavior problems exhibited in academic settings.

Abstract: Social skills deficits and excesses are a defining aspect of mental retardation (MR). Research indicates that there is an established relationship between social skills and maladaptive behaviors. A number of studies demonstrate that the social competence of individuals with MR and comorbid psychopathology can be enhanced with social skills training. However, to design an effective training package, an accurate assessment of adaptive and social functioning must first be conducted. Unique problems arise when assessing social skills in individuals with severe and profound MR (i.e., individuals often have limited verbal repertoires). Thus, a clinician must often rely on observable behavior and caregiver report rather than self-report. The three most common methods for assessing social skills are behavioral observations, role-playing, and checklists. These assessment strategies will be discussed, as well as suggestions for future research.

Abstract: Although investigations have consistently demonstrated the effectiveness of sport psychology interventions, these methods have been underutilized by athletes. In this study, 124 athletes completed the athletes' Attitudes Toward Seeking Sport Psychology Consultation Questionnaire (ATSSPCQ) and were subsequently randomly assigned to receive one of the two semistructured interview formats. One interview focused on discussing the athlete's experiences in sports, and the other focused on delineating sport psychology and its potential benefits to the athlete. Upon being interviewed, athletes were readministered the ATSSPCQ. Discussing sport psychology and its personal benefits was more effective in enhancing athletes' perception of need for sport psychology than discussing sport experiences. However, neither interview format enhanced athletes' perceptions of openness to discuss personal issues with a sport psychology consultant and tolerance of stigma associated with sport psychology consultation. Indeed, participants who received the discussion of sports intervention reported a significant decrease in personal openness to discuss personal issues relevant to sports psychology from pre- to postintervention. Intervention effects were similar for male and female athletes. Study implications and future directions are discussed in light of these results.

Abstract: This quasi-experimental field study assessed whether an incentive/reward intervention can change the drinking behavior and the subsequent levels of intoxication among college students attending fraternity parties. A total of 356 blood alcohol concentration (BAC) assessments, using hand-held breathalyzers. were obtained at two baseline and at two intervention parties at the same fratenity house. At the intervention parties, the students were informed they could win a cash prize if their BAC was below .05, and they were given nomograms to aid in monitoring their levels of intoxication. Mean BAC and the percentage of partiers with intoxication levels above .05 were significantly lower at the two intervention parties. More than twice as many partygoers were legally intoxicated (i.e., BAC > .08) at the two baseline parties than at the two intervention parties. indicating a clinically significant impact of the incentive/reward intervention. Greek-life students, in particular, were significantly less intoxicated at intervention parties, compared to baseline parties (p < .001).

Abstract: Expanded school mental health (ESMH) programs, the focus of this special issue, provide comprehensive mental health care to youth in general and special education through partnerships between schools and community mental health agencies and programs. As these programs progressively develop in the United States, there is a critical need to build the research and evidence base for them. This article presents background to the national movement toward ESMH and provides an overview of articles contained in this special issue, which provide in-depth details and early research findings on diverse aspects of mental health programs in schools. Advantages of greater involvement of behavioral professionals in ESMH are discussed.

Abstract: Are the eating disorders discrete diagnostic entities or do they fall along one or more continua ranging from normal body weight, eating behavior, and weight concerns to severely disturbed patterns? Researchers have debated this question for at least 30 years and have used numerous creative strategies to examine this and related questions. This body of research is reviewed with particular attention to the more recent use of taxometric methods. Although somewhat mixed, much of the earlier research has been interpreted as supporting the continuity model. However, more recent taxometric research suggests the presence of one or more latent discontinuities, particularly with disorders associated with binge eating. These findings have implications for assessment, treatment, and possible prevention of eating disorders, and may ultimately allow us to better predict who will or will not develop an eating disorder in response to dieting, as well as who will or will not respond to particular treatments for an existing eating disorder.

Abstract: Out-of-home treatment for youth with conduct problems is increasing rapidly in this country. Most programs for these youth deliver treatment in a group format and commonly employ some version of a token economy. Despite widespread evidence of effectiveness, a substantial minority of treated youth fail to respond. Participants for this study were 3 youth who were nonresponsive to treatment provided in a family-style residential care program with a comprehensive token economy. Our approach to the “nonresponse” of these youth involved modifications of the frequency and immediacy of their access to the backup rewards earned with tokens. We evaluated the effects of the modifications with a treatment-withdrawal experimental design. Dependent measures included two indices of youth response to treatment: intense behavioral episodes and backup rewards earned. Results showed substantial improvement among these indices during treatment conditions.

Abstract: Self-monitoring of stroke count by swimmers is a common coaching strategy, it is but one that has little data to support it. Although research has demonstrated that self-monitoring can motivate beh...

Abstract: Little research has been published on tattling, even less on its social impact, and we found none directly investigating tattling by adolescents. This study assessed the extent to which tattling, as perceived by peers and caregivers of adolescents in a residential care program, was associated with various dimensions of social status and other behavioral correlates. Eighty-eight adolescent participants rated their housemates on likeability, perceived rates of tattling, and other behavioral descriptors. In addition, caretakers also rated each youth in terms of perceived tattling. On the basis of likeability ratings, participants were classified into one of five categories: popular, average, controversial, neglected, and rejected. Results showed a significant negative correlation between likeability and perceived tattling rates. In addition, youth classified as socially rejected were more likely to be perceived by both their peers and care providers as engaging in high rates of tattling.

Abstract: A survey was made of the leaders in the Latino community from four East coast cities on the mental health, academic, and behavioral needs of Latino youth, services available to them, and recommendations to better address their needs. Of the 112 Latino leaders recruited, 46 responded to the survey, expressing their views that Latino youth experience significant stress in the United States, present behavioral and academic adjustment problems, and generally have difficulty accessing appropriate services and resources. Programs for these youth were presented as limited in number and lacking in cultural sensitivity. Community leaders endorsed the development of comprehensive and culturally sensitive programs for Latino youth in schools that address their psychosocial and academic needs.

Abstract: The exhibition of stereotypic and self-injurious behavior (SIB) combined with a lack of work engagement makes it very difficult to place a person with severe disabilities in an integrated work environment. The purpose of this research was to examine use of a positive procedure to increase engagementon-task and reduce self-injurious slapping and stereotypicclo the smanipulation by a 46-year-old man with severe disabilities. A single-subject research design was used to examine the effects of the combined DRA-DRO (differential reinforcement of alternative behavior-differential reinforcement of other behavior) procedure in fostering more appropriate behavior. Following 30 years of institutionalization, the man was successfully integrated into community-based employment.

Abstract: This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city's public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed.

Abstract: This article describes the structure and costs of a multidisciplinary hospital-based program for severe eating disorders. The program utilizes multiple levels of care (inpatient, partial day hospital, intensive outpatient, and traditional outpatient) to provide continuity of care during the recovery process, which often spans 2 to 3 months of intensive treatment. Details about the expectations of staff, patients, and family members are provided. Also, special protocols for refeeding, weight gain, and motivation for eating are described. The costs of treatment can be managed by greater utilization of the partial day hospital level of care, as opposed to lengthy inpatient hospitalization.

Abstract: Articles about systematic desensitization that appeared in mainstream behavior therapy journals between the years 1970 and 2002 were counted. Graphic displays of the data point to a sudden and lasting decline of interest in systematic desensitization among academics and researchers. A questionnaire concerning clinical use of orthodox systematic desensitization was mailed to 310 selected providers. Returns from 171 of those providers show that use of systematic desensitization has declined but continues to be fairly widespread. The decline of interest in systematic desensitization is explained; arguments are offered that revitalized interest would be beneficial but is not likely to occur.

Abstract: This pilot study was designed to evaluate the feasibility and the impact of a smoking-cessation program that would meet the specific needs of high school students. Feedback from focus groups conducted with adolescent smokers at a Connecticut high school was used to develop a tailored intervention. Intervention components included commonly used behavioral strategies, with additional options to assist students to quit smoking, including use of bupropion, concomitant support for parent smoking cessation, stress management, and physician counseling. On completion, 20 of the 22 enrolled students remained committed to quitting. Twenty-seven percent of students quit smoking and 69% of those who continued to smoke reduced the number of cigarettes smoked per day by an average of 13. Providing additional options to students and additional support for concomitant parental cessation may enhance the appeal of adolescent smoking-cessation programs. Further investigation into efficacy of bupropion use for adolescent cessation is warranted.

Abstract: Although perpetrators of child neglect often abuse illicit substances, treatment outcome evaluations in drug-abusing young mothers who have been found to neglect their children are conspicuously absent. Problem-solving interventions and family-based therapies that include skill acquisition components have demonstrated effectiveness in substance-abusing adolescents and child-neglecting mothers. The purpose of this article is (a) to review studies that have examined the relationship of drug abuse and child neglect, (b) to review clinical treatments that appear to be effective in both perpetrators of child neglect and drug-abusing adolescents, and (c) to integrate empirically validated drug abuse and child neglect interventions for use in adolescent mothers who have been found to abuse drugs and neglect their children.

Abstract: The authors investigated the effects of an intervention package to support five high school students with extensive support-needs to initiate and engage in recreational activities with general-education peers in their physical education classes. The intervention components were (a) assessing participants' recreational activity goals, (b) teaching self-prompting using a picture book, (c) programming common stimuli, and (d) asking participants to assess daily performance and evaluate daily goal achievement. The intervention was associated with increases in participants' initiation of and engagement in recreational activities with general-education peers, as well as increases in ratings of quality of interaction. In addition, participants typically assessed with accuracy their performance of recreational activities and whether they had achieved their recreational goals. Findings are discussed with respect to future research and practice.

Abstract: Seizures can be debilitating across a number of physical, social, occupational, and personal variables. Given the deficits in all of these areas frequently present in persons with mental retardation, effective assessment and subsequent treatment of seizures is a primary goal for individuals with both mental retardation and epilepsy. To thoroughly address the behavioral domains related to seizures in persons with mental retardation and epilepsy, areas of assessment should include seizure behavior, triggering stimuli, reinforcing consequences, and antiepileptic medication side effects. Assessment of these areas in this population often deviates from methods typically used with persons of normal intelligence. Specifically, direct behavioral observation and third-party report with structured interviews are the most viable and accessible means of assessment, and efforts to establish reliable and valid protocols have been successful in some areas. This article reviews this assessment methodology and discusses the extant issues in establishing and proliferating such approaches.

Abstract: The Body Logic Program for Adolescents was developed as a two-stage intervention to prevent the development of eating disorder symptoms. Preliminary results indicate that this program shows promise as an effective prevention effort. The current article provides a detailed description of the protocol for implementing Body Logic Part I, a school-based intervention. A brief review of Body Logic Part II, an intensive family-based intervention for high-risk students, is also provided. Examples of exercises are introduced and goals for practitioners are discussed. The authors hope that by providing this in-depth description of the protocol, researchers and clinicians can use this program in future prevention efforts.

Abstract: A concurrent-operants design was used to analyze the repetitive behavior of observing reflective surfaces while simultaneously engaging in erratic gross-motor body movements (EBMs) exhibited by a young boy diagnosed with autism. The assessment involved an evaluation of preference for controlled (i.e., the participant controlled the visual activity on a TV screen) versus uncontrolled (i.e., the participant viewed a previously recorded tape from the controlled condition) TV footage of his EBMs. The analysis indicated that both observing and EBMs were maintained by the direct correspondence between the body movements and the visual stimulation they produced when controlled by the participant. Thus, the EBMs appeared to be maintained on a conjugate schedule of reinforcement.

Abstract: This study examined the influence of (a) low, medium, or high adolescent involvement (degree to which adolescent input was solicited in determining consequence) in discipline decisions and (b) parental versus adolescent focus of impact of behavior problem (parent emphasized inconvenience to either self or adolescent). After viewing videotaped vignettes of disciplinary interactions, high school students (N = 95) rated how close they would feel toward the parent, how fair they felt the intervention was, and the degree to which they would feel respected by the parent. Adolescents also provided ratings of anger and self-esteem, as well as how willing they would be to accept/abide by the consequences. Overall, significantly more favorable ratings were found for interactions with (a) higher levels of invited adolescent involvement and (b) the parent as the focus of impact. Findings suggest the importance of encouraging adolescent involvement in discipline and the value of refraining from emphasizing adverse impact to adolescent.

Abstract: Simplified regulated breathing (SRB) has been demonstrated to reduce or eliminate stuttering in children. However, much of the current research has evaluated the intervention with school-aged children within educational contexts. In the current case report, we extended the application of SRB by evaluating its effectiveness in treating stuttering displayed by a 15-year-old resident of a large midwestern residential facility. Further, we evaluated the impact across different assessment conditions. Results showed that SRB resulted in decreased stuttering for the participant, although differential effectiveness across conditions was noted. These results are discussed in terms of the generality of SRB across client populations and clinical settings, as well as the value of addressing contextual variables when treating stuttering.

Abstract: Conduct problems (CP) include a wide range of behavioral disruptions ranging from relatively minor problems, such as whining, crying, sassing or talking back, temper tantrums, and passive defiance/ noncompliance, to more significant challenges, such as active defiance, property destruction, truancy, and verbal and physical aggression (McMahon & Wells, 1998). Research indicates that oppositional and defiant behaviors (e.g., noncompliance, sassiness) may serve as precursors to more serious forms of antisocial behavior (Beiderman et al., 1996; Loeber, Green, Keenan, & Lahey, 1995). Although historically CP were conceptualized along a one-dimensional bipolar scale of overt-covert behavior (Loeber & Lahey, 1989; Loeber & Schmaling, 1985), more recent evidence suggests a multidimensional approach with two bipolar dimensions, overt-covert and nondestructive-destructive (Frick et al., 1993). Using such an approach, CP have been categorized into four quadrants: (a) oppositional behavior (e.g., stubborn, angry, touchy), (b) aggression (e.g., bullies, fights, blames others), (c) property violations (e.g., vandalism, fire setting, cruelty to animals), and (d) status violations (e.g., substance use, truancy). Adolescent CP are a concern for educational, mental health, justice, and other systems across the nation (Dishon, McCord, & Poulin, 1999). Although extensive literature has been written regarding issues relevant to CP in youth (see McMahon & Wells, 1998), relatively less research has been conducted on the behavioral assessment and treatment of adolescents with CP as compared to younger children. This can be shown by simply conducting a literature search with a popular