Demonstrating Nursing Excellence Through Equality: The Relationship Between Magnet® Status and Organizational LGBTQ Client Services and Support.

Introduction: Human Rights Campaign annually scores health care treatment of lesbian, gay, bisexual, transgender, and queer (LGBTQ) employees and clients among four measured dimensions in its Healthcare Equality Index (HEI). The purpose of this study was to determine if the score organizations earned on the 2018 HEI dimension measuring LGBTQ client services and support correlated with organizations' American Nurses Credentialing Center Magnet® recognition status, a distinction of nursing excellence. Method: Using a secondary data analysis approach, data obtained from Human Rights Campaign that specifically rated LGBTQ client services and support in 2018 HEI participating organizations (n = 626) were compared with the most recent inventory of American Nurses Credentialing Center Magnet health care organizations (n = 477). Results: LGBTQ client services and support HEI scores positively correlated with Magnet status (p = .0002). Discussion: Provision of LGBTQ client services and Magnet recognition is strongly related to higher quality nursing care, suggesting organizations earning Magnet recognition provide more equitable services to its LGBTQ clients.

Predictors of treatment initiation, completion, and selection among youth offered trauma-informed care.

OBJECTIVE: Few studies have investigated determinants of trauma-informed care (TIC) in vulnerable youth populations. The purpose of the present study was to investigate factors associated with initiation, completion, and selection of type of TIC treatment among a sample of 128 treatment-seeking youth who experienced crime or violence. METHOD: This retrospective medical record review study used data collected through routine clinical care at an outpatient, no-cost community mental health clinic. RESULTS: We found that 69.5% of treatment-seeking youth (n = 89) initiated treatment, defined as attending at least 1 TIC session. Among youth who initiated treatment, 61.8% (n = 55) completed a TIC treatment. Predisposing and need characteristics were not significantly associated with initiating or completing treatment in adjusted models. Youth assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) were more likely to complete treatment compared with those assigned to child-centered therapy (CCT) approaches (odds ratio [OR] = 4.48, 95% CI [1.35, 14.91], p = .014). Logistic regression analyses suggested therapists were less likely to select TF-CBT for children with higher externalizing symptoms (OR = 0.92, 95% CI [0.85, 0.99], p = .035). CONCLUSIONS: Findings suggest among youth who called in for treatment, many successfully initiated treatment, and of those who initiated, most completed treatment. Empirically supported treatments such as TF-CBT may further promote treatment completion. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A latent profile analysis of first-year university students' academic expectations / Un análisis de perfil latente de las expectativas académicas de estudiantes universitarios de primer curso

Academic expectations are an important variable in the explanation of adaptation and academic success in higher education. This paper uses latent profile analysis as a person-centered statistical approach to classify students into groups of similar types of expectations for higher education, at the beginning of the first year in university. Participants were 2,478 first-year Portuguese students. Based on the scores of seven dimensions of expectations, we identified six classes of students. Most students (84%) presented moderate levels of expectations, while 8% and 4%, respectively, reported very high and low expectations. One class represented a group of students (4%) with high expectations for the quality of education and for political engagement and citizenship and lower expectations for social interaction and attending to social pressures. Male and older students showed more positive expectations. Students from privileged family backgrounds are more likely to present higher expectations for political engagement and citizenship experiences, and lower expectations for social interaction and leisure and attending to social pressures

Las expectativas académicas son una variable importante en la explicación de la adaptación de los estudiantes de primer año y su éxito académico. Este trabajo utiliza el análisis de perfil latente como estrategia estadística centrada en la persona para clasificar a los estudiantes en grupos de expectativas similares en relación con la educación superior, al comienzo del primer año en la universidad. Participaron 2.478 estudiantes portugueses de primer año. Basándonos en las puntuaciones de las siete dimensiones de las expectativas, identificamos seis tipos de estudiantes. La mayoría de los estudiantes (84%) presentaron niveles moderados de expectativas, mientras que el 8% y el 4% presentaron expectativas muy altas y bajas, respectivamente. Una clase incluyó al 4% de los estudiantes, con altas expectativas en relación a la calidad de la educación y para el compromiso político y la ciudadanía y menores expectativas en cuanto a interacción social y atención a las presiones sociales. Varones e estudiantes mayores presentan expectativas más positivas. Estudiantes de familias más privilegiadas presenten mayores expectativas hacia el compromiso político y de experiencias de ciudadanía, así como menores expectativas de interacción social y de ocio y de atención a las presiones sociales

Influence of Sleep Disturbance on Global Functioning After Posttraumatic Stress Disorder Treatment.

Chronic insomnia and recurrent nightmares are prominent features of posttraumatic stress disorder (PTSD). Evidence from adult research indicates that these sleep disturbances do not respond as well to cognitive-behavioral therapies for PTSD and are associated with poorer functional outcomes. This study examined the effect of prolonged exposure therapy for adolescents versus client-centered therapy on posttraumatic sleep disturbance, and the extent to which sleep symptoms impacted global functioning among adolescents with sexual abuse-related PTSD. Participants included 61 adolescent girls seeking treatment at a rape crisis center. The Child PTSD Symptom Scale-Interview (Foa, Johnson, Feeny, & Treadwell, 2001) was used to assess PTSD diagnosis and severity of symptoms, including insomnia and nightmares. The Children's Global Assessment Scale (Shaffer et al., 1983) was used to assess global functioning. There were significant main effects of time and treatment on insomnia symptoms. Additionally, there was a main effect of time on nightmares. Results also showed that insomnia and nightmares significantly predicted poorer global functioning posttreatment (R2 = .21). Despite significant improvements in posttraumatic sleep disturbance, there were still clinically significant insomnia symptoms after treatment, suggesting that additional interventions may be warranted to address residual sleep disturbance in PTSD.

Treatment of Adolescent PTSD: The Impact of Prolonged Exposure Versus Client-Centered Therapy on Co-Occurring Emotional and Behavioral Problems.

The present study evaluated secondary emotional and behavioral outcomes among adolescents who received prolonged exposure (PE-A) or client-centered therapy (CCT) for posttraumatic stress disorder (PTSD) in a randomized controlled trial. Participants were 61 adolescent girls (age: M = 15.33, SD = 1.50 years) with sexual abuse related PTSD seeking treatment at a community mental health clinic. Multilevel modeling was employed to evaluate group differences on the Youth Self-Report (YSR) over acute treatment and 12-month follow-up. Both treatment groups showed significant improvements on all YSR scales from baseline to 12-month follow-up. Adolescents who received PE-A showed significantly greater reductions than those receiving CCT on the Externalizing subscale (d = 0.70), rule-breaking behavior (d = 0.63), aggressive behavior (d = 0.62), and conduct problems (d = 0.78). No treatment differences were found on the Internalizing subscale or among other YSR problem areas. Both PE-A and CCT effectively reduced many co-occurring problems among adolescents with PTSD. Although PE-A focuses on PTSD and not on disruptive behaviors, PE-A was associated with greater sustained changes in externalizing symptoms, supporting broad effects of trauma-focused treatment on associated problem areas.

The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.

The effects of non-directive supportive therapy (NDST) for adult depression have been examined in a considerable number of studies, but no meta-analysis of these studies has been conducted. We selected 31 studies on NDST from a comprehensive database of trials, examining psychotherapies for adult depression, and conducted meta-analyses in which NDST was compared with control groups, other psychotherapies and pharmacotherapy. We found that NDST is effective in the treatment of depression in adults (g=0.58; 95% CI: 0.45-0.72). NDST was less effective than other psychological treatments (differential effect size g=-0.20; 95% CI: -0.32 to -0.08, p<0.01), but these differences were no longer present after controlling for researcher allegiance. We estimated that extra-therapeutic factors (those processes operating in waiting-list and care-as-usual controls) were responsible for 33.3% of the overall improvement, non-specific factors (the effects of NDST compared with control groups) for 49.6%, and specific factors (the effects of NDST compared with other therapies) for 17.1%. NDST has a considerable effect on symptoms of depression. Most of the effect of therapy for adult depression is realized by non-specific factors, and our results suggest that the contribution of specific effects is limited at best.

Innovative moments and change in client-centered therapy.

Previous studies have used the Innovative Moments Coding System (IMCS) to describe the process of change in Narrative Therapy (NT) and in Emotion-Focused Therapy (EFT). This study aims to extend this research program to a sample of Client-Centered Therapy (CCT). The IMCS was applied to six cases of CCT for depression to track the Innovative Moments (IMs) which are exceptions to the problematic self-narrative in therapeutic conversation. Results suggest that IMCS can be applied to CCT, allowing the tracking of IMs' emergence. The analysis based on a generalized linear model revealed that the overall amount of IMs is significantly associated with symptom improvement, which is congruent with former studies done with the IMCS.