A Pilot Feasibility Study of an Intensive Summer Day Camp Intervention for Children with Selective Mutism.

Cost, scheduling, and implementation competency are barriers to accessing traditional evidence-based behavioral interventions for childhood selective mutism (SM). Brief, or intensive, interventions are a disruptive innovation to traditional therapy given the use of fewer sessions during a short-term time period. This study explored the acceptability, integrity, and effectiveness (i.e., single-case replicated AB design) of an intensive summer camp consisting of a 5-day behavioral therapy for 25 children with SM. Caregiver-rated treatment acceptability ratings and family interviews support intensive summer day camp as an acceptable intervention approach for SM. Additionally, results revealed that counselors and parents implemented SM behavioral therapy during camp with impressive integrity (>90%) after receiving training about SM behavioral therapy from an SM expert clinician. Effect size calculations of counselor-rated daily behavior ratings revealed reductions in anxiety during camp for 18 of the 25 campers. Significant caregiver-rated improvements in speaking behaviors were reported for 9 out of 14 campers with data available for analysis at the 3-month follow-up. This pilot feasibility study is the first to investigate intensive summer day camp as a treatment approach for SM and implications for future research are discussed.

Integrated care models for ADHD in children and adolescents: A systematic review.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) in children and adolescents is commonly managed in primary care. Changes in United States health care have led to the integration of behavioral health services within a patient's "medical home" to improve access to, engagement in, and continuity of quality health care. Despite proliferation of these integrated care models, no studies have specifically examined models for managing ADHD in children and adolescents within primary care. METHOD: We searched PsycINFO, MEDLINE, and Google Scholar databases, and found 8 studies describing 6 integrated care models (i.e., combined psychosocial and medication treatments with coordination of care between primary care clinicians and behavioral health clinicians). We reviewed characteristics (i.e., settings, target populations, providers, levels of integration, evaluation and treatment approaches, and methods of interprofessional collaboration) and outcomes (i.e., access, outcomes, and acceptability) of these models. RESULTS: The 6 integrated care models demonstrate the potential to improve access to and acceptability of ADHD care for children and adolescents. The models also demonstrate that behavioral health clinicians can integrate at various levels within primary care to achieve superior clinical outcomes compared with nonintegrated models. DISCUSSION: We identified 6 effective integrated care models for addressing ADHD in children and adolescents that may be adaptable to local needs and internal capacities. We discuss results of these models with regard to their implications for clinical practice and research. (PsycINFO Database Record

Community implementation outcomes of Attachment and Biobehavioral Catch-up.

Bringing evidence-based treatments to community practice is a critical challenge for the field. When implemented in the community, evidence-based treatments often fail to provide the benefits shown in laboratory settings. Therefore, when evidence-based treatments are transported to the community, it is essential to investigate implementation process and outcomes. The present study assessed whether Attachment and Biobehavioral Catch-up (ABC), an intervention for high-risk parents that has been shown to be efficacious in randomized clinical trials (RCTs), changed parent behavior in a community-based setting. This study examined data collected from 78 cases by 9 parent coaches in a diverse community setting in Hawaii, and compared data to benchmarks from RCTs. Parent coach fidelity was coded from intervention session video clips, and was also compared with benchmarks. Caregivers participating in ABC were primarily birth parents, and most were referred through Child Protective Services involvement or for reasons of harsh parenting or neglect. Parental behavior was assessed before and after intervention using a semi-structured play task. Increases in parental following the lead and delight, and decreases in parental intrusiveness, were observed; these changes were comparable to effect sizes observed in RCTs. Intent to treat analyses were conducted using behavioral data from videotaped sessions, and suggested that ABC also improved following the lead in parents who subsequently dropped out of treatment. These results support the viability of ABC for enhancing parenting behavior among parents at high risk for maltreatment, and demonstrate that parent coaches in community agencies can successfully implement ABC.