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21. Henggeler, S. W., Smith, B. H., & Schoenwald, S. K. (1994). Key theoretical and methodological issues in conducting treatment research in the juvenile justice system. Journal of Clinical Child Psychology, 23, 143-150.

53.  Cunningham, P.B., Henggeler, S.W., & Pickrel, S.G., (1996). The cross-ethnic equivalence of measures commonly used in mental health services research with children. Journal of Emotional and Behavioral Disorders, 4, 231-239.

58.  Henggeler, S.W. and Randall, J. (2000). Conducting randomized treatment studies in real world settings. In D. Drotar (Ed.), Handbook of Research Methods in Pediatric and Child Clinical Psychology (447-461). New York: Plenum Publishing Corporation.

76.  Saylor, C.F., Swenson, C.C., Reynolds, S.S.,Taylor, M. (1999). The Pediatric Emotional Distress Scale: A brief screening measure for young children exposed to traumatic events. Journal of Clinical Child Psychology, 28, 70-81.

105.  Henggeler, S. W., Burr-Harris, A. W., Borduin, C. M., & McCallum, G. (1991). Use of the family adaptability and cohesion evaluation scales in child clinical research. Journal of Abnormal Child Psychology, 19(1), 53-63.

200.  Cunningham, P.B., & Henggeler, S.W.,Brondino, M.J.,Pickrel, G.G., (1999). Testing Underlying Assumptions of the Family Empowerment Perspective. Journal of Child and Family Studies 8(4), 437-449.

205.  Wagner, E.F.,Swenson, C.C., Henggeler, S.W., (2000). Practical and Methodological Challenges in Validating Community-Based Interventions. Children's Services: Social Policy, Research, and Practice, 3 (4), 211-231.

224.  Letourneau, E.J. (2002). A comparison of objective measures of sexual arousal and interest: Visual reaction time and penile plethysmography. Sexual Abuse: A Journal of Research and Treatment, 14 (3), 205-223.

226.  Clingempeel, W.G., & Henggeler, S.W. (2002). Randomized clinical trials (RCTs), developmental theory, and antisocial youth: Guidelines for research. Development and Psychopathology, 14, 695-711.

228. Cunningham, P.B., Foster, S.L., & Henggeler, S.W. (2002). The elusive concept of cultural competence. Journal of Children's Services: Social Policy, Research, and Practice, 5(3), 231-243.

243.  Henggeler, S.W., & Sheidow, A.J. (2003). Conduct disorder and delinquency. Journal of Marital & Family Therapy, 29, 505-522 .

254.  Henggeler, S. W. (2004). Decreasing effect sizes for effectiveness studies –Implications for the transport of evidence-based treatments: Comment on Curtis, Ronan, and Borduin (2004). Journal of Family Psychology , 18, 420-423.

265.  Cunningham, P. B., & Foster, S. L. (2005). Operationalizing cultural competence: One programmatic effort. Child and Family Policy and Practice Review, 1(1), 12-15.

269.  Letourneau, E. J., Prescott, D.S. (2005). Ethical issues in sexual offender assessments. In S.W. Cooper, R.J. Estes, A.P. Giardino, N.D. Kellogg, & V.I. Vieth (Eds.), Medical, Legal, & Social Science Aspects of Child Sexual Exploitation: A Comprehensive Review of Pornography, Prostitution, and Internet Crimes (pp. 277-296). G.W. Medical Publishing, Inc.: St Louis , MO.

282.  Lawson, L., & Swenson, C.C. (2006). Research with vulnerable populations.  In V. Lynch, (Ed.), Forensic Nursing (pp. 235-248).  Elsiever Mosby, St. Louis, MO.

286.  Saldana, L., DuBois, D. (2006).  Youth reactions to participation in psychological assessment procedures.  Journal of Clinical Child and Adolescent Psychology, 35 (1), 155-161.

301.  Saldana, L., Chapman, J.E., Henggeler, S.W., Rowland, M.D. (2007). The organizational readiness for change scale in adolescent programs: Criterion validity. Journal of Substance Abuse Treatment, 33, 159-169.

302.   Asscher, J.J, Dekovié, M., van Laan, P.H., Prins, P.J.M., van Arum, S. (2007). Implementing randomized experiments in criminal justice settings: An evaluation of multi-systemic therapy in the Netherlands. Journal of Experimental Ciminology, 3 (2) 113-129.

322.  Chapman, J.E., Sheidow, A.J., Henggeler, S.W., Halladay-Boykins, C.A., & Cunningham, P.B. (2008). Developing a measure of therapist adherence to contingency management: An application of the many-facet rasch model. Journal of Child and Adolescent Substance Abuse, 17(3), 47-68.

333 Sheidow, A.J., Donohue, B.C., Hill, H.H., Henggeler, S.W., & Ford, J.D. (2008). Development of an audio-tape review system for supporting adherence to an evidence-based treatment. Professional Psychology: Research and Practice, 39, 553-560.

376.  Cunningham, P. B., Foster, S. L., Warner, S. E. (2010). Culturally relevant family-based treatment for adolescent delinquency and substance abuse: Understanding within-session processes. Journal of clinical Psychology: In Session, 66(8), 830-846.

391.   Ashcraft, R. G. P., Foster, S. L., Lowery, A. E., Henggeler, S. W., Chapman, J. E., Rowland, M. D. (2011). Measuring practitioner attitudes toward evidence-based treatments: A validation study. Journal of Child & Adolescent substance Abuse, 20, 166-183.

395.   Carcone, A. I., MacDonell, K. E., Naar-King, S., Ellis, D. E., Cunningham, P. B., Kaljee, L. (2011). Treatment engagement in a weight-loss intervention for African American adolescents and their families. Children’s Health Care, 40, 1-21.

406.
   Glebova, T., Foster, S. L., Cunningham, P. B., Brennan, P. A., Whitmore, E. (2012). Examining therapist comfort in delivering family therapy in home and community settings: Development and evaluation of the therapist comfort scale. Psychotherapy, 49(1) 52-61.

421.  Cunningham, P. B., Foster, S. L. & Warner, S. E. (2010) Culturally relevant family-based treatment for adolescent delinquency and substance abuse: Understanding within-session processes. Journal of Clinical Psychology: In Session, 66(8) 830-846.

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Research Methods Abstracts

21. Key Theoretical and Methodological Issues in Conducting Treatment Research in the Juvenile Justice System

Addressed are critical conceptual and methodological problems that have hampered the development and implementation of effective treatment for juvenile offenders. Theoretical formulations underlying extant treatments are considered, and the nature and scope of theoretical models better suited to the development of effective intervention programs are described. Discussed methodological issues focus on the validity of comparisons between groups and the construct validity of treatment. Suggestions for addressing key issues are informed by conclusions of leading methodologists and our experience in conducting several clinical trials with serious juvenile offenders.

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53. The cross-ethnic equivalence of measures commonly used in mental health services research with children 

The developmental and validation of culturally competent mental health services requires culturally equivalent instrumentation be used in evaluations of such services.  Unfortunately, cross-ethnic equivalence has rarely been examined for research instruments commonly used with Black and White children.  In a sample of 117 juvenile offenders with diagnosed substance abuse of dependence disorders and considerable psychiatric comorbidities, the present study examined the cross-ethnic equivalence of several measures commonly used by service researchers to tap contextual correlates (i.e., parental symptomatology, family relations, peer relations) of serious emotional disturbance in children.  Results indicated that associations between these measures and criterion measures of youth behavior problems and social competence did not vary as a function of ethnicity.  Thus, the findings support the cultural equivalence of the measures used in this study; such as, they support the validity of findings from studies that have used these measures with Black and White youth and their families.

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76. The pediatric emotional distress scale:  A brief screening measure for young children exposed to traumatic events

Introduced the Pediatric Emotional Distress Scale (PEDS), which was developed to quickly assess behaviors identified in empirical and theoretical literature as significantly elevated in children after experiencing traumatic events.  The 21-item parent-report rating scale includes 17 general behavior items and 4 trauma-specific items.  Factor analyses on the 17 items, with 475 two- to ten-year-olds (Traumatic event exposure and nontraumatic event exposure), yielded 3 reliable factors labeled Anxious/Withdrawn, Fearful, and Acting Out.  Factor and total scores were shown to have good internal consistency, and both test-retest and interrater reliability were at acceptable levels.  Discriminant analyses demonstrated the PEDS could distinguish traumatic event exposure and nonexposure groups, although maternal education should be a significant consideration in interpretation.  Future research with diverse populations who have documented trauma is needed to enhance the utility of the full PEDS scale.

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105.  Use of the family adaptability and cohesion evaluation scales in child clinical research

Although the FACES has become a widely used instrument for assessing children’s family relations in possible linearity vs. curvilinearity of its cohesion and adaptability scales has been treated inconsistently by investigators.  This study evaluated whether samples of adolescent repeat offenders, young adult prisoners, and adolescent nonoffenders were discriminated better by a linear or curvilinear treatment of the FACES scores.  Between-groups comparisons are showed that significant effects were observed for each of the curvilinear measures (cohesion-curvilinear, adaptability-curvilinear, distance-from-center) and only one of the two superiority of a curvilinear treatment of the FACES.  In light of these findings, it is suggested that investigators who use FACES evaluate the linearity of the scales and determine whether a linear or curvilinear treatment of the data produces more meaningful results.

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200.  Testing underlying assumptions of the family empowerment perspective

We examined two underlying assumptions of the family empowerment perspective.  The first assumption is that a well-validated family-based treatment that explicitly aims to empower caregivers can do so.  The second assumption is that increased caregiver empowerment should be associated with improved youth and family functioning.  The data used to examine these assumptions are based on a randomized trial multisystemic therapy versus usual community services for 118 substance abusing and dependent juvenile offenders.  Results provided partial support for the underlying assumptions of the family empowerment perspective.  The family-based treatment in comparison with usual services increased caregiver perceptions of empowerment at the service system level, but not at the family level.  In addition, increased empowerment at the family and service system levels were associated with improved family relations, but not with decreased youth behavior problems.  The conceptual implications and limitations of the findings are discussed.

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205.  Practical and methodological challenges in validating community-based interventions

Practical and methodological challenges in conducting research on community-based interventions for adolescent problems are described.  First, a conceptual framework for the development of community-based interventions is provided, with an emphasis on the ecological and commonwealth advantages of such interventions.  Next, important issues that investigators confront when pursuing the dual goals of providing good community-based intervention and conducting rigorous intervention research are addressed.  These issues include research design, intervention specification and integrity, participant concerns, changing clinical culture, community challenges, school challenges, and appropriate staffing.  Finally, a summary of challenges to conducting good community-based intervention research and effective responses to these challenges is presented.

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224.  A comparison of objective measures of sexual arousal and interest: Visual reaction time and penile plethysmography 

This study assessed the reliability and validity of a visual reaction time (VRT) measure of sexual interest (G. G. Abel, J Huffman, B. Warberg, & C. L. Holland, 1998) and the penile plethysmograph (PPG) with the audio stimuli.  A sample of 57 sex offenders incarcerated at a high-security military prison completed physiological and self-report measures of sexual interests, including the VRT and the PPG.  Results indicated adequate internal consistency for both measures.  Convergent validity and an assessment of clinical usefulness for both measures indicated that (a) both measures accurately identified offenders against young boys; (b) the VRT, but not the PPG, significantly identifies offenders against adolescent girls; (c) neither measure reached statistical significance in identifying offenders against adult women; and (d) the VRT did not reach statistical significance in identifying offenders against young girls and the PPG did reach statistical significance but in the opposite direction as was expected (i.e., men with female child victims had significantly lower arousal to female child stimuli than did men in other victim choice categories).

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226.   Randomized clinical trials (RCTs), developmental theory, and antisocial youth: Guidelines for research

The design of effective interventions for antisocial adolescents has been greatly influenced by research-based developmental theories.  However, randomized clinical trials (RCTs) demonstrating effectiveness of these treatments have contributed minimally to alterations and refinements of these theories.  In this article, nine guidelines for research that enhance the contributions of RCTs to developmental theory are proposed: (1) use mediational analyses to test and refine theories of change; (2) use moderator analyses to test differential pathways to change; (3) assess changes processes separately for different types of antisocial behavior; (4) use constructive and dismantling designs to isolate effects of intervention components on targeted mediators and outcomes; (5) assess time-sensitive nature of changes mechanisms with theoretically-relevant spacing of multiple assessments and long term follow-ups; (6) expand the nomological net of developmental theories by assessing intervention effects on nontargeted constructs; (7) use RCTs to disentangle “direction of effects” questions in developmental theories; (8) conduct secondary analyses of RCTs to assess extra-treatment influences on antisocial behavior; and (9) assess generalizability of mediator and moderator effects.  Use of these guidelines may promote a recursive and iterative relationship between RCTs and theory building.  Improved developmental theories may yield effective interventions, and theory-testing interventions may engender more comprehensive and better-informed theories.  

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228.  The elusive concept of cultural competence

Examined agreement statistics (kappas) to access the extent to which 2 groups of experts (those nominated by important peer scholars as having expertise in cultural competence and therapists with extensive experience and training in working with African Americans) agreed on the specific composition of constructs related to cultural competence.  Using items from existing psychotherapy process measures, peer-nominated experts indicated whether each item was related to the construct of cultural competence.  Therapists with expertise in treating African Americans indicated whether an item fir the same cultural competence categories generated through expert consensus.  Peer nominated experts and therapist experts showed poor agreement (kappas) in their classification of which items were relevant to cultural competence.  Despite poor overall agreement, however, the groups concurred that a small subset of items were relevant to culturally competent practice with African Americans.  These results indicate the need for improved operationalization of the construct of cultural competence.

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243. Conduct disorder and delinquency

Overview evidence-based family treatments for adolescent conduct problems.  Three treatments succeed in meeting recommendations for treatment development set forth in recent evaluations by reviewers and federal entities.  These treatments (Functional Family Therapy, Multisystemic Therapy, and Oregon Treatment Foster Care) have achieved their success by using the science base of known risk factors, providing an effective alternative to restrictive placements, and using scientific methods to evaluate effectiveness.  Major features of these three treatments are presented, including clinical and quality assurance procedures, controlled outcome research support, cost analyses, and process research.  Bases of treatment success and parallels among settings.  Finally, suggestions for future research and clinical implications are discussed.

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254.  Decreasing effect sizes for effectiveness studies-implications for the transport of evidence-based treatments: Comment on Curtis, Ronan, and Borduin (2004)

The most important finding from the N. M. Curtis, K. R. Ronan, and C. M. Borduin (2004) meta-analysis for the broader field is likely the difference in effect sizes between multisystemic therapy efficacy versus effectiveness studies. This difference has important implications for research on the transport of evidence-based treatments to community practice settings. For example, factors rarely considered in efficacy research (e.g., funding structures, organizational climate, program maturity, site characteristics) are emerging as important determinants of treatment fidelity and, in turn, clinical outcomes for practice in real-world settings. Current research is clearly demonstrating that evidence-based practices can be successfully transported, but much remains to be learned regarding the optimal parameters of such transport. keywords: multisystemic therapy, evidence-based practice, transportability, effectiveness research

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282.  Chapter 22: Research with vulnerable participants

Violence is a complex, sometimes deadly experience that leaves surviving victims at risk of physical, emotional, and social difficulties. Effective prevention and intervention strategies are key to resolving these difficulties. Unfortunately, interventions for victims and those accused or convicted of committing crimes are still in their infancy. As forensic nurse examiners who are committed to evidence-based practice develop and test new interventions, it will be important to maximize the protection of the victims and those accused or convicted of committing crimes who participate in our research. In addition to an obligation to learn and teach, forensic nurses must protect those from whom they learn, especially when they become a subject of attention due to personal adverse situations.

This chapter examines the risks and benefits of conducting research with victims and those accused or convicted of committing crimes who are vulnerable because of their safety needs and lack of autonomy (Lutz, 1999). This discussion (1) defines vulnerable research participants; (2) presents principles guiding human participants research; (3) reviews protections for vulnerable participants, in addition to those requiring extra protection via Title 45; (4) discusses issues in protecting vulnerable participants; and (5) presents practical steps for researchers to assure protection and compliance with Institutional Review Board (IRB) regulations.

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286.  Youth reactions to participation in psychological assessment procedures

This study investigates self-reported positive and negative reactions of youth to psychological assessment procedures.  A community sample (COM) reported reactions to completing a self-report questionnaire of negative emotional states.  A clinical sample (CL) reported reactions both to completion of the questionnaire and to a clinical intake.  Confirmatory factor analysis (CFAs) supported distinct, relatively independent positive and negative reactions for both samples.  Participants reported significantly greater positive than negative reactions.  Developmental and gender differences indicated that girls reported greater positive reactions than boys and that younger children reported greater positive and negative reactions than adolescents.  The CL reported greater positive reactions to the clinical intake relative to completing the questionnaire.  Discussion focuses on increasing understanding of youth reactions to psychological assessments and potential implications for research and clinical practice.

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301.  The organizational readiness for change scale in adolescent programs: Criterion validity

This study examined the convergent validity and concurrent validity of the Organizational Readiness for Change (ORC; Lehman WEK, Greener JM, Simpson DD, 2002. Assessing organizational readiness for change. Journal of Substance Abuse Treatment. 22 197-210) scale among practitioners who treat adolescents. Within the context of a larger study, we administered the ORC scale and measures of practitioner attitudes toward evidence-based practices as well as treatment manuals to a heterogeneous sample of 543 community-based therapists in the state mental health and substance abuse treatment sectors. Using a contextual random-effects regression model, the association between ORC scale domains and measures of practitioner characteristics and attitudes were examined at both therapist and agency levels. The results support the convergent validity and concurrent validity of several domains. Namely, the domains focusing on motivational readiness and training needs were associated with higher appeal and openness to innovations. Those on program resources and climate were less related, however. Our discussion focuses on the utility of the ORC scale in helping evaluate the needs of programs considering the adoption of evidence-based practices.

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302.  Implementing randomized experiments in criminal justice settings: An evaluation of multi-systemic therapy in the Netherlands

This paper addresses several issues that we encountered when implementing a randomized experiment to evaluate a promising intervention for serious juvenile delinquents, multi-systemic therapy (MST). The issues overlap with issues others experienced when trying to conduct randomized experiments in clinical practice, but are complicated because MST takes place in a legal context. The complex juvenile justice system makes it difficult to come up with a simple system of randomization. Problems encountered are the complexity of the referral process in this type of intervention, legal issues and the ethical concerns raised by clinicians. Our experiences might be useful to others planning to carry out a randomized efficacy study within the juvenile justice system. Firstly, other researchers might feel supported if they realize that others experience similar problems, and, secondly, we provide some concrete suggestions concerning the following: selecting the procedures and determining the moment of randomization, dealing with and overcoming the resistance of institutions involved, maintaining the cooperation of both the institution and the sample, and keeping turnover of research staff to a minimum.

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322.  Developing a measure of therapist adherence to contingency management: An application of the many-facet rasch model

A unique application of the Many-Facet Rasch Model (MFRM) is introduced as the preferred method for evaluating the psychometric properties of a measure of therapist adherence to Contingency Management (CM) treatment of adolescent substance use. The utility of psychometric methods based in Classical Test Theory was limited by complexities of the data, including: (1) ratings provided by multiple informants (i.e., youth, caregivers, and therapists), (2) data from separate research studies, (3) repeated measurements, (4) multiple versions of the questionnaire, and (5) missing data. Two dimensions of CM adherence were supported: adherence to Cognitive Behavioral components and adherence to monitoring components. The rating scale performed differently for items in these subscales, and of 11 items evaluated, eight were found to perform well. The MFRM is presented as a highly flexible approach that can be used to overcome the limitations of traditional methods in the development of adherence measures for evidence-based practices.

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333. Development of an audio-tape review system for supporting adherence to an evidence-based treatment

In bridging the science-to-service gap, effective yet practical strategies are needed for supportig practitioner implementation of evidence-based treatments. The development and preliminary evaluation of an adherence monitoring system to support clinician fidelity to an evidence-based treatment for substance-abusing adolescents was tested for community-based practitioners. Session tapes were monitored for adherence to a family-based approach to contingency management for 27 practitioners during baseline, postworkshop, and follow-up periods. Approximately half of the practitioners were randomized to receive intensive quality assurance following a family-based contingency management workshop as part of a larger study. Findings supported the clinical feasibility of the developed system as well as the face and content validity, reliability, and concurrent validity. Future directions are discussed in light of these results, including instructions for the use of the developed system to efficiently train clinicians to adequate fidelity.

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