TOPIC-Anxiety disorders are the most common mental health concern for youth. Unfortunately, a substantial number of children and adolescents do not respond positively to current evidencebased interventions and/or relapse. As pediatric anxiety disorders are fundamentally a systemic phenomenon, focusing on the ways in which parents become involved in their children's anxiety symptoms may be a promising alternative approach to treatment.PURPOSE-To inform psychiatric mental health nurse practitioners (PMHNPs) about the phenomenology, associated neurobiology, and assessment of family accommodation (FA) as well as clinical interventions targeting FA. FA refers to ways that parents adapt their own behaviors to reduce their children's anxiety-related distress.SOURCES USED-A literature search was performed using Psyc-INFO and PubMed.CONCLUSIONS-Current findings indicate a high prevalence of FA associated with pediatric anxiety disorders. FA has a potentially deleterious impact on course of illness and treatment response and is associated with greater caregiver burden. Potential neurobiological underpinnings of FA include dysregulation of parent cortico-limbic circuitry and the oxytocinergic system. PMHNPs are in a unique position to identify families engaged in problematic FA, educate their clientele, provide psychotherapy services with the goal of reducing FA, and consult with multidisciplinary team members. Search termsAssessment; family accommodation; neurobiology; nursing; oxytocin; pediatric anxiety disorder; treatment Anxiety disorders are the most common mental health concern for children and adolescents, with lifetime prevalence estimates ranging upwards of 30% (Costello, Egger, & Angold, 2005;Merikangas et al., 2010 ). Pediatric anxiety disorders are chronic illnesses and are often associated with physical health concerns (Gandhi, Cheek, & Campo, 2012). They significantly impair the functioning of youth and burden families (Keller et al., 1992).Correspondence to: Eli R. Lebowitz, eli.lebowitz@yale.edu. Conflict of interest statement: KRN and WKS declare that they have no conflicts of interest. HHS Public AccessAuthor manuscript J Child Adolesc Psychiatr Nurs. Author manuscript; available in PMC 2016 August 04. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptPsychiatric mental health nurse practitioners (PMHNPs) are in a valuable position to be agents of positive change, working at the crossroads of medicine, mental health, youth, and their families. In the current paper, we aim to discuss the need for additional treatments for youth with anxiety disorders, introduce family accommodation (FA) and its role in pediatric anxiety, and present potential neurobiological systems involved in FA. We will conclude with the assessment of FA and its modification through parent-based interventions. Our goal is not to be comprehensive, but to provide an overview of the topic and discuss the implications for PMHNPs. Clinical Interventions for Pediatric Anxiety DisordersFrontline interventions for ...

MST may be an important component within cognitive remediation programmes for first-episode psychosis.

This pragmatic study evaluated the effectiveness of a collaborative assessment intervention as an approach to midtherapy consultation, which has yet to be empirically tested. Ten adult participants in ongoing psychotherapy with a variety of presenting concerns, primarily consisting of general mood and adjustment issues, received a brief assessment-based intervention based on Finn's (2007) Therapeutic Assessment model. Following the collection of assessment questions and the administration of a multimethod assessment battery, clients and therapists participated in a joint feedback session with the assessor. Clients were then followed as their psychotherapy continued. The results of idiographic and aggregate analytic approaches revealed significant reductions in client-reported symptomatic distress, as evidenced by a medium effect size (d = -.50) and a significant change in the trajectory of distress. Client reports of the process of psychotherapy revealed a significant increase in the clients' ratings of the working alliance. The findings suggest that a midtherapy consultation using collaborative/therapeutic assessment methods is beneficial but that further rigorous investigation is needed.

BackgroundCognitive remediation (CR) has shown significant promise in addressing the cognitive deficits that accompany serious mental illness. However, this intervention does not appear to completely ameliorate the cognitive deficits that accompany these illnesses. D-cycloserine (DCS), an NMDA receptor partial agonist, has been shown to enhance the therapeutic benefits of learning-based psychosocial interventions for psychiatric disorders. Thus, the goal of this study is to examine the utility of combining cognitive remediation and d-cycloserine in the treatment of cognitive deficits among individuals with bipolar disorder.Methods/DesignApproximately forty individuals with bipolar disorder will be recruited to participate in this study. Participants will be randomized to one of two study arms: CR + DCS or CR + placebo. The primary outcome for this study is change in cognitive functioning. We will also examine several secondary outcomes, including the rate of change of cognitive functioning, social functioning, and symptomatology.DiscussionCognitive deficits are a rate-limiting factor in functional recovery among individuals with bipolar disorder. Unfortunately, treatment options for these deficits are limited. The results of the proposed study may reveal a valuable intervention strategy (i.e., CR with concurrent DCS) to improve cognitive functioning among individuals with bipolar disorder. Ultimately, this treatment strategy may prove useful in addressing the cognitive deficits that are ubiquitous across serious mental illnesses.Trial registrationClinicalTrials.gov NCT01934972.

No abstract