Objective This study evaluates a parent-teen skills-based therapy for ADHD blended with motivational interviewing (MI) to enhance family engagement. Supporting Teens’ Academic Needs Daily (STAND) is an adolescent-specific treatment for ADHD that targets empirically identified adolescent (i.e., organization, time management, and planning; OTP skills) and parent-based (i.e., monitoring and contingency management) mechanisms of long-term outcome through individual parent-teen sessions. Method The current randomized trial (N=128) evaluates efficacy at post-treatment and six-month follow-up. Participants were ethnically diverse teens (7.7% non-Hispanic White, 10.8% African-American, 78.5% Hispanic, 3.0% other) randomly assigned to STAND or Treatment As Usual (TAU). Results Primary findings were that: (1) STAND was delivered in an MI-adherent fashion and most families fully engaged in treatment (85% completed), (2) STAND produced a range of significant acute effects on ADHD symptoms, OTP skills, homework behavior, parent-teen contracting, implementation of home privileges, parenting stress, and daily homework recording, and (3) six months after treatment ceased, effects on ADHD symptom severity, OTP skills, and parenting stress maintained, while parent use of contracting and privilege implementation strategies, as well as teen daily homework recording and homework behavior gains, were not maintained. Conclusions Skills-based behavior therapy blended with MI is an acutely efficacious treatment for adolescents with ADHD although more work is needed to establish the nature of long-term effects. Public Health Significance A skills-based parent-teen behavior therapy blended with MI successfully engages families and leads to long-term improvement in parent-reported ADHD symptoms, organization skills, and parenting stress. Effects on school setting variables were less robust, requiring continued work to enhance these outcomes.

No abstract

No abstract

No abstract

Contribution des hôpitaux de jour en psychiatrie dans le champ contemporain de la santé mentale au Québec

No abstract

Les auteures explorent comment l'intégration des services se concrétise dans des contextes particuliers en s'appuyant sur une recherche portant sur les discours et les pratiques d'intervenants et des personnes utilisatrices regroupées au sein d'organismes de la communauté. Leur analyse vise à comprendre comment les modèles prévalant au niveau de l'organisation des services se répercutent d'une part, sur les règles qui régissent l'organisation du travail des intervenants et leur conception des problèmes et des interventions ; et d'autre part, sur le climat des organismes et la vie quotidienne des personnes, les rapports entre elles et les intervenants ainsi que sur la place accordée à la parole, aux projets et aux désirs des personnes utilisatrices. Il s'agit ainsi d'examiner comment les modèles organisationnels et leurs implications affectent les possibilités offertes aux personnes utilisatrices et les voies qui s'ouvrent ou non pour améliorer leurs conditions d'existence.Integration of services and practices: the test of experience The authors explore how integration of services takes shape in specific contexts according to data of a research on discourses and practices of mental health workers and consumers of community groups. The analysis aims at understanding how the models prevailing on the level of organization of services impact on one hand, on the rules of work organization of professionals and their concept of problems and interventions and on the other hand, on the climate of organizations and the daily lives of consumers, the relationship between themselves as well as with mental health workers and the place given to consumer's words, projects and wishes. The authors thus examine how organizational models and their implications affect the possibilities offered to consumers and the paths opening or not to improve their lives.La integración de servicios y prácticas. La prueba de la experiencia Los autores exploran como se concretisa la integración de servicios en contextos particulares apoyandose sobre una investigación tratando de los discursos y prácticas de intervenantes y personas utilizadoras reagrupadas al seno de un organismo de la comunidad. Su análisis pretende comprender como los modelos que prevalecen al nivel de la organisación de servicios repercute por una parte sobre las reglas qui rigen la organisación del trabajo de los intervenantes y su concepción de los problemas y de las intervenciones y, por otra parte, sobre el clima de los organismos y la vida cotidiana de las personas, las relaciones entre ellas y los intervenantes asi que el lugar acordado a la palabra, a los proyectos y a los deseos de personas utilizadoras. Asi trata de examinar como los modelos organisacionales y sus implicaciones afectan las posibilidades ofertas a las personas utilizadoras y las vias que se abren o no para mejorar las condiciones de existencia.Integração dos serviços e das...

Este artículo analiza la situación de diversificación del comercio en el contexto de una estrategia de desarrollo económico para México en el marco internacional. Se argumentan algunas consideraciones sobre la evaluación económica a partir de la quiebra del mercado de desarrollo sustitutivo de importaciones así como la crisis de deuda externa en 1982. Minalmente se propone algunas alternativas estratégicas para la diversificación del comercio.