Structural Ecosystems Therapy for HIV-Seropositive African American Women: Effects on Psychological Distress, Family Hassles, and Family Support.

Szapocznik, José; Feaster, Daniel J.; Mitrani, Victoria B.; Prado, Guillermo; Smith, Lila; Robinson-Batista, Carleen; Schwartz, Seth J.; Mauer, Magaly H.; Robbins, Michael S.

doi:10.1037/0022-006x.72.2.288

Cited by 69 publications

(106 citation statements)

References 67 publications

(78 reference statements)

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“…; and c) what are the antecedent variables and distal outcomes associated with participants belonging to particular classes. An interesting application of GMM to psychotherapy data can be found in Szapocznik, Feaster, Mitrani, Prado, Smith, Robinson-Batista, Schwartz, Mauer, and Robbins (2004). In this application, GMM was used to explore whether there were differing classes of trajectories representing differential response to Structural Ecosystems Family Therapy in HIV-seropositive, inner-city, African American women.…”

Section: Growth Mixture Modelingmentioning

confidence: 99%

Some methodological and statistical issues in the study of change processes in psychotherapy

Laurenceau

Hayes

Feldman

2007

Clinical Psychology Review

194

190

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As the number of psychotherapies with demonstrated efficacy accumulates, an important task is to identify principles and processes of change. This information can guide treatment refinement, integration, and future development. However, the standard randomized control trial (RCT) design can limit the questions that can be asked and the statistical analyses that can be conducted. We discuss the importance of examining the shape of change, in addition to identifying mediators and moderators of change. We suggest methodological considerations for longitudinal data collection that can improve the kinds of therapy process questions that can be examined. We also review some data analytic approaches that are being used in other areas of psychology that have the potential to capture the complexity and dynamics of change in psychotherapy.The central question of interest in the study of psychotherapy is change over time. Patients come into therapy with certain behavioral, emotional, and/or cognitive difficulties, and they seek relief from these problems and an improved quality of life by the time therapy is completed. One way to determine this change is to assess problems prior to treatment (point A) and at the end of treatment (point B). When it comes to understanding change in psychotherapy, is it enough to know simply that there has been improvement from point A to point B? Process researchers argue no-that is, in addition to knowing that change occurs in response to a treatment, it is crucial to understand how individuals change from point A to point B. We present some important methodological issues to consider to improve the quality of data and statistical analyses in studies of change in clinical trials.In the first section of this paper, we briefly describe the types of questions that can be the focus of process research. In the second section, we discuss some of the ways in which the standard outcome study design, the randomized control trial (RCT) design, can limit the types of process questions that can be asked and the statistical analyses that can be conducted. We present two methodological recommendations that can address some of these limitations. First, we recommend that psychotherapy researchers increase the number of repeated assessments of symptoms and putative mediators or covariates of change over the course of treatment and follow-up. Second, we recommend that psychotherapy researchers carefully consider the timing of the effect of an intervention so that assessments are taken over an appropriate period.In the third section of this paper, we follow these methodological issues with a description of what might be considered the current statistical state of the art in assessing change and Correspondence regarding this paper can be addressed to Jean-Philippe Laurenceau,

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Section: Growth Mixture Modelingmentioning

confidence: 99%

Some methodological and statistical issues in the study of change processes in psychotherapy

Laurenceau

Hayes

Feldman

2007

Clinical Psychology Review

194

190

View full text Add to dashboard Cite

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“…While there is some support for the efficacy of cognitivebehavioral interventions with HIV-positive women (88,89) and heterosexual men (32), it is worth examining whether treatments that intervene at the family level will demonstrate superior efficacy for these groups (90)(91)(92). It is clear that there is a need for more trials examining the efficacy of psychological interventions for women and heterosexual men living with HIV/ AIDS.…”

Section: Limitations and Directions For Future Researchmentioning

confidence: 99%

Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials

Carrico

Antoni

2008

Psychosomatic Medicine

131

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We reviewed randomized controlled trials (RCTs) that examined the effects of psychological interventions on HIV disease markers including neuroendocrine hormone regulation and immune status. Utilizing both PubMed and PsycINFO, we searched for RCTs published over the past 20 years . Of the 31 RCTs identified, 14 tested effects of psychological interventions on neuroendocrine regulation or immune status. Despite the fact that there are significant methodological limitations of RCTs that have been conducted to date, psychological interventions for HIV-positive persons have been shown to be efficacious in improving psychological adjustment compared with wait-list or treatment as usual control conditions. However, there is little support for differential efficacy of group-based interventions that have been tested to date, even in comparison with semistructured social support groups. Irrespective of the treatment modality, it seems that interventions that are successful in improving psychological adjustment are more likely to have salutary effects on neuroendocrine regulation and immune status. Psychological interventions represent a viable adjuvant treatment that can assist patients with improving psychological adjustment and potentially enhancing immune status. To inform the development of innovative treatments with potentially superior efficacy, deconstruction trials are necessary to examine the effects of distinct components of multimodal psychological interventions compared with nonspecific social support effects. Effectiveness trials of promising psychological interventions with more representative samples of HIV-positive persons are also needed to provide more definitive information on the clinical utility and potential cost-effectiveness of treatments that have been developed to date.

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“…women (SET) was developed to address the family and contextual factors of HIV ? African American women [14][15][16]. The intervention was designed to reintegrate women into their family after returning from a 6-month drug treatment program and to reframe past conflictual issues for the woman and her family.…”

Section: Description Of Research Studymentioning

confidence: 99%

Statistical Challenges in Studying Complex and Changing Families

Bray

Pequegnat

2011

AIDS Behav

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This paper describes challenges of studying complex and changing families and provides suggestions for methods of analyses to study these family systems. Five common problems that NIMH-funded investigators have encountered in analyzing family based studies are addressed and analytic solutions for addressing these problems are illustrated using data from Family HIV/AIDS projects. The problems discussed in the paper are (1) differences in subgroup responses to interventions; (2) longitudinal changes in family relationships and covariates that vary by group in nested designs; (3) dealing with missing data over time from attrition and planned missing data due to death; (4) dealing with multiple reports from different family members; and (5) developing concordance measures among family members. The use of multi-level and growth curve modeling techniques to address these problems is illustrated with some of the studies.

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Structural Ecosystems Therapy for HIV-Seropositive African American Women: Effects on Psychological Distress, Family Hassles, and Family Support.

Cited by 69 publications

References 67 publications

Some methodological and statistical issues in the study of change processes in psychotherapy

Some methodological and statistical issues in the study of change processes in psychotherapy

Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials

Statistical Challenges in Studying Complex and Changing Families

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