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Clinical Science APA CLINICAL SCIENCE Society for the Science of Clinical Psychology III Section III of the Division of Clinical Psychology of Division12 Ψ the American Psychological Association Developing clinical psychology as an experimental-behavioral science N E W sle TT E R WINTER 2013: VOLUME 16, ISSUE 1 SSCP Executive Board Table of Contents President: Presidential Column Michelle Craske, Ph.D. M. Craske...............................................................................................2-5 University of California, Los Angeles Past-President: Announcement: New SSCP Board Members......................................5 Richard Heimberg, Ph.D. Temple University Presidential Reflections President-Elect: R. Heimberg..............................................................................................6-7 Bethany Teachman, Ph.D. University of Virgina Treasurer’s Report D. Smith.....................................................................................................8-9 Secretary/Treasurer: David Smith, Ph.D. (outgoing) University of Notre Dame Call for applications: SSCP Clinical Science Training Grant...........9 Stewart Shankman, Ph.D. (incoming) Role of Internships in Clinical Science Training University of Illinois-Chicago M. Atkins..............................................................................................10-14 Division 12 Representative: Douglas Mennin, Ph.D. Internship Crisis: Results from the Internship Survey Hunter College S. Stasik, R. Brock, F. Farach, K. Benoit, & K. Willson....................15-20 Student Representatives: Kristy Benoit, M.A. Update from the Student Representatives Virginia Tech K. Benoit & V. Smith..........................................................................21-22 Victoria C. Smith, M.S. University of Maryland-College Park Student Perspectives Series B. Feinstein............................................................................................23-25 At Large Members: Sherryl Goodman, Ph.D. Emory University SSCP Dissertation Award Winners...............................................26-27 Lauren B. Alloy, Ph.D. SSCP Events at APS.................................................................................28 Temple University --------------------------------------------------- Clinical Science Editor: Articles published in Clinical Science represent the views of the authors and not Lea Rose Dougherty, Ph.D. necessarily those of the Society for a Science of Clinical Psychology, the Society University of Maryland-College Park of Clinical Psychology, or the American Psychological Association. Submissions representing differing views, comments, and letters to the editor are welcome. Clinical Science Vol. 16 (1): Winter, 2013 2 Presidential Column The Science of Intervention: From Translation to Implementation Michelle G. Craske Ph.D. University of California Los Angeles I am honored to assume the role of President of SSCP into clear statements regarding interventions for the for the 2013 term. Thank you to Rick Heimberg, our treatment of people with various health conditions. Past-President, for his leadership during 2012. In this Despite past hesitation about such guidelines, the column, I outline the latest research developments evidence-base is now sufficiently strong to justify this across the full spectrum of intervention science, from major undertaking by APA. However, clinical efficacy translation to implementation, and conclude with my research is only one part of the spectrum of interven- goals for my term as President of SSCP. tion science. Across the developmental trajectory of behavioral Lisa Onken, from the National Institute on Drug therapy, then cognitive behavioral therapy, and now Abuse, has outlined six stages for the development of acceptance-based approaches, the majority of clinical behavioral therapies (basic research, intervention gen- psychology research has focused on clinical efficacy eration/refinement, efficacy-research clinics, efficacy- trials, in which we evaluate treatment outcomes in community clinics, effectiveness, and implementation highly controlled research settings. Most recently, and dissemination) that represent the full continuum clinical efficacy trials have expanded to include -so of intervention science. More broadly speaking, phisticated mediational modeling to isolate the bio- the spectrum of intervention science extends from logical, behavioral and cognitive mechanisms that are translational models that use basic science to inform accountable for therapeutic change. Predictor models treatment development, to testing of clinical outcomes are another burgeoning research area, aimed at iden- in controlled settings (labeled clinical efficacy trials tifying for whom treatment is more or less effective. in the preceding section), to implementation in the Even more valuable are moderator models to identify real world. Some of the most exciting developments which of a set of treatments is more or less effective within our field are occurring at either end of that for a given individual. Clinical efficacy research has spectrum. served an enormously important role in establish- ing the evidence-base for psychological treatments. Translational models enhance our understanding of Indeed, this evidence-base is now being reviewed by behavioral, cognitive and biological dysregulation that independent panels as part of the APA effort (from underlies psychopathology and the mechanisms by the Board of Professional Affairs, Board of Scientific which such dysregulation can be modified or treated. Affairs, and the Committee on the Advancement of Translational intervention science offers the potential Professional Practice) to develop Clinical Practice to identify novel mechanisms and treatments and to Guidelines, in accord with standards established by optimize existing treatments. An example is the way in which the basic science of Pavlovian conditioning has the Institute of Medicine. The mission of the guide- optimized exposure therapy for anxiety disorders and lines is to translate the best available research evidence substance use disorders. For example, recognition of Clinical Science Vol. 16 (1): Winter, 2013 3 the context specificity of extinction learning has led science is alerting us to differences at the individual to investigation of retrieval cues that bridge the gap level that should also inform treatment. For example, between therapy contexts and the contexts in which even though attentional bias to threat is stronger on substances are encountered once therapy is completed, average in anxious groups relative to healthy con- in order reduce cravings. Also, recognition that patho- trols, large individual differences exist within anxious logical anxiety often is characterized by deficits in groups in terms of attentional bias toward or away extinction learning, which in turn may be linked to from threat (Schechner et al., 2012). This would sug- deficits in inhibition of fear responding, has opened gest that attentional bias modification training is best new pathways for modifying exposure therapy for suited to that subset of anxious individuals who show anxiety disorders. These include d-cycloserine aug- a selective attention towards threat. Similarly, whereas mentation of exposure therapy to enhance the consoli- anxious individuals on average display deficits in dation of extinction learning, and behavioral methods extinction relative to healthy controls, not all anxious that aim to increase the encoding and retrieval of individuals show such deficits. This would suggest inhibitory learning (e.g., stimulus variability). Another that methods for augmenting extinction learning (e.g., example of translational intervention science is cogni- d-cycloserine) may be optimal for only a subset of tive bias modification training for anxiety and depres- anxious individuals as they progress through exposure sion. Particularly exciting is the use of neuroscience therapy. In other words, translational research may to inform intervention. The most direct example is lead to improvement in clinical outcomes by personal- neurofeedback, but indirect examples exist as well. For izing treatment to the areas of cognitive, behavioral, example, ‘affect labeling’ as a means for augmenting emotional, or other functioning that are most dysreg- exposure therapy (Kircanski et al., 2012) was derived ulated for a given patient, akin to the biomarkers and from evidence for the neurobiological effects of lin- biosignature approach recommended by NIMH. guistic processing of emotional material. At the level of implementation, recent advances Neuroscience, behavioral science and cognitive sci- involve technologies to enhance the fidelity of evi- ence are also serving to identify core dimensions of dence-based treatments when implemented in real psychopathology that cut across traditional diagnostic world settings. As Varda Shoham noted in her SSCP categories and which may eventually guide treatment Presidential Column in 2011, with current changes in development. For example, whereas amygdala hyper- the health care system, we can expect an increase in activity to threat stimuli is characteristic of anxiety the delivery of mental health, and therefore run the and depression (e.g., Craske, Rauch et al., 2009), defi- risk of greater provision of services with lesser assur- cits in striatal activation to reward stimuli appear to be ance of fidelity. We are faced with enormous chal- more relevant to depression than to anxiety (e.g., Har-
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