Assignment 2: LASA: Research Proposal
States the research question in operational terms that make the question measurable, but neglects to articulate the primary hypothesis and the null hypothesis in operational terms or the relationship between them.
Addresses the importance of the research with limited examples of appropriate scholarly support.
Mentions the theoretical but only superficially developed.
Presents a comprehensive literature review in support of the proposed research question.
Presents and defines the research design.
Presents limited scholarly research to support the selected research design.
Identify and define all relevant variables (e.g., participants).
Present procedures for obtaining informed consent.
States most appropriate variables with the appropriate statistical research questions for each variable.
Provides a general description of informed consent.
Present a systematic description of the methodology to be used in the proposed research.
States the type of data being collected.
Partially defines how that data would be collected.
Addresses some limitations, but neglected others.
Identify and discuss the assessment instruments to be administered and rationale. Present the empirical support for the assessments you have suggested.
Stated tests or assessment procedures proposed to address forensic issues are accurate based on the information provided in the vignette and empirically supported, but underdeveloped.
Accurate but incomplete description of how these tests would be used.
Vague reference to cultural and forensic issues that may affect evaluation.
Anticipated conclusions have some inconsistencies with the information provided in the vignette or the forensic assessments described.
Identify the potential ethical issues that might affect the proposed research. Propose a resolution plan for these issues
Responses either do not articulate respect for the rights of others or neglect aspects of his/her professional code of ethics (ACA/APA) and local state law.
States a few relevant ethical codes, general information about applicable laws and regulations, general times when he/she would seek consultation, and reasonable courses of action.
Writing is generally clear and in an organized manner. It demonstrates ethical scholarship in accurate representation and attribution of sources; and generally displays accurate spelling, grammar, punctuation. Errors are few, isolated, and do not interfere with reader’s comprehension.
LASA Research Proposal
Establishing the Efficacy of Cognitive Behavioral Group Therapy in the Treatment of Severe Mental Disorders among Juvenile Delinquents
Juvenile delinquency is one of the serious problems that most states are facing. Majority of youths, especially adolescents, are at increased risk of committing various forms of crimes such as burglary, assault, drug and substance abuse, and among others. Nonetheless, a smaller number of young individuals are likely to start engaging in crime during childhood. The juvenile justice system aims at rehabilitating juvenile offenders and reintegrating them back to the community. It is worth noting that the efficacy of the juvenile justice system in reintegrating juvenile offenders to the community depends on the effectiveness of the treatment programs for juvenile offenders. Failure to implement proper treatment procedures on identified juvenile offenders increases the risk that juveniles will transition into adulthood and continue with the same behaviors. Moreover, there is increased risk of recidivism among juveniles who leave detention. Owing to the above factors, there is need to establish robust treatment procedures that can effectively help juveniles to drop undesirable behaviors.
Research indicates that individuals with mental health problems are at an increased risk of engaging in various forms of crimes. More still, these individuals are more likely to recede into criminal behavior on leaving detention centers. Offender rehabilitation aims at restoring offenders to normal and acceptable behaviors by the community. Various offender rehabilitation programs exist within the criminal justice institutions. However, the efficacy of these treatment programs has been the subject of great debate over time. Cognitive behavioral group therapy is one of the treatment programs commonly used in the juvenile justice system. The cognitive behavioral approach has been hailed as an effective treatment methodology for juvenile offenders with severe mental disorders. This study aims at establishing the effectiveness of cognitive behavioral group therapy in the treatment of juvenile offenders with severe mental disorders and in reducing the risk of recidivism.
Cognitive behavioral paradigm is based on the assumption that it is possible to change the cognitive distortions present in juvenile offenders through conditioned learning (Morgan et al., 2012). The goal of the cognitive behavioral therapy is to change erratic patterns of behavior that lead increase the likelihood of engaging in crime. This study seeks to address the effectiveness of cognitive behavioral group therapy in reducing the risk of recidivism among juvenile offenders with severe mental disorders. This study will address the question: What is the effectiveness of the cognitive behavioral group therapy in treatment of juvenile offenders with severe mental disorders and in reducing their risk of recidivism? In exploring the effectiveness of the cognitive behavioral approach, the study makes a number of hypotheses. The null hypothesis (H0) states that cognitive behavioral group therapy does not improve the treatment outcomes of juvenile offenders with severe mental disorders. Consistent with available literature, this study also hypothesizes that cognitive behavioral therapy significantly improves the treatment outcomes of juvenile offenders with severe mental health issues. This is the alternative hypothesis (H1). It is further hypothesized that cognitive behavioral approach reduces the risk of recidivism based on the positive outcomes (H2).
Cognitive behavioral therapy is a treatment model that focuses on the manner in which people process information. The theory assumes that people suffering from various mental disorders process information in biased ways, causing distortions during the process of constructing experiences (Skodlar, Henriksen, Sass, Nelson, & Parnas, 2013). The distortions comprise of three elements: dysfunctional beliefs, cognitive biases in construction of reality, and persistent maladaptive cognitive structures, also known as schemas. The cognitive biases/errors and schemas are stored representations of reality. The schemas are any form of repetitive patterns associated with the process of coding, screening, and classifying stimuli (Skodlar et al., 2013). The schemas determine the manner in which specific thought processes develop. An individual who is faced by the three forms of distortion (dysfunctional beliefs, schema, and errors) experiences characteristic that become a form of a mental disorder.
This study uses cognitive behavioral therapy to refer to treatment approaches that focus on the mental processes as well as information processing among individuals. Juvenile offenders are the persons below the age of 18 who commit various felonies that contravene the written law. The study defines mental disorders as any form of mental incapacitation that impairs judgement. Cognition refers to the psychological result of learning, reasoning and perception.
Vast volumes of literature exist regarding the efficacy of cognitive behavioral therapy in the treatment of various mental disorders. Most researchers have focused on establishing the efficacy of cognitive behavioral approaches in general, but few of these have focused on examining the efficacy of cognitive behavioral group therapy in treatment of severe mental disorders. Cognitive behavioral group therapy is a treatment program that focuses on a group rather than individuals. This approach is considered effective comparing to a personal approach.
Brazao et al. (2015) examines the efficacy of cognitive behavioral approach in eliminating schemas and cognitive distortions among a population of prison inmates. Specifically, the study examines the efficacy of structured multimodal programs in helping young and adult offenders to undergo rehabilitation successfully and in reducing the risk of recidivism. The findings indicate that cognitive behavioral therapy that targets the improvement of cognitive correlates (schemas, cognitive products, & cognitive distortions) is effective in helping offenders drop their antisocial behaviors. In an effort to establish the effectiveness of a cognitive behavioral approach known as the Reasoning and Rehabilitation program, Yip et al. (2013) conduct an investigation using a sample of 59 prison inmates. Of these, 30 inmates received group treatment while 29 inmates received normal treatment. The findings indicate that the group-based approach had a higher completion rate and was more effective in helping prisoners achieve a positive outcome.
A number of researchers have examined the effectiveness of cognitive behavioral group therapy in treatment of specific mental health issues. Matusiewicz, Hopwood, Banducci, and Lejuez (2010) investigate the effectiveness of cognitive behavioral therapy in treatment of patients with borderline personality disorder. The study provides further support that cognitive behavioral therapy is of the effective approaches that can help criminals change their erratic behavior. White, Ollendick, Scahill, Oswald, and Albano (2009) examine the efficacy of combined group and individual treatment models among youths with autism spectrum disorders. This study does not find conclusive evidence of the effectiveness of a combination of group and individual cognitive behavioral approach in treatment of mental health issues among juveniles.
There is growing evidence linking the origins of mental disorders with biological basis. Much of the mental health disorders are associated with neurobiological issues, and as such require a cognitive behavioral approach in treatment. A common stress disorder associated with increased risk of criminal behavior is posttraumatic stress disorder. Makinson and Young investigate the efficacy of individual and group behavioral therapy in the treatment of posttraumatic stress disorder using a meta-analytic approach. The duo finds that group therapy is more effective comparing to individual counseling programs. Gavita, David, Bujoreanu, Tiba, and Ionutiu (2012) examines how the cognitive behavioral group therapy can be used in the treatment of externalizing behavioral disorders. The authors conduct a randomized controlled trial on a group of 97 Romanian parents involved in the care of foster children. The study finds that an enhanced-behavioral parent program is effective curbing externalizing behavior among foster children.
A number of researchers examine the efficacy of cognitive behavioral therapy with other common treatment options for mental health disorders. Inger, Birgitta, Anita, Lars and Kent-inge (2015) examine the effectiveness of self-care groups versus the cognitive behavioral group therapy treatment. The research focuses on employees who have taken sick leave due to mental health issues. Employing an experimental approach, the researchers found that cognitive behavioral therapy was more effective comparing to treatment using the methods based treatment options. Hedman et al. (2013) examines the effectiveness of the individual cognitive behavioral approach versus the cognitive behavioral group therapy in the treatment of social anxiety disorder. The researchers draw data from 94 respondents who either receive individual cognitive therapy of underwent group therapy. The study findings contradict majority of available studies – findings indicate that the individual cognitive therapy was more effective in reducing social anxiety disorder comparing to the cognitive behavioral group therapy.
Blanco et al. (2010) conducts a randomized controlled trial to investigate the impact of cognitive behavioral therapy in treatment of social anxiety disorder. The findings indicate that cognitive behavioral group therapy is more effective in treatment of social anxiety disorder compared to placebo interventions such as use of pills and other psychological measures. Nevertheless, the study does not discredit the efficacy of individual cognitive behavioral therapy in the treatment of social anxiety disorder. Merom et al (2007) examines the efficacy of brisk walking as a form of an enhancement to the cognitive behavioral group therapy in treatment of a range of anxiety disorders. The participants were a group of anxiety patients from an outpatient clinic. The findings indicate that there is need for further research in the area, as conclusive results could not be established. Moreover, the study notes the paucity of research that exists in this area as requiring attention or further studies.
Some studies have examined the effectiveness of cognitive behavioral group model in assisting individuals with alcohol and substance abuse problem, which is a major contributor to juvenile delinquency. Osilla, Hepner, Ricardo, Munoz, woo, and Watkins (2009) employs a cognitive behavioral group approach in treatment of people suffering depression and alcohol and substance abuse. The authors conduct investigations using focus groups and interview method. The findings indicate that cognitive behavioral group approach is effective in the treatment of individuals with co-occurring disorders. Those with co-occurring disorders were identified as having increased risks of substance abuse problems.
This study aims at establishing the efficacy of cognitive behavioral therapy Group therapy in the treatment of severe mental health disorders among Juvenile Delinquents. The treatment model includes cognitive behavioral therapy experts (they will determine whether the cognitive theory is applied in the right way), clinician stakeholders in juvenile incarceration facilities, and the team of researchers. The researchers will document observable changes between juvenile offenders who successfully undergo cognitive behavioral group therapy (experimental group) and those who do not undergo group therapy (the control group). Current data suggests that cognitive behavioral group therapy is effective to individual therapy in treatment of severe mental health disorders. This study will aim at examining the accuracy of study findings concerning group therapy models.
This study seeks to utilize a randomized controlled trial in the examination of the efficacy of cognitive behavioral group therapy in treatment of severe mental health disorders. In randomized controlled trial, participants will be randomly assigned to either the control group or experimental group (Taylor, 2010). Those in the experimental group will receive close monitoring for a period of one year following exposure to the cognitive behavioral group therapy program. The program will run for a period of three months or as per the recommendations of the psychologists. The cognitive behavioral program will comprise of 12 sessions that will be implemented in stages.
The participants will be selected from a juvenile incarceration facility for males. Participants will range between 13 and 18 years. The selection criteria will consider a number of factors besides age. First, participants must be having a proven mental health disorder at the time of incarceration. The range of mental health disorders to be included in the study range includes depression, social anxiety, posttraumatic stress disorder, borderline personality disorder, drug & substance abuse, and attention deficit hyperactive disorder. Second, the participants must have been handed a sentence of more than three months in a juvenile detention facility. Lastly, the participants must participate throughout the cognitive behavioral therapy program. A sample of 100 participants will be enrolled in the study. The participants will be randomly assigned to the control and experimental groups.
The history of offenses committed as well a nature of the mental health issue will be collected from the available clinical files at the beginning of the study. Psychological tests will be used to examine the mental health aspects of the juvenile delinquents. Psychological tests are more accurate since they eliminate misreporting, which is common with self-reporting such as in the questionnaire method. The psychotic Symptoms Rating Scale (PSYRATS) is one of the instruments to be used in analyzing the psychotic symptoms among participants (Mash & Barkley, 2012). The Disruptive Behavior and Social Problem Scale (DBSP) will be used to assess the effectiveness of the cognitive behavioral approach in eliminating antisocial behavior (Veiga, 2008).
Participants who will meet criteria will be referred by a qualified psychologist and through evaluation of available records. Since the treatment program is not mandatory, the juvenile delinquents will choose whether to participate in the study or not. The participants will be divided into three groups. Allocation to groups will follow randomized approaches to avoid bias. On obtaining informed consent from relevant authorities, participants will complete self-report measure, while the researchers, throughout the course of the study, will complete others. The researcher or a psychologist will complete the DBSP measure. A trained professional will conduct the cognitive behavioral group therapy program.
Data analysis will be completed in accordance to the Treatment Received principle. As per the principle, outcomes involving the juvenile delinquents in the experimental group will measured and compared with the results of the control group. The experimental group and the control group will compared at baseline, using appropriate statistical tests. The statistical method to be used is analysis of covariance (ANCOVA). ANCOVA method will help in examining the differences in the mean responses in difference treatment levels. Within-group t-tests will be conducted to examine the difference between samples. Analysis of covariance will be used on each of the dependent variables. Adjusted mean scores and also standard deviations will be used to in examining ANCOVA and t-test.
Limitations of the study (i.e., threats to validity)
This study faces a number of limitations. The sample used in the study is small. As such, it may be difficult to generalize the findings across a larger population. This study does not address all variables that contribute to antisocial behavior. The study, for instance, does not address variables such as anger, paranoia, and shame. The study partly relies on self-reporting of experiences by juvenile offenders. The data obtained from self-reporting may not be accurate since the respondents may give false information intentionally or unintentionally. It may be difficult for the researcher to verify the validity of such information.
A number of ethical issues were involved in the study. An ethical issue present in this study relates to confidentiality. There is no identification of participants in the study in order to protect their privacy. Approval of the study will be sought from relevant authorities. Another ethical issue in the study relates to harm of the participants. The study will be conducted in accordance to established guidelines, and this avoid harming participants in any way.
The dissemination strategy will ensure that the research findings reach the appropriate audience. Media coverage can be an important way to disseminate the study findings to a large audience. Local newspapers, radio, and television can be good ways of disseminating the study findings to a large audience. Another important strategy is to share the research findings with collaborators or community partners. These are important especially since the community partners can provide valuable feedback that one can use to improve the report before the final publishing (“Yale Center for Clinical Investigation,” n.d). Another method of disseminating the findings is be creating flyers and posters. These are especially effective for the local school community
This study investigates the efficacy of cognitive behavioral group therapy in treatment of mental health disorders among juvenile offenders. The study utilizes an experimental approach in assessing the efficacy of the cognitive behavioral approach. The study adds to the growing body of evidence on the efficacy of cognitive behavioral group approach in the treatment of mental health issues. The study will be important to clinicians and psychologists involved in child rehabilitation and enforcing behavior change among minors.
Blanco, R.G. Heimberg, F.R. Schneier, D.M. Fresco, H. Chen, C.L. Turk, et al. (2010). A placebo-controlled trial of phenelzine, cognitive behavioral group therapy, and their combination for social anxiety disorder. Archives of General Psychiatry, 67(3): pp. 286– 295.
Brazao, N., Motta, C., Rijo, D., Seelvador, M., Pinto-Gouveia, J., & Ramos, J. (2015). Clinical change in cognitive distortions and core schemas after a cognitive-behavioral group intervention: preliminary findings from a randomized trial with male prison inmates. Cognitive Therapy Research, 39: 578 – 589.
Gavita, O. A., David, D., Bujoreanu, S., Tiba, A., Ionutiu, D. R. (2012). The efficacy of a short cognitive–behavioral parent program in the treatment of externalizing behavior disorders in Romanian foster care children: Building parental emotion-regulation through unconditional self- and child-acceptance strategies. Children and Youth Services Review, 34(7): 12990-1297.
Hedman, E., Mortberg, E., Hesser, H., Clark, D. M., Lekander, M., Andersson, E., & Ljotsson, B. (2013). Mediators in psychological treatment of social anxiety disorder: individual cognitive therapy compared to cognitive behavioral group therapy. Behavior Research and Therapy, 51(10): 696-705.
Jansson, I., Gunnarsson, A. B., Björklund, A., Brudin, L., & Perseius, K. (2015). Problem-based self-care groups versus cognitive behavioural therapy for persons on sick leave due to common mental disorders: A randomised controlled study. Journal of Occupational Rehabilitation, 25(1), 127-140.
Makinson, R. A., & Young, S. (2012). Cognitive behavioral therapy and the treatment of posttraumatic stress disorder: where counseling and neuroscience meet. Journal of Counseling and Development, 90(2): 131 – 140.
Mash, E. J., & Barkley, R. A. (2012). Assessment of childhood disorders, fourth edition. Retrieved from https://books.google.co.ke/books?id=P98F1- 1rqfwC&dq=psychotic+symptoms+rating+scale&source=gbs_navlinks_s
Matusiewicz, A. K., Hopwood, C. J., Banducci, A. N., & Lejuez, C. W. (2010). The Effectiveness of Cognitive Behavioral Therapy for Personality Disorders. The Psychiatric Clinics of North America, 33(3), 657–685. http://doi.org/10.1016/j.psc.2010.04.007
Merom, D., Phongsavan, P., Wagner, R. et al. (2007). Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders—A pilot group randomized trial. Journal of Anxiety Disorders, 22(6): 959-968.
Morgan, R. D., Flora, D. B., Kroner, D. G., Mills, J. F., Varghese, F., & Steffan, J. S. (2012). Treating Offenders with Mental Illness: A Research Synthesis. Law and Human Behavior, 36(1), 37–50. http://doi.org/10.1037/h0093964
Skodlar, B., Henriksen, M. G., Sass, L. A., Nelson, B., & Parnas, J. (2013). Cognitive- Behavioral Therapy for Schizophrenia: A Critical Evaluation of Its Theoretical Framework from a Clinical-Phenomenological Perspective. Psychopathology, 46: 249- 265.
Taylor, C. B. (2010). How to practice evidence-based psychiatry: Basic principles and case studies. Washington, DC: American Psychiatric Pub.
Veiga, F. H. (2008). Disruptive behavior scale professed by students (DBS-PS): development and validation. International Journal of Psychology and Psychological Therapy, 8(2): 203-216.
White, S. W., Ollendick, T., Scahill, L., Oswald, D., & Albano, A. M. (2009). Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. J Autism Dev Disord, 39: 1652 – 1662.
Yale Center for Clinical Investigation. (n.d). Beyond scientific publication: strategies for disseminating research findings. Retrieved from https://ctsacorus.org/resources/252/download/CARE_Dissemination_Strategies_FINAL_ eversion_2.pdf
Yip, V. C., Gudjonsson, G. H., Perkins, D., Doidge, A., Hopkin, G., Young, S. (2013). A non- randomised controlled trial of the R&R2MHP cognitive skills program in high risk male offenders with severe mental illness. BMC Psychiatry, 13: 267-280.