Marilee Comfort - Academia.edu (original) (raw)
Papers by Marilee Comfort
There is a great deal of evidence to suggest that parenting behaviour is one of the most importan... more There is a great deal of evidence to suggest that parenting
behaviour is one of the most important factors in child
development and wellbeing. Recent initiatives have argued
for the societal benefits of investment in early intervention
in childhood development (WAVE Trust, 2013). In the UK,
health visitors are the key professionals involved in parenting
support, and this is part of the Universal offer laid out in the
Health Visitor Implementation Plan (Department of Health,
2011). Parenting assessment tools can help practitioners to
demonstrate outcomes, which is essential in order to gain
funding and resources. This paper provides a US perspective
on how observational parenting assessment can strengthen
family services and why it should be considered best practice.
Journal of Early Intervention, 1986
Page 1. http://jei.sagepub.com/ Journal of Early Intervention http://jei.sagepub.com/ content/10/... more Page 1. http://jei.sagepub.com/ Journal of Early Intervention http://jei.sagepub.com/ content/10/2/156 The online version of this article can be found at: DOI: 10.1177/105381518601000207 1986 10: 156 Journal of Early Intervention ...
Tradition-a Journal of Orthodox Jewish Thought, 1986
While the conceptual and clinical utility of the goodness of fit concept has been documented exte... more While the conceptual and clinical utility of the goodness of fit concept has been documented extensively, the number of specific empirical tests of the concept has been limited. In this study, the concept was applied in the conceptualization and analysis of early intervention ...
Journal of Reproductive and Infant Psychology, 1987
Research on maternal involvement with a handicapped child has frequently focused on discrete beha... more Research on maternal involvement with a handicapped child has frequently focused on discrete behaviours rather than on more general aspects of the interaction, although it has been suggested that the quality and sensitivity of maternal involvement may be more salient to the development of the child. While it is clear that characteristics of both mother and child influence the relationship,
Journal of Early Intervention, 1988
DOI: 10.1177/105381518801200204 1988 12: 126 Journal of Early Intervention Marilee Comfort and Ja... more DOI: 10.1177/105381518801200204 1988 12: 126 Journal of Early Intervention Marilee Comfort and James Helm Donald B. Bailey, Jr, Rune J. Simeonsson, Patricia Isbell, Gail S. Huntington, Pamela J. Winton, Outcomes and Issues Inservice Training in Family ...
Alcoholism Treatment Quarterly, 1990
No abstract available for this article.
Journal of Psychoactive Drugs, 1999
The purpose of this descriptive study was to compare the characteristics and treatment outcomes o... more The purpose of this descriptive study was to compare the characteristics and treatment outcomes of pregnant cocaine-dependent women and their infants enrolled in residential (N=32) and outpatient (N=32) treatment settings. Biopsychosocial characteristics and issues that influenced the women's multiple treatment outcomes are highlighted. Comparisons of retention and infant birth outcomes found no significant differences between treatment programs. whereas abstinence and patterns of attrition showed meaningful differences favoring residential treatment. Further research is needed to evaluate whether the reported treatment outcomes are markers of improved life functioning that hold promise for the women in treatment, their families and the community.
Journal of Substance Abuse Treatment, 1999
The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess ... more The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess the status, history, and needs of women in substance abuse treatment. The PSH retains the fundamental scoring structure of the Addiction Severity Index (ASI), while adding supplemental questions considered clinically useful and relevant for predicting outcomes. The present study examined the psychometric properties and general utility of both instruments with a sample of women enrolled in substance abuse treatment. Initially, the instruments were tested independently and found to have excellent test–retest reliability and acceptable internal consistency. A reliability trial between the instruments found that the composite scores (CS) of the ASI and PSH yielded satisfactory correlations among four of the six CS domains. The PSH had higher CS scores than the ASI across domains, which may reflect the comprehensive nature of the PSH items that prompt greater disclosure of problems and needs. Validity analyses showed significant correlations of PSH and ASI psychiatric CSs with Symptom Checklist-90-Revised totals. These results suggest that the PSH yields reliable and valid assessment data similar to the ASI. Moreover, the PSH provides a more comprehensive assessment than the ASI in the area of pregnancy, family issues, and victimization.
Substance Abuse, 2000
This study examined whether client characteristics at admission predict Retention, Abstinence, an... more This study examined whether client characteristics at admission predict Retention, Abstinence, and utilization of Required Services and Specialized Services for pregnant women in outpatient and residential substance abuse treatment. Retrospective data were collected with the Psychosocial History (PSH), a structured clinical interview that is an expansion of the Addiction Severity Index, designed specifically to assess substance abusing women. The PSH was administered at intake for 183 pregnant women admitted to outpatient (n = 133) or residential (n = 50) treatment. Factor analysis reduced predictors to five factors with composite scores, and multiple regression procedures determined client characteristics that predict treatment outcomes. The findings suggest the complexity of predicting treatment outcomes for pregnant women. Significant predictors were composites of variables that encompassed all aspects of women's personal and family lives including medical and psychiatric needs, family and parenting issues, housing, victimization, and clients' perceived needs for treatment and assistance in all of these areas. The results suggest the need for a holistic approach to substance abuse treatment and continued exploration of a broad range of psychosocial assessments at intake in order to develop substance abuse treatment programs that effectively address multiple aspects of women's lives.
Addictive Behaviors, 2003
The purpose of this study was to identify client factors that predict treatment and life outcomes... more The purpose of this study was to identify client factors that predict treatment and life outcomes of women enrolled in outpatient (OP) and residential (RT) substance abuse treatment. Subjects were 95 women who enrolled in OP or RT from September 1994 through February 1997, remained in treatment a minimum of 3 months, and completed a 12-month assessment protocol. Factor analyses and a series of multiple regression procedures were conducted to examine whether biopsychosocial characteristics at intake predicted treatment outcomes and life outcomes. The results indicated that client intake characteristics explained 27-34% of the variance in OP treatment outcomes and 40-63% of the variance for women in RT. The findings suggest that prediction of women's life outcomes is complex, differs for women in RT and OP treatment, and consists of multiple factors. These risk and protective factors include social support, daily stressors, life satisfaction, partner abuse, substance abuse by self and significant others, psychiatric history, chronic medical conditions, childbirth history, childcare responsibilities, and treatment engagement.
Substance Abuse, 2000
This study examined whether client characteristics at admission predict Retention, Abstinence, an... more This study examined whether client characteristics at admission predict Retention, Abstinence, and utilization of Required Services and Specialized Services for pregnant women in outpatient and residential substance abuse treatment. Retrospective data were collected with the Psychosocial History (PSH), a structured clinical interview that is an expansion of the Addiction Severity Index, designed specifically to assess substance abusing women. The PSH was administered at intake for 183 pregnant women admitted to outpatient (n ϭ 133) or residential (n ϭ 50) treatment. Factor analysis reduced predictors to five factors with composite scores, and multiple regression procedures determined client characteristics that predict treatment outcomes. The findings suggest the complexity of predicting treatment outcomes for pregnant women. Significant predictors were composites of variables that encompassed all aspects of women's personal and family lives including medical and psychiatric needs, family and parenting issues, housing, victimization, and clients' perceived needs for treatment and assistance in all of these areas. The results suggest the need for a holistic approach to substance abuse treatment and continued exploration of a broad range of psychosocial assessments at intake in order to develop substance abuse treatment programs that effectively address multiple aspects of women's lives.
Social Work in Health Care, 2000
Retention is a well-documented predictor of favorable outcome of substance abuse treatment. In or... more Retention is a well-documented predictor of favorable outcome of substance abuse treatment. In order to remain in treatment, clients must initially engage in the treatment process. This issue is a particular challenge for clinicians who continually seek motivational strategies that will draw each individual into the treatment process. Few engagement strategies have been specifically tested to determine their efficacy. The results of this study indicate that outpatient clients who received engagement services during the intake period showed increased use of these services, relative to a comparison group, throughout the treatment process. In addition, tangible engagement services provided to women during the intake period for outpatient substance abuse treatment had no significant effect on the rates of admission, discharge, and service utilization.
The movement toward evidence-based practices has stimulated greater interest in assessing parenti... more The movement toward evidence-based practices has stimulated greater interest in assessing parenting outcomes. The purpose of these studies was to further validate the Keys to Interactive Parenting Scale (KIPS), a structured observational assessment of parenting quality, with 397 diverse families. Factor analysis demonstrated that the 12 KIPS items comprise one construct that explained 60% of the variance and showed high internal consistency (�= 0.95). Analyses of KIPS scores did not detect significant differences in parenting quality among African American, White, and Latino parents observed during parent-child play. Parents rated by home visitors as more engaged in services showed higher quality parenting (r = 0.22, p <.0001). KIPS scores correlated significantly with the NCATS Caregiver Total (r = 0.35, p =.0001) and subscales (Response to Distress r = 0.38, p <.0001; Social-Emotional Growth Fostering r = 0.29, p =.001; Cognitive Growth Fostering r = 0.19, p =.03), and two HOME subscales (Acceptance r = 0.23, p =.01; Responsivity r = 0.19, p =.038). These findings, together with previous research, demonstrate the reliability, validity, evaluative value, and clinical relevance of KIPS. KIPS offers a practical tool that providers can use to tailor services to diverse families, track progress, and demonstrate outcomes.
There is a great deal of evidence to suggest that parenting behaviour is one of the most importan... more There is a great deal of evidence to suggest that parenting
behaviour is one of the most important factors in child
development and wellbeing. Recent initiatives have argued
for the societal benefits of investment in early intervention
in childhood development (WAVE Trust, 2013). In the UK,
health visitors are the key professionals involved in parenting
support, and this is part of the Universal offer laid out in the
Health Visitor Implementation Plan (Department of Health,
2011). Parenting assessment tools can help practitioners to
demonstrate outcomes, which is essential in order to gain
funding and resources. This paper provides a US perspective
on how observational parenting assessment can strengthen
family services and why it should be considered best practice.
Journal of Early Intervention, 1986
Page 1. http://jei.sagepub.com/ Journal of Early Intervention http://jei.sagepub.com/ content/10/... more Page 1. http://jei.sagepub.com/ Journal of Early Intervention http://jei.sagepub.com/ content/10/2/156 The online version of this article can be found at: DOI: 10.1177/105381518601000207 1986 10: 156 Journal of Early Intervention ...
Tradition-a Journal of Orthodox Jewish Thought, 1986
While the conceptual and clinical utility of the goodness of fit concept has been documented exte... more While the conceptual and clinical utility of the goodness of fit concept has been documented extensively, the number of specific empirical tests of the concept has been limited. In this study, the concept was applied in the conceptualization and analysis of early intervention ...
Journal of Reproductive and Infant Psychology, 1987
Research on maternal involvement with a handicapped child has frequently focused on discrete beha... more Research on maternal involvement with a handicapped child has frequently focused on discrete behaviours rather than on more general aspects of the interaction, although it has been suggested that the quality and sensitivity of maternal involvement may be more salient to the development of the child. While it is clear that characteristics of both mother and child influence the relationship,
Journal of Early Intervention, 1988
DOI: 10.1177/105381518801200204 1988 12: 126 Journal of Early Intervention Marilee Comfort and Ja... more DOI: 10.1177/105381518801200204 1988 12: 126 Journal of Early Intervention Marilee Comfort and James Helm Donald B. Bailey, Jr, Rune J. Simeonsson, Patricia Isbell, Gail S. Huntington, Pamela J. Winton, Outcomes and Issues Inservice Training in Family ...
Alcoholism Treatment Quarterly, 1990
No abstract available for this article.
Journal of Psychoactive Drugs, 1999
The purpose of this descriptive study was to compare the characteristics and treatment outcomes o... more The purpose of this descriptive study was to compare the characteristics and treatment outcomes of pregnant cocaine-dependent women and their infants enrolled in residential (N=32) and outpatient (N=32) treatment settings. Biopsychosocial characteristics and issues that influenced the women's multiple treatment outcomes are highlighted. Comparisons of retention and infant birth outcomes found no significant differences between treatment programs. whereas abstinence and patterns of attrition showed meaningful differences favoring residential treatment. Further research is needed to evaluate whether the reported treatment outcomes are markers of improved life functioning that hold promise for the women in treatment, their families and the community.
Journal of Substance Abuse Treatment, 1999
The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess ... more The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess the status, history, and needs of women in substance abuse treatment. The PSH retains the fundamental scoring structure of the Addiction Severity Index (ASI), while adding supplemental questions considered clinically useful and relevant for predicting outcomes. The present study examined the psychometric properties and general utility of both instruments with a sample of women enrolled in substance abuse treatment. Initially, the instruments were tested independently and found to have excellent test–retest reliability and acceptable internal consistency. A reliability trial between the instruments found that the composite scores (CS) of the ASI and PSH yielded satisfactory correlations among four of the six CS domains. The PSH had higher CS scores than the ASI across domains, which may reflect the comprehensive nature of the PSH items that prompt greater disclosure of problems and needs. Validity analyses showed significant correlations of PSH and ASI psychiatric CSs with Symptom Checklist-90-Revised totals. These results suggest that the PSH yields reliable and valid assessment data similar to the ASI. Moreover, the PSH provides a more comprehensive assessment than the ASI in the area of pregnancy, family issues, and victimization.
Substance Abuse, 2000
This study examined whether client characteristics at admission predict Retention, Abstinence, an... more This study examined whether client characteristics at admission predict Retention, Abstinence, and utilization of Required Services and Specialized Services for pregnant women in outpatient and residential substance abuse treatment. Retrospective data were collected with the Psychosocial History (PSH), a structured clinical interview that is an expansion of the Addiction Severity Index, designed specifically to assess substance abusing women. The PSH was administered at intake for 183 pregnant women admitted to outpatient (n = 133) or residential (n = 50) treatment. Factor analysis reduced predictors to five factors with composite scores, and multiple regression procedures determined client characteristics that predict treatment outcomes. The findings suggest the complexity of predicting treatment outcomes for pregnant women. Significant predictors were composites of variables that encompassed all aspects of women's personal and family lives including medical and psychiatric needs, family and parenting issues, housing, victimization, and clients' perceived needs for treatment and assistance in all of these areas. The results suggest the need for a holistic approach to substance abuse treatment and continued exploration of a broad range of psychosocial assessments at intake in order to develop substance abuse treatment programs that effectively address multiple aspects of women's lives.
Addictive Behaviors, 2003
The purpose of this study was to identify client factors that predict treatment and life outcomes... more The purpose of this study was to identify client factors that predict treatment and life outcomes of women enrolled in outpatient (OP) and residential (RT) substance abuse treatment. Subjects were 95 women who enrolled in OP or RT from September 1994 through February 1997, remained in treatment a minimum of 3 months, and completed a 12-month assessment protocol. Factor analyses and a series of multiple regression procedures were conducted to examine whether biopsychosocial characteristics at intake predicted treatment outcomes and life outcomes. The results indicated that client intake characteristics explained 27-34% of the variance in OP treatment outcomes and 40-63% of the variance for women in RT. The findings suggest that prediction of women&amp;amp;amp;amp;amp;#39;s life outcomes is complex, differs for women in RT and OP treatment, and consists of multiple factors. These risk and protective factors include social support, daily stressors, life satisfaction, partner abuse, substance abuse by self and significant others, psychiatric history, chronic medical conditions, childbirth history, childcare responsibilities, and treatment engagement.
Substance Abuse, 2000
This study examined whether client characteristics at admission predict Retention, Abstinence, an... more This study examined whether client characteristics at admission predict Retention, Abstinence, and utilization of Required Services and Specialized Services for pregnant women in outpatient and residential substance abuse treatment. Retrospective data were collected with the Psychosocial History (PSH), a structured clinical interview that is an expansion of the Addiction Severity Index, designed specifically to assess substance abusing women. The PSH was administered at intake for 183 pregnant women admitted to outpatient (n ϭ 133) or residential (n ϭ 50) treatment. Factor analysis reduced predictors to five factors with composite scores, and multiple regression procedures determined client characteristics that predict treatment outcomes. The findings suggest the complexity of predicting treatment outcomes for pregnant women. Significant predictors were composites of variables that encompassed all aspects of women's personal and family lives including medical and psychiatric needs, family and parenting issues, housing, victimization, and clients' perceived needs for treatment and assistance in all of these areas. The results suggest the need for a holistic approach to substance abuse treatment and continued exploration of a broad range of psychosocial assessments at intake in order to develop substance abuse treatment programs that effectively address multiple aspects of women's lives.
Social Work in Health Care, 2000
Retention is a well-documented predictor of favorable outcome of substance abuse treatment. In or... more Retention is a well-documented predictor of favorable outcome of substance abuse treatment. In order to remain in treatment, clients must initially engage in the treatment process. This issue is a particular challenge for clinicians who continually seek motivational strategies that will draw each individual into the treatment process. Few engagement strategies have been specifically tested to determine their efficacy. The results of this study indicate that outpatient clients who received engagement services during the intake period showed increased use of these services, relative to a comparison group, throughout the treatment process. In addition, tangible engagement services provided to women during the intake period for outpatient substance abuse treatment had no significant effect on the rates of admission, discharge, and service utilization.
The movement toward evidence-based practices has stimulated greater interest in assessing parenti... more The movement toward evidence-based practices has stimulated greater interest in assessing parenting outcomes. The purpose of these studies was to further validate the Keys to Interactive Parenting Scale (KIPS), a structured observational assessment of parenting quality, with 397 diverse families. Factor analysis demonstrated that the 12 KIPS items comprise one construct that explained 60% of the variance and showed high internal consistency (�= 0.95). Analyses of KIPS scores did not detect significant differences in parenting quality among African American, White, and Latino parents observed during parent-child play. Parents rated by home visitors as more engaged in services showed higher quality parenting (r = 0.22, p <.0001). KIPS scores correlated significantly with the NCATS Caregiver Total (r = 0.35, p =.0001) and subscales (Response to Distress r = 0.38, p <.0001; Social-Emotional Growth Fostering r = 0.29, p =.001; Cognitive Growth Fostering r = 0.19, p =.03), and two HOME subscales (Acceptance r = 0.23, p =.01; Responsivity r = 0.19, p =.038). These findings, together with previous research, demonstrate the reliability, validity, evaluative value, and clinical relevance of KIPS. KIPS offers a practical tool that providers can use to tailor services to diverse families, track progress, and demonstrate outcomes.