Acceptance and Commitment Therapy (ACT) has a growing empirical base in the treatment of anxiety among adults and children with other concerns. This study reports on the main outcomes of a randomized controlled trial of ACT and traditional cognitive behavioral therapy (CBT) in children with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) anxiety disorder. Participants were 193 children from urban Sydney, Australia, who were block-randomized to a 10-week group-based program of ACT or CBT or a 10-week waitlist control (WLC). Completers included 157 children (ACT = 54, CBT = 57, WLC = 46; M = 11 years, SD = 2.76; 78% Caucasian, 58% female). Pretreatment, posttreatment, and 3 months posttreatment assessments included clinician/self/parent-reported measures of anxiety, quality of life (QOL; anxiety interference, psychosocial and physical health-related QOL), and acceptance/defusion outcomes. Completer and intention-to-treat analyses revealed that ACT and CBT were both superior to WLC across outcomes, reflecting statistically and clinically significant differences, with gains maintained at 3 months posttreatment. Both completer and intention-to-treat analyses found ACT and CBT to produce similar outcomes. There was some support for ACT having greater effect sizes for QOL outcomes but not for avoidance/fusion. Although this study does not suggest that ACT is equivalent to CBT or should be adopted in its place, it does provide evidence that ACT might be another empirically supported treatment option for anxious youth. Further research is needed to replicate these findings.

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National research priorities have been developed and published by the College of Occupational Therapists (Ilott and White 2001). Such an exercise, however, cannot provide the specific research priorities of a particular area of practice. A questionnaire survey was undertaken to ascertain the specific research priorities of forensic occupational therapists. The survey had three parts: determining research priorities, examining outcome measures and exploring the use of protocol-driven group work. Three specific research priorities were clearly defined by part one of the survey: the development of appropriate outcome measures, the development of rigorous and effective group-work programmes and the development of effective risk assessment tools. The nominal group technique was used in order to triangulate the data. The survey also examined the participants' use of outcome measures: a high number of the participants (62%, 44/71) stated that they used outcome measures in practice. The participants' responses to the third aspect of the survey, regarding the use of protocol-driven groups, were more varied. The majority of the groups reported by the participants were ‘home grown’, with little research base underpinning their implementation. The methodological weaknesses of undertaking such a survey are examined. The paper concludes that having identified clinicians' priorities in forensic occupational therapy research, the challenge is how best to gather robust evidence for practice.

Climate change is one factor increasing the risk of hydro-meteorological hazards globally. The use of nature-based solutions (NbS), and more specifically ecosystem-based disaster risk reduction measures (Eco-DRR), has become a popular response for risk reduction that also provides highly-valued co-benefits. Public acceptance is of particular importance for NbS since they often rely on local collaborative implementation, management, and monitoring, as well as long-term protection against competing societal interests. Although public engagement is a common goal of NbS projects, it is rarely carried out with a sufficient understanding of the (de)motivating factors tied to public perceptions. Successful collaboration demands consideration of societal attitudes and values in relation to risk, nature, and place. However, existing research does not sufficiently explore these themes together, their interactions, and their implications for the public acceptance of NbS. This may lead to misaligned public expectations and failed participatory initiatives, while jeopardizing the success of NbS projects and their continued funding and uptake. We conducted citizen surveys within local NbS “host” communities to determine the degree of pro-NbS attitudes and behavior, associated variables, and how these may be leveraged to increase acceptance. We compared results across sites, relying primarily on correlations and regression models along with survey comments and expert knowledge. Three distinct rural NbS being implemented within the OPERANDUM project aim to reduce risk from (socio-)natural hazards in Scotland (landslides and coastal erosion; n = 66 respondents), Finland (eutrophication and algal blooms; n = 204) and Greece (river flooding and water scarcity; n = 84). Our research thus centers on rural NbS for risk reduction within a large EU project. Trust in implementers is a consistent factor for defining attitudes towards the NbS across the sites, and attitudes are strongly associated with respondents’ commitment to nature and behavioral acceptance (i.e., willingness to engage). Behaviorial acceptance is most consistently predicted by connectedness to place and the extent of expected future impacts. Skepticism of NbS effectiveness leads to high public demand for relevant evidence. To increase public acceptance, we recommend greater framing of NbS in relation to place-based values as well as demonstration of the effectiveness of NbS for risk reduction. However, distinct hazard types, proposed NbS, and historical characteristics must be considered for developing strategies aimed at increasing acceptance. An understanding of these characteristics and their interactions leads to evidence-based recommendations for our study sites and for successful NbS deployment in Europe and beyond.

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