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Bartuska AD, Eaton EL, Akinrimisi P, Kim R, Cheron DM, Park AL. Provider Adherence to Modular Cognitive Behavioral Therapy for Children and Adolescents. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:597-609. [PMID: 38334882 DOI: 10.1007/s10488-024-01353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
This study explored predictors of community-based providers' adherence to MATCH, a modular cognitive behavioral therapy for children and adolescents. Provider-reported adherence to MATCH was measured using three increasingly strict criteria: (1) session content (whether the session covered MATCH content consistent with the client's target problem), (2) session content and sequencing (whether the session covered MATCH content in the expected sequence for the client's target problem), and (3) session content, sequencing, and participant (whether the session covered MATCH content in the expected sequence and with the expected participant(s) for the client's target problem). Session, client, provider, and organizational predictors of adherence to MATCH were assessed using multilevel modeling. Results revealed that nearly all providers delivered MATCH content that corresponded to the target problem, but only one-third of providers delivered MATCH content in the expected sequence and with the expected participant for the client's target problem. This difference underscores the need for nuanced adherence measurement to capture important implementation information that broad operationalizations of adherence miss. Regardless of the criteria used providers were most adherent to MATCH during sessions when clients presented with interfering comorbid mental health symptoms. This suggests that the design of MATCH, which offers flexibility and structured guidance to address comorbid mental health problems, may allow providers to personalize treatment to address interfering comorbidity symptoms while remaining adherent to evidence-based practices. Additional guidance for providers on managing other types of session interference (e.g., unexpected events) may improve treatment integrity in community settings.
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Affiliation(s)
- Anna D Bartuska
- Department of Psychology, University of Oregon, Eugene, OR, USA.
| | - Emma L Eaton
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | | | - Rachel Kim
- The Baker Center for Children and Families, Boston, MA, USA
| | - Dan M Cheron
- The Baker Center for Children and Families, Boston, MA, USA
| | - Alayna L Park
- Department of Psychology, University of Oregon, Eugene, OR, USA
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Slovak P, Munson SA. HCI Contributions in Mental Health: A Modular Framework to Guide Psychosocial Intervention Design. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2024; 2024:692. [PMID: 38770195 PMCID: PMC11105670 DOI: 10.1145/3613904.3642624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Many people prefer psychosocial interventions for mental health care or other concerns, but these interventions are often complex and unavailable in settings where people seek care. Intervention designers use technology to improve user experience or reach of interventions, and HCI researchers have made many contributions toward this goal. Both HCI and mental health researchers must navigate tensions between innovating on and adhering to the theories of change that guide intervention design. In this paper, we propose a framework that describes design briefs and evaluation approaches for HCI contributions at the scopes of capabilities, components, intervention systems, and intervention implementations. We show how theories of change (from mental health) can be translated into design briefs (in HCI), and that these translations can bridge and coordinate efforts across fields. It is our hope that this framework can support researchers in motivating, planning, conducting, and communicating work that advances psychosocial intervention design.
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Dobler VB, Nestler J, Konzelmann M, Kennerley H. Mapping evidence-based interventions to the care of unaccompanied minor refugees using a group formulation approach. Behav Cogn Psychother 2024; 52:14-32. [PMID: 37974439 DOI: 10.1017/s1352465823000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND How we adapt treatment algorithms to complex, clinically untested, difficult-to-engage patient groups without losing evidence base in everyday practice is a clinical challenge. Here we describe process and reasoning for fast, pragmatic, context-relevant and service-based adaptations of a group intervention for unaccompanied minor asylum seekers (UASC) arriving in Europe. We employed a distillation-matching model and deployment-focused process in a mixed-method, top-down (theory-driven) and bottom-up (participant-informed) approach. Prevalence of mental disorders amongst UASC is extremely high. They also represent a marginalised and hard-to-engage group with limited evidence for effective treatments. METHOD Content and process adaptations followed four steps: (1) descriptive local group characterisation and theoretical formulation of problems; (2) initial adaptation of evidenced treatment, based on problem-to-component grid; (3) iterative adaptation using triangulated feedback; and (4) small-scale pilot evaluation. RESULTS Based on evidence and participant feedback, adaptations included minimising verbal demands, facilitating in-session inductive learning, fostering social connectedness via games, enhancing problem-solving skills, accounting for multi-traumatisation, uncertainty and deportation. Quantitative evaluation suggested improved feasibility, with increased attendance, low drop-out and symptom improvement on depression and trauma scores. CONCLUSIONS By describing the principles under-pinning development of a group intervention for severely traumatised UASC, we contribute to the literature supporting dynamic adaptations of psychological interventions, without losing reference to evidence base. Complex and difficult-to-reach clinical groups are often those in most need of care, yet least researched and most affected by inequality of care. Pragmatic adaptations of proven programs are often necessary to increase feasibility.
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Affiliation(s)
- V B Dobler
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, D-89075Ulm, Germany
| | - Judith Nestler
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, D-89075Ulm, Germany
| | | | - Helen Kennerley
- Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford, UK
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Gil M, Kim SS, Kim D, Kim S. Online coaching blended couple-oriented intervention for preventing depression among Korean middle adulthood: A feasibility study. FAMILY PROCESS 2023; 62:1478-1505. [PMID: 37641515 DOI: 10.1111/famp.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/27/2023] [Accepted: 07/22/2023] [Indexed: 08/31/2023]
Abstract
Depression and marital satisfaction have a reciprocal cause-and-effect relationship. Thus, couple relationships should be considered to maximize the effectiveness of couple-oriented interventions for depression. Moreover, developing culturally tailored couple-oriented interventions is critical for improving cultural acceptability and enhancing the perceived effectiveness of the interventions. A new culturally tailored MindGuide Couple intervention was developed to prevent Korean middle adulthood depression and enhance couple relationships using intervention mapping. This feasibility study used a single-arm, pre- and post-test, and 2-month follow-up design to explore the reach, acceptability, and preliminary effectiveness of this preventive intervention. Reach was assessed by recruitment, retention, and completion rates; acceptability was measured based on helpfulness, suitability, and satisfaction; and preliminary effectiveness was measured by depression (CES-D), positive and negative affect (PANAS), satisfaction with life (SWLS), couple satisfaction (CSI), and healthy relationship between spouses (FRAS). Fifteen middle-aged couples participated in four psychoeducational and asynchronous online modules and four synchronous coaching sessions via videoconferencing for 5-7 weeks. Data were analyzed using descriptive statistics and repeated measures with analysis of variance. With a 94.1% completion rate, the participants demonstrated high satisfaction with the online coaching blended intervention and reported that it was helpful and easy to use. Both husbands and wives showed significant differences over time in depression, couple satisfaction, and healthy relationships between spouses. This feasibility study demonstrated the successful reach, acceptability, and potential effectiveness of this preventive intervention. Additionally, we suggest the importance of culturally tailored and online coaching blended couple-oriented intervention for preventing depression and promoting healthy couple relationships.
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Affiliation(s)
- Minji Gil
- College of Nursing, Ewha Womans University, Seoul, South Korea
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
| | - Suk-Sun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Daeun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Sunhai Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
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Sanchez BEL, Klein CC, Tremblay M, Rastogi M, Corcoran F, Barnett ML. Adapting to Unprecedented Times: Community Clinician Modifications to Parent-Child Interaction Therapy during COVID-19. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 8:348-363. [PMID: 37981955 PMCID: PMC10656036 DOI: 10.1080/23794925.2023.2238741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Parent-Child Interaction Therapy (PCIT) is an evidence-based practice that effectively prevents and treats child disruptive behaviors and child physical maltreatment and reduces parenting stress. PCIT was adapted for telehealth delivery, internet-delivered PCIT (iPCIT), before the COVID-19 pandemic but was not widely implemented until the rapid transition to telehealth during stay-at-home orders. To understand how clinicians adapted PCIT during COVID-19, we followed up on a previous study investigating community clinician adaptations of PCIT pre-COVID-19 using the Lau et al. (2017) Augmenting and Reducing Framework. Clinicians (N = 179) who responded to the follow-up survey and reported delivering PCIT remotely completed a quantitative measure of adaptations at both time points (Fall 2019; Summer 2020) to assess how adaptations to PCIT changed following lockdown measures. Clinicians (n = 135) also provided qualitative descriptions of adaptations made early in the COVID-19 pandemic. Clinicians in the full sample were 74.3% Non-Hispanic White and 14% Latinx. Most clinicians had a master's degree (66.5%), were licensed (80.4%), and were PCIT-certified (70.4%). Paired samples t-tests showed that clinicians reported similar levels of augmenting t(179) = -0.09, p=.926) and reducing adaptations t(179) = -0.77, p=.442) at both time points. Unlike quantitative findings, qualitative findings indicated that clinicians described engaging in many types of adaptations in response to the pandemic. Clinicians discussed engaging in augmenting adaptations by extending treatment length and integrating other practices into treatment. Clinicians also discussed engaging in reducing adaptations. Implications and future directions will be discussed.
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Raymond IJ. Intentional practice: a common language, approach and set of methods to design, adapt and implement contextualised wellbeing solutions. FRONTIERS IN HEALTH SERVICES 2023; 3:963029. [PMID: 37395993 PMCID: PMC10312088 DOI: 10.3389/frhs.2023.963029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/05/2023] [Indexed: 07/04/2023]
Abstract
Reducing the "science-to-practice" gap has gained significant attention across multi-disciplinary settings, including school psychology and student wellbeing, trauma-informed practice, community and human services, and clinically focused health care. There has been increasing calls for complexity and contextualisation to be integrated within the implementation science literature. This includes the design and implementation of interventions spanning "systems" (whole-of-community capacity building initiatives), "programs" (e.g., evidence-based programs, clinical interventions) and "moment-to-moment" support or care. The latter includes responses and communication designed to deliver specific learning, growth or wellbeing outcomes, as personalised to an individual's presenting needs and context (e.g., trauma-informed practice). Collectively, this paper refers to these interventions as "wellbeing solutions". While the implementation science literature offers a range of theories, models and approaches to reduce the science-to-practice gap in wellbeing solution design and implementation, they do not operationalise interventions into the "moment", in a manner that honours both complexity and contextualisation. Furthermore, the literature's language and content is largely targeted towards scientific or professional audiences. This paper makes the argument that both best-practice science, and the frameworks that underpin their implementation, need to be "sticky", practical and visible for both scientific and non-scientific knowledge users. In response to these points, this paper introduces "intentional practice" as a common language, approach and set of methods, founded upon non-scientific language, to guide the design, adaptation and implementation of both simple and complex wellbeing solutions. It offers a bridge between scientists and knowledge users in the translation, refinement and contextualisation of interventions designed to deliver clinical, wellbeing, growth, therapeutic and behavioural outcomes. A definitional, contextual and applied overview of intentional practice is provided, including its purported application across educational, wellbeing, cross-cultural, clinical, therapeutic, programmatic and community capacity building contexts.
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Kagan R, Pressley J, Espinoza R, Lanktree C, Henry J, Knoverek A, Duffy S, Labruna V, Habib M, Blaustein ME, Spinazzola J. Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:145-159. [PMID: 36776636 PMCID: PMC9908809 DOI: 10.1007/s40653-022-00479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 06/18/2023]
Abstract
Youths and parents/caregivers who have experienced multiple forms of severe interpersonal trauma may demonstrate severe and persistent symptoms of complex trauma including high-risk behaviors. Engagement, and sustaining engagement, of these youths and parents/caregivers in evidence-supported trauma treatment is a critical challenge, especially when youths or parents/caregivers have experienced chronic traumas that may be expected to continue into the foreseeable future. An extensive literature review was conducted leading to development of an assessment framework that could increase engagement of youths and parents/caregivers in trauma treatment based on research on chronic trauma, complex trauma, Developmental Trauma Disorder (DTD), and factors that promote engagement. A multi-dimensional assessment guide was developed to enable clinicians to differentiate types of chronic trauma based on a continuum of past, current and expected exposure over time and then to use this guide collaboratively with youths and parents/caregivers to develop priorities for treatment and service planning that matches their needs and strengths. The assessment guide incorporates exposure to intra-familial and community forms of interpersonal trauma, attachment disruptions, established symptoms of PTSD, Complex PTSD and DTD, as well as social-emotional development. The assessment and treatment planning guides proposed in this article expand applicability of evidence-supported trauma-informed therapy to youths and families who have not been engaged by programs offering treatments that are focused on past or single incident traumas or do not address disrupted attachments, multi-generational experiences of adversity, discrimination and community violence, life-threatening dangers or the impact of chronic trauma on youth, parent/caregiver and family development.
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Affiliation(s)
- Richard Kagan
- Training Programs on Traumatic Stress, Family Treatment Center Foundation, The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | - Jana Pressley
- The Foundation Trust, Richmont Graduate University, Chattanooga, USA
| | - Rosa Espinoza
- The Foundation Trust, Children’s Hospital Los Angeles/USC UCEDD, Los Angeles, USA
| | - Cheryl Lanktree
- Department of Psychiatry & Behavioral Sciences, Keck Medical School, University of Southern California Adolescent Trauma Training Center, University of Southern California, Los Angeles, USA
| | - Jim Henry
- School of Social Work and Children’s Trauma Assessment Center, Western Michigan University, Kalamazoo, USA
| | - Angel Knoverek
- School of Counselor Education, Culver-Stockton College, Adams State University, Alamosa, USA
| | | | - Victor Labruna
- The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | - Mandy Habib
- The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | | | - Joseph Spinazzola
- The Foundation Trust, Richmont Graduate University, Chattanooga, USA
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Kline ER, Depestre S. Promoting implementation of deployment-ready psychosocial interventions. Schizophr Res 2023; 252:146-147. [PMID: 36645933 PMCID: PMC10627347 DOI: 10.1016/j.schres.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Affiliation(s)
- Emily R Kline
- Boston University School of Medicine, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America; Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America.
| | - Sohenga Depestre
- Boston University School of Medicine, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America; Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America
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Russette HC, Grubin F, Ingalls A, Martin L, Leonard A, Kushman E, Cisler A, Leffler E, Herman A, Haroz EE. Home visitor perspectives on implementing a precision approach to home visiting in communities serving Native American families. Infant Ment Health J 2022; 43:744-755. [PMID: 35921432 DOI: 10.1002/imhj.22012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/10/2022] [Indexed: 12/15/2022]
Abstract
Family Spirit (FS) is a federally endorsed evidence-based home visiting programs serving as a key prevention strategy for expectant families and families with young children. Like other home-visiting programs, it shares client challenges in retention and engagement during implementation. We assessed (1) the feasibility and acceptability of implementing a precision approach to FS; and (2) differences in approaches to FS delivery. Home visitors, serving primarily Native American families, that delivered a standard (N = 6) or a precision approach (N = 6) to FS across four study sites each participated in up to four virtual focus group discussions (FGDs) (N = 16). Facilitators and barriers to implementation were identified across the curriculum approach, relational and contextual levels. Facilitators: Relevant and culturally sensitive lessons, lesson structure, client-home visitor relationship, client buy-in, home visitor autonomy, leadership support, flexible funding, and training. Barriers: Irrelevant lessons, substance use content, missing topics, families experiencing crises, client and home visitor availability, client feedback, nonsupportive leadership, inadequate funding, and organizational policies and practices. The precision approach offers (1) tailoring of lessons that supports relevance of content to clients; and (2) a target timeframe that supports flexibility in lesson delivery. This model structure may improve client participation and retention.
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Affiliation(s)
- Helen C Russette
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Fiona Grubin
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allison Ingalls
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Martin
- Maternal, Infant and Early Childhood Services, Inter-Tribal Council of Michigan, Inc., Sault Sainte Marie, Michigan, USA
| | - Amanda Leonard
- Maternal, Infant and Early Childhood Services, Inter-Tribal Council of Michigan, Inc., Sault Sainte Marie, Michigan, USA
| | - Elizabeth Kushman
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aimee Cisler
- American Indian Health and Family Services, Detroit, Michigan, USA
| | | | | | - Emily E Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Alvarez K, Cervantes PE, Nelson KL, Seag DEM, Horwitz SM, Hoagwood KE. Review: Structural Racism, Children's Mental Health Service Systems, and Recommendations for Policy and Practice Change. J Am Acad Child Adolesc Psychiatry 2022; 61:1087-1105. [PMID: 34971730 PMCID: PMC9237180 DOI: 10.1016/j.jaac.2021.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Racism is a public health crisis that impacts on children's mental health, yet mental health service systems are insufficiently focused on addressing racism. Moreover, a focus on interpersonal racism and on individual coping with the impacts of racism has been prioritized over addressing structural racism at the level of the service system and associated institutions. In this paper, we examine strategies to address structural racism via policies affecting children's mental health services. METHOD First, we identify and analyze federal and state policies focused on racism and mental health equity. Second, we evaluate areas of focus in these policies and discuss the evidence base informing their implementation. Finally, we provide recommendations for what states, counties, cities, and mental health systems can do to promote antiracist evidence-based practices in children's mental health. RESULTS Our analysis highlights gaps and opportunities in the evidence base for policy implementation strategies, including the following: mental health services for youth of color, interventions addressing interpersonal racism and bias in the mental health service system, interventions addressing structural racism, changes to provider licensure and license renewal, and development of the community health workforce. CONCLUSION Recommendations are provided both within and across systems to catalyze broader systems transformation.
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Affiliation(s)
- Kiara Alvarez
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | - Katherine L Nelson
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Merck & Co., Inc., Kenilworth, New Jersey
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Elsaesser M, Herpertz S, Piosczyk H, Jenkner C, Hautzinger M, Schramm E. Modular-based psychotherapy (MoBa) versus cognitive-behavioural therapy (CBT) for patients with depression, comorbidities and a history of childhood maltreatment: study protocol for a randomised controlled feasibility trial. BMJ Open 2022; 12:e057672. [PMID: 35820739 PMCID: PMC9277372 DOI: 10.1136/bmjopen-2021-057672] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as well as underlying transdiagnostic mechanisms and factors like early childhood maltreatment may lead to better outcomes. A modular-based psychotherapy (MoBa) approach provides a treatment model of independent and flexible therapy elements within a systematic treatment algorithm to combine and integrate existing evidence-based approaches. By optimally tailoring module selection and application to the specific needs of each patient, MoBa has great potential to improve the currently unsatisfying results of psychotherapy as a bridge between disorder-specific and personalised approaches. METHODS AND ANALYSIS In a randomised controlled feasibility trial, N=70 outpatients with episodic or persistent major depression, comorbidity and childhood maltreatment are treated in 20 individual sessions with MoBa or standard cognitive-behavioural therapy for depression. The three modules of MoBa focus on deficits associated with early childhood maltreatment: the systems of negative valence, social processes and arousal. According to a specific questionnaire-based treatment algorithm, elements from cognitive behavioural analysis system of psychotherapy, mentalisation-based psychotherapy and/or mindfulness-based cognitive therapy are integrated for a personalised modular procedure.As a proof of concept, this trial will provide evidence for the feasibility and efficacy (post-treatment and 6-month follow-up) of a modular add-on approach for patients with depression, comorbidities and a history of childhood maltreatment. Crucial feasibility aspects include targeted psychopathological mechanisms, selection (treatment algorithm), sequence and application of modules, as well as training and supervision of the study therapists. ETHICS AND DISSEMINATION This study obtained approval from the independent Ethics Committees of the University of Freiburg and the University of Heidelberg. All findings will be disseminated broadly via peer-reviewed articles in scientific journals and contributions to national and international conferences. TRIAL REGISTRATION NUMBER DRKS00022093.
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Affiliation(s)
- Moritz Elsaesser
- Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Sabine Herpertz
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Hannah Piosczyk
- Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Carolin Jenkner
- Clinical Trials Unit, Universitatsklinikum Freiburg, Freiburg, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology, and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Luis Sanchez BE, Klein CC, Corcoran F, Barnett ML. A Mixed-Methods Study of Clinician Adaptations to Parent-Child Interaction Therapy - What about Culture? EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 8:269-285. [PMID: 37456065 PMCID: PMC10348697 DOI: 10.1080/23794925.2022.2070883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Parent-Child Interaction Therapy (PCIT) is an evidence-based practice (EBP) for young children with challenging behaviors. PCIT has been adapted to treat varying presentations and culturally diverse families. Although efforts have been made to disseminate PCIT into community settings, which often serve clinically complex, socio-culturally diverse, and marginalized communities, barriers to disseminating adapted models remain. An alternative strategy to understanding how to increase access to appropriately adapted PCIT is to learn from community clinicians' practice-based adaptations to meet their clients' diverse needs related to clinical presentation, culture, and language. This mixed-method study investigated community clinician adaptations of PCIT. Clinicians (N = 314) were recruited via PCIT listservs to complete a survey collecting background information, and adaptations to PCIT. Most clinicians had a master's degree (72.1%), were licensed (74.2%), and were PCIT-certified (70.7%). Qualitative interviews were conducted with a purposeful sample of 23 community clinicians, who were 39% Spanish-speaking, were 30% Latinx, and 30% reported serving a ≥50% Latinx clientele. Clinicians reported engaging in adaptations aimed at augmenting PCIT more extensively than adaptations involving removing core components. Themes from qualitative interviews converged with quantitative findings, with clinicians most frequently describing augmenting adaptations, and highlighted reasons for adapting PCIT. Clinicians primarily augmented treatment to address clients' clinical presentations. Clinicians rarely adapted treatment specifically for culture, but when mentioned, clinicians discussed tailoring idioms and phrases to match clients' culture for Spanish-speaking clients. Implications for training PCIT clinicians in intervention adaptations will be discussed.
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Affiliation(s)
| | | | | | - Miya L Barnett
- University of California Santa Barbara, Santa Barbara, CA
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Sood E, Gramszlo C, Perez Ramirez A, Braley K, Butler SC, Davis JA, Divanovic AA, Edwards LA, Kasparian N, Kelly SL, Neely T, Ortinau CM, Riegel E, Shillingford AJ, Kazak AE. Partnering With Stakeholders to Inform the Co-Design of a Psychosocial Intervention for Prenatally Diagnosed Congenital Heart Disease. J Patient Exp 2022; 9:23743735221092488. [PMID: 35493441 PMCID: PMC9039438 DOI: 10.1177/23743735221092488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Input from diverse stakeholders is critical to the process of designing healthcare interventions. This study applied a novel mixed-methods, stakeholder-engaged approach to co-design a psychosocial intervention for mothers expecting a baby with congenital heart disease (CHD) and their partners to promote family wellbeing. The research team included parents and clinicians from 8 health systems. Participants were 41 diverse parents of children with prenatally diagnosed CHD across the 8 health systems. Qualitative data were collected through online crowdsourcing and quantitative data were collected through electronic surveys to inform intervention co-design. Phases of intervention co-design were: (I) Engage stakeholders in selection of intervention goals/outcomes; (II) Engage stakeholders in selection of intervention elements; (III) Obtain stakeholder input to increase intervention uptake/utility; (IV) Obtain stakeholder input on aspects of intervention design; and (V) Obtain stakeholder input on selection of outcome measures. Parent participants anticipated the resulting intervention, HEARTPrep, would be acceptable, useful, and feasible for parents expecting a baby with CHD. This model of intervention co-design could be used for the development of healthcare interventions across chronic diseases.
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Affiliation(s)
- Erica Sood
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Colette Gramszlo
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Alejandra Perez Ramirez
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Katherine Braley
- Nemours Cardiac Center, Nemours Children’s Hospital Florida, Orlando, FL, USA
| | | | - Jo Ann Davis
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Allison A Divanovic
- Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | | | - Nadine Kasparian
- Center for Heart Disease and Mental Health, Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | - Sarah L Kelly
- Departments of Pediatrics and Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Cynthia M Ortinau
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA
| | - Erin Riegel
- Parent Research Partner, Wilmington, DE, USA
| | | | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Quail KR, Ward CL. Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence. TRAUMA, VIOLENCE & ABUSE 2022; 23:620-638. [PMID: 33111651 DOI: 10.1177/1524838020967340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Violence against children is a widespread problem with devastating consequences, and corporal punishment is a risk factor for more serious forms of physical abuse. One reason for the persistence of corporal punishment may be the lack of awareness of positive disciplinary alternatives. Nonviolent options offered to caregivers and teachers must be effective in addressing challenging behavior, or they may be rejected in favor of a return to physical punishment. There is an urgent need to determine which discipline options are evidence-supported and what that evidence says so that robust alternatives to corporal punishment can be made available. The primary objective of this research was to find, and explore the state of the science on, individual nonviolent interventions for challenging behavior, in so doing forming a "tool kit" for use by caregivers and teachers. A systematic overview of systematic reviews was conducted. Included systematic reviews were peer-reviewed and published in English between 1999 and 2018. Screening, quality assessment using AMSTAR, and data extraction were performed independently by two reviewers. A total of 223 reviews were included, covering data from 3,921 primary studies. A wide range of evidence-supported interventions exist, many of which have been found effective with severely challenging behavior. Important positive outcomes shown suggest that the use of these tools should be promoted not only for the prevention of violence but also for optimum child development. More research is needed on the use of these methods in home situations and on de-escalation skills.
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Affiliation(s)
- Karen R Quail
- Department of Psychology, University of Cape Town, South Africa
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Stiles DA, Alaraudanjoki E, Wilkinson LR, Ritchie KL, Brown KA. Researching the Effectiveness of Tree of Life: an Imbeleko Approach to Counseling Refugee Youth. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:123-139. [PMID: 33708288 PMCID: PMC7900289 DOI: 10.1007/s40653-019-00286-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
With the growing worldwide refugee crisis, there is a need for evidence-based interventions that specifically deal with the consequences of cumulative trauma-exposure in refugee youth. Refugee children have unique service needs and differ from their non-refugee peers in terms of sociocultural trauma, language, culture, and educational barriers. This article explains the complexities associated with understanding refugee youth and presents a proposal for studying the possible benefits of Tree of Life therapy. At the present time, Tree of Life therapy has no evidence-base because the published studies of Tree of Life with refugee and/or immigrant youth have sample sizes of one, six, eight, and twenty-nine. As a culturally-grounded, strength-based group counseling approach, Tree of Life therapy addresses traumatic experiences, recognizes participants' cultural differences, highlights individual skills, and aids in instilling both confidence and hope for the future. Ncazelo Ncube, the co-founder and main developer of Tree of Life, describes this therapy as a collective narrative practice that considers cultural beliefs and values (2006, 2010, 2018, 2019). The proposed research design is to study the effectiveness of the Tree of Life in Canada, the United States, the United Kingdom, and South Africa. The research plan is to use pragmatic, group-randomized controlled trials in the "real world" settings of schools and agencies in each of the four countries. In addition, the article describes the development of the Roots and Wings Questionnaire for Children and Youth, a culturally relevant, child-friendly questionnaire. The Tree of Life is a readily available therapy with great potential for helping traumatized refugee youth as well as other trauma-impacted young people worldwide.
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Affiliation(s)
- Deborah A. Stiles
- Applied Educational Psychology and School Psychology, Webster University, 470 Lockwood Ave, St. Louis, MO 63119 USA
| | - Esa Alaraudanjoki
- Applied Educational Psychology and School Psychology, Webster University, 470 Lockwood Ave, St. Louis, MO 63119 USA
| | - Lisa R. Wilkinson
- Applied Educational Psychology and School Psychology, Webster University, 470 Lockwood Ave, St. Louis, MO 63119 USA
| | - Keary L. Ritchie
- Applied Educational Psychology and School Psychology, Webster University, 470 Lockwood Ave, St. Louis, MO 63119 USA
| | - Kelly Ann Brown
- Applied Educational Psychology and School Psychology, Webster University, 470 Lockwood Ave, St. Louis, MO 63119 USA
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Ingalls A, Barlow A, Kushman E, Leonard A, Martin L, Team PFSS, West AL, Neault N, Haroz EE. Precision Family Spirit: a pilot randomized implementation trial of a precision home visiting approach with families in Michigan-trial rationale and study protocol. Pilot Feasibility Stud 2021; 7:8. [PMID: 33407939 PMCID: PMC7786970 DOI: 10.1186/s40814-020-00753-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Home visiting is a well-supported strategy for addressing maternal and child health disparities. However, evidence-based models generally share implementation challenges at scale, including engagement and retention of families. Precision home visiting may address this issue. This paper describes the first known pilot randomized implementation trial of a precision home visiting approach vs. standard implementation. Primary aims are to: 1) explore the acceptability and feasibility of a precision approach to home visiting and 2) examine the difference between Standard Family Spirit and Precision Family Spirit on participants’ program satisfaction, client-home visitor relationship, goal alliance, and the impact of these factors on participant engagement and retention. Secondary aims are to explore potential differences on maternal behavioral and mental health outcomes and child development outcomes to inform sample size estimations for a fully powered study. Methods This is a pilot Hybrid Type 3 implementation trial. Four Michigan communities primarily serving the Native American families and already using Family Spirit were randomized by site to receive Standard Family Spirit or Precision Family Spirit. Participants include N = 60 mothers at least 14 years of age (pregnant or with a newborn < 2 months of age) currently enrolled in Family Spirit. Precision Family Spirit participants receive core lessons plus additional lessons based on needs identified at baseline and that emerge during the trial. Control mothers receive the standard sequence of Family Spirit lessons. Data is collected at baseline (< 2 months postpartum), and 2, 6, and 12 months postpartum. All Precision Family Spirit participants are invited to complete qualitative interviews at study midpoint and endpoint. All home visitors are invited to participate in focus groups between study midpoint and endpoint. Exploratory data analysis will assess feasibility, acceptability, client-home visitor relationship, retention, adherence, and potential differences in intervention outcomes. Discussion This trial will provide new information about the acceptability and feasibility of precision home visiting and pilot data on program satisfaction, client-home visitor relationship, goal alliance, retention, and targeted maternal-child intervention outcomes. Findings will inform the design of a fully powered randomized implementation trial of precision vs. standard home visiting. Trial registration ClinicalTrials.gov #NCT03975530; Registered on June 5, 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-020-00753-4.
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Affiliation(s)
- Allison Ingalls
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Allison Barlow
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Kushman
- Maternal, Infant and Early Childhood Services, Inter-Tribal Council of Michigan, Inc., Sault Sainte Marie, MI, USA
| | - Amanda Leonard
- Maternal, Infant and Early Childhood Services, Inter-Tribal Council of Michigan, Inc., Sault Sainte Marie, MI, USA
| | - Lisa Martin
- Maternal, Infant and Early Childhood Services, Inter-Tribal Council of Michigan, Inc., Sault Sainte Marie, MI, USA
| | | | - Allison L West
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicole Neault
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily E Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Lyon AR, Dopp AR, Brewer SK, Kientz JA, Munson SA. Designing the Future of Children's Mental Health Services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 47:735-751. [PMID: 32253634 PMCID: PMC7395914 DOI: 10.1007/s10488-020-01038-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Advancements in evidence-based psychosocial interventions, digital technologies, and implementation strategies (i.e., health services research products) for youth mental health services have yet to yield significant improvement in public health outcomes. Achieving such impact will require that these research products are easy to use, useful, and contextually appropriate. This paper describes how human-centered design (HCD), an approach that aligns product development with the needs of the people and settings that use those products, can be leveraged to improve youth mental health services. We articulate how HCD can advance accessibility, effectiveness, and equity, with specific consideration of unique aspects of youth mental health services.
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Affiliation(s)
- Aaron R. Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA 98115 USA
| | - Alex R. Dopp
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401 USA
| | - Stephanie K. Brewer
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA 98115 USA
| | - Julie A. Kientz
- Department of Human Centered Design and Engineering, University of Washington, 428 Sieg Hall, Seattle, WA 98195 USA
| | - Sean A. Munson
- Department of Human Centered Design and Engineering, University of Washington, 428 Sieg Hall, Seattle, WA 98195 USA
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Baumann AA, Mejia A, Lachman JM, Parra Cardona JR, López-Zerón G, Amador Buenabad NG, Vargas E, Domenech Rodríguez MM. Parenting Programs for Underserved Populations in Low- and Middle-Income Countries: Issues of Scientific Integrity and Social Justice. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2019; 6:199-207. [PMID: 32095423 PMCID: PMC7036747 DOI: 10.1007/s40609-018-0121-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research suggests that parenting programs are effective for preventing behavioral and emotional difficulties in children, but a lot more attention needs to be paid to issues of context and culture during the development, testing and implementation of these interventions. The views and needs of underserved and disenfranchised communities in the US and the Global South are often not taken into account for the development and testing of interventions. The successful implementation of evidence-based interventions for vulnerable children and families in underserved and marginalized communities requires careful consideration of how existing paradigms of prevention, evaluation, and implementation science impact issues of social justice and equity. This paper will describe how a team of parenting program researchers has been collaborating with their partners globally in generating local knowledge by balancing the need for rigorous scientific methods with issues of power. Authors from the U.S., Latin America, Africa and Southeast Asia draw on their experiences regarding challenges and successes with issues regarding study design and measurement, the transferability and adaptation of interventions, and the dissemination and implementation of different parenting interventions while placing communities at the center of their efforts through participatory methods. We describe innovative approaches that span the continuum of intervention development, adaptation, optimization, evaluation, implementation, and scale up of different parenting programs for vulnerable children and families across the world. We conclude by offering specific and pragmatic recommendations to increase access of culturally relevant and effective parenting programs in these communities.
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Affiliation(s)
| | - Anilena Mejia
- Instituto de Investigaciones Científicas y Servicios de Alta
Tecnología (INDICASAT)
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Lyon AR, Bruns EJ. From evidence to impact: Joining our best school mental health practices with our best implementation strategies. SCHOOL MENTAL HEALTH 2019; 11:106-114. [PMID: 31709018 PMCID: PMC6839825 DOI: 10.1007/s12310-018-09306-w] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
There is substantial research evidence for the effectiveness of school mental health strategies across problem areas, developmental levels, and the prevention-intervention spectrum. At the same time, it is clear that the education and mental health fields continue to struggle to apply this evidence at any level of scale. This commentary reflects on ways in which education-specific applications of implementation science principles - and explicit consideration of determinants of implementation success - may guide more consistent use of evidence in school mental health. After reviewing implementation determinants and strategies across multiple levels of effect (i.e., the outer setting, inner setting, individual, and intervention levels), the commentary goes on to recommend specific areas of needed attention in school mental health implementation efforts and research. These include a need to adapt interventions to better fit the context of schools, streamlining school mental health programs and practices to make them more implementable, and recognizing the critical role of assessment and selection of evidence-based interventions by school leaders. The commentary concludes by reflecting on the substantial opportunity provided by the education sector to both apply and advance implementation science.
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Martin P, Murray LK, Darnell D, Dorsey S. Transdiagnostic treatment approaches for greater public health impact: Implementing principles of evidence‐based mental health interventions. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12270] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Prerna Martin
- Department of PsychologyUniversity of Washington Seattle Washington
| | - Laura K Murray
- Department of Mental HealthJohns Hopkins Bloomberg School of Public Health Baltimore Maryland
| | - Doyanne Darnell
- Department of Psychiatry and Behavioral SciencesUniversity of Washington Seattle Washington
| | - Shannon Dorsey
- Department of PsychologyUniversity of Washington Seattle Washington
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Lyon AR, Stanick C, Pullmann MD. Toward high‐fidelity treatment as usual: Evidence‐based intervention structures to improve usual care psychotherapy. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges. EDUCATION SCIENCES 2018. [DOI: 10.3390/educsci8040178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.
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Lyon AR, Pullmann MD, Walker SC, D'Angelo G. Community-Sourced Intervention Programs: Review of Submissions in Response to a Statewide Call for "Promising Practices". ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 44:16-28. [PMID: 25855511 DOI: 10.1007/s10488-015-0650-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was initiated to add to the nascent literature on locally-grown intervention programs in the youth mental health, child welfare, and juvenile justice service sectors, many of which demonstrate practice-based or community-defined evidence, but may not have been subjected to empirical evaluation. Characteristics of applications submitted in response to three public calls for additions to an inventory of research-supported intervention programs were reviewed on evidence for effectiveness, the use of key quality assurance (QA) elements (e.g., clearly specified training or integrity monitoring procedures), and cultural specificity. Findings indicate that four QA processes were identified in approximately half of all submissions: a specific initial training process, the existence of intervention integrity measures, routine outcome monitoring, and ongoing support post-training. An initial training process and integrity measurement were more commonly described among programs determined to have greater research evidence for their effectiveness. Overall, cultural elements were described relatively infrequently and most often reflected surface-level program delivery characteristics (e.g., offering services in languages other than English). Discussion is focused on the alignment of submitted programs with the larger literatures focused on implementation science and cultural competence.
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Affiliation(s)
- Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Suite 100, Seattle, WA, 98115, USA.
| | - Michael D Pullmann
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Suite 100, Seattle, WA, 98115, USA
| | - Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Suite 100, Seattle, WA, 98115, USA
| | - Gabrielle D'Angelo
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Suite 100, Seattle, WA, 98115, USA
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The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of "Evidence-Based" in a Policy Context. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 44:42-54. [PMID: 25894313 DOI: 10.1007/s10488-015-0652-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge. In this paper we review the development of the Washington State Inventory of Evidence-Based, Research-Based and Promising Practices as a case study for the process of defining evidence-based practice in a policy context. As part of this study we also present a comparison of other well-known evidence-based practice inventories and examine consistencies and differences in the process of identifying and developing program ratings.
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A systematic review of interventions targeting men's alcohol use and family relationships in low- and middle-income countries. Glob Ment Health (Camb) 2018; 5:e10. [PMID: 29632682 PMCID: PMC5885490 DOI: 10.1017/gmh.2017.32] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/16/2017] [Accepted: 10/25/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Problem drinking accounts for 9.6% of disability-adjusted life years worldwide. It disproportionally affects men and has disabling physical, psychological, and behavioral consequences. These can lead to a cascade of negative effects on men's families, with documented ties to intimate partner violence (IPV) and child maltreatment. These multi-level problems are often exacerbated where poverty rates are high, including low and middle-income countries (LMICs). In contexts where strong patriarchal norms place men in positions of power, family-level consequences are often even more pronounced. METHODS We conducted a systematic review of the literature on interventions in LMICs targeting men's problem drinking and any family-related outcomes. Cochrane and PRISMA procedures guided the review. The search was conducted in PsychInfo, PubMed, and Web of Science. RESULTS The search yielded 1357 publications. Nine studies from four different countries met inclusion criteria. Of those, only one had the primary goal of simultaneously improving drinking and a related family-level outcome (IPV). Six of the studies documented modest improvements on both drinking and couples or family outcomes. Strategies common to these included cognitive-behavioral techniques, communication skills training, narrative therapy, and participatory learning. Gender-transformative approaches were associated with reduced IPV and more equitable gender norms, and motivational interviewing and behavioral approaches were beneficial for reducing alcohol use. CONCLUSIONS Findings highlight the scarcity of interventions addressing men's drinking and its effects on families, particularly for parent-child outcomes. However, results point to strategies that, combined with other evidence-based family interventions can guide the development and rigorous evaluation of integrated programs.
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Lau A, Barnett M, Stadnick N, Saifan D, Regan J, Wiltsey Stirman S, Roesch S, Brookman-Frazee L. Therapist report of adaptations to delivery of evidence-based practices within a system-driven reform of publicly funded children's mental health services. J Consult Clin Psychol 2017; 85:664-675. [PMID: 28471210 PMCID: PMC5501960 DOI: 10.1037/ccp0000215] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined clinical adaptations reported by community therapists to multiple evidence-based practices (EBPs) currently implemented in children's mental health services. Based on an item set informed by Stirman and colleagues' model (2015), 2 factors emerged describing Augmenting adaptations and Reducing/Reordering adaptations. We used multilevel modeling to examine therapist- and practice-level predictors of therapist reports of each type of adaptation. METHOD Data were drawn from an online survey, including a novel therapist report measure of EBP adaptations, completed by 572 therapists (89.2% female, Mage = 37.08 years, 33.4% non-Hispanic White) delivering EBPs in the context of a system-driven, fiscally mandated implementation effort. RESULTS Analyses revealed that the 2 types of therapist adaptations (Augmenting and Reducing/Reordering) could be readily discriminated, with therapists reporting significantly more Augmenting than Reducing/Reordering adaptations. Therapists of Hispanic/Latino ethnicity and with fewer years of experience reported more extensive Augmenting adaptations, but no therapist background characteristics were associated with Reducing/Reordering adaptations. Therapists' general attitudes that EBPs diverged from their personal approach to therapy were associated with reporting more Augmenting and Reducing/Reordering adaptations. In contrast, negative perceptions toward the specific EBP predicted Reducing/Reordering adaptations, but not Augmenting adaptations. CONCLUSIONS Community therapist reports suggest that most adaptations undertaken involve engaging with the practice to augment the fit of the EBPs for local contexts; however, when practices were perceived negatively, therapists were more likely to make adaptations reducing or rearranging components. (PsycINFO Database Record
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Affiliation(s)
- Anna Lau
- Department of Psychology, University of California, Los Angeles
| | - Miya Barnett
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara
| | - Nicole Stadnick
- Department of Psychiatry, Child and Adolescent Services Research Center, University of California, San Diego
| | - Dana Saifan
- Department of Psychology, University of California, Los Angeles
| | | | | | - Scott Roesch
- Department of Psychology, San Diego State University
| | - Lauren Brookman-Frazee
- Department of Psychiatry, Child and Adolescent Services Research Center, University of California, San Diego
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Shernoff ES, Bearman SK, Kratochwill TR. Training the Next Generation of School Psychologists to Deliver Evidence-Based Mental Health Practices: Current Challenges and Future Directions. SCHOOL PSYCHOLOGY REVIEW 2017. [DOI: 10.17105/spr-2015-0118.v46.2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Shernoff ES, Bearman SK, Kratochwill TR. Training the Next Generation of School Psychologists to Deliver Evidence-Based Mental Health Practices: Current Challenges and Future Directions. SCHOOL PSYCHOLOGY REVIEW 2017. [DOI: 10.17105/spr-2015-0118.v46-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Weist MD, Bruns EJ, Whitaker K, Wei Y, Kutcher S, Larsen T, Holsen I, Cooper JL, Geroski A, Short KH. School mental health promotion and intervention: Experiences from four nations. SCHOOL PSYCHOLOGY INTERNATIONAL 2017. [DOI: 10.1177/0143034317695379] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
All around the world, partnerships among schools and other youth-serving systems are promoting more comprehensive school-based mental health services. This article describes the development of international networks for school mental health (SMH) including the International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS) and the more recent School Mental Health International Leadership Exchange (SMHILE). In conjunction with World Conferences on Mental Health Promotion, SMHILE has held pre-conference and planning meetings and has identified five critical themes for the advancement of global SMH: 1) Cross-sector collaboration in building systems of care; 2) meaningful youth and family engagement; 3) workforce development and mental health literacy; 4) implementation of evidence-based practices; and 5) ongoing monitoring and quality assurance. In this article we provide general background on SMH in four nations, two showing strong progress (the United States and Canada), one showing moderate progress (Norway), and one beginning the work (Liberia). Following general background for each country, actions in relation to the SMHILE themes are reviewed. The article concludes with plans and ideas for future global collaboration towards advancement of the SMH field.
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Abstract
The emotional health and wellbeing of children and adolescents and their families is of utmost importance. Pediatricians are at the front line in identifying mental illness in children and adolescents and either linking them to resources in the community or providing treatment options themselves. Collaboration and integrative health care models is the cornerstone of effective strategies to provide access and quality mental health care to children and families in communities across the country.
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Lyon AR, Koerner K. User-Centered Design for Psychosocial Intervention Development and Implementation. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016; 23:180-200. [PMID: 29456295 PMCID: PMC5812700 DOI: 10.1111/cpsp.12154] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The current paper articulates how common difficulties encountered when attempting to implement or scale-up evidence-based treatments are exacerbated by fundamental design problems, which may be addressed by a set of principles and methods drawn from the contemporary field of user-centered design. User-centered design is an approach to product development that grounds the process in information collected about the individuals and settings where products will ultimately be used. To demonstrate the utility of this perspective, we present four design concepts and methods: (a) clear identification of end users and their needs, (b) prototyping/rapid iteration, (c) simplifying existing intervention parameters/procedures, and (d) exploiting natural constraints. We conclude with a brief design-focused research agenda for the developers and implementers of evidence-based treatments.
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Interpreting Progress Feedback to Guide Clinical Decision-Making in Children's Mental Health Services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 43:199-206. [PMID: 25627140 DOI: 10.1007/s10488-015-0630-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Measurement feedback systems (MFSs) can help improve clinical outcomes by enhancing clinical decision-making. Unfortunately, limited information exists to guide the use and interpretation of data from MFSs. This study examined the amount of data that would provide a reasonable and reliable prediction of a client's rate of symptomatology in order to help inform clinical decision-making processes. Results showed that use of more data predicted greater levels of accuracy. However, there were diminishing returns on the ability for additional data to improve predictive accuracy. Findings inform efforts to develop guidelines on the interpretation of data from MFSs.
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A School-Based Post-Katrina Therapeutic Intervention. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2014; 42:363-72. [DOI: 10.1007/s10488-014-0576-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lyon AR, Ludwig K, Romano E, Koltracht J, Vander Stoep A, McCauley E. Using modular psychotherapy in school mental health: provider perspectives on intervention-setting fit. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 43:890-901. [PMID: 24134063 DOI: 10.1080/15374416.2013.843460] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The "fit" or appropriateness of well-researched interventions within usual care contexts is among the most commonly cited, but infrequently researched, factors in the successful implementation of new practices. The current study was initiated to address two exploratory research questions: How do clinicians describe their current school mental health service delivery context? and How do clinicians describe the fit between modular psychotherapy and multiple levels of the school mental health service delivery context? Following a year-long training and consultation program in an evidence-based, modular approach to psychotherapy, semistructured qualitative interviews were conducted with 17 school-based mental health providers to evaluate their perspectives on the appropriateness of implementing the approach within a system of school-based health centers. Interviews were transcribed and coded for themes using conventional and directed content analysis. Findings identified key elements of the school mental health context including characteristics of the clinicians, their practices, the school context, and the service recipients. Specific evaluation of intervention-setting appropriateness elicited many comments about both practical and value-based (e.g., cultural considerations) aspects at the clinician and client levels but fewer comments at the school or organizational levels. Results suggest that a modular approach may fit well with the school mental health service context, especially along practical aspects of appropriateness. Future research focused on the development of methods for routinely assessing appropriateness at different stages of the implementation process is recommended.
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