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Calvete E, Fernández-González L, Orue I. A Growth Mindset and Self-Affirmation Intervention to Reduce Violent and Risky Online Behaviors: The Moderating Role of Previous Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5875-5901. [PMID: 36213954 DOI: 10.1177/08862605221127221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The Internet is the setting for several forms of violent and risky behavior among adolescents, such as cyberbullying, sexualized interactions with adults, sexting, and online dating violence. Often, these behaviors are responses to experiences of online victimization. This study examined the differential effects of a wise intervention (WI), combining growth mindset and self-affirmation strategies, on these behaviors for adolescents who had experienced victimization and those who had not. A sample of 1,085 adolescents (54.3% girls; ages 11-18 years) were randomized into two intervention conditions (WI and an anti-stress control intervention). They completed measures of violent and risky behaviors at pretest and at 3- and 6-month follow-ups and measures of victimization at pretest. The results of multilevel analyses indicated that the WI was beneficial for adolescents without experiences of victimization at pretest, as they displayed smaller increases in online peer aggressions, sexualized interactions with adults, and sexting than the adolescents in the control condition. However, the WI was not beneficial for adolescents with experiences of victimization at pretest. Moreover, the adolescents under the anti-stress control condition displayed better outcome. These findings suggest that previous victimization experiences of adolescents should be considered to select an appropriate intervention.
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2
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De Ossorno Garcia S, Edbrooke-Childs J, Salhi L, Ruby FJM, Sefi A, Jacob J. Examining concurrent validity and item selection of the Session Wants and Needs Outcome Measure (SWAN-OM) in a children and young people web-based therapy service. Front Psychiatry 2023; 14:1067378. [PMID: 36846241 PMCID: PMC9947788 DOI: 10.3389/fpsyt.2023.1067378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/16/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Single-session mental health interventions are frequently attended by children and young people (CYP) in both web-based and face-to-face therapy settings. The Session "Wants" and "Needs" Outcome Measure (SWAN-OM) is an instrument developed in a web-based therapy service to overcome the challenges of collecting outcomes and experiences of single-session therapies (SSTs). It provides pre-defined goals for the session, selected by the young person prior to the intervention, on which progress toward achievement is scored at the end of the session. OBJECTIVE The objective of this study was to evaluate the instrument's psychometric properties, including concurrent validity against three other frequently used outcome and experience measures, at a web-based and text-based mental health service. METHODS The SWAN-OM was administered for a period of 6 months to 1,401 CYP (aged 10-32 years; 79.3% white; 77.59% female) accessing SST on a web-based service. Item correlations with comparator measures and hierarchical logistic regressions to predict item selection were calculated for concurrent validity and psychometric exploration. RESULTS The most frequently selected items were "Feel better" (N = 431; 11.61%) and "Find ways I can help myself" (N = 411; 11.07%); unpopular items were "Feel safe in my relationships" (N = 53; 1.43%) and "Learn the steps to achieve something I want" (N = 58; 1.56%). The SWAN-OM was significantly correlated with the Experience of Service Questionnaire, particularly the item "Feel better" [rs(109) = 0.48, p < 0.001], the Youth Counseling Impact Scale, particularly the item "Learn the steps to achieve something I want" [rs(22) = 0.76, p < 0.001], and the Positive and Negative Affect Schedule, particularly the items "Learn how to feel better" [rs(22) = 0.72, p < 0.001] and "Explore how I feel" [rs(70) = -0.44, p < 0.001]. CONCLUSION The SWAN-OM demonstrates good concurrent validity with common measures of outcome and experience. Analysis suggests that lesser-endorsed items may be removed in future iterations of the measure to improve functionality. Future research is required to explore SWAN-OM's potential to measure meaningful change in a range of therapeutic settings.
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Affiliation(s)
| | - Julian Edbrooke-Childs
- Anna Freud Centre, CORC, London, United Kingdom.,Evidence Base Practice Unit (EBPU), University College London, London, United Kingdom
| | - Louisa Salhi
- Kooth Plc, London, United Kingdom.,School of Psychology, University of Kent, Canterbury, Kent, United Kingdom
| | | | - Aaron Sefi
- Kooth Plc, London, United Kingdom.,Department of Psychology, University of Exeter, Exeter, Devon, United Kingdom
| | - Jenna Jacob
- Anna Freud Centre, CORC, London, United Kingdom
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3
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Holzman JBW, Hawks JL, Kennedy SM, Anthony BJ, Anthony LG. Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth. Behav Modif 2022; 47:128-153. [PMID: 35707864 PMCID: PMC10076234 DOI: 10.1177/01454455221103226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.
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Affiliation(s)
- Jacob B W Holzman
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Jessica L Hawks
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Sarah M Kennedy
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Bruno J Anthony
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Laura G Anthony
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
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4
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Flynn KC, Riske-Morris M, Hussey DL. Opportunities to improve behavioral health crisis response: Results of a large urban county's community status assessment. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1008-1027. [PMID: 34428323 DOI: 10.1002/jcop.22697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
A comprehensive community status assessment of an Ohio urban county's crisis response (CR) system explored the experiences of its behavioral health services' clients and providers to surface themes characterizing the system's responsiveness and identifying opportunities for improvements. Forty-eight focus groups and two online surveys were conducted. Data were analyzed using qualitative content analysis and descriptive statistics. The greatest areas of needed improvement ascertained by this effort are in increased CR system resources, more efficient use of resources, and capacity enhancements in nine areas: the mobile crisis team, CR protocols, psychiatric inpatient and crisis stabilization beds, stabilization admission for eligible persons, stabilization services for in-crisis but admission-ineligible persons, continuity of care, research into child versus adult CR systems, Provider Emergency Support Program, and first responder crisis intervention training. The assessment provides a foundation for the county to identify further opportunities for system scale-up.
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Affiliation(s)
- Karen Coen Flynn
- Begun Center for Violence Prevention Research and Education, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michelle Riske-Morris
- Begun Center for Violence Prevention Research and Education, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - David L Hussey
- Begun Center for Violence Prevention Research and Education, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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5
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Abdul-Adil J, Suárez LM. The Urban Youth Trauma Center: A Trauma-Informed Continuum for Addressing Community Violence Among Youth. Community Ment Health J 2022; 58:334-342. [PMID: 33870469 PMCID: PMC8053560 DOI: 10.1007/s10597-021-00827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 04/09/2021] [Indexed: 11/29/2022]
Abstract
Contemporary community violence has escalated into a national public health crisis with urban youth, particularly ethnic minorities, suffering disproportionate negative impacts. The Urban Youth Trauma Center (UYTC) promotes a trauma-informed continuum of prevention-to-intervention services that combines community-based and clinic-based manualized protocols designed to reduce and prevent community violence for youth and families. Based on a socio-ecological model, UYTC has the main goals of addressing community violence and related traumatic stress as well as co-occurring conditions of substance abuse and disruptive behavior problems in urban youth by: (1) raising public awareness; (2) disseminating specialized trauma-informed training; and (3) mobilizing service system coalitions. UYTC employs this evidence-based yet flexible structure for disseminating, implementing, and evaluating trauma-informed training as a means of contributing to the reduction and prevention of community violence for low-income urban minority youth and families who bear the biggest burden of this current crisis.
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Affiliation(s)
- Jaleel Abdul-Adil
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, 1747 West Roosevelt Road, Mail Code 747, Chicago, IL, 60608, USA.
| | - Liza M Suárez
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, 1747 West Roosevelt Road, Mail Code 747, Chicago, IL, 60608, USA
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6
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Wittenborn AK, Holtrop K. Introduction to the special issue on the efficacy and effectiveness of couple and family interventions: Evidence base update 2010-2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:5-22. [PMID: 34904252 DOI: 10.1111/jmft.12576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 05/14/2023]
Abstract
This is the fourth Journal of Marital and Family Therapy (JMFT) special issue on the efficacy and effectiveness of couple and family therapy. Articles in this issue review studies published from 2010 to 2019 on couple and family interventions for prevalent mental and behavioral disorders and health conditions. The final article on mental health disparities tracks progress in the field and emphasizes the need for additional attention. In the current article, we provide a description of our methodological approach for the special issue and an overview of the state of the evidence for couple and family interventions across the conditions reviewed. We also offer recommendations to inspire researchers to further expand the empirical support for couple and family interventions to address pressing public health needs.
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Affiliation(s)
- Andrea K Wittenborn
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Kendal Holtrop
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
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7
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de Ossorno Garcia S, Salhi L, Sefi A, Hanley T. The Session Wants and Need Outcome Measure: The Development of a Brief Outcome Measure for Single-Sessions of Web-Based Support. Front Psychol 2021; 12:748145. [PMID: 34777142 PMCID: PMC8588807 DOI: 10.3389/fpsyg.2021.748145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
Single-session, brief interventions in therapy for young people make up a large proportion of service provision, including in digital mental health settings. Current nomothetic mental health measures are not specifically designed to capture the benefit or ‘change’ directly related to these brief interventions. As a consequence, we set out to design an outcome measure to concretely demonstrate the value of single-session interventions. The Session Wants and Needs Outcome Measure (SWAN-OM) aims to capture in-session goals and focuses on being user-centric, elements critical to the success of single-session and brief interventions which typically are asset-based and solution-focused. We describe the 4-stage process that was followed to develop this measure: (I) classical item generation and development, (II) content and (III) face validity pilot testing, and (IV) a user-experience approach with young people using framework analysis. This final stage was critical to ensure the integration of this outcome tool into a web-based digital therapy setting, a context which adds another layer of design complexity to item and measure development. This iterative methodology was used to overcome the challenges encountered and to place the needs of the young people and service practitioners at the centre of the design process, thus ensuring measure usability. To end, we highlight the main lessons learnt from engaging in this design process. Specifically, the needs of a measure for single-session interventions are considered, before outlining the learning associated with integrating the measure into a digital mental health platform. Both of these areas are emerging fields and, as such, this study contributes to our understanding of how an idiographic patient outcome theory driven measure can be created for use in a web-based digital mental health therapy service.
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Affiliation(s)
| | - Louisa Salhi
- Kooth plc, London, United Kingdom.,School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Aaron Sefi
- Kooth plc, London, United Kingdom.,Department of Psychology, University of Exeter, Devon, United Kingdom
| | - Terry Hanley
- School of Environment, Education and Development, The University of Manchester, Manchester, United Kingdom
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8
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Graaf G, Accomazzo S, Matthews K, Mendenhall A, Grube W. Evidence Based Practice in Systems of Care for Children with Complex Mental Health Needs. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:394-412. [PMID: 33827388 DOI: 10.1080/26408066.2021.1891172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: Community-based social work with families and youth with complex behavioral health needs highlights challenges to incorporating empirical evidence into routine practice. This article presents a framework for integrating evidence in community-based Systems of Care for these children and their families.Method: This article reviews research on various approaches to integrating evidence into children's behavioral health and community-based care and contextualizes it within dominant paradigms of Systems of Care (SoC) and Wraparound principles.Results: Based on this review, this article proposes the Evidence-Based Practice in Systems of Care (EBP in SoC) model. The model describes how to incorporate evidence into every aspect of community-based SoCs for children with mental health concerns.Discussion and Conclusion: Discussion of the model will focus on implications of using the framework for practitioners, mental health organizations, communities, and state and federal administration and policymaking.
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Affiliation(s)
- Genevieve Graaf
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Sarah Accomazzo
- School of Social Welfare, University of Kansas, Lawrence, USA
| | - Kris Matthews
- School of Social Welfare, University of Kansas, Lawrence, USA
| | - Amy Mendenhall
- School of Social Welfare, University of Kansas, Lawrence, USA
| | - Whitney Grube
- School of Social Welfare, University of Kansas, Lawrence, USA
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9
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Rusch D, Walden AL, DeCarlo Santiago C. A Community-Based Organization Model to Promote Latinx Immigrant Mental Health Through Advocacy Skills and Universal Parenting Supports. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:337-346. [PMID: 32880968 DOI: 10.1002/ajcp.12458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The unique mental health context of children in Latinx immigrant families calls for innovative community-based intervention strategies. We use an ecological public health approach to highlight the importance of community-based organization (CBO) settings, the critical role of community-based paraprofessionals (i.e., non-clinicians, near-peers) and capacity-building, and the expansion of mental health promotion strategies to include realistic, day-to-day supports for Latinx immigrant parents and families. This realigns mental health with the goals and mission of trusted spaces, like CBOs, that can offer more equitable and non-stigmatized access for Latinx immigrant families. We draw upon two strength-based and empowerment-focused interventions that utilize community-based workforces to promote positive parenting skills (Partners Achieving Student Success-PASS; Mehta et al., 2019) and self-advocacy skills (Community Advocacy Project-CAP; Sullivan & Bybee, 1999) to provide the conceptual framework for Family Mental Health Advocacy (FMHA). FMHA aligns mental health promotion with the advocacy mission of CBOs, engages CBO staff with feasible mental health "messages," and empowers immigrant parents as critical change agents in the lives of their children. We acknowledge the challenges associated with implementing mental health promotion strategies and providing workforce support, as well as the importance of local and national policy influences.
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Affiliation(s)
- Dana Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Angela L Walden
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
- Office of the Vice Provost for Diversity, University of Illinois at Chicago, Chicago, IL, USA
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10
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Hoagwood KE, Purtle J, Spandorfer J, Peth-Pierce R, Horwitz SM. Aligning dissemination and implementation science with health policies to improve children's mental health. AMERICAN PSYCHOLOGIST 2020; 75:1130-1145. [PMID: 33252950 PMCID: PMC8034490 DOI: 10.1037/amp0000706] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The prevalence of mental health problems among children (ages 0-21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build "health in all policies" to address broad familial, social, and economic factors known to affect children's healthy development and mental health. These health policy initiatives offer a rare opportunity to repurpose D&I science, shifting it from a primary focus on evidence-based practice implementation, to a focus on policy development and implementation to support child and family health and well-being. This shift is critical as states develop policy responses to address the health and mental health impacts of the COVID-19 pandemic on already-vulnerable families. We provide a typology for building research on D&I and children's mental health policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University
| | - Julia Spandorfer
- Department of Child and Adolescent Psychiatry, New York University Langone Health
| | | | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University Langone Health
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11
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Vargas-Huicochea I, Álvarez-del-Río A, Rodríguez-Machain AC, Aguirre-Benítez EL, Kelsall N. Seeking Psychiatric Attention Among University Students with Mental Health Problems: the Influence of Disease Perception. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00380-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Schleider JL, Dobias ML, Sung JY, Mullarkey MC. Future Directions in Single-Session Youth Mental Health Interventions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:264-278. [PMID: 31799863 PMCID: PMC7065925 DOI: 10.1080/15374416.2019.1683852] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The United States spends more money on mental health services than any other country, yet access to effective psychological services remains strikingly low. The need-to-access gap is especially wide among children and adolescents, with up to 80% of youths with mental health needs going without services, and the remainder often receiving insufficient or untested care. Single-session interventions (SSIs) may offer a promising path toward improving accessibility, cost-effectiveness, and completion rates for youth mental health services. SSIs are structured programs that intentionally involve only one visit or encounter with a clinic, provider, or program; they may serve as stand-alone or adjunctive clinical services. A growing body of evidence supports the capacity of SSIs to reduce and prevent youth psychopathology of multiple types. Here, we provide a working definition of SSIs for use in future research and practice; summarize the literature to date on SSIs for child and adolescent mental health; and propose recommendations for the future design, evaluation, and implementation of SSIs across a variety of settings and contexts. We hope that this paper will serve as an actionable research agenda for gauging the full potential of SSIs as a force for youth mental health.
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Affiliation(s)
| | | | - Jenna Y. Sung
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | - Michael C. Mullarkey
- Department of Psychology, Stony Brook University, Stony Brook, NY
- Department of Psychology, University of Texas at Austin, Austin, TX
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Gaffney H, Mansell W, Tai S. Agents of change: Understanding the therapeutic processes associated with the helpfulness of therapy for mental health problems with relational agent MYLO. Digit Health 2020; 6:2055207620911580. [PMID: 32206331 PMCID: PMC7079311 DOI: 10.1177/2055207620911580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/07/2020] [Indexed: 11/15/2022] Open
Abstract
Objective To understand the therapeutic processes associated with the helpfulness of an online relational agent intervention, Manage Your Life Online (MYLO). Methods Fifteen participants experiencing a mental health related problem used Manage Your Life Online for 2 weeks. At follow-up, the participants each identified two helpful and two unhelpful questions posed by Manage Your Life Online within a single intervention session. Qualitative interviews were conducted and analyzed using thematic and content analysis to gain insight into the process of therapy with Manage Your Life Online. Results MYLO appeared acceptable to participants with a range of presenting problems. Questions enabling free expression, increased awareness, and new insights were key to a helpful intervention. The findings were consistent with the core processes of therapeutic change, according to Perceptual Control Theory, a unifying theory of psychological distress. Questions that elicited intense emotions, were repetitive, confusing, or inappropriate were identified as unhelpful and were associated with disengagement or loss of faith in Manage Your Life Online. Conclusions The findings provide insight into the likely core therapy processes experienced as helpful or hindering and outlines further ways to optimize acceptability of Manage Your Life Online.
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Affiliation(s)
- Hannah Gaffney
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Warren Mansell
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Sara Tai
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
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