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Blomquist KK, Wenze SJ, Fleming CJE, Ernestus SM. Assessing the need for pre-mental health competencies in undergraduate education: insights from graduate faculty surveys. Front Psychol 2024; 14:1252451. [PMID: 38250125 PMCID: PMC10797007 DOI: 10.3389/fpsyg.2023.1252451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Despite the value of clinical competencies for masters- and doctoral-level practitioners as well as the tremendous variability in preparedness for graduate school and at graduation from graduate school, there are no competency standards for students pursuing mental healthcare careers prior to graduate study. This study aimed to identify potential pre-mental health competency standards for undergraduates pursuing mental healthcare careers. Methods Faculty at masters and doctoral programs in a range of mental healthcare fields were asked to rate their expectations of entry-level competence and the perceived entry-level competence of their first-year, bachelor-level graduate students on 42 sub-competencies derived from the APA's Competency Benchmarks in Professional Psychology. Results Faculty of both masters (N = 320) and doctoral (N = 220) programs reported high expectations of first-year graduate students for 11 competency categories (professional values/attitudes; relationships; management-administration; interdisciplinary systems; individual/cultural diversity; advocacy; scientific knowledge and methods; reflective practice, self-assessment, and self-care; ethical standards and policy; supervision, and research/evaluation) and 25 sub-competencies. Faculty in masters programs rated students as not meeting their expectations in 28 sub-competencies, while faculty in doctoral programs rated students as not meeting their expectations in 17 sub-competencies. Faculty recommended internships as well as improvement in writing, counseling skills, professional behavior, diversity, equity, and inclusion, cultural competence and humility, research methods, reading research, connecting research to practice, and education about the different mental healthcare professions. Discussion Our findings suggest that students would benefit from intentional training in multiple pre-mental health competency areas at the undergraduate level to facilitate graduate-level training in mental healthcare and to better prepare our future clinicians.
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Affiliation(s)
| | - Susan J. Wenze
- Department of Psychology, Lafayette College, Easton, PA, United States
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Ernestus SM, Ellingsen R, Gray K, Aralis H, Lester P, Milburn NG. Evaluating the KidCOPE for Children in Active Duty Military Families. Child Psychiatry Hum Dev 2023; 54:76-83. [PMID: 34357501 DOI: 10.1007/s10578-021-01226-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 01/25/2023]
Abstract
The KidCOPE is a widely used measure designed to examine how children cope in the face of stressful events. The current study aimed to replicate the factor structure of the KidCOPE found in four prior studies. KidCOPE responses from children of military families (2256 children, ages 7-12 years, 47.9% female, Age M = 8.90, SD = 1.62) enrolled in the Families OverComing Under Stress (FOCUS) at baseline were used. No prior factor structure could be replicated. The sample was then split, and exploratory and confirmatory factor analyses were conducted. A 2-factor model including factors for generally positive and negative coping was identified; but not confirmed. Overall, this study supports prior research suggesting limitations of the KidCOPE as a valid measure of coping style.
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Affiliation(s)
- Stephanie M Ernestus
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA. .,Department of Psychology, Stonehill College, 320 Washington Street, North Easton, MA, 02357, USA.
| | - Ruth Ellingsen
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.,Department of Psychology, 1227 University of Oregon, Eugene, OR, 97403, USA
| | - Kristin Gray
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Hilary Aralis
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.,Department of Biostatistics, Fielding School of Public Health, University of California, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
| | - Patricia Lester
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Norweeta G Milburn
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
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Asarnow JR, Zullo L, Ernestus SM, Venables CW, Goldston DB, Tunno AM, Betz ME. "Lock and Protect": Development of a Digital Decision Aid to Support Lethal Means Counseling in Parents of Suicidal Youth. Front Psychiatry 2021; 12:736236. [PMID: 34690841 PMCID: PMC8528190 DOI: 10.3389/fpsyt.2021.736236] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/27/2021] [Indexed: 12/31/2022] Open
Abstract
Objective: Reducing access to lethal methods is an effective suicide prevention strategy that is often neglected in routine care. Digital interventions have shown promise for addressing such gaps in care; and decision aids have proven useful for supporting complicated health-related decisions, like those involving lethal means restriction. This article describes a parent/caregiver-facing web-based decision aid, the development process, and user testing. Method: A user-centered, participatory, mixed methods development design was employed. Beginning with an adult-focused decision aid developed by members of our team, we assessed ten iterations of the parent/caregiver decision aid with stakeholders (N = 85) using qualitative interviews and quantitative surveys. Stakeholders included: parents/caregivers whose children had histories of suicidal episodes before age 25, young adults with histories of suicidal thoughts/behaviors, firearm owners/representatives from firearm stores/ranges/groups, mental and medical health care providers, and emergency responders. Results: The final "Lock and Protect" decision aid was viewed as "useful for changing access to lethal means" by 100% of participants. Ninety-four percent of participants rated the information on reducing access to lethal means as good to excellent, and 91% rated the information on storage options as good to excellent. Qualitative feedback underscored a preference for offering this digital tool with a "human touch," as part of safety and discharge planning. Conclusions: "Lock and Protect" is a user-friendly web-based tool with potential for improving rates of lethal means counseling for parents/caregivers of suicidal youth and ultimately reducing pre-mature deaths by suicide.
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Affiliation(s)
- Joan R Asarnow
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lucas Zullo
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Chase W Venables
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Angela M Tunno
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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Siry BJ, Knoepke CE, Ernestus SM, Matlock DD, Betz ME. Lethal Means Counseling for Suicidal Adults in the Emergency Department: A Qualitative Study. West J Emerg Med 2021; 22:471-477. [PMID: 34125016 PMCID: PMC8203001 DOI: 10.5811/westjem.2021.8.49485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/08/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Lethal means counseling (to reduce access to firearms or other suicide methods) is a recommended critical yet challenging component of care of suicidal patients. Questions remain about communication strategies for those in acute crisis. Methods This qualitative study was an analysis of semi-structured interviews with English-speaking, community-dwelling adults with a history of lived-experience of suicidal ideation or attempts in themselves or a family member. We used a mixed inductive and deductive approach to identify descriptive themes related to communication and decision-making. Results Among 27 participants, 14 (52%) had personal and 23 (85%) had family experience with suicide ideation or attempts. Emergent themes fell into two domains: (1) communication in a state of high emotionality; and (2) specific challenges in communication: initiating, maintaining engagement, considering context. Conclusion Engaging suicidal individuals in lethal means counseling may be more effective when messaging and approaches consider their emotional state and communication challenges.
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Affiliation(s)
- Bonnie J Siry
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Christopher E Knoepke
- University of Colorado School of Medicine, Division of Cardiology, Aurora, Colorado.,University of Colorado School of Medicine, Adult & Child Consortium for Outcomes Research & Delivery Science, Aurora, Colorado.,University of Southern California, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California
| | | | - Daniel D Matlock
- University of Colorado School of Medicine, Adult & Child Consortium for Outcomes Research & Delivery Science, Aurora, Colorado.,University of Colorado School of Medicine, Department of Geriatric Medicine, Aurora, Colorado.,VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado
| | - Marian E Betz
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado.,VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado
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Wemm SE, Ernestus SM, Glanton Holzhauer C, Vaysman R, Wulfert E, Israel AC. Internalizing Risk Factors for College Students' Alcohol use: A Combined Person- and Variable-Centered Approach. Subst Use Misuse 2018; 53:629-640. [PMID: 28937921 PMCID: PMC6106781 DOI: 10.1080/10826084.2017.1355385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Most studies that investigate internalizing problems (i.e., depression and anxiety symptoms) and alcohol use disorders use variable-centered approaches, losing important information about differences among individuals. OBJECTIVES To group college students by different profiles of alcohol-use risk factors using a person-centered cluster analysis in two separate samples. METHODS Questionnaires were used in both studies to assess positive expectancies regarding alcohol use, coping motives for alcohol use, and symptoms of depression and anxiety. In the first study (2012), we collected information about past month alcohol use, including frequency and binge drinking episode (n = 171). In the second study (2013), we also included measures of externalizing behaviors and negative alcohol-related consequences (n = 526). RESULTS In Study 1, the cluster analysis identified four groups of students who displayed different patterns of risk: a low-risk group, moderate cognitions/low internalizing cluster, a high internalizing/low coping motives group of drinkers, and a high internalizing/high coping motives cluster of drinkers. This fourth group showed high levels of depression, moderate anxiety, high positive expectancies and coping motives for alcohol use, and reported the highest frequency of alcohol use. Study 2 replicated the findings from the previous study. Three groups of individuals were identified, replicating the low-risk cluster, the moderate cognitions/low internalizing cluster, and the internalizing cluster of drinkers from Study 1. Participants in the latter cluster endorsed the highest number of negative consequences of alcohol use. CONCLUSIONS Results from both studies highlight the importance of tailoring alcohol abuse prevention efforts to a subgroup young adult who endorse internalizing symptoms.
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Affiliation(s)
- Stephanie E Wemm
- a Department of Psychiatry , Yale University , New Haven, Connecticut , USA
| | - Stephanie M Ernestus
- b Semel Institute of Neuroscience and Human Behavior , University of California Los Angeles , Los Angeles , California , USA
| | - Cathryn Glanton Holzhauer
- c Department of Psychiatry , University of Massachusetts Medical School , Worcester , Massachusetts , USA
| | - Renata Vaysman
- d New York Police Department , New York , New York , USA
| | - Edelgard Wulfert
- e Psychology Department , University at Albany State University of New York , Albany , New York , USA
| | - Allen C Israel
- e Psychology Department , University at Albany State University of New York , Albany , New York , USA
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Ernestus SM, Prelow HM, Ramrattan ME, Wilson SA. Self-system Processes as a Mediator of School Connectedness and Depressive Symptomatology in African American and European American Adolescents. School Mental Health 2014. [DOI: 10.1007/s12310-014-9122-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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