Psychological Services最新文献

For rural women veterans, significant barriers exist in accessing high-quality, multicomponent behavioral pain self-management interventions. As such, a telehealth behavioral pain self-management intervention designed specifically for rural-dwelling women veterans with chronic pain was piloted for this study. This mixed methods, single-arm preliminary study examined the feasibility and acceptability of this intervention and completed a responder analysis. Participants completed surveys before and 1-month following the intervention, and they completed a qualitative interview following the intervention. About one quarter (24%) of potentially eligible participants who were sent a letter about the study consented to participate (N = 44). All participants identified as female and were rural dwelling, with mean age of 56 years (range = 34-80), and the majority of the sample (81%) self-identified as White and non-Hispanic or Latino. Average baseline scores on the Pain, Enjoyment of Life, and General Activity three-item scale (PEG-3) measure indicated severe pain and functional interference (M_{PEG-3 total} = 6.88, SD = 1.62). Of the 44 participants who consented, 70% completed the intervention. About half of treatment completers (47%, 14/30) were deemed responders, reporting ≥ 30% reduction on their PEG-3 total scores. On the Global Impression of Change scale, 87% reported improvement. Study completers indicated that the telehealth platform facilitated their engagement and that they perceived the intervention to be beneficial and credible. Qualitative data emphasized themes of connection with other women veterans who experienced chronic pain while perceiving a retained sense of individual identity. These preliminary data support feasibly of this intervention for rural-dwelling women veterans with chronic pain. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Across the United States, polarizing politics have contributed to the increased stigmatization of transgender (trans) and gender expansive (TGE) youth, reinforcing health inequities for this population. Although lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) youth centers have often served as places of refuge for young people across the gender spectrum, literature has yet to show how practices and strategies used in these settings promote TGE affirmation. This qualitative study explores youth and staff experiences within these settings; identifies the services, policies, and environments needed to support TGE community members; and ultimately calls for the expansion of the limited research on TGE experience and affirmation across such spaces. Using data collected in a larger study on affirming practices for LGBTQ+ youth, this article presents findings from in-depth, semistructured focus groups and interviews with TGE (n = 12) youth and staff (n = 12) across four LGBTQ+ community-based organizations in two large urban centers. Study findings show these organizations provide TGE affirmation through language, programming, and atmospheres of openness to identity exploration. Essential to these offerings are organizational policy mandates, such as correct pronoun usage and TGE-specific programming. Youth often juxtapose their experiences of affirmation within LGBTQ+ spaces with experiences of invalidation from the cisheteronormative cultures within their school or home environments. Implications for future practice and research include administering ongoing training on TGE-affirming language and developing comprehensive accountability measures (e.g., TGE-inclusive community guidelines). Institutions with these systems in place are well-equipped to contribute to the fight for trans liberation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Artificial intelligence is a useful tool for examining suicidality on social media, where people share their thoughts. However, existing research has primarily focused on text analysis to predict risk in single posts and raised privacy concerns. This study aimed to use text, images, and user features on Instagram to predict the risk of each user in Hawaii with user permission. One hundred forty-two participants completed online questionnaires about their current suicidal ideation. With their consent, their Instagram data were collected to train Artificial intelligence model to predict suicidal ideation of each user. Thirty-three (23.2%) participants reported having current suicidal ideation. The best model predicts suicidal ideation with 52% sensitivity, 92% specificity, 65% positive predictive value, and 82% accuracy. The significant predictors were negative description, lower hue and more red in an image, fewer nature and sky images, more art, fashion, a close-up of a body part, and spoof content in an image. These findings highlight the potential of suicide prediction on social media, which help mental health providers plan patient online interventions and appointments. Additionally, the influence of Hawaii's unique social-cultural context on significant predictors, helping gatekeepers to recognize signs of suicide on the social media of people in Hawaii. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Veteran suicide is a public health crisis. Suicide rates for U.S. veterans have remained disproportionately higher than their nonveteran counterparts during the last 2 decades (White House, 2023; U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, Community-Based Interventions for Suicide Prevention, 2022). Additionally, the majority of veterans who die by suicide are not engaged in care from the Veterans Health Administration (U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, 2023). Veterans Health Administration's Suicide Prevention 2.0 (SP 2.0) was developed to address this problem through a combination of clinical and community-based efforts that form a comprehensive public health approach for veteran SP (Carroll et al., 2020). In this article, the authors briefly outline the national, regional, and local program development of VA's Community-Based Interventions for SP within SP 2.0. Then, they describe local-level program development and implementation of the Community Engagement and Partnership Coordinators. Community Engagement and Partnership Coordinators are tasked with developing and facilitating coalitions with local agencies and organizations aimed at reducing suicide risk among service members, veterans, and their families. The authors review the implementation of this program from 2020 to 2024 and then suggest directions for future program evaluation and research on the impact of this approach in preventing veteran suicide. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Veterans' reluctance to engage in mental health treatment coupled with high attrition in such treatment should motivate practitioners and researchers to create innovative ways to treat veterans. Nature-based interventions show promise as a means for addressing veterans' mental health needs. The present study aimed to test the feasibility and acceptability of a manualized nature-based mindfulness intervention for veterans with mental illness. The authors hypothesized that veterans participating in the outdoor, nature-based intervention would report greater reductions in posttraumatic stress disorder symptoms and psychological distress compared to those participating in an indoor mindfulness intervention. Recruited from a Veterans Affairs health care center, 41 veterans with diagnosed mental illness were randomized to either a six-session outdoor group mindfulness intervention or a comparable six-session group mindfulness intervention delivered indoors at the Veterans Affairs. A t test and chi-square tests were used to examine treatment session attendance and treatment completer status. An intent-to-treat framework was used to assess between-group differences by fitting separate generalized linear mixed models with robust estimation for the outcomes of posttraumatic stress disorder symptoms, psychological distress, sense of restoration, and nature connectedness. Results showed that, while the average number of training sessions attended did not statistically differ by group, the number of treatment completers did; there were more treatment completers in the outdoor group. Additionally, linear mixed modeling with robust estimation revealed a significant Condition × Time interaction for posttraumatic stress disorder symptoms. The findings of this research demonstrate that nature-based interventions show promise as an approach to treating veteran mental illness while combating mental health care stigma and increasing treatment completion rates. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This study outlines the development and implementation of a law enforcement led, co-responder program that occurred in one Florida county from 2017 to 2021. The goal was to reduce involuntary commitment (i.e., Baker Act) examinations initiated by frontline officers. The program was embedded in the sheriff's office, designed for youth under the age of 18, and relied on licensed therapists to provide on-scene crisis de-escalation assistance to responding officers. First, we describe the strategic planning process which included a survey of sworn officers and dispatchers (n = 165), semistructured interviews with the chain of command (n = 30), and analysis of months of administrative records. Then, we report findings from 29 months of program implementation. Data describing 206 juvenile mobile crisis responses, youths' suicidal risk factors, and involuntary commitment decisions are presented, as well as monthly and yearly trends in recorded calls for service that involve a youth experiencing a mental health crisis and their dispositions (i.e., involuntary commitment or de-escalation). A reduction in the rate of involuntary commitment examinations made by frontline officers, timely on-scene arrival by a mental health professional, and clear alignment in suicide risk severity and response dispositions were some of the observed benefits of the program. We highlight the critical role that police mental health collaborations have in providing effective care for youth in crisis and emphasize the critical role that these initiatives will play in the future. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The goal of this study was to examine the cost-effectiveness of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), including prolonged exposure and cognitive processing therapy, by comparing four delivery modalities: home-based telehealth (patient in home), office-based telehealth (patient in one office, provider in another), in-home in-person, and in-office in-person. Pooled data from 268 veterans enrolled in two harmonized PTSD clinical trials were used to examine costs related to personnel, travel mileage, and office space. Cost-effectiveness was calculated using an incremental cost-effectiveness ratio that included unadjusted medians of cost differences between modalities and percent change in clinical outcomes. K-sample equality of medians tests were used to ascertain statistical significance in differences across treatment modalities for the total cohort, as well as for cohorts based on greater baseline PTSD severity (baseline Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, score ≥39 points), for the half of participants who did not respond as well to therapy, and for those who experienced reliable change in PTSD symptoms. The median incremental cost-effectiveness ratio was -$81 across all treatment modalities, -$92 for in-office in-person, -$92 for home-based telehealth, -$131 for office-based telehealth, and -$55 for in-home in-person. Sensitivity analyses examining baseline PTSD severity and responder status are also presented. Cost-effectiveness differed across treatment modalities, but only for those who were considered treatment responders. Shared decision making can help clinicians determine the best therapy delivery approach for each patient suffering from PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Even after intensive trainings, human and health service professionals may not optimally take up new approaches, such as motivational interviewing (MI). To decrease this knowledge-action gap, scaffolding of learning MI has been proposed. We developed (a) a workbook that aimed to boost MI uptake from the perspective of practitioner behavior change using goal setting, planning, self-monitoring, and social support and (b) structured peer group sessions to support this scaffolded learning process. We examine participants' perceptions of and engagement with these components and whether the use of workbook and peer group meetings was associated with changes in participants' MI skills. Social workers (n = 33) participated in an MI training over 2 months and responded to a survey about engagement at midintervention. At baseline and postintervention, real or simulated conversations with service users were assessed using the social work and interviewing motivationally coding system to identify the use of MI skills. Survey responses were aggregated into an engagement index, and its relationship to mean social work and interviewing motivationally assessed skill change was explored, using visualization methods in R. Approximately half of the respondents found the workbook useful for learning MI, while the other half reported that the workbook was difficult to use. The use of the workbook and peer group support was positively but modestly associated with skill improvement. Structured program to support behavior change to take up MI can improve training results. Basing training materials on both behavior change science strategies and feedback from the trainees has the potential to overcome the knowledge-action gap in MI trainings and promote sustained, high-quality training results. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Transgender and gender diverse (TGD) people are at increased risk for suicide. Gender minority stress is associated with suicidal ideation (SI), and lack of social connection mediates this relationship. However, these associations have largely been studied in nonclinical samples and without also considering social connection as a resilience factor. The present study tested the relationships among minority stress, social connection, and SI among a sample of inpatient TGD adults. Fifty participants completed measures of proximal and distal gender minority stress, community connectedness, thwarted belongingness, perceived burdensomeness (PB), and SI. Structural equation modeling was employed to determine mediators of the relationship between gender minority stress and SI. Proximal, but not distal, minority stress was significantly correlated with SI. The proximal minority stress-SI relationship was partially mediated by PB but not thwarted belongingness. Community connectedness was also a mediator when explored in isolation; however, when community connectedness was included in the model along with thwarted belongingness and PB, only PB remained as a significant mediator. Proximal minority stress and PB are potential treatment mechanisms for reducing SI among inpatient TGD adults. Bolstering social connection with other TGD individuals may also lessen the negative impacts of proximal gender minority stress. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The Department of Veterans Affairs requires integrated mental health (MH) services across programs, including 132 facility nursing homes (community living centers, CLCs). As part of a national survey of CLC MH providers in the fall of 2022, which aimed to characterize CLC MH practice patterns and service integration, information was also shared regarding the impact of the COVID-19 pandemic in CLC. The aim of this article was to present qualitative feedback from CLC MH providers regarding MH service integration and interdisciplinary teamwork in the CLC during the pandemic. Response rate to the entire survey was 48%. Out of the 107 survey participants, 82 responded to open-ended survey questions; of these, 71 (87%) were psychologists, and 11 (13%) were psychiatric providers. This analysis focuses on presents two major themes: (a) impact of the COVID-19 pandemic on CLC MH providers, staff, and veterans and (b) importance of team morale and functioning. In their feedback, CLC MH providers emphasized the importance of broad stakeholder engagement, including MH providers, in addressing a public health crisis in ways that optimize person-centered care, strong interdisciplinary team functioning, and support from leaders. Findings highlight the importance of MH integration in the nursing home setting, especially during times of crisis such as the pandemic. (PsycInfo Database Record (c) 2026 APA, all rights reserved).