Psychological Services最新文献

Interventions for substance use disorders (SUDs) are typically delivered face-to-face or remotely via telehealth. In recent years, there has been a rapid rise in the number of SUD services delivered using telehealth. However, the literature on which mode of service delivery SUD patients and providers prefer is still emerging, particularly with respect to family-based interventions in Opioid Treatment Programs (OTPs). This study sought to identify/explain preferences for delivering family-based programs among OTP patients and providers. Data collection from a total of 40 participants (20 patients and 20 providers) was conducted from August 2022 to October 2022 at two OTPs in Florida. An online survey was used to collect demographic data, while individual qualitative interviews were conducted to explore preferences for delivering family-based programs. Audiotapes of interviews were transcribed, coded, and thematically analyzed. Analyses revealed that patients and providers had similar preferences, with the most salient being (a) concerns about keeping children engaged during telehealth sessions, (b) concerns about communication barriers when using telehealth, (c) preference for telehealth using live video (as opposed to prerecorded content), and (d) preference for telehealth over face-to-face due to greater convenience for patients. These findings show that preferences for delivering family-based services are varied and may differ somewhat from preferences for delivering traditional individual therapy services. The data presented here can be used to develop and further refine protocols for adapting and delivering family-based interventions in OTP settings, and are especially timely as legislative discussions are currently occurring about expanding telehealth services in these facilities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Cognitive remediation (CR) for schizophrenia has been extensively studied and has proven effective in improving both cognition and functioning. Yet, implementation into mental health services is poor, with implementation and engagement barriers and facilitators not understood. The present study aimed to assess expert opinions on CR barriers and facilitators that pertain to staff, mental health services, and consumers. Thirty-seven international CR experts (clinicians/researchers) responded to Likert-scale questions on implementation and engagement facilitators, essential CR components, barriers in mental health facilities, barriers for clinicians, and barriers for consumer access and engagement across three rounds of a Delphi survey. The main barriers to CR implementation were (a) lack of staff training, (b) lack of perceived relevance/lack of knowledge about cognitive deficits in schizophrenia and CR usefulness in both clinicians and consumers, as well as (c) lack of staff employed in cognitive rehabilitation roles. The presence of defeatist beliefs and difficulty in accessing the place of delivery were both barriers to consumer engagement and access. The most important facilitators for CR were a good therapeutic alliance, CR delivered as part of integrated rehabilitation services, psychoeducation provided to families and stakeholders, and CR focusing on generalization of learning to everyday life. This study highlights the barriers to CR implementation from experts. A multitude of factors were identified that need attention. It is also apparent that CR cost-effectiveness studies are needed to facilitate organizational change and national guideline recommendations for improving mental health services policy around serious mental illness/schizophrenia health care provisions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

We examined beliefs and practices regarding firearm assessment and lethal means safety counseling (LMSC) among U.S. Air Force (USAF) mental health providers (MHPs) and behavioral health technicians (BHTs). Data were collected from 204 USAF MHPs (74.0%; n = 151) and BHTs (26.0%; n = 53) via an anonymous, voluntary survey. A modest proportion indicated they strongly/extremely believe that firearm ownership (42.2%) and storage practices (58.3%) are related to suicide risk. A minority indicated they "strongly"/"extremely" believe that LMSC will yield changes in storage practices (30.9%) and decreases in suicide risk (29.9%). Across patient scenarios, most indicated that "most of the time"/"always" they assess for firearm access (74.5%-99.5%) and provide LMSC (57.8%-95.6%). About half (52.5%) reported having distributed cable locks. Most (59.3%) indicated they are somewhat interested/very interested in receiving additional training on LMSC. MHPs, compared with BHTs, were significantly more likely to report believing a link between firearm ownership and storage practices and suicide risk, believing LMSC is effective at reducing suicide risk, providing LMSC to female patients and patients with current suicidal ideation, and having distributed cable locks. Findings suggest that there is not widespread agreement among USAF MHPs and BHTs that personal firearm ownership and nonsecure storage practices are associated with elevated suicide risk, and there were low levels of confidence in the effectiveness of LMSC. Yet, most USAF MHPs and BHTs reported they integrate firearm access assessment and LMSC as part of their routine clinical care, particularly for patients with identified suicide risk. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Understanding the prevalence of mental health concerns, rates of treatment access, and barriers to care can help identify strategies for improving mental health support and access. In a sample of U.S. military servicemembers, we examined (a) the rate and type of care sought for various mental health concerns and (b) barriers to care across presenting concerns. We conducted cross-sectional analyses using web-based survey data collected via population-based stratified random sampling from the Department of Defense 2018 Health-Related Behavior Survey (N = 33,641 U.S. military servicemembers, 67.1% male). We assessed the percentage of participants reporting a range of mental health concerns (e.g., posttraumatic stress disorder, suicidality, aggression, and alcohol problems) who received various treatments, perceived an unmet treatment need, and reported specific barriers to care. Treatment rates were highest for suicidality and posttraumatic stress disorder and lowest for alcohol binges, gambling problems, and risky sexual behavior. Practical difficulties with care access, concerns about confidentiality, and concerns about harm to career were among the most endorsed barriers across all mental health variables. Treatment rates were similar or slightly higher than previous findings for internalizing psychopathology, and rates were generally lower for externalizing behaviors. Significant treatment gaps persist for all mental health concerns examined. Organization-based interventions to enhance access to confidential care and allow time off for mental health treatment may help close treatment gaps for all mental health concerns. Prevention and intervention efforts should focus on raising awareness about the health and social consequences of externalizing behavior to encourage help-seeking from mental health professionals in these areas. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Veterans deployed in the post-9/11 wars in Iraq and Afghanistan (Operations Enduring Freedom, Iraqi Freedom, and New Dawn) face a multitude of challenges reintegrating into civilian life after military service. There is a need for evidence-based support programs to address the wide-reaching cognitive, psychological, and physical symptoms that can impede civilian reintegration. The present study incorporates quantitative and qualitative methods to assess veterans' experiences with two reintegration treatments (Short-Term Executive Plus-Home [SH] and Present Centered Group Therapy for Reintegration [PCGT-R]) within the context of a larger randomized clinical trial. A total of 131 veterans ages 24-65 years, drawn from the SH (n = 66) and PCGT-R (n = 65) treatment arms, completed quantitative feedback forms and qualitative interviews. Quantitative surveys indicated SH was more highly rated than PCGT-R in terms of program satisfaction (p < .01), helpfulness (p = .03), and connection to other Veterans Affairs (VA) services (ps < .05). Thematic qualitative analysis indicated that both interventions provided beneficial social support and that both groups appreciated online implementation. They also revealed that SH veterans acquired more emotion regulation and impulse control skills and reported greater willingness to engage in further VA treatments, than PCGT-R veterans. Dropout did not differ significantly between groups, and the most highly cited reasons for dropout among both groups were scheduling conflict and dislike of group formats. Findings emphasize the opportunity for group and skills-based interventions focused on reintegration to increase support and access to VA care among veterans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

With the rise in demand for mental health services and the changed landscape of post-COVID-19 therapy delivery, examining both therapy modality (e.g., individual, group) and delivery methods (e.g., in-person, remote) has become increasingly important. While empirical evidence generally supports equivalency of outcomes across modalities and delivery methods, there is less evidence regarding comparative preferences and perceptions of these variables. To begin to answer these questions, we surveyed a random sample of 777 university students at a large, western university. Congruent with the previous literature, results suggest that there is a strong preference for in-person individual therapy, in spite of the increased experience with teletherapy. We also found a strong reluctance to engage with group therapy. Demographic factors predicting modality and delivery preferences indicated that being older and a woman were associated with increased likelihood to prefer individual therapy (both in-person and teletherapy), and lower class standing was associated with a stronger preference for group therapy. The only symptoms predictor for preferences included higher levels of social anxiety being associated with a higher preference for online self-help. While those who had previously engaged in a particular type of therapy were typically two to three times more likely to prefer it in the future, those who had attended in-person group therapy were over five times more likely to prefer it in the future. Finally, perceptions of past experiences with in-person therapy were significantly more positive than experiences with teletherapy. We discuss the implications of these findings for future research and practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The high prevalence of major depressive disorder (MDD) combined with low treatment response supports continued research in this area. Electronic health records (EHR) are an important real-world data source for such MDD research, yet indicators of depression severity, a key confounder, are unreliably available. We examined the availability of depression severity indicators in the EHR and identified patient characteristics associated with having a severity indicator available for patients with an MDD diagnosis. We leveraged EHR data from academic health systems in Colorado and Utah from 2016 to 2021 to calculate the proportion of MDD encounters with a severity indicator from two sources in the EHR (diagnosis codes and Patient Health Questionnaire-9 total scores). We compared characteristics between patients with and without severity indicators using chi-square and t tests. We also estimated the proportional agreement between the two sources of severity. Among 1.55 million encounters with an MDD diagnosis from 2016 to 2021, 38% had a severity indicator available from the diagnosis code or Patient Health Questionnaire-9 total score. Availability increased from 28% in 2016 to 47% in 2021. Overall agreement was low at the MDD encounter level. Hispanic patients and those with anxiety, bipolar disorder, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and substance use disorder were more likely to have a severity indicator. While availability of depression severity in EHR data is increasing, it remains low. Researchers wanting to use depression severity data from the EHR should be cognizant of the potential impact of missing severity on their research and be cautious about using diagnosis codes and Patient Health Questionnaire-9 scores as indicators of severity in isolation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Criticisms of police use of force policies and the over policing of communities of color have generated calls to reallocate part of the funding that routinely goes to police departments to fund more social welfare programs. In particular, analysts and policy makers have supported the implementation of alternative crisis response programs, such as the use of unarmed behavioral health workers, to reduce police contact and improve mental health service provision to citizens. The present study examined the extent to which one such civilian-based 911 diversion program in St. Petersburg, Florida, called the Community Assistance and Life Liaison program, provides equitable access to communities in need. Through analysis of contact data (N = 6,653 contacts with residents) and zip code-level Census data of community characteristics, we found that the program diverted 37% of the noncrime crisis calls coming through the emergency communication line. The program additionally engaged in a substantial number of proactive and follow-up contacts, responded to a diverse group of individuals, and disproportionately served communities showing higher drivers of inequity. At the same time, notable disparities were found in that fewer follow-up services and nonlive referrals (e.g., officer or proactive contacts) were provided by Community Assistance and Life Liaison program to communities with higher poverty rates, Black youth were less likely to be diverted from police contact, and communities with more Black and non-U.S. citizen residents were less likely to receive live dispatch contacts from the program. Implications and recommendations for reducing over policing and health disparities are provided. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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).