Psychological Services最新文献

Prior studies on individuals with posttraumatic stress disorder (PTSD) defined an adequate dose of psychotherapy as receiving at least nine sessions within a 15-week period. Yet, few studies have examined whether this definition of adequate dose is associated with meaningful change in PTSD symptoms over an extended period. To examine whether an adequate dose of individual or group psychotherapy was associated with PTSD symptom improvement, we identified mental health outpatient visits in the electronic medical record for a cohort of veterans enrolled in Veterans Health Administration (VHA) services (N = 1,649) across 5 years. Using latent growth curve modeling, we estimated the effect of receiving an adequate dose of psychotherapy on the PTSD symptom course. Among the sample, 992 participants (60.16%) received at least one individual therapy session and 506 participants (30.7%) received at least one group therapy session; of those, 226 (22.78%) received an adequate dose of individual therapy and 212 (41.9%) received an adequate dose of group therapy, respectively. An adequate individual therapy dose, but not group therapy dose, was associated with a decrease in PTSD Checklist for DSM-5 (PCL-5) scores over time. This improvement was extremely gradual (average of 1.57 PCL-5 point decrease per year). Adequate dose of psychotherapy, defined as nine sessions of routine psychotherapy over 15 weeks, is associated with minimal symptom change. This suggests that commonly used definitions of adequate dose have minimal clinical utility. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Professional firefighters are routinely exposed to occupational stressors that place them at a higher risk of developing mental health symptoms, including anxiety, depression, and posttraumatic stress. This article discusses findings of the National Wellness Survey for Public Safety Personnel, specifically the stressors that professional firefighters are exposed to on the job and their impact. Results indicated high levels of both occupational and individual stressors in this group. Common occupational and personal stressors and mental health symptomology endorsed by professional firefighters are discussed. Findings also revealed that about 40% of professional firefighters are facing clinically substantial levels of anxiety and depression, and more than 10% are experiencing clinically significant levels of posttraumatic stress disorder in numbers surpassing the general population. Most professional firefighters indicated being adversely impacted by their duties but did not want to utilize services, which is in line with prior research. Suggestions for assisting professional firefighters in mitigating occupational and personal stress are presented, and proposals for future research are provided. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Although there have been momentous and critical advancements in serious mental illness (SMI) psychology doctoral training models and competencies, there is still much systemic change needed to increase access to evidence-based SMI training for psychologists. In the last decade, there has been little to no growth or expansion of SMI training opportunities in clinical psychology doctoral programs in the United States, and psychologists are underrepresented in serving clients with SMI. As trainees and trainers committed to careers in SMI, the contributors aimed to identify barriers and facilitators throughout each stage of the SMI doctoral training pathway, including pregraduate school, graduate school, and internship to reflect critically on systemic issues that have impeded trainees from accessing the appropriate tools for SMI training. This conceptual article reviews the existing literature on barriers and facilitators to accessing SMI training. In centering trainee perspectives, the contributors also reflect on their own experiences through brief narratives illustrating the barriers and facilitators they have faced across training stages with existing empirical research. Recommendations made by the contributors include increasing access to financial support and mechanisms, diversifying departments and practicum sites to include SMI-focused training, and people in positions of power advocating for and centering trainee voices in departmental training decisions and development. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Research shows that jailed women have disproportionately elevated rates of behavioral health conditions, including serious mental illness and substance use disorders; however, jails have not been able to effectively address these needs. There is a research gap in our understanding of mental health screening tools, linkages to care, and behavioral health service utilization for jailed women, specifically across multiple jails situated in urban and rural contexts. This two-part study compares the behavioral health needs and service utilization of women and men in eight Michigan jails. Results show significant differences in women's and men's behavioral health needs, including proportions of severe mental illness, alcohol and drug misuse, opioid preference, concerns for withdrawal, and length of jail stays. Mental health outcomes show significant gendered differences in advocacy for early release and jail- and post-jail treatment engagement. These findings highlight the need for jails to better assess behavioral health needs among women and may inform interventions aimed at improving women's (and men's) experiences while jailed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Individuals at clinical high risk for psychosis (CHR) report a strong desire for psychoeducation, and clinical guidelines recommend psychoeducation in early psychosis care. Although several CHR psychoeducation models have been developed, additional research is needed to establish the effectiveness of these models. The goal of this study was to conduct a pilot trial of the Brief Educational Guide for Individuals in Need (BEGIN). BEGIN is a brief structured psychoeducation intervention designed to educate CHR individuals on symptoms and treatment options. We conducted a feasibility and pilot study of 25 CHR individuals (60% female, M_age = 20.6, 64% non-White, 52% Hispanic/Latino) identified via the Structured Interview for Psychosis Risk Syndromes. Qualitative interviews were administered to learn about their experience and analyzed using iterative thematic analysis. Participants (n = 12) completed pre- and post-BEGIN self-report measures to assess factors that influence treatment engagement, including CHR knowledge and motivation for therapy. Data were analyzed using Hedges' g effect sizes and paired samples t tests. The intervention completion rate (83%) and therapeutic alliance were high. Qualitative themes and quantitative measures converged on similar results showing how CHR individuals were impacted by receiving psychoeducation via BEGIN, including increased CHR knowledge (g = 1.37), competence to monitor symptoms (g = 0.53), hope (g = 0.87), and motivation for therapy (g = 0.46). This study demonstrated the feasibility, acceptability, and potential benefits of the BEGIN CHR psychoeducation model, including enhancing motivation for treatment. The flexible but standardized format can facilitate BEGIN's implementation and dissemination.This pilot study found that the Brief Educational Guide for Individuals in Need (BEGIN), a standardized five-session psychoeducation intervention for individuals at clinical high risk for psychosis (CHR), was feasible, acceptable, and enhanced mental health literacy and motivation for subsequent treatment. Clinicians can utilize the BEGIN intervention to ensure the empathic provision of psychoeducation when disclosing patients' CHR status. Future research with a larger sample will establish efficacy and the development of a clinician training to facilitate implementation (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Partial hospitalization programs (PHPs) are increasingly relied upon to provide intensive mental health treatment for youth with acute and severely impairing mental health symptoms, yet very few interventions have been adapted to fit this unique delivery context. Transdiagnostic treatments hold promise for addressing the complex clinical presentations and workflow needs of PHP programs, but more work is needed to understand factors that influence successful implementation. We conducted a formative implementation process evaluation to identify barriers and facilitators of acceptability, appropriateness, and feasibility of implementing an evidence-based transdiagnostic intervention in a PHP setting and further targets for intervention and implementation adaptation. Seventeen PHP clinical providers completed a survey about the implementation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A). Providers completed measures on the UP-C/A's characteristics, acceptability, appropriateness, feasibility, leadership implementation support, and open-ended questions about the UP-C/A implementation. A mixed methods approach was used to analyze and integrate data. Ratings of acceptability, appropriateness, and feasibility were high. The most influential implementation facilitators were positive views of the innovation characteristics, while the most influential barriers were insufficient access to knowledge and information as well as limited processes for reflecting on implementation. Aspects of intervention design (e.g., low complexity, observability, adaptability) contributed to high levels of acceptability. Barriers to appropriateness and feasibility included perceived deficiencies in leadership and training supports and perceived needs of some intervention recipients not matching the intervention. Key adaptations included translating the UP-C/A, increasing interactive group components, providing additional supervision, and a process for receiving implementation feedback. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The U.S. Department of Veterans Affairs (VA) developed evidence-informed mental health mobile applications (MH apps) to supplement treatment and serve as self-care resources for veterans. However, lack of awareness and understanding of how to integrate MH apps into care pose barriers to uptake. The VA Mobile Mental Health Apps Project was conducted from 2019 to 2021 to train and support VA health care staff in integrating VA MH apps into practice using implementation facilitation. Interdisciplinary staff (N = 1,110) from 19 VA sites, led by local site champions, and supported by project Facilitators, participated. The training phase successfully equipped staff with key knowledge and skills for MH app integration (McGee-Vincent et al., 2023), but training is not sufficient for practice change (Schueller & Torous, 2020). The current article summarizes results from a mixed methods evaluation of the preimplementation planning and active implementation phases of the project. Survey data from 3-month posttraining (n = 362) and qualitative interview data (n = 27) assessed within the Consolidated Framework for Implementation Research (Damschroder et al., 2022b) were analyzed to highlight facilitators and barriers to implementation. Results showed positive perceptions, meaningful adoption, and expanded reach of MH apps for veterans by staff across VA. Given that the project was well-received and perceived to be sustainable, the adaptability of the innovation and implementation model, and the relatively limited number of perceived barriers, this project may serve as a model for other practice changes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Today's workplace continually requires organizations to empower employees to go beyond their job description to help maintain a competitive edge in the market. Developing transformational leadership in an organization is one means in which a company can attempt to empower and inspire their employees. However, thus far there are a limited number of tools to assist in the development of transformational leadership. The following exploratory review sought to examine the potential use of an assessment center as a means to develop transformational leadership. The topic was examined by analyzing both the assessment center and transformational leadership literatures. The literatures were obtained via a search on Ebscohost and Google scholar databases. The intersection of the literatures was used to develop a proposed framework for the transformational leadership development center that includes suggested dimensions, exercises, and future approaches. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Chronic insomnia is one of the most common health problems among veterans and can significantly impact health, function, and quality of life. Brief behavioral treatment for insomnia (BBTI), an adaptation of cognitive behavioral therapy for insomnia (CBT-I), was developed to help increase access to care outside of specialty settings. However, training providers alone is rarely sufficient, and implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care. The current analysis compares the impact of providing BBTI training alone (BBTI) versus training plus implementation strategies (BBTI + IS) on veteran engagement in BBTI (i.e., reach) in Primary Care Mental Health Integration clinics. Providers from four Veterans Affairs (VA) medical centers completed BBTI training and then were given access to and support for implementation strategies. Core strategies implemented across all sites included developing an implementation blueprint, organizing implementation and educational meetings, developing and distributing educational materials, developing tools for quality monitoring, and facilitation. Veteran engagement in BBTI, CBT-I, insomnia diagnoses, and prescription sleep medication was measured using retrospective data from the VA Corporate Data Warehouse. Analyses were conducted using generalized linear models. Overall, sites significantly increased veteran engagement in BBTI (reach) from training alone and achieved further engagement with implementation strategies. At the site level, there was variability by phase, with three sites increasing BBTI only with training and one site increasing BBTI with training plus implementation support. These results are promising-increasing access to evidence-based behavioral insomnia care can be accomplished via BBTI training and easily implementable strategies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Suicide occurs at high rates in both military and veteran populations. The Interpersonal Theory of Suicide is a widely applied framework incorporating the requisite construct of acquired capability for suicide, which is the ability to engage in suicidal behaviors developed through painful and provocative life experiences. The Acquired Capability for Suicide Scale (ACSS) was developed to assess this construct. Despite substantial literature examining Interpersonal Theory of Suicide in military samples, many versions of ACSS have been used without adequate validation. The goal of this study was to examine the factor structure of the ACSS and derive a version of the ACSS with initial validity for use in military populations. We also examined the stability of acquired capability over time. Data were collected among Wisconsin Army National Guard service members, who were deployed to the Middle East from 2008 to 2010, at three assessment points: before deployment (n = 714), immediately after return from deployment (n = 2,553), and 6-9 months postdeployment (n = 646). Exploratory and confirmatory factor analyses of postdeployment data suggest adoption of a novel, abbreviated 15-item, four-factor version of the ACSS. Analyses provided preliminary support for discriminant and predictive validity. Results also revealed that acquired capability for suicide increases after deployment and remains stable for at least 6-9 months after return from the combat. The four-factor version of the ACSS shows promise as a theory-relevant and empirically supported instrument for research and clinical applications in the military population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).