Psychological Services最新文献

U.S. Armed Forces members experience specific demands and stressors that lead to several risk factors of self-harm or harm against others. Military spouses face unique challenges as partners of service members and are often placed in a position to intervene in potentially harmful situations. This study aimed to use qualitative methods to explore military spouses' exposure to their active-duty partner's risk of violence perpetration, firearm suicide, and associated circumstances such as alcohol use and access to personally owned firearms. Participants were adult spouses/partners of active-duty service members, Reserve or Guard members, or recent Veterans (referred to as "military spouses"). Participants completed a 30- to 60-min in-depth interview. An inductive-deductive approach and pattern coding were used to identify trends and key themes. A total of 34 military spouses participated in interviews. Most participants were female (97.06%), White (76.47%), and non-Hispanic (88.24%). Nearly two thirds (61.76%) of participants reported that they and/or their spouse had access to at least one personally owned firearm within their home. Military spouses shared experiences with real-time crisis management related to harmful or hazardous alcohol use and threats of intimate partner violence and firearm suicide. Participants also noted several perceived barriers to prevention and intervention resources and strategies. Due to military spouses' significant exposure to their partner's suicidal behaviors and threat of violence perpetration, as well as the increased access to lethal means (i.e., firearms) and potential for harmful or hazardous alcohol use, existing prevention and intervention strategies may be insufficient. There are multiple intervention opportunities for health care providers to fill this gap. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Intimate partner violence (IPV) poses a tremendous public health burden across large health care systems. While the predominant response to IPV focuses on individual screening and referral, relationship and family services provide an opportunity to prevent low-risk verbal aggression from escalating and to address some forms of bidirectional physical IPV. This study examines mental health and screening variables associated with IPV experience and subsequent referral to family services using a large national data set of N = 256,894 patients screened for IPV in the first year of the Veterans Health Administration's adoption of a national IPV screen. Of those screened, 7.4% reported any IPV, 1.4% reported severe IPV, and only 0.1% received a referral for couple and family services within the next 90 days. Mental health conditions associated with greater likelihood of IPV (e.g., personality disorders, posttraumatic stress disorder, substance use disorders, and depression) were in turn associated with greater likelihood of referral. Despite the overlap between IPV and mental health conditions that benefit from couple-based interventions, referrals remained infrequent. Referrals were often placed by a different clinic than the service assessing the IPV. Risk behaviors for severe violence (e.g., choking) and suicide ideation were also associated with increased couple and family service referrals, underscoring the need for integrated assessment and risk management. These findings highlight important opportunities for health care systems to enhance the alignment of IPV screening and appropriate treatment recommendations by strengthening screening-to-referral pathways for family services and integrating systematic safety assessments. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study aimed to understand the factors contributing to psychological distress among nonconsultant hospital doctors in Ireland. To achieve this goal, we first sought to identify correlates of psychological distress among help-seeking physicians and, second, to explore the experiences of doctors working within Irish hospitals. The study employed a mixed-method approach. Correlates of psychological distress were identified through a secondary analysis of data obtained from n = 170 physicians accessing counseling services from 2020 to 2022, collected by the Royal College of Physicians of Ireland. Multiple linear regression was used to examine how age, gender, specialty, work hours, mental health history, and familial background were associated with increased vulnerability to adverse mental health, measured by a psychologist's "level of concern" for the physician. In addition, physician's experiences of working within Irish hospitals were explored using semistructured interviews with n = 10 doctors. Data were analyzed through thematic analysis. Descriptive statistics indicated a higher proportion of female doctors seeking counseling services, with 123 out of 170 female participants. Greater concern for physician's well-being was associated with younger age, less years of training, and female sex. Workplace culture, barriers to accessing mental health resources, illegal working hours, and understaffing all emerged as themes describing physicians' experiences of working in Irish hospitals. These findings underscore the multifaceted nature of psychological distress among nonconsultant hospital doctors and emphasize the importance of addressing systemic barriers to support their mental well-being. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Suicide rates have increased substantially among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) veterans, as well as among women veterans. The Veterans Crisis Line (VCL) is a resource available to all veterans as part of the Department of Veterans Affairs' multifaceted suicide prevention strategy. Despite well-documented gender differences in suicide risk and reasons for contacting the VCL, little is known about AANHPI veterans' use of the VCL and whether their reasons for contacting the VCL differ by gender. This descriptive analysis examined the demographics, reasons for contacting the VCL, and suicide risk assessment ratings for AANHPI veterans who contacted the VCL, by gender, as a first step to better understand VCL use in this heterogenous population. Using VCL and Veterans Affairs administrative data, we examined demographics, reasons for contacting the VCL, and suicide risk assessment ratings for 1,645 AANHPI veterans who contacted the VCL in Calendar Year 2020, stratified by gender and disaggregated between Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) veterans. Mental health was indicated as the most frequent reason for VCL contact for AANHPI women (84.8% of contacts) and men (66.1% of contacts). Suicidal thoughts or crises (34.5% of women, 27.5% of men) were noted as the second most frequent reason for contact across groups, followed by relationship problems (23.7% of women, 21.4% of men). We observed some similar patterns across race/ethnicity and gender subgroups, with some variation between groups. Nearly three quarters (74.6%) of NHPI women endorsed suicide risk screen indicator(s), with lower proportions among AA women (69.1%), AA men (57.8%), and NHPI men (57.3%). Additionally, 12.7% of NHPI women, 9.8% of NHPI men, 8.1% of AA men, and 5.6% of AA women were rated by VCL responders as being at elevated suicide risk. These initial descriptive findings highlight the importance of disaggregating data both by gender and race/ethnicity among AANHPI veterans. Further study of suicide risk and protective factors salient to each subgroup of AANHPI veterans is a critical next step to suicide prevention among these veterans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

African American veterans who use tobacco use evidence-based tobacco-cessation treatment less than other racial/ethnic groups, contributing to higher tobacco-related treatment burden for them. This study aimed to assess barriers and facilitators African American patients face before engaging in Veterans Health Administration behavioral tobacco-cessation treatment services, as an initial step to identify new implementation strategies. African American veterans (N = 30) who use tobacco at a large Veterans Affairs Medical Center completed interviews about perceived barriers and facilitators to behavioral treatment, views on telehealth, and suggested care improvements. We used a combination of deductive and inductive analytic approaches and identified four themes: (1) Ambivalence towards Quitting Tobacco: Patients described how low motivation to quit and intense withdrawal symptoms impede treatment engagement, despite known health risks; (2) Limited Interaction with Health Care System: Patients described how histories of mistrust and stigma toward treatment impact engagement with the health care system, resulting in lack of awareness of treatment options and preference for self-reliance in quitting; (3) Individualized Factors for Engagement: Patients described how persistent providers, access to telehealth modalities, personal health complications exacerbated by tobacco use, and benefits of positive lifestyle change increase motivation for treatment; and (4) Suggestions for Culturally Tailored Treatment Engagement: Patients expressed a desire for more African American group-specific outreach, including targeted advertisement and culturally aware providers to combat mistrust of the health care system. Findings indicate that generating patient-driven implementation strategies such as tailored education and proactive outreach are necessary to increase engagement of African American patients in tobacco-cessation treatment programs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Veterans Health Administration (VHA) has rolled out evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD); however, reach has remained low, and there is a need for briefer interventions. The National Center for PTSD conducted a facilitated learning collaborative to train clinicians and support VHA PTSD teams in their adoption of an emerging best practice, written exposure therapy (WET). Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) evaluation framework, the present study utilized longitudinal data from 178 clinicians and 556 patients across seven training cohorts to evaluate key clinical and implementation outcomes and whether clinic (i.e., implementation climate) or clinician factors (i.e., treatment attitudes) were associated with effectiveness and implementation. Intent-to-treat analyses indicated WET was effective in reducing PTSD (d = 0.54) and depression symptoms (d = 0.39). Data indicated that 87.60% of clinicians reported using WET 6 months postconsultation. Clinic-wide reach was modest after training (14.53% of individuals with PTSD); however, WET-trained clinicians continued to offer WET to an average of 87.38% of their patients. Fidelity remained high after training, with essential session elements most often being offered "always" (M = 6.65 on a scale from 1 to 7). More positive postconsultation clinician treatment attitudes predicted higher posttraining rates of having patients engaged in WET. Clinician treatment attitudes and implementation climate did not predict any other implementation or effectiveness outcomes examined. Results suggest that WET implementation is advancing in VHA, with good clinical outcomes. Data provide evidence that a facilitated learning collaborative can be used to support and scale EBPs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Safety Planning Intervention (SPI) is an evidence-based therapeutic intervention designed to mitigate suicide risk by providing a suicidal individual with a written, personalized safety plan. The Department of Veterans Affairs (VA) has implemented safety planning, but research found variability in the quality of safety plans. To improve quality, the VA developed an Advanced Training in the Safety Planning Intervention (ASPI) that went beyond previous didactic training efforts by emphasizing experiential learning. The aim of this article is to describe the procedures and initial results of VA's competency-based ASPI Training Program. Before training, providers participating in this program uploaded a written, deidentified safety plan completed with a Veteran. Providers then completed four training components, including evaluation of fidelity of written safety plans and competency in SPI during live, standardized roleplays at the conclusion of training, and at a 3-month follow-up evaluation. Of the 409 providers who initiated training, 367 (90%) completed training, 26 (6%) dropped out of training, and 16 (4%) did not meet the competency requirements for training completion. Relative to pretraining, there was a medium to large increase in the effect size of the quality of written Safety Plans at the end of training that was maintained at the 3-month follow-up. Using a standardized, observational measure of SPI competency, 383 of 391 (98%) providers met competency criteria following the training, and 367 of 375 (98%) providers met competency at 3-month follow-up. Findings suggest that ASPI training is effective in helping providers achieve and maintain fidelity in safety planning. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

U.S. Latino/a/x adolescents experience inequities in depression treatment use in comparison to non-Latino/a/x White peers. The purpose of this study was to describe barriers to depression treatment use and implementation strategy preferences to address these barriers among Latinx teens. A qualitative descriptive study was conducted with Latino/a/x teens diagnosed with depression (n = 7), their parents (n = 7), and health care providers (n = 18) from across the United States. Qualitative content analysis was conducted to determine common barriers and preferences across groups. Family-level barriers included parents' knowledge and beliefs about depression treatment, parents' own stress, and generational gaps between parents and teens. Provider-level barriers were related to the lack of a bilingual and bicultural health care workforce, and health care system-level barriers included difficulties paying for and scheduling care, inadequate systems for follow-up, and policies limiting innovation and adolescent consent to treatment. Participants emphasized that family involvement was crucial and the importance of tailoring implementation strategies to meet the specific needs of individual Latino/a/x teens. Social support, psychoeducation about depression, and resource navigation support were preferred strategy components that should be facilitated by a bilingual Latinx individual with relevant lived experience and address cultural context. Multilevel implementation strategies will need to be developed to address the multilevel barriers to depression treatment use. Future research will further refine and test an implementation strategy package to determine the effect on the use of depression treatment among Latinx teens screening positive for depression in primary care settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Health care faces a persistent research-to-practice gap, with evidence-based innovations taking 17-20 years to reach routine clinical practice and less than 50% being successfully implemented. This introduction to the special section on implementation science presents 27 studies across two editions that demonstrate how systematic implementation science approaches can transform health care delivery. The first edition focuses on mental health services, examining evidence-based psychotherapy implementation, suicide prevention programs, and health equity initiatives across diverse populations including Veterans, incarcerated individuals, and marginalized communities. The second edition explores implementation frameworks, screening and assessment innovations, and approaches for vulnerable populations in complex health care settings. Key findings reveal that contextual adaptation, stakeholder engagement, and organizational support are critical for successful implementation. These articles provide empirical evidence that implementation science can significantly reduce the research-to-practice gap while improving intervention fidelity and sustainability, offering important insights for researchers, clinicians, administrators, and policymakers committed to evidence-based health care delivery. (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).