Pub Date : 2024-10-01DOI: 10.1007/s11414-024-09914-2
Chuck Ingoglia
{"title":"Correction to: National Council Publishes Study on Causes and Solutions to Mass Violence.","authors":"Chuck Ingoglia","doi":"10.1007/s11414-024-09914-2","DOIUrl":"10.1007/s11414-024-09914-2","url":null,"abstract":"","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1007/s11414-024-09907-1
Chuck Ingoglia
{"title":"National Council Publishes Study on Causes and Solutions to Mass Violence.","authors":"Chuck Ingoglia","doi":"10.1007/s11414-024-09907-1","DOIUrl":"10.1007/s11414-024-09907-1","url":null,"abstract":"","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 10.1007/s11414-024-09912-4
Paul R King, Gregory P Beehler, Jacob L Scharer
Model adherence indicates the degree to which a program or intervention is delivered as intended. In integrated primary care, where mental health services are embedded into primary care clinics, appraisal of model adherence provides insight into whether these services align with key features of this unique practice environment (e.g., brief, interdisciplinary care). To date, such evaluations have emphasized system and provider factors. This study is a preliminary evaluation of whether a novel patient-facing measure, the Primary Care Behavioral Health Provider Adherence Questionnaire-Patient Version (PPAQ-Patient), can provide insight into adherence to the Primary Care Behavioral Health (PCBH) model of integrated primary care. Survey data were collected from 281 veterans who received PCBH care. Exploratory factor analyses evaluated the data structure. Results suggest that 19 items spanning three temporally-referenced subscales may feasibly capture patient perspectives on PCBH adherence at various stages of treatment. Future work is needed to refine the measure.
{"title":"Exploratory Factor Analysis of a Patient-Facing PCBH Adherence Measure: The PPAQ-Patient.","authors":"Paul R King, Gregory P Beehler, Jacob L Scharer","doi":"10.1007/s11414-024-09912-4","DOIUrl":"https://doi.org/10.1007/s11414-024-09912-4","url":null,"abstract":"<p><p>Model adherence indicates the degree to which a program or intervention is delivered as intended. In integrated primary care, where mental health services are embedded into primary care clinics, appraisal of model adherence provides insight into whether these services align with key features of this unique practice environment (e.g., brief, interdisciplinary care). To date, such evaluations have emphasized system and provider factors. This study is a preliminary evaluation of whether a novel patient-facing measure, the Primary Care Behavioral Health Provider Adherence Questionnaire-Patient Version (PPAQ-Patient), can provide insight into adherence to the Primary Care Behavioral Health (PCBH) model of integrated primary care. Survey data were collected from 281 veterans who received PCBH care. Exploratory factor analyses evaluated the data structure. Results suggest that 19 items spanning three temporally-referenced subscales may feasibly capture patient perspectives on PCBH adherence at various stages of treatment. Future work is needed to refine the measure.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1007/s11414-024-09913-3
Laura Bond, Faith Cheonga, William Byansi, Eve Puffer, Theresa S Betancourt
Families in low- and middle-income countries (LMICs) face significant mental health and psychosocial care gaps. In recent years, researchers and practitioners have addressed these gaps by task-sharing evidence-based mental health and psychosocial support (MHPSS) interventions to nonspecialist community providers. Supervision and training approaches are intended to prepare nonspecialists to deliver evidence-based interventions with quality. However, there is still little research exploring nonspecialist experiences with training and supervision and how, if at all, their training and supervision experiences result in fidelity and competence in delivering the intervention. This qualitative study uses data from a cluster-randomized trial of a family strengthening and violence prevention program in Rwanda, known as Sugira Muryango. In semi-structured interviews, the nonspecialists provided examples of using skills such as rapport-building, empathy, and active listening to deliver Sugira Muryango effectively. Because nonspecialists were serving in their own communities, they found that it was easier to earn trust with friends and neighbors, and this facilitated effective delivery of Sugira Muryango. Nonspecialists discussed how training, monthly supervision, in-person monitoring visits, and the use of the manual and audio recorders equipped them to deliver Sugira Muryango with quality. Nonspecialists also provided examples of barriers to quality of delivery, including supervisor lack of availability, delayed compensation, and technology issues. Preparedness was consistent across gender; however, nonspecialists serving in a better-resourced district had previous experiences delivering evidence-based interventions and felt more prepared at the beginning of Sugira Muryango.
{"title":"Exploring Nonspecialist Preparedness to Deliver an Evidence-Based, Family Strengthening Intervention in Rwanda: A Qualitative Study.","authors":"Laura Bond, Faith Cheonga, William Byansi, Eve Puffer, Theresa S Betancourt","doi":"10.1007/s11414-024-09913-3","DOIUrl":"https://doi.org/10.1007/s11414-024-09913-3","url":null,"abstract":"<p><p>Families in low- and middle-income countries (LMICs) face significant mental health and psychosocial care gaps. In recent years, researchers and practitioners have addressed these gaps by task-sharing evidence-based mental health and psychosocial support (MHPSS) interventions to nonspecialist community providers. Supervision and training approaches are intended to prepare nonspecialists to deliver evidence-based interventions with quality. However, there is still little research exploring nonspecialist experiences with training and supervision and how, if at all, their training and supervision experiences result in fidelity and competence in delivering the intervention. This qualitative study uses data from a cluster-randomized trial of a family strengthening and violence prevention program in Rwanda, known as Sugira Muryango. In semi-structured interviews, the nonspecialists provided examples of using skills such as rapport-building, empathy, and active listening to deliver Sugira Muryango effectively. Because nonspecialists were serving in their own communities, they found that it was easier to earn trust with friends and neighbors, and this facilitated effective delivery of Sugira Muryango. Nonspecialists discussed how training, monthly supervision, in-person monitoring visits, and the use of the manual and audio recorders equipped them to deliver Sugira Muryango with quality. Nonspecialists also provided examples of barriers to quality of delivery, including supervisor lack of availability, delayed compensation, and technology issues. Preparedness was consistent across gender; however, nonspecialists serving in a better-resourced district had previous experiences delivering evidence-based interventions and felt more prepared at the beginning of Sugira Muryango.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s11414-024-09910-6
Joanne M Stubbs, Shanley Chong, Helen M Achat
Timely receipt of community-based follow-up after inpatient psychiatric discharge is associated with positive outcomes. This retrospective cross-sectional study aimed to identify socio-demographic and clinical factors associated with failure to receive community mental health follow-up within 7 days. Routinely collected hospital and community mental health data were linked for all inpatients discharged with a mental health condition in 2017 to 2019 in a local health district in New South Wales, Australia. Of the 8780 patients discharged, 28% (n = 2466) did not have 7-day follow-up. Males were significantly more likely than females to fail follow-up. Adjusted logistic regression analyses revealed that both male and female patients aged 65 years and older were generally less likely to fail follow-up than those who were younger; conversely, patients referred to a hospital by a law enforcement agency and those who left the hospital at their own risk were more likely to fail follow-up. Other factors significantly related to failure to follow-up varied between the sexes. Improved outcomes may be achieved by enhancing the transition from inpatient to outpatient care through targeted strategies aimed at patients who are more likely to disengage with care.
{"title":"Identifying Patients at Risk of Not Receiving Timely Community Mental Health Follow-Up After Psychiatric Hospitalisation Using Linked Routinely Collected Data.","authors":"Joanne M Stubbs, Shanley Chong, Helen M Achat","doi":"10.1007/s11414-024-09910-6","DOIUrl":"https://doi.org/10.1007/s11414-024-09910-6","url":null,"abstract":"<p><p>Timely receipt of community-based follow-up after inpatient psychiatric discharge is associated with positive outcomes. This retrospective cross-sectional study aimed to identify socio-demographic and clinical factors associated with failure to receive community mental health follow-up within 7 days. Routinely collected hospital and community mental health data were linked for all inpatients discharged with a mental health condition in 2017 to 2019 in a local health district in New South Wales, Australia. Of the 8780 patients discharged, 28% (n = 2466) did not have 7-day follow-up. Males were significantly more likely than females to fail follow-up. Adjusted logistic regression analyses revealed that both male and female patients aged 65 years and older were generally less likely to fail follow-up than those who were younger; conversely, patients referred to a hospital by a law enforcement agency and those who left the hospital at their own risk were more likely to fail follow-up. Other factors significantly related to failure to follow-up varied between the sexes. Improved outcomes may be achieved by enhancing the transition from inpatient to outpatient care through targeted strategies aimed at patients who are more likely to disengage with care.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1007/s11414-024-09909-z
Patricia V Chen, Hardeep Singh, Natalie E Hundt, Mark E Kunik, Melinda A Stanley, Maribel Plasencia, Terri L Fletcher
Up to 33% of American adults will experience a diagnosable anxiety disorder in their lifetime. Approximately one-third of anxiety diagnoses assigned by mental health providers in outpatient settings are unspecified. The tendency of many providers to use an unspecified anxiety diagnosis may negatively impact the provision of evidence-based treatments for specific anxiety disorders. This study examines the perspectives of mental health providers working in an integrated and stepped health care system, asking how their roles and responsibilities shape their practices related to diagnosing specific anxiety disorders. The authors conducted semi-structured interviews with 32 Veteran Health Administration (VHA) mental health providers to understand their perspectives on diagnosing anxiety disorders. Matrix analysis was used to identify different roles and responsibilities articulated. Thematic analysis was used to highlight themes across providers' discussion of their roles in diagnosing and treating patients. The results show that, for most providers, assigning a specific diagnosis is a component of duties but rarely their focus. Second, it is unclear in which clinic setting a specific anxiety diagnosis should be made. Finally, among different types of mental health professionals, there is no clear designation on who should be providing a specific anxiety diagnosis. Altogether, results indicate that many providers feel making a specific diagnosis for anxiety is the responsibility of others-either those in other clinic settings or with other credentials. Findings call for clearer guidelines that specify individual clinician accountability for obtaining a specific anxiety diagnosis in a team-based environment.
{"title":"Whose Job is it Anyway? A Qualitative Study of Providers' Perspectives on Diagnosing Anxiety Disorders in Integrated Health Settings.","authors":"Patricia V Chen, Hardeep Singh, Natalie E Hundt, Mark E Kunik, Melinda A Stanley, Maribel Plasencia, Terri L Fletcher","doi":"10.1007/s11414-024-09909-z","DOIUrl":"https://doi.org/10.1007/s11414-024-09909-z","url":null,"abstract":"<p><p>Up to 33% of American adults will experience a diagnosable anxiety disorder in their lifetime. Approximately one-third of anxiety diagnoses assigned by mental health providers in outpatient settings are unspecified. The tendency of many providers to use an unspecified anxiety diagnosis may negatively impact the provision of evidence-based treatments for specific anxiety disorders. This study examines the perspectives of mental health providers working in an integrated and stepped health care system, asking how their roles and responsibilities shape their practices related to diagnosing specific anxiety disorders. The authors conducted semi-structured interviews with 32 Veteran Health Administration (VHA) mental health providers to understand their perspectives on diagnosing anxiety disorders. Matrix analysis was used to identify different roles and responsibilities articulated. Thematic analysis was used to highlight themes across providers' discussion of their roles in diagnosing and treating patients. The results show that, for most providers, assigning a specific diagnosis is a component of duties but rarely their focus. Second, it is unclear in which clinic setting a specific anxiety diagnosis should be made. Finally, among different types of mental health professionals, there is no clear designation on who should be providing a specific anxiety diagnosis. Altogether, results indicate that many providers feel making a specific diagnosis for anxiety is the responsibility of others-either those in other clinic settings or with other credentials. Findings call for clearer guidelines that specify individual clinician accountability for obtaining a specific anxiety diagnosis in a team-based environment.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1007/s11414-024-09901-7
Jennifer I Manuel, Tania DeBarros, Daniel Baslock, Caroline Davidson, Teresa Halliday, Flannery Peterson, Pam Pietruszewski, Alexandra Plante, J'Neal Woods Razaa, William Sloyer, Amanda Stark, Victoria Stanhope
Despite a wealth of evidence-based messaging on youth alcohol and drug prevention, there remains a dearth of research on how to construct and deliver these messages effectively. Communication science is useful for increasing the efficacy of these messages in reducing substance use risk among youth. This study explores the perspectives of youth and youth-serving providers to identify theory-informed substance use prevention messages and strategies and how the content and delivery of prevention messages evolved during the COVID-19 pandemic. This is a secondary analysis of qualitative data derived from focus groups with 53 youth ages 13 to 18 years and 18 youth-serving providers conducted in the USA between 2021 and 2022. The results describe theory-informed strategies that are important to consider when constructing effective substance use prevention messaging for youth, including preferences around key communication framework constructs, including sources, content, channels, and context. An element that emerged across the communication constructs was the saliency of "connection" in youth substance use prevention messaging content. Findings point to the need to further explore connection related to having shared experiences and the extent to which these dimensions are critical ingredients to effective substance use prevention.
{"title":"Applying Communication Science to Substance Use Prevention Messaging.","authors":"Jennifer I Manuel, Tania DeBarros, Daniel Baslock, Caroline Davidson, Teresa Halliday, Flannery Peterson, Pam Pietruszewski, Alexandra Plante, J'Neal Woods Razaa, William Sloyer, Amanda Stark, Victoria Stanhope","doi":"10.1007/s11414-024-09901-7","DOIUrl":"https://doi.org/10.1007/s11414-024-09901-7","url":null,"abstract":"<p><p>Despite a wealth of evidence-based messaging on youth alcohol and drug prevention, there remains a dearth of research on how to construct and deliver these messages effectively. Communication science is useful for increasing the efficacy of these messages in reducing substance use risk among youth. This study explores the perspectives of youth and youth-serving providers to identify theory-informed substance use prevention messages and strategies and how the content and delivery of prevention messages evolved during the COVID-19 pandemic. This is a secondary analysis of qualitative data derived from focus groups with 53 youth ages 13 to 18 years and 18 youth-serving providers conducted in the USA between 2021 and 2022. The results describe theory-informed strategies that are important to consider when constructing effective substance use prevention messaging for youth, including preferences around key communication framework constructs, including sources, content, channels, and context. An element that emerged across the communication constructs was the saliency of \"connection\" in youth substance use prevention messaging content. Findings point to the need to further explore connection related to having shared experiences and the extent to which these dimensions are critical ingredients to effective substance use prevention.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1007/s11414-024-09905-3
Isabella J Kneeland, Judith N Biesen, Brandi C Fink, Lori A Keeling, Larissa Lindsey
The purpose of this brief report was to examine the association between COVID-fear with psychiatric symptoms severity and substance use risk in an outpatient population with co-occurring substance use and mental health disorders and whether these associations were moderated by treatment engagement, especially after providers had shifted from an in-person care model to a telehealth format. A total of 136 patients receiving outpatient treatment for comorbid substance use and mental health disorders completed self-report questionnaires on their psychiatric symptoms, substance use, and treatment engagement (i.e., frequency, length, and helpfulness of phone and video sessions with a mental health counselor, psychiatrist, or primary care provider) in the past month between November 2020 and March 2021. Results showed that COVID-fear was significantly associated with psychiatric symptom severity, but not substance use risk. Additionally, perceived helpfulness of phone counseling sessions moderated the associations between COVID-fear and global psychiatric symptom severity, such that COVID-fear and global psychiatric symptom severity were positively associated when perceived helpfulness was low, and not associated if perceived helpfulness was high. The present results highlight the importance of directly addressing fears specific to a national emergency, as well as for providers to build strong rapport with their clients.
{"title":"The Association Between COVID-fear with Psychological Distress and Substance Use: the Moderating Effect of Treatment Engagement.","authors":"Isabella J Kneeland, Judith N Biesen, Brandi C Fink, Lori A Keeling, Larissa Lindsey","doi":"10.1007/s11414-024-09905-3","DOIUrl":"https://doi.org/10.1007/s11414-024-09905-3","url":null,"abstract":"<p><p>The purpose of this brief report was to examine the association between COVID-fear with psychiatric symptoms severity and substance use risk in an outpatient population with co-occurring substance use and mental health disorders and whether these associations were moderated by treatment engagement, especially after providers had shifted from an in-person care model to a telehealth format. A total of 136 patients receiving outpatient treatment for comorbid substance use and mental health disorders completed self-report questionnaires on their psychiatric symptoms, substance use, and treatment engagement (i.e., frequency, length, and helpfulness of phone and video sessions with a mental health counselor, psychiatrist, or primary care provider) in the past month between November 2020 and March 2021. Results showed that COVID-fear was significantly associated with psychiatric symptom severity, but not substance use risk. Additionally, perceived helpfulness of phone counseling sessions moderated the associations between COVID-fear and global psychiatric symptom severity, such that COVID-fear and global psychiatric symptom severity were positively associated when perceived helpfulness was low, and not associated if perceived helpfulness was high. The present results highlight the importance of directly addressing fears specific to a national emergency, as well as for providers to build strong rapport with their clients.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1007/s11414-024-09900-8
Briana S Last, Madeline Kiefer, Yuanyuan Yang, Ahnaf Annur, Natalie Dallard, Emily Schaffer, Courtney Benjamin Wolk
Session planning is a core activity for implementing evidence-based practices (EBPs), yet it is unknown whether public mental health settings provide the support for therapists to session plan. This two-part study conducted in collaboration with EBP leaders in Philadelphia's public mental health system deployed mixed methods to examine therapists' session planning practices and preferences. In Study 1, 61 public mental health therapists completed an online survey to identify session planning barriers and facilitators, current practices, and desired planning supports. In Study 2, nine therapists who ranked a session planning tool as a top choice support in Study 1 participated in two focus groups to elaborate on their survey responses and provide feedback on three session planning tool prototypes. Study 1 survey respondents cited multi-level barriers and facilitators to session planning. In both closed- and open-ended responses, analyzed descriptively and via content analysis respectively, therapists described wanting more time, lower caseloads, financial incentives for session planning, and additional clinical resources and guidance from trainings, peers, and supervisors to support session planning. Study 2 focus group participants, whose responses were analyzed using content analysis, reiterated the need for these multi-level supports and expressed the need for a "one-stop" database of session planning tools that would be free, easily searchable, and modifiable for varied clinical needs. All three session planning tool prototypes reviewed were acceptable; two were also considered feasible and appropriate. This investigation of an under-studied aspect of the EBP implementation process reveals the need for multi-level session planning supports.
{"title":"A Mixed Methods Examination of Session Planning Among Public Mental Health Therapists.","authors":"Briana S Last, Madeline Kiefer, Yuanyuan Yang, Ahnaf Annur, Natalie Dallard, Emily Schaffer, Courtney Benjamin Wolk","doi":"10.1007/s11414-024-09900-8","DOIUrl":"https://doi.org/10.1007/s11414-024-09900-8","url":null,"abstract":"<p><p>Session planning is a core activity for implementing evidence-based practices (EBPs), yet it is unknown whether public mental health settings provide the support for therapists to session plan. This two-part study conducted in collaboration with EBP leaders in Philadelphia's public mental health system deployed mixed methods to examine therapists' session planning practices and preferences. In Study 1, 61 public mental health therapists completed an online survey to identify session planning barriers and facilitators, current practices, and desired planning supports. In Study 2, nine therapists who ranked a session planning tool as a top choice support in Study 1 participated in two focus groups to elaborate on their survey responses and provide feedback on three session planning tool prototypes. Study 1 survey respondents cited multi-level barriers and facilitators to session planning. In both closed- and open-ended responses, analyzed descriptively and via content analysis respectively, therapists described wanting more time, lower caseloads, financial incentives for session planning, and additional clinical resources and guidance from trainings, peers, and supervisors to support session planning. Study 2 focus group participants, whose responses were analyzed using content analysis, reiterated the need for these multi-level supports and expressed the need for a \"one-stop\" database of session planning tools that would be free, easily searchable, and modifiable for varied clinical needs. All three session planning tool prototypes reviewed were acceptable; two were also considered feasible and appropriate. This investigation of an under-studied aspect of the EBP implementation process reveals the need for multi-level session planning supports.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1007/s11414-024-09904-4
Zachary D Zuschlag, Benjamin Lord, Teagen Smith, Alexander Lengerich, Brianna Tindall, Kaitlin Leonard, Yvette Guereca, Vanessa Panaite, Ambuj Kumar, Michael A Norred, Vanessa A Milsom
Collaborative care management (CoCM) is an evidenced based approach to psychiatric treatment in primary care, yet literature examining factors associated with program adherence is lacking. This study analyzed predictors of adherence to a CoCM model of psychopharmacological treatment of depression and anxiety in primary care by conducting a retrospective cohort analysis on Veterans referred to a large VA Medical Center's CoCM program over an 18-month period. Baseline characteristics, symptomatic assessments, and covariates of interest were collected. For the primary outcome, the association between covariates and programmatic completion were analyzed. Secondary analyses assessed improvements in psychiatric symptoms. A total of 757 Veterans with depressive or anxiety disorders were included, and 256 completed the CoCM program. Baseline covariates associated with differences in completion rates included the following: age, contact with psychology prior to referral, baseline PHQ-9, baseline GAD-7, and a number of comorbid psychiatric/substance abuse covariates. After controlling for baseline differences, age remained a significant positive predictor of completion (OR 1.019, 95% CI 1.008‒1.030) and cannabis use a significant negative predictor (OR 0.507, 95% CI 0.275‒0.934). Both early improvement in PHQ-9 (OR 1.864, 95% CI 1.210‒2.872) and GAD-7 (OR 1.762, 95% CI 1.154‒2.691) scores were positive predictors. Secondary analyses showed that programmatic completion was associated with greater reductions in psychiatric symptoms. Results identified a number of modifiable parameters associated with differences in completion rates and greater symptomatic reduction for those who complete the program. Additional studies should be conducted examining interventions to optimize CoCM programs by supporting positive predictors while minimizing negative predictors.
协作护理管理(CoCM)是一种在初级医疗中进行精神治疗的循证方法,但目前还缺乏研究与坚持该计划相关因素的文献。本研究通过对转诊至退伍军人协会医疗中心的大型 CoCM 项目的退伍军人进行为期 18 个月的回顾性队列分析,分析了在初级医疗中对抑郁和焦虑进行精神药物治疗的 CoCM 模式的依从性预测因素。我们收集了基线特征、症状评估和相关协变量。对于主要结果,分析了协变量与计划完成之间的关联。次要分析评估了精神症状的改善情况。共有 757 名退伍军人患有抑郁症或焦虑症,其中 256 人完成了 CoCM 计划。与完成率差异相关的基线协变量包括:年龄、转介前与心理学的接触、PHQ-9 基线、GAD-7 基线以及一些合并精神病/药物滥用协变量。在控制了基线差异后,年龄仍然是完成治疗的一个重要正向预测因素(OR 1.019,95% CI 1.008-1.030),而吸食大麻则是一个重要的负向预测因素(OR 0.507,95% CI 0.275-0.934)。PHQ-9(OR 1.864,95% CI 1.210-2.872)和 GAD-7 (OR 1.762,95% CI 1.154-2.691)评分的早期改善都是积极的预测因素。二次分析表明,计划的完成与精神症状的进一步减轻有关。研究结果发现,一些可调整的参数与完成率的差异以及完成项目者症状减轻的程度有关。应开展更多研究,通过支持积极的预测因素,同时尽量减少消极的预测因素,研究优化 CoCM 计划的干预措施。
{"title":"The Management of Depression and Anxiety in Primary Care: Examining Predictors of Adherence to a Psychopharmacological Collaborative Care Management Program for Veterans.","authors":"Zachary D Zuschlag, Benjamin Lord, Teagen Smith, Alexander Lengerich, Brianna Tindall, Kaitlin Leonard, Yvette Guereca, Vanessa Panaite, Ambuj Kumar, Michael A Norred, Vanessa A Milsom","doi":"10.1007/s11414-024-09904-4","DOIUrl":"https://doi.org/10.1007/s11414-024-09904-4","url":null,"abstract":"<p><p>Collaborative care management (CoCM) is an evidenced based approach to psychiatric treatment in primary care, yet literature examining factors associated with program adherence is lacking. This study analyzed predictors of adherence to a CoCM model of psychopharmacological treatment of depression and anxiety in primary care by conducting a retrospective cohort analysis on Veterans referred to a large VA Medical Center's CoCM program over an 18-month period. Baseline characteristics, symptomatic assessments, and covariates of interest were collected. For the primary outcome, the association between covariates and programmatic completion were analyzed. Secondary analyses assessed improvements in psychiatric symptoms. A total of 757 Veterans with depressive or anxiety disorders were included, and 256 completed the CoCM program. Baseline covariates associated with differences in completion rates included the following: age, contact with psychology prior to referral, baseline PHQ-9, baseline GAD-7, and a number of comorbid psychiatric/substance abuse covariates. After controlling for baseline differences, age remained a significant positive predictor of completion (OR 1.019, 95% CI 1.008‒1.030) and cannabis use a significant negative predictor (OR 0.507, 95% CI 0.275‒0.934). Both early improvement in PHQ-9 (OR 1.864, 95% CI 1.210‒2.872) and GAD-7 (OR 1.762, 95% CI 1.154‒2.691) scores were positive predictors. Secondary analyses showed that programmatic completion was associated with greater reductions in psychiatric symptoms. Results identified a number of modifiable parameters associated with differences in completion rates and greater symptomatic reduction for those who complete the program. Additional studies should be conducted examining interventions to optimize CoCM programs by supporting positive predictors while minimizing negative predictors.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}