Pub Date : 2022-04-03DOI: 10.1080/23794925.2022.2070885
O. Gudiño, Ernestine C. Briggs
Despite longstanding disparities in access to and quality of mental health services, efforts within the field of child and adolescent mental health have primarily focused on documenting these disparities. While identifying disparities is a critical first step, additional work is needed to develop an evidence base that can be leveraged to eliminate disparities. Fortunately, there has been a growing emphasis on diversity, equity, and inclusion in training, practice, research, and policy (e.g., Bernard et al., 2021; Clauss-Ehlers et al., 2019; Collins et al., 2021; U.S. Department of Health and Human Services, Office of Public Health and Science, Office of Minority Health (US DHHS), 2008). A racial reckoning in the United States and the ongoing impacts of the COVID-19 pandemic globally have also brought inequity to the forefront of society’s consciousness. Awareness of the need to dismantle institutional structures that maintain inequity and a motivation to achieve social justice provide a key opportunity to advance health equity. This special issue highlights work that advances our ability to achieve equity in youth mental health services. We rely on definitions of equity that emphasize the provision of resources based on need, fair access to those services, a goal of supporting optimal levels of health, and a focus on the social determinants of wellbeing (American Psychological Association (APA), 2021; Braverman et al., 2017). By centering equity and diversity at all levels, the articles in this special issue contribute to an evidence base that is equipped to support action. Part I of the special issue includes articles that synthesize and advance knowledge on the needs of diverse populations and examine key issues impacting equity in access to needed services. Part II of the special issue includes articles focused on engagement, service delivery and effectiveness, and the sustainability of services within systems. Articles in this first part of the special issue utilize systematic review, qualitative, quantitative, and community-engaged methods to address important questions related to health equity across unique populations, clinical needs, and service settings. DeLuca et al. (2022) use a minority stress and intersectional lens in their review of the literature on youth at clinical high risk for psychosis. The authors first describe the relevant social and policy contexts influencing inequities in identification and treatment of youth who could be served by specialty clinics targeting youth at clinical high risk for psychosis. They subsequently provide a narrative review of the literature across a comprehensive range of areas, making explicit connections to issues of equity. They end with a call-to-action and provide specific recommendations for advancing equity for this population. In a systematic narrative review of the literature, Xin et al. (2022) consider randomized controlled trials of cognitive behavior therapy (CBT) conducted with Asian
{"title":"Advancing Equity in Youth Mental Health Services: Introduction to the Special Issue (Part I)","authors":"O. Gudiño, Ernestine C. Briggs","doi":"10.1080/23794925.2022.2070885","DOIUrl":"https://doi.org/10.1080/23794925.2022.2070885","url":null,"abstract":"Despite longstanding disparities in access to and quality of mental health services, efforts within the field of child and adolescent mental health have primarily focused on documenting these disparities. While identifying disparities is a critical first step, additional work is needed to develop an evidence base that can be leveraged to eliminate disparities. Fortunately, there has been a growing emphasis on diversity, equity, and inclusion in training, practice, research, and policy (e.g., Bernard et al., 2021; Clauss-Ehlers et al., 2019; Collins et al., 2021; U.S. Department of Health and Human Services, Office of Public Health and Science, Office of Minority Health (US DHHS), 2008). A racial reckoning in the United States and the ongoing impacts of the COVID-19 pandemic globally have also brought inequity to the forefront of society’s consciousness. Awareness of the need to dismantle institutional structures that maintain inequity and a motivation to achieve social justice provide a key opportunity to advance health equity. This special issue highlights work that advances our ability to achieve equity in youth mental health services. We rely on definitions of equity that emphasize the provision of resources based on need, fair access to those services, a goal of supporting optimal levels of health, and a focus on the social determinants of wellbeing (American Psychological Association (APA), 2021; Braverman et al., 2017). By centering equity and diversity at all levels, the articles in this special issue contribute to an evidence base that is equipped to support action. Part I of the special issue includes articles that synthesize and advance knowledge on the needs of diverse populations and examine key issues impacting equity in access to needed services. Part II of the special issue includes articles focused on engagement, service delivery and effectiveness, and the sustainability of services within systems. Articles in this first part of the special issue utilize systematic review, qualitative, quantitative, and community-engaged methods to address important questions related to health equity across unique populations, clinical needs, and service settings. DeLuca et al. (2022) use a minority stress and intersectional lens in their review of the literature on youth at clinical high risk for psychosis. The authors first describe the relevant social and policy contexts influencing inequities in identification and treatment of youth who could be served by specialty clinics targeting youth at clinical high risk for psychosis. They subsequently provide a narrative review of the literature across a comprehensive range of areas, making explicit connections to issues of equity. They end with a call-to-action and provide specific recommendations for advancing equity for this population. In a systematic narrative review of the literature, Xin et al. (2022) consider randomized controlled trials of cognitive behavior therapy (CBT) conducted with Asian ","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"7 1","pages":"173 - 175"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43323157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-03DOI: 10.1080/23794925.2022.2070884
Kalani Gates, A. Damashek, Kailyn Alderman, B. Babcock, Brendan Skinner
ABSTRACT Racial disparities exist in the quality of and access to mental health services for people of color. Provider bias has been found to avert African American adults from accessing services. However, it is unknown whether provider bias affects service access for African and Arab American youth. Moreover, little is known about the role of client gender and community variables such as urbanicity (i.e., urban versus non-urban) in access to care for youth. Audit methodology examined whether client race/ethnicity and gender predicted providers’ responses to help-seeking messages in an urban and non-urban area of Michigan. Voice actresses created audio recordings portraying a White, African American, or Arab American mother requesting a therapy appointment for her adolescent. Recordings were left on providers’ voicemails in Metro Detroit and Southwest Michigan. Data were collected on whether the providers: (i) called back, and (ii) initiated or denied services. The effect of client characteristics on the odds of a provider calling back differed by location. In the non-urban location, White clients had a 3.4–3.8 times greater odds of receiving a callback than the African and Arab American clients. Additionally, in the urban location, female clients had a 2 times greater odds of receiving a callback than the male clients. Findings from this study suggest that provider bias limited access to mental health services for African and Arab American adolescents in the non-urban location, highlighting the need for strategies to address disparities in access to mental health services for youth of color.
{"title":"Racial and Ethnic Disparities in Access to Mental Health Services for African and Arab American Youth: An Audit Study","authors":"Kalani Gates, A. Damashek, Kailyn Alderman, B. Babcock, Brendan Skinner","doi":"10.1080/23794925.2022.2070884","DOIUrl":"https://doi.org/10.1080/23794925.2022.2070884","url":null,"abstract":"ABSTRACT Racial disparities exist in the quality of and access to mental health services for people of color. Provider bias has been found to avert African American adults from accessing services. However, it is unknown whether provider bias affects service access for African and Arab American youth. Moreover, little is known about the role of client gender and community variables such as urbanicity (i.e., urban versus non-urban) in access to care for youth. Audit methodology examined whether client race/ethnicity and gender predicted providers’ responses to help-seeking messages in an urban and non-urban area of Michigan. Voice actresses created audio recordings portraying a White, African American, or Arab American mother requesting a therapy appointment for her adolescent. Recordings were left on providers’ voicemails in Metro Detroit and Southwest Michigan. Data were collected on whether the providers: (i) called back, and (ii) initiated or denied services. The effect of client characteristics on the odds of a provider calling back differed by location. In the non-urban location, White clients had a 3.4–3.8 times greater odds of receiving a callback than the African and Arab American clients. Additionally, in the urban location, female clients had a 2 times greater odds of receiving a callback than the male clients. Findings from this study suggest that provider bias limited access to mental health services for African and Arab American adolescents in the non-urban location, highlighting the need for strategies to address disparities in access to mental health services for youth of color.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"7 1","pages":"260 - 274"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47730101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-15DOI: 10.1080/23794925.2022.2042876
Paige J. Trojanowski, R. Mehlenbeck, Sarah F. Fischer
ABSTRACT Adolescent girls with Type 1 diabetes (T1D) are at high risk for developing eating disorders (EDs), a comorbidity that undermines treatment adherence and contributes to serious medical complications. Despite these concerns, no teen prevention programs exist that address risk factors specific to T1D. This study aimed to adapt an existing, empirically supported cognitive dissonance-based ED prevention program (Body Project) for teen girls with T1D. Young women with T1D, parents, and multidisciplinary medical professionals participated in semi-structured focus groups and individual interviews centered on understanding T1D-specific factors that influence body image development and eating and gathering suggestions for modifying the program to address T1D-specific factors. Multiple themes were identified related to complicating factors: diabetes stereotypes and misinformation, illness non-acceptance, demands of T1D management, adolescent-doctor relations, and family factors. Three themes related to protective factors also emerged: illness acceptance, validation and normalization of experiences, and family factors. Stakeholder feedback on program structure was also gathered. The adapted manual protocol is described in detail in addition to how findings extend current theoretical models of ED development in young women with T1D. The adapted ED prevention program, Body Project (T1D Style), centers on promoting illness acceptance, encouraging self-affirmation, teaching effective communication skills, and enhancing social support in addition to the original program’s focus on challenging and resisting sociocultural appearance pressures.
{"title":"Adapting a Cognitive Dissonance-based Eating Disorders Prevention Program for Adolescent Girls with Type 1 Diabetes","authors":"Paige J. Trojanowski, R. Mehlenbeck, Sarah F. Fischer","doi":"10.1080/23794925.2022.2042876","DOIUrl":"https://doi.org/10.1080/23794925.2022.2042876","url":null,"abstract":"ABSTRACT Adolescent girls with Type 1 diabetes (T1D) are at high risk for developing eating disorders (EDs), a comorbidity that undermines treatment adherence and contributes to serious medical complications. Despite these concerns, no teen prevention programs exist that address risk factors specific to T1D. This study aimed to adapt an existing, empirically supported cognitive dissonance-based ED prevention program (Body Project) for teen girls with T1D. Young women with T1D, parents, and multidisciplinary medical professionals participated in semi-structured focus groups and individual interviews centered on understanding T1D-specific factors that influence body image development and eating and gathering suggestions for modifying the program to address T1D-specific factors. Multiple themes were identified related to complicating factors: diabetes stereotypes and misinformation, illness non-acceptance, demands of T1D management, adolescent-doctor relations, and family factors. Three themes related to protective factors also emerged: illness acceptance, validation and normalization of experiences, and family factors. Stakeholder feedback on program structure was also gathered. The adapted manual protocol is described in detail in addition to how findings extend current theoretical models of ED development in young women with T1D. The adapted ED prevention program, Body Project (T1D Style), centers on promoting illness acceptance, encouraging self-affirmation, teaching effective communication skills, and enhancing social support in addition to the original program’s focus on challenging and resisting sociocultural appearance pressures.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"88 - 104"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49640022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-11DOI: 10.1080/23794925.2022.2034551
Casey D. Calhoun, Elizabeth A. Nick, Kyrill Gurtovenko, Aaron J. Vaughn, S. Simmons, R. Taylor, Eileen Twohy, Jessica E. Flannery, Alysha D. Thompson
ABSTRACT Children and adolescents admitted to psychiatric inpatient units typically present with severe psychopathology, trauma histories, and risk to self or others. Unfortunately, inpatient care has proven to be largely ineffective in changing the course of mental illness for these youth, with many experiencing readmission or continued risk following discharge. A critical examination of child and adolescent psychiatric inpatient practices, and guiding models of care, are greatly needed. This comprehensive review provides an overview of contemporary inpatient care, highlighting specific areas where empirically-informed guidance is present and lacking. The content reviewed includes: scope and structure of inpatient care, intake and evaluation, safety and security, therapeutic interventions, and discharge planning. Following our review, we present the 5S model as a guiding framework for inpatient care and continued research. Lastly, given the critical importance of inpatient care and the sparse empirical literature in this area, we issue a call for research investigating all aspects of inpatient care from admission to post-discharge.
{"title":"Child and Adolescent Psychiatric Inpatient Care: Contemporary Practices and Introduction of the 5S Model","authors":"Casey D. Calhoun, Elizabeth A. Nick, Kyrill Gurtovenko, Aaron J. Vaughn, S. Simmons, R. Taylor, Eileen Twohy, Jessica E. Flannery, Alysha D. Thompson","doi":"10.1080/23794925.2022.2034551","DOIUrl":"https://doi.org/10.1080/23794925.2022.2034551","url":null,"abstract":"ABSTRACT Children and adolescents admitted to psychiatric inpatient units typically present with severe psychopathology, trauma histories, and risk to self or others. Unfortunately, inpatient care has proven to be largely ineffective in changing the course of mental illness for these youth, with many experiencing readmission or continued risk following discharge. A critical examination of child and adolescent psychiatric inpatient practices, and guiding models of care, are greatly needed. This comprehensive review provides an overview of contemporary inpatient care, highlighting specific areas where empirically-informed guidance is present and lacking. The content reviewed includes: scope and structure of inpatient care, intake and evaluation, safety and security, therapeutic interventions, and discharge planning. Following our review, we present the 5S model as a guiding framework for inpatient care and continued research. Lastly, given the critical importance of inpatient care and the sparse empirical literature in this area, we issue a call for research investigating all aspects of inpatient care from admission to post-discharge.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"7 1","pages":"477 - 492"},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49260705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-08DOI: 10.1080/23794925.2022.2042870
R. Lewandowski, J. Jenness, Carolyn N. Spiro, Kathryn Delonga, K. Crowe, Kavita Tahilani, Katie Happer, Paul Sullivan, Kathleen S Camacho, Jiyon Kim, Karen Fleiss, Alan Schlechter, B. Watson, Mark J. Knepley, C. Martell, K. Hoagwood, S. Horwitz, E. McCauley
ABSTRACT This paper describes the implementation of Behavioral Activation (BA) as the core psychotherapy treatment within a broader clinician-led effort to establish a care pathway for adolescent depression in an academic medical center that served public and private hospital systems. This quality improvement effort required a standardized yet flexible approach to psychotherapy to be used by clinicians with a range of experience and training backgrounds while serving diverse clinical populations in child psychiatry and pediatric clinics. This paper highlights implementation of BA in treating adolescent depression across these varying systems. In particular, the paper emphasizes the application of BA as a principle-driven, treatment that enables flexibility across settings while remaining rooted in scientific evidence. The paper also reviews lessons learned from this effort that may support efforts to implement BA in other clinical settings and systems.
{"title":"Implementation of Behavioral Activation within a Care Pathway for Adolescent Depression at an Academic Medical Center","authors":"R. Lewandowski, J. Jenness, Carolyn N. Spiro, Kathryn Delonga, K. Crowe, Kavita Tahilani, Katie Happer, Paul Sullivan, Kathleen S Camacho, Jiyon Kim, Karen Fleiss, Alan Schlechter, B. Watson, Mark J. Knepley, C. Martell, K. Hoagwood, S. Horwitz, E. McCauley","doi":"10.1080/23794925.2022.2042870","DOIUrl":"https://doi.org/10.1080/23794925.2022.2042870","url":null,"abstract":"ABSTRACT This paper describes the implementation of Behavioral Activation (BA) as the core psychotherapy treatment within a broader clinician-led effort to establish a care pathway for adolescent depression in an academic medical center that served public and private hospital systems. This quality improvement effort required a standardized yet flexible approach to psychotherapy to be used by clinicians with a range of experience and training backgrounds while serving diverse clinical populations in child psychiatry and pediatric clinics. This paper highlights implementation of BA in treating adolescent depression across these varying systems. In particular, the paper emphasizes the application of BA as a principle-driven, treatment that enables flexibility across settings while remaining rooted in scientific evidence. The paper also reviews lessons learned from this effort that may support efforts to implement BA in other clinical settings and systems.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"73 - 87"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44025463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-08DOI: 10.1080/23794925.2022.2042875
Stephanie K. Gusler, Angela Moreland, M. D. de Arellano
ABSTRACT Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for the reduction of trauma symptoms among trauma-exposed children and adolescents. Although the effectiveness of TF-CBT has been repeatedly evidenced when administered via telehealth or in non-English languages, no work has examined the effectiveness of TF-CBT through telehealth and with support of language interpretation. Providing information about TF-CBT implementation via telehealth utilizing interpreter services can help to reduce barriers to evidence-based care among trauma-exposed youth. The present case study reviews a treatment case of two teen siblings, for whom TF-CBT was administered through telehealth, and whose caregiver’s primary language was Spanish. The teens reported experiencing multiple traumatic events and evidenced subthreshold posttraumatic stress disorder (PTSD) symptoms, which were impairing their mood and interactions with others. TF-CBT was completed over the course of 15 sessions through a HIPAA-compliant telehealth platform, using interpretation support in caregiver meetings. Both teens evidenced reductions in trauma symptoms at post-treatment, demonstrating the effectiveness of TF-CBT in this case which utilized interpretation and telehealth. Guidelines, considerations, challenges, and lessons learned specific to both interpretation and telehealth are discussed.
{"title":"Implementing Telehealth-Based TF-CBT with Support of Interpretation: A Case Study","authors":"Stephanie K. Gusler, Angela Moreland, M. D. de Arellano","doi":"10.1080/23794925.2022.2042875","DOIUrl":"https://doi.org/10.1080/23794925.2022.2042875","url":null,"abstract":"ABSTRACT Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for the reduction of trauma symptoms among trauma-exposed children and adolescents. Although the effectiveness of TF-CBT has been repeatedly evidenced when administered via telehealth or in non-English languages, no work has examined the effectiveness of TF-CBT through telehealth and with support of language interpretation. Providing information about TF-CBT implementation via telehealth utilizing interpreter services can help to reduce barriers to evidence-based care among trauma-exposed youth. The present case study reviews a treatment case of two teen siblings, for whom TF-CBT was administered through telehealth, and whose caregiver’s primary language was Spanish. The teens reported experiencing multiple traumatic events and evidenced subthreshold posttraumatic stress disorder (PTSD) symptoms, which were impairing their mood and interactions with others. TF-CBT was completed over the course of 15 sessions through a HIPAA-compliant telehealth platform, using interpretation support in caregiver meetings. Both teens evidenced reductions in trauma symptoms at post-treatment, demonstrating the effectiveness of TF-CBT in this case which utilized interpretation and telehealth. Guidelines, considerations, challenges, and lessons learned specific to both interpretation and telehealth are discussed.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"148 - 162"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41955840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28DOI: 10.1080/23794925.2022.2034553
Kristin E. Canavera, T. Ollendick, Lara J. Farrell, S. Whiteside
ABSTRACT The need for effective treatments for obsessive-compulsive disorder (OCD) in childhood is evident given that as many as 50% of the adults with OCD report symptom onset before age 15. Despite the growing evidence supporting the efficacy of Exposure and Response Prevention (ERP) for youth with OCD, children seeking services for their OCD symptoms often do not receive ERP because of difficulties with treatment accessibility. Brief time-intensive treatment programs may be a feasible treatment option for children and their families who do not have access to ERP treatment and/or live in an area where therapists trained in ERP are limited. To evaluate the initial efficacy, feasibility, and acceptability of a brief, five-day intensive ERP program for pediatric OCD, eight children with OCD were randomized to a one-week, two-week, or three-week baseline period in a single-case, non-concurrent multiple-baseline experimental design. In most cases, there were clinically significant improvements in OCD symptoms with the implementation of treatment; moreover, treatment gains were maintained at 3-month follow-up. Children and families perceived the program to be acceptable, feasible, and beneficial. This study extends the support for the efficacy and feasibility of a five-day intensive treatment program for pediatric OCD.
{"title":"A Five-Day Intensive Treatment for Pediatric Obsessive-Compulsive Disorder: A Multiple Baseline Design Pilot Study","authors":"Kristin E. Canavera, T. Ollendick, Lara J. Farrell, S. Whiteside","doi":"10.1080/23794925.2022.2034553","DOIUrl":"https://doi.org/10.1080/23794925.2022.2034553","url":null,"abstract":"ABSTRACT The need for effective treatments for obsessive-compulsive disorder (OCD) in childhood is evident given that as many as 50% of the adults with OCD report symptom onset before age 15. Despite the growing evidence supporting the efficacy of Exposure and Response Prevention (ERP) for youth with OCD, children seeking services for their OCD symptoms often do not receive ERP because of difficulties with treatment accessibility. Brief time-intensive treatment programs may be a feasible treatment option for children and their families who do not have access to ERP treatment and/or live in an area where therapists trained in ERP are limited. To evaluate the initial efficacy, feasibility, and acceptability of a brief, five-day intensive ERP program for pediatric OCD, eight children with OCD were randomized to a one-week, two-week, or three-week baseline period in a single-case, non-concurrent multiple-baseline experimental design. In most cases, there were clinically significant improvements in OCD symptoms with the implementation of treatment; moreover, treatment gains were maintained at 3-month follow-up. Children and families perceived the program to be acceptable, feasible, and beneficial. This study extends the support for the efficacy and feasibility of a five-day intensive treatment program for pediatric OCD.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"120 - 132"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42909652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-02DOI: 10.1080/23794925.2022.2025631
Niza A. Tonarely-Busto, Dominique Phillips, Estefany Saez-Clarke, Ashley R. Karlovich, Kelly Kudryk, A. Lewin, Jill Ehrenreich-May
ABSTRACT Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.
{"title":"Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents to Misophonia: A Case Example","authors":"Niza A. Tonarely-Busto, Dominique Phillips, Estefany Saez-Clarke, Ashley R. Karlovich, Kelly Kudryk, A. Lewin, Jill Ehrenreich-May","doi":"10.1080/23794925.2022.2025631","DOIUrl":"https://doi.org/10.1080/23794925.2022.2025631","url":null,"abstract":"ABSTRACT Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"133 - 147"},"PeriodicalIF":0.0,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42428565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-20DOI: 10.1080/23794925.2022.2025629
Alayna L. Park, Leslie R. Rith-Najarian, Dana Saifan, R. Gellatly, Stanley J. Huey, B. Chorpita
ABSTRACT This review summarized the literature on psychosocial interventions for youth of color. Ninety-three journal articles of randomized clinical trials, with samples comprising youth of color, published between 1974 and 2018 were coded for sample characteristics, intervention characteristics, and strategies for incorporating culture into psychotherapy. Results found 69 psychosocial interventions to be efficacious for youth of color; 32% of these psychosocial interventions included a strategy for incorporating culture into psychotherapy. The evidence base was largest for Black and Hispanic/Latinx populations and for psychosocial interventions targeting disruptive behavior problems. The most common strategies for incorporating culture into treatment among effective psychosocial interventions were employing procedures for addressing cultural context and including providers with awareness and knowledge of the client’s culture. The inclusion of strategies for incorporating culture was not associated with treatment efficacy. Findings from this review highlight the laudable efforts that have been made to identify efficacious psychosocial interventions for youth of color and illuminate remaining gaps in the evidence base (e.g., efficacious psychosocial interventions for Asian, Native American and Alaska Native, and Native Hawaiian and Pacific Islander youth). Findings also emphasize the nuance of providing effective mental health services that are compatible with client’s cultural worldviews, values, and practices and allude to the promise of decision support tools to help providers determine whether, when, and how to culturally tailor their psychotherapy with youth of color.
{"title":"Strategies for Incorporating Culture into Psychosocial Interventions for Youth of Color","authors":"Alayna L. Park, Leslie R. Rith-Najarian, Dana Saifan, R. Gellatly, Stanley J. Huey, B. Chorpita","doi":"10.1080/23794925.2022.2025629","DOIUrl":"https://doi.org/10.1080/23794925.2022.2025629","url":null,"abstract":"ABSTRACT This review summarized the literature on psychosocial interventions for youth of color. Ninety-three journal articles of randomized clinical trials, with samples comprising youth of color, published between 1974 and 2018 were coded for sample characteristics, intervention characteristics, and strategies for incorporating culture into psychotherapy. Results found 69 psychosocial interventions to be efficacious for youth of color; 32% of these psychosocial interventions included a strategy for incorporating culture into psychotherapy. The evidence base was largest for Black and Hispanic/Latinx populations and for psychosocial interventions targeting disruptive behavior problems. The most common strategies for incorporating culture into treatment among effective psychosocial interventions were employing procedures for addressing cultural context and including providers with awareness and knowledge of the client’s culture. The inclusion of strategies for incorporating culture was not associated with treatment efficacy. Findings from this review highlight the laudable efforts that have been made to identify efficacious psychosocial interventions for youth of color and illuminate remaining gaps in the evidence base (e.g., efficacious psychosocial interventions for Asian, Native American and Alaska Native, and Native Hawaiian and Pacific Islander youth). Findings also emphasize the nuance of providing effective mental health services that are compatible with client’s cultural worldviews, values, and practices and allude to the promise of decision support tools to help providers determine whether, when, and how to culturally tailor their psychotherapy with youth of color.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"181 - 193"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46905393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-20DOI: 10.1080/23794925.2021.1996299
Sarah E. Martin, B. Kavanaugh, Claudia Paszek, Mia Demarco, Lauren R. Mernick, J. Boekamp
ABSTRACT Children with deficits in executive function are at risk for poor outcomes in academic, social-emotional, and behavioral domains. These deficits have been particularly well documented in school-aged children with attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders. However, there have been fewer studies exploring the links between executive function and psychopathology in preschool-aged children, particularly among young children with diagnosed psychiatric disorders and significant clinical impairment. This study examined associations between executive dysfunction, psychiatric symptoms, and behavioral dysregulation in a sample of 44 preschoolers participating in an intensive psychiatric day treatment program. The NIH Toolbox Early Childhood Cognition Battery was used to assess EF, including inhibitory control and cognitive flexibility, and parent-reported assessments were used to examine child psychiatric symptoms and behavioral dysregulation. Analyses using linear and logistic regression equation modeling suggest that executive dysfunction – particularly cognitive inflexibility – is a significant predictor of ADHD symptoms and behavioral dysregulation in clinically-referred preschoolers. Findings are discussed with respect to the role of executive dysfunction in early childhood psychopathology, with implications for treatment. Findings also suggest the NIH Toolbox is feasible for use in an early childhood psychiatric treatment setting and provides valid neurocognitive results to inform treatment planning and clinical care.
{"title":"Executive Dysfunction, Psychiatric Symptoms, and Behavioral Dysregulation in Preschoolers: Preliminary Findings in a Clinical Sample","authors":"Sarah E. Martin, B. Kavanaugh, Claudia Paszek, Mia Demarco, Lauren R. Mernick, J. Boekamp","doi":"10.1080/23794925.2021.1996299","DOIUrl":"https://doi.org/10.1080/23794925.2021.1996299","url":null,"abstract":"ABSTRACT Children with deficits in executive function are at risk for poor outcomes in academic, social-emotional, and behavioral domains. These deficits have been particularly well documented in school-aged children with attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders. However, there have been fewer studies exploring the links between executive function and psychopathology in preschool-aged children, particularly among young children with diagnosed psychiatric disorders and significant clinical impairment. This study examined associations between executive dysfunction, psychiatric symptoms, and behavioral dysregulation in a sample of 44 preschoolers participating in an intensive psychiatric day treatment program. The NIH Toolbox Early Childhood Cognition Battery was used to assess EF, including inhibitory control and cognitive flexibility, and parent-reported assessments were used to examine child psychiatric symptoms and behavioral dysregulation. Analyses using linear and logistic regression equation modeling suggest that executive dysfunction – particularly cognitive inflexibility – is a significant predictor of ADHD symptoms and behavioral dysregulation in clinically-referred preschoolers. Findings are discussed with respect to the role of executive dysfunction in early childhood psychopathology, with implications for treatment. Findings also suggest the NIH Toolbox is feasible for use in an early childhood psychiatric treatment setting and provides valid neurocognitive results to inform treatment planning and clinical care.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"1 - 9"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43049552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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