Pub Date : 2022-06-13DOI: 10.1080/23794925.2022.2081947
Callie Gilchrest, Kyle D Srnka, Lauren Gardner, W. Frye, J. Katzenstein, Marissa A Feldman
ABSTRACT The impact of COVID-19 on the psychology training community has included modifications to internship and postdoctoral fellowship training programs to assure the safety of patients, trainees, and staff. Studies assessing the impact of COVID-19 on training in health service psychology are emerging; however, few studies have provided the opportunity for psychology trainees to candidly report about their experiences during the ongoing pandemic. This paper aims to describe how the pandemic effected internship and fellowship training experiences from the trainee’s perspective. Participants included 58 trainees from pediatric psychology internship and postdoctoral fellowship programs in the United States. A survey containing open- and close-ended questions was distributed to trainees via their training directors to assess training experiences during COVID-19. Qualitative analysis of responses revealed four themes describing 1) reduced depth and breadth of training opportunities, 2) social isolation and limited professional and personal support, 3) increased use of telepsychology and reduced in-person training, and 4) increased levels of stress and burnout combined with decreased morale. Many internship trainees described pandemic-related challenges to completion of dissertation, and postdoctoral fellows experienced altered or delayed professional trajectories due to financial, mental health, and career readiness factors. Implications and future directions include the need for increased support both professionally and personally for trainees who are completing internship and postdoctoral fellowship training in the midst of COVID-19.
{"title":"Trainee Perspectives on Internship and Fellowship Training Experiences in Pediatric Health Service Psychology during a Global Pandemic","authors":"Callie Gilchrest, Kyle D Srnka, Lauren Gardner, W. Frye, J. Katzenstein, Marissa A Feldman","doi":"10.1080/23794925.2022.2081947","DOIUrl":"https://doi.org/10.1080/23794925.2022.2081947","url":null,"abstract":"ABSTRACT The impact of COVID-19 on the psychology training community has included modifications to internship and postdoctoral fellowship training programs to assure the safety of patients, trainees, and staff. Studies assessing the impact of COVID-19 on training in health service psychology are emerging; however, few studies have provided the opportunity for psychology trainees to candidly report about their experiences during the ongoing pandemic. This paper aims to describe how the pandemic effected internship and fellowship training experiences from the trainee’s perspective. Participants included 58 trainees from pediatric psychology internship and postdoctoral fellowship programs in the United States. A survey containing open- and close-ended questions was distributed to trainees via their training directors to assess training experiences during COVID-19. Qualitative analysis of responses revealed four themes describing 1) reduced depth and breadth of training opportunities, 2) social isolation and limited professional and personal support, 3) increased use of telepsychology and reduced in-person training, and 4) increased levels of stress and burnout combined with decreased morale. Many internship trainees described pandemic-related challenges to completion of dissertation, and postdoctoral fellows experienced altered or delayed professional trajectories due to financial, mental health, and career readiness factors. Implications and future directions include the need for increased support both professionally and personally for trainees who are completing internship and postdoctoral fellowship training in the midst of COVID-19.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"7 1","pages":"363 - 373"},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43857256","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 : 2022-05-17DOI: 10.1080/23794925.2022.2051214
Abigail E. Candelari, A. Viana
ABSTRACT Despite repeated calls regarding the need to target parental accommodation and overcontrol in child anxiety treatment, brief protocols specifically targeting these behaviors in parents of clinically anxious youth are currently limited in number. The present investigation piloted and refined a theoretically informed, internet-delivered, single-session intervention (SSI) specifically aimed at reducing parental accommodation and overcontrolling behaviors. Socioeconomically and racially diverse parents of clinically anxious children (N = 12; M age =10.08 years, SD = 1.74, range = 7–14 years) were recruited in two phases. In Phase One, three online focus groups with two parents each (n = 6) received the intervention and provided qualitative and quantitative feedback on the feasibility and acceptability of the intervention program. Parental feedback from the focus groups was used to revise the program. In Phase Two, the revised program was administered to six new parents to examine the program’s acceptability and feasibility for increasing psychoeducational knowledge regarding child anxiety, parental accommodation, and overcontrol. Across both phases, the intervention was well-received by parents in terms of relevance, acceptability, and feasibility. Parents demonstrated significant increases in knowledge of parental accommodation, overcontrol, and child anxiety from pre- to post-intervention. Qualitative data indicated that parents benefited from the unique online format as well as the content. Findings support the feasibility and acceptability of an accessible and time-efficient SSI designed to target problematic parenting behaviors among parents of clinically anxious children.
{"title":"Single-Session Computer-Delivered Intervention for Parental Accommodation and Overcontrolling Behaviors: A Pilot Study","authors":"Abigail E. Candelari, A. Viana","doi":"10.1080/23794925.2022.2051214","DOIUrl":"https://doi.org/10.1080/23794925.2022.2051214","url":null,"abstract":"ABSTRACT Despite repeated calls regarding the need to target parental accommodation and overcontrol in child anxiety treatment, brief protocols specifically targeting these behaviors in parents of clinically anxious youth are currently limited in number. The present investigation piloted and refined a theoretically informed, internet-delivered, single-session intervention (SSI) specifically aimed at reducing parental accommodation and overcontrolling behaviors. Socioeconomically and racially diverse parents of clinically anxious children (N = 12; M age =10.08 years, SD = 1.74, range = 7–14 years) were recruited in two phases. In Phase One, three online focus groups with two parents each (n = 6) received the intervention and provided qualitative and quantitative feedback on the feasibility and acceptability of the intervention program. Parental feedback from the focus groups was used to revise the program. In Phase Two, the revised program was administered to six new parents to examine the program’s acceptability and feasibility for increasing psychoeducational knowledge regarding child anxiety, parental accommodation, and overcontrol. Across both phases, the intervention was well-received by parents in terms of relevance, acceptability, and feasibility. Parents demonstrated significant increases in knowledge of parental accommodation, overcontrol, and child anxiety from pre- to post-intervention. Qualitative data indicated that parents benefited from the unique online format as well as the content. Findings support the feasibility and acceptability of an accessible and time-efficient SSI designed to target problematic parenting behaviors among parents of clinically anxious children.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41371313","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 : 2022-05-02DOI: 10.1080/23794925.2022.2056929
Atara Hiller, Christopher D Hughes
ABSTRACT The goal of this study was to evaluate the effectiveness of dialectical behavior therapy for adolescents (DBT-A) with borderline personality disorder (BPD) features under routine health-care conditions, particularly an urban hospital that primarily treats low income and ethnic minority individuals. Ninety-one adolescents (age 11–18) participated in at least one cycle of an outpatient DBT-A program, with the option to continue in additional cycles. The majority, 39% (N = 35), identified as Hispanic/Latinx, 29% (N = 27) as non-Hispanic White, and 20% (N = 18) as Black; 84% (N = 76) identified as female. Prior to beginning treatment, adolescents completed baseline assessments on BPD symptoms (BPD subscale of the Structured Clinical Interview for DSM-IV; Life Problems Inventory), lifetime history of suicidal and non-suicidal self-injurious behaviors (Lifetime-Suicide Attempt Self-Injury Interview), depression (Beck Depression Inventory), and higher level of care utilization. After each treatment cycle, participants completed these measures again; they and their caregivers also completed a DBT acceptability questionnaire (DBT-A Satisfaction Survey). Results yielded statistical and clinical significance, and reliable change (reduction) in suicidal behavior, non-suicidal self-injurious behavior, BPD symptoms (impulsivity, identity disturbance, interpersonal problems, and emotion dysregulation), depression, and service utilization (effect sizes ranging from medium to large) with high client satisfaction. These findings expand upon previous DBT-A effectiveness research by engaging a larger and more diverse sample with broader inclusion criteria that is consistent with outpatient community settings, reporting on the clinical significance of DBT-A, and assessing outcomes beyond one cycle of treatment.
{"title":"Dialectical Behavior Therapy for Adolescents: Treatment Outcomes in an Outpatient Community Setting","authors":"Atara Hiller, Christopher D Hughes","doi":"10.1080/23794925.2022.2056929","DOIUrl":"https://doi.org/10.1080/23794925.2022.2056929","url":null,"abstract":"ABSTRACT The goal of this study was to evaluate the effectiveness of dialectical behavior therapy for adolescents (DBT-A) with borderline personality disorder (BPD) features under routine health-care conditions, particularly an urban hospital that primarily treats low income and ethnic minority individuals. Ninety-one adolescents (age 11–18) participated in at least one cycle of an outpatient DBT-A program, with the option to continue in additional cycles. The majority, 39% (N = 35), identified as Hispanic/Latinx, 29% (N = 27) as non-Hispanic White, and 20% (N = 18) as Black; 84% (N = 76) identified as female. Prior to beginning treatment, adolescents completed baseline assessments on BPD symptoms (BPD subscale of the Structured Clinical Interview for DSM-IV; Life Problems Inventory), lifetime history of suicidal and non-suicidal self-injurious behaviors (Lifetime-Suicide Attempt Self-Injury Interview), depression (Beck Depression Inventory), and higher level of care utilization. After each treatment cycle, participants completed these measures again; they and their caregivers also completed a DBT acceptability questionnaire (DBT-A Satisfaction Survey). Results yielded statistical and clinical significance, and reliable change (reduction) in suicidal behavior, non-suicidal self-injurious behavior, BPD symptoms (impulsivity, identity disturbance, interpersonal problems, and emotion dysregulation), depression, and service utilization (effect sizes ranging from medium to large) with high client satisfaction. These findings expand upon previous DBT-A effectiveness research by engaging a larger and more diverse sample with broader inclusion criteria that is consistent with outpatient community settings, reporting on the clinical significance of DBT-A, and assessing outcomes beyond one cycle of treatment.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43195533","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 : 2022-05-02DOI: 10.1080/23794925.2022.2062687
M. Castro, R. J. Rodríguez, Bradley O. Hudson, V. R. Weersing, M. Kipke, Brad Peterson, A. West
ABSTRACT The purpose of this qualitative study was to capture the perspectives of individuals representing an urban, predominantly Latinx community who are underresourced by mental health services about the use of telehealth to deliver mental health treatment. The COVID-19 pandemic required hospital- and community-based mental health programs to pivot to telehealth with alarming speed and very little opportunity to assess the feasibility, acceptability, and disparate impact on unique populations of patients. This study aimed to assess perceived strengths and limitations of telehealth mental health service delivery via qualitative focus group methods. Three focus groups were conducted with 13 youth (aged 8–17) who were being treated at an urban, academic children’s hospital serving a predominantly Latinx community mental health population; two focus groups were conducted with 19 parents of said children; and one focus group was conducted with four mental health providers providing services to this population. A coding schema was designed to capture themes relevant to the following: (1) privacy and confidentiality; (2) perceived limitations of telehealth; (3) comfort with telehealth; (4) therapeutic relationship; (5) perceived strengths of telehealth; (6) perceived safety of telehealth; and (7) advice for providers engaging in telehealth. Findings were illustrative of both perceived strengths and limitations across these domains that can inform optimized telehealth mental health services moving forward.
{"title":"Delivery of Cognitive Behavioral Therapy With Diverse, Underresourced Youth Using Telehealth: Advancing Equity Through Consumer Perspectives","authors":"M. Castro, R. J. Rodríguez, Bradley O. Hudson, V. R. Weersing, M. Kipke, Brad Peterson, A. West","doi":"10.1080/23794925.2022.2062687","DOIUrl":"https://doi.org/10.1080/23794925.2022.2062687","url":null,"abstract":"ABSTRACT The purpose of this qualitative study was to capture the perspectives of individuals representing an urban, predominantly Latinx community who are underresourced by mental health services about the use of telehealth to deliver mental health treatment. The COVID-19 pandemic required hospital- and community-based mental health programs to pivot to telehealth with alarming speed and very little opportunity to assess the feasibility, acceptability, and disparate impact on unique populations of patients. This study aimed to assess perceived strengths and limitations of telehealth mental health service delivery via qualitative focus group methods. Three focus groups were conducted with 13 youth (aged 8–17) who were being treated at an urban, academic children’s hospital serving a predominantly Latinx community mental health population; two focus groups were conducted with 19 parents of said children; and one focus group was conducted with four mental health providers providing services to this population. A coding schema was designed to capture themes relevant to the following: (1) privacy and confidentiality; (2) perceived limitations of telehealth; (3) comfort with telehealth; (4) therapeutic relationship; (5) perceived strengths of telehealth; (6) perceived safety of telehealth; and (7) advice for providers engaging in telehealth. Findings were illustrative of both perceived strengths and limitations across these domains that can inform optimized telehealth mental health services moving forward.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"206 - 220"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48414106","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 : 2022-04-20DOI: 10.1080/23794925.2022.2051213
Corinna C. Klein, J. González, M. Tremblay, M. Barnett
ABSTRACT Although engaging fathers effectively can bolster and sustain treatment outcomes, fathers participate in their children’s treatment at lower rates than mothers and have been left out of the literature on caregiver engagement. Because provider attitudes and behaviors shape the course of treatment, therapist perspectives on father attendance and engagement should be investigated. A mixed-method study design examined rates and predictors of father attendance in treatment and therapist perspectives on father engagement in Parent-Child Interaction Therapy (PCIT). Quantitative data were gathered through a survey distributed to PCIT therapists (n = 267) to identify the effects of: 1) therapist and caseload characteristics, 2) therapist confidence working with fathers, 3) therapist use of father engagement strategies, and 4) organizational practices for engaging fathers, on father attendance rates. Qualitative interviews with 23 therapists were thematically analyzed to expand upon therapist experiences engaging fathers. Therapists reported that on average, 60.97% of cases with a father available had regular session attendance by the father. Only frequency of therapist use of father engagement strategies predicted father attendance rate. Qualitative interviews expanded on the many barriers therapists face to engaging fathers and the variety of strategies they employ to engage fathers. Rates of father attendance in PCIT are higher than what has been previously reported in the literature but still show room for improvement. Despite barriers, therapists remain dedicated to developing solutions to elicit father engagement. Future research should evaluate whether therapist-reported engagement strategies effectively increase father participation and can be more widely disseminated.
{"title":"Father Participation in Parent-Child Interaction Therapy: Predictors and Therapist Perspectives","authors":"Corinna C. Klein, J. González, M. Tremblay, M. Barnett","doi":"10.1080/23794925.2022.2051213","DOIUrl":"https://doi.org/10.1080/23794925.2022.2051213","url":null,"abstract":"ABSTRACT Although engaging fathers effectively can bolster and sustain treatment outcomes, fathers participate in their children’s treatment at lower rates than mothers and have been left out of the literature on caregiver engagement. Because provider attitudes and behaviors shape the course of treatment, therapist perspectives on father attendance and engagement should be investigated. A mixed-method study design examined rates and predictors of father attendance in treatment and therapist perspectives on father engagement in Parent-Child Interaction Therapy (PCIT). Quantitative data were gathered through a survey distributed to PCIT therapists (n = 267) to identify the effects of: 1) therapist and caseload characteristics, 2) therapist confidence working with fathers, 3) therapist use of father engagement strategies, and 4) organizational practices for engaging fathers, on father attendance rates. Qualitative interviews with 23 therapists were thematically analyzed to expand upon therapist experiences engaging fathers. Therapists reported that on average, 60.97% of cases with a father available had regular session attendance by the father. Only frequency of therapist use of father engagement strategies predicted father attendance rate. Qualitative interviews expanded on the many barriers therapists face to engaging fathers and the variety of strategies they employ to engage fathers. Rates of father attendance in PCIT are higher than what has been previously reported in the literature but still show room for improvement. Despite barriers, therapists remain dedicated to developing solutions to elicit father engagement. Future research should evaluate whether therapist-reported engagement strategies effectively increase father participation and can be more widely disseminated.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"393 - 407"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42021546","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 : 2022-04-20DOI: 10.1080/23794925.2022.2062689
Joy R. Pemberton, Lauren B. Quetsch, Glenn R. Mesman, Karin L. Vanderzee, Elissa H. Dougherty, Caitlin A. Williams, Richard F. Davis, Allison R. Morton
ABSTRACT Parent-Child Interaction Therapy (PCIT), an evidence-based parent-training treatment, is unique from many other parent-training programs in that it utilizes coaching (i.e., in-vivo support) and feedback to enhance targeted parenting skills. One important skill-building technique in PCIT is a “drill” (within-session skill practice for a brief, focused time). Although the PCIT protocol states that drill exercises should be used starting in the fourth coaching session, limited guidance is present – leaving specifics and implementation to therapist discretion. This paper compiles drills used by PCIT therapists and trainers to provide practitioners with a variety of drill options and suggestions for utilization. We include a description of each drill, examples of clinical situations for which each drill may be appropriate, and recommendations for introducing a drill in session, with discussion regarding the importance of using culturally-sensitive language. Case vignettes are included to illustrate recommendations outlined within the paper and the application of specific drills.
{"title":"Drills in the PCIT Child-Directed Interaction Phase: A Compilation with Recommendations for Appropriate Use","authors":"Joy R. Pemberton, Lauren B. Quetsch, Glenn R. Mesman, Karin L. Vanderzee, Elissa H. Dougherty, Caitlin A. Williams, Richard F. Davis, Allison R. Morton","doi":"10.1080/23794925.2022.2062689","DOIUrl":"https://doi.org/10.1080/23794925.2022.2062689","url":null,"abstract":"ABSTRACT Parent-Child Interaction Therapy (PCIT), an evidence-based parent-training treatment, is unique from many other parent-training programs in that it utilizes coaching (i.e., in-vivo support) and feedback to enhance targeted parenting skills. One important skill-building technique in PCIT is a “drill” (within-session skill practice for a brief, focused time). Although the PCIT protocol states that drill exercises should be used starting in the fourth coaching session, limited guidance is present – leaving specifics and implementation to therapist discretion. This paper compiles drills used by PCIT therapists and trainers to provide practitioners with a variety of drill options and suggestions for utilization. We include a description of each drill, examples of clinical situations for which each drill may be appropriate, and recommendations for introducing a drill in session, with discussion regarding the importance of using culturally-sensitive language. Case vignettes are included to illustrate recommendations outlined within the paper and the application of specific drills.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"364 - 375"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44457046","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 : 2022-04-20DOI: 10.1080/23794925.2022.2051215
Jacqueline Sperling
This study investigated the role of intolerance of uncertainty (IU) in an intensive group-based cognitive behavioral therapy (CBT) program with family involvement for children with anxiety disorders and obsessive-compulsive disorder (OCD). One hundred four children and adolescents, aged 8–19 years, who were patients in an intensive outpatient group-based treatment program and their parents participated in this intervention-based study. From both children’s and parents’ perspectives at admission, higher IU in children was associated with both higher levels of anxiety and functional impairment. Both children and parents reported significant reductions in children’s IU by discharge, and these reductions were associated with greater reductions in children’s anxiety and functional impairment. However, children who reported higher levels of IU at admission, reported fewer reductions in their anxiety and functional impairment. These findings demonstrate an association between IU and children’s anxiety and OCD intensive treatment outcomes. Those with higher levels of IU may benefit from more interventions that address tolerating uncertainty.
{"title":"The Role of Intolerance of Uncertainty in Treatment for Pediatric Anxiety Disorders and Obsessive-Compulsive Disorder","authors":"Jacqueline Sperling","doi":"10.1080/23794925.2022.2051215","DOIUrl":"https://doi.org/10.1080/23794925.2022.2051215","url":null,"abstract":"This study investigated the role of intolerance of uncertainty (IU) in an intensive group-based cognitive behavioral therapy (CBT) program with family involvement for children with anxiety disorders and obsessive-compulsive disorder (OCD). One hundred four children and adolescents, aged 8–19 years, who were patients in an intensive outpatient group-based treatment program and their parents participated in this intervention-based study. From both children’s and parents’ perspectives at admission, higher IU in children was associated with both higher levels of anxiety and functional impairment. Both children and parents reported significant reductions in children’s IU by discharge, and these reductions were associated with greater reductions in children’s anxiety and functional impairment. However, children who reported higher levels of IU at admission, reported fewer reductions in their anxiety and functional impairment. These findings demonstrate an association between IU and children’s anxiety and OCD intensive treatment outcomes. Those with higher levels of IU may benefit from more interventions that address tolerating uncertainty.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44218863","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 : 2022-04-04DOI: 10.1080/23794925.2022.2056928
Erum Nadeem, Elizabeth Mcnamee, Jason M. Lang, Diana L. Perry, K. Lich
ABSTRACT Efforts to improve access to mental health care and the quality of available services are a central issue in advancing mental health equity for children and adolescents. This current case study represents a large-scale effort to develop and implement a sustainment plan for the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), an evidence-based program to support youth with traumatic stress symptoms, in an urban community. A diverse group of stakeholders including federally qualified health centers, state and federal government representatives, researchers, and local advocacy groups worked together to identify a method for assessing the program’s assets and needs, execute the selected method, and analyze the results to formulate a concrete action plan. This case study includes a novel application of System Support Mapping, a process that guides stakeholders to consider and document a system from their own perspective by creating a “map” of the roles, responsibility, needs, and resources. This process was applied for the first time as a method used to support and enhance sustainment of promising or evidence-based practices in a real-time, real-world context. Stakeholders identified the following sustainment priorities: 1) Funding to support non-billable service components; 2) Board of Education, teacher, and principal buy-in and support; and 3) Obtaining consent from guardians for screening and CBITS services. Results are discussed with respect to their alignment with sustainment factors in the literature and the ways in which local data collection through the System Support Mapping process led to actionable steps toward program sustainment.
{"title":"Novel Application of System Support Mapping for Sustainment of Trauma-focused Mental Health Intervention in School-Based Health Centers: A Case Study","authors":"Erum Nadeem, Elizabeth Mcnamee, Jason M. Lang, Diana L. Perry, K. Lich","doi":"10.1080/23794925.2022.2056928","DOIUrl":"https://doi.org/10.1080/23794925.2022.2056928","url":null,"abstract":"ABSTRACT Efforts to improve access to mental health care and the quality of available services are a central issue in advancing mental health equity for children and adolescents. This current case study represents a large-scale effort to develop and implement a sustainment plan for the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), an evidence-based program to support youth with traumatic stress symptoms, in an urban community. A diverse group of stakeholders including federally qualified health centers, state and federal government representatives, researchers, and local advocacy groups worked together to identify a method for assessing the program’s assets and needs, execute the selected method, and analyze the results to formulate a concrete action plan. This case study includes a novel application of System Support Mapping, a process that guides stakeholders to consider and document a system from their own perspective by creating a “map” of the roles, responsibility, needs, and resources. This process was applied for the first time as a method used to support and enhance sustainment of promising or evidence-based practices in a real-time, real-world context. Stakeholders identified the following sustainment priorities: 1) Funding to support non-billable service components; 2) Board of Education, teacher, and principal buy-in and support; and 3) Obtaining consent from guardians for screening and CBITS services. Results are discussed with respect to their alignment with sustainment factors in the literature and the ways in which local data collection through the System Support Mapping process led to actionable steps toward program sustainment.","PeriodicalId":72992,"journal":{"name":"Evidence-based practice in child and adolescent mental health","volume":"8 1","pages":"286 - 302"},"PeriodicalIF":0.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41435696","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: 10.1080/23794925.2022.2070885
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
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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.
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