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Psychological Services
Journal Prestige (SJR): 0.788

Citation Impact (citeScore): 2
Number of Followers: 4

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ISSN (Print) 1541-1559 - ISSN (Online) 1939-148X
Published by APA

[89 journals]

Legally involved individuals in state hospitals and community mental
health settings: Introduction to the special section.
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  Abstract: Over the past several years, individuals with serious mental illness (SMI) have become involved with the legal system at an increasing rate. State psychiatric hospitals and community mental health programs have seen a high number of referrals and admissions at a time when resources and staffing have been challenges. Individuals with SMI continue to be highly represented among those incarcerated in jails and prisons, often for minor charges. This article serves as an introduction to a special section of Psychological Services on innovations in assessment and treatment of legally involved patients in state hospitals and community mental health settings. Data are presented on the prevalence of legal involvement among individuals with serious mental illness, including the exponential growth in individuals evaluated and found incompetent to stand trial. A brief summary of the articles in the special section is presented, broken down by themes of assessment, treatment, and policy. We hope that the studies described in this issue will lead to further exploration of problems, barriers, and potential solutions for individuals with SMI who become involved with the legal system. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Mon, 16 May 2022 00:00:00 GMT
A pilot study: Positive behavioral support assessment and intervention for
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  Abstract: Individuals with serious mental illness (SMI) are consistently interfacing with the criminal justice (CJ) system. They are overrepresented in our nation’s prisons and jails rather than being in appropriate treatment settings. They also exhibit behavioral challenges in such CJ settings that result in rule violations leading to punitive consequences, such as segregation and isolation, which have deleterious effects on their mental health and well-being. Individuals with SMI who are incarcerated also make up the majority of suicide attempts and stay longer than those without SMI. Positive Behavioral Support (PBS) is a form of assessment and intervention with demonstrated efficacy for mitigating disruptive behaviors in individuals with SMI. This article describes a pilot study aimed at evaluating the efficacy of implementing PBS to decrease behaviors of concern (BOC) by those who experience SMI and interface with the CJ system. Findings indicated that PBS has a positive impact on reducing the frequency and severity of challenging behaviors and consequentially reducing interactions with the CJ system. Implications of this intervention are explored as a mechanism to support recovery and build lives of meaning. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Mon, 31 Jan 2022 00:00:00 GMT
"Distinguishing the need for crisis mental health services among college
students": Correction to Sapadin and Hollander.
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  Abstract: Reports an error in "Distinguishing the need for crisis mental health services among college students" by Kate Sapadin and Beth L. G. Hollander (Psychological Services, Advanced Online Publication, Mar 18, 2021, np). In the original article, the Method heading that appears above the Crisis Walk-In Sessions heading should appear instead as the Results. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2021-25597-001). The increasing frequency of college students’ use of crisis mental health services at college counseling centers is exacerbating the existing challenges college counseling centers face to meet students’ growing demand for mental healthcare on campus. The purpose of the present study was to investigate whether any clinical or demographic variables distinguished between students in the clinical population who did and did not use crisis services, including crisis walk-in sessions and transport to the hospital for emergency psychiatric evaluation. Clinical and demographic data from the intake paperwork of 408 students who received services from a university counseling center over a 2-year time-period were collected and analyzed to determine whether any variables were associated with significantly higher levels of crisis service use. Only prior use of self-harm as a coping strategy was associated with both increased likelihood of accessing crisis walk-in sessions and hospital transports. Black students were more likely to use crisis walk-in sessions than White students and students with a history of prior counseling were more likely to attend multiple crisis walk-in sessions. A higher likelihood of being transported to the hospital was associated with history of prior counseling, suicidal ideation at intake, higher scores on the Counseling Center Assessment of Psychological Symptoms-62 depression and social anxiety subscales, and use of one versus multiple crisis walk-in sessions. Results are discussed in the context of how counseling centers might employ these findings to identify students who are more likely to require crisis services and target interventions proactively to mitigate this need. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 26 Aug 2021 00:00:00 GMT
Olmstead’s implementation: Differences in enforcement
approaches.
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  Abstract: Olmstead v. L.C. ex rel Zimring (1999) was a landmark U.S. Supreme Court decision holding that unjustified segregation of people with disabilities is impermissible discrimination; specifically, if the clinician and client believe community integration to be appropriate, the state must have reasonable accommodations in place for the client to be in the community. Enforcement of the Olmstead decision for people with serious mental illness (SMI) has taken many shapes, from the U.S. Department of Justice’s (DOJ) settlement agreements requiring substantive development of community mental health services and aggressive community integration protocols, to the Third Circuit approach which requires only lower census numbers in the state psychiatric hospital (SPH). The question of whether Olmstead is being differentially enforced is addressed in an empirical, qualitative analysis of legal documents, including court opinions and settlement agreements. Through legal research spanning all U.S. jurisdictions, five distinct Olmstead enforcement approaches in ten different states were identified. The enforcement approaches are described, and limitations and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 10 Jun 2021 00:00:00 GMT
Examination of a social-learning program implemented in a maximum-security
state hospital setting.
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  Abstract: The present study examines the extent to which clients with serious mental illnesses (SMI) enrolled in a social-learning program (SLP) within a maximum-security state hospital were able to achieve discharge to less restrictive settings without requiring a return to maximum security. Retrospective analyses were undertaken to examine several time periods of the SLP’s operation within maximum security. From 1988 to 2019, 248 clients were discharged from the SLP. Only 20 were readmitted to maximum security, primarily for violence in less restrictive facilities. The proportion of clients who were discharged from one 19-bed ward offering the SLP differed significantly from the proportion of clients who were discharged from an identical 19-bed ward offering treatment as usual within maximum security from 1988 to 1995. The rate of readmission to maximum security was also significantly lower for clients treated on the SLP than for clients treated on other long-term treatment programs within maximum security from 2010 to 2019. Violence in a less restrictive facility was the most common reason for readmission, which typically occurred more than 1 year after discharge. The results of the present study demonstrate the SLP’s success in discharging clients with SMI from a maximum-security state hospital. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 27 May 2021 00:00:00 GMT
Perceived barriers to mental healthcare among spouses of military service
members.
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  Abstract: Barriers to mental healthcare services are reported among military service members. However, little is known about these barriers among the spouses of military personnel, who face unique stressors and may subsequently be at high-need for mental health services. Understanding barriers to care among this vulnerable population may help improve access to psychological services. The current study utilized data from the Millennium Cohort Family Study. Participants were referred by their military spouses or through targeted mailers. Participants completed self-report measures of mood, psychosocial functioning, and perceived barriers to mental healthcare via web- or paper-based surveys. A factor analysis was conducted to identify subscales of the barriers to mental healthcare measure, and logistic regressions were conducted adjusting for relevant sociodemographic variables, to determine psychosocial factors associated with likelihood of reporting barriers to mental healthcare. The sample comprised 9,666 military spouses (86% female; Mage: 27.73 ± 5.09; 29.2% racial/ethnic minority; 19.5% with prior/current military service). Logistic factors were the most frequently reported barrier to care (63%), followed by negative beliefs about mental healthcare (52%), fear of social/occupational consequences (35%), and internalized stigma (32%). Spouses with prior or current military service themselves and individuals with a psychiatric condition were most likely to report barriers to mental healthcare. A preponderance of military spouses reported barriers to mental healthcare services. Prospective data are needed to elucidate the associations between barriers to care and mental healthcare utilization. Efforts may be warranted to improve access to mental healthcare among the spouses of military personnel. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 15 Apr 2021 00:00:00 GMT
The role of PTSD symptom clusters and criterion in predicting future
high-risk drug and alcohol use among returning veteran men and women.
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  Abstract: The prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) remains exceptionally high among returning veterans, with numerous studies linking PTSD, but not specific PTSD symptoms, to future SUD risk. Further explication of PTSD symptom effects on future SUD risk will likely promote intervention development and refinement while offsetting SUD risk. Accordingly, In this study we explored the prospective associations between PTSD symptom clusters, symptoms, and future SUD risk and use of specific drug classes. Returning veterans (N = 1,295; Mage = 42.3, SD = 9.89; 51% female; 66.8% White) completed structured diagnostic interviews to assess PTSD symptoms and self-report measures of substance use 14–36 months later (M = 24.59, SD = 2.97). Hyperarousal and reckless/self-destructive symptoms specifically predicted future high-risk drug use and binge drinking behavior, and avoidance of internal stimuli (i.e., of trauma memories, thoughts, and feelings) differentiated individuals classified as high-risk for alcohol use based on their AUDIT total score. Further, negative alterations in cognition and mood predicted future opioid (i.e., nightmares) and stimulant use (i.e., flashbacks), whereas concentration difficulties were inversely associated with future binge drinking. This longitudinal study identified prospective and enduring associations between specific PTSD symptom clusters, symptoms, and future high-risk substance use patterns among returning veterans. Accordingly, careful assessment of specific PTSD criteria and differential motivations for substance use is warranted, along with tailored interventions to offset risk for opioid, stimulant, and alcohol use among returning veterans. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Mon, 12 Apr 2021 00:00:00 GMT
Mental health treatment and the role of tele-mental health at the veterans
health administration during the COVID-19 pandemic.
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  Abstract: To quantify overall trends in patients treated for mental health disorders and adverse events, including via tele-mental health (TMH) and psychopharmacology during pandemic-related health care transformation. Longitudinal observational study including veterans receiving mental health treatment at a Veterans Health Administration (VHA) facility from January 1, 2017 to June 16, 2020. Observed and expected patient care for on-going and new treatment of depression, posttraumatic stress, substance use disorder, severe mental illness diagnoses, overdose, and suicide attempts, and psychotropic prescriptions for antidepressant, antipsychotic, benzodiazepine, opioid, and mood stabilizing medications are depicted. Percent change between actual and expected counts in the early months of the COVID pandemic (March 18–May 5, 2020) are computed. Decreases in counts of patients receiving mental health treatment early in the pandemic ranged from 7% to 20% for on-going treatment, and 28% to 37% for new treatment. TMH rapidly expanded across VHA, becoming the primary means by which encounters were delivered. Counts of patients receiving on-going care for suicide attempts were stable, and for overdoses, decreased by 17%. Counts of patients initiating care for suicide attempts and overdoses decreased by 30% and 38%, respectively. Weekly prescriptions and medication on-hand for psychotropics ranged from a 2% decrease to a 4% increase. New patient prescribing decreased 21%–50%. VHA and other large healthcare systems will need to expand outreach and continue to develop TMH services to maintain care continuity and initiate care for existing and new patients during COVID-19 and future large-scale outbreaks, epidemics, and disasters. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 08 Apr 2021 00:00:00 GMT
Implementation facilitation strategies to promote routine progress
monitoring among community therapists.
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  Abstract: Despite substantial support for the importance of routine progress monitoring (RPM) as part of evidence-based practice, few providers utilize measurement-based care. This study sought to identify the relative importance of facilitation strategies viewed as most helpful for increasing intention to use RPM among 388 ethnically diverse community therapists serving children and families. Four types of facilitation strategies were examined: language/interpretability, automation, staffing/access, and requirements. Mixed analyses of variance found that therapists’ reported intentions to use RPM were more influenced by strategies of automating assessment administration, provision of clerical assistance, and agency requirements than by making linguistically appropriate measures available. However, the importance of strategies differed depending on therapist race/ethnicity and current RPM use. Language/interpretability of RPM assessments was less emphasized for non-Hispanic White therapists and therapists who have not yet or only minimally adopted RPM compared with ethnic minority therapists and therapists who regularly use RPM, respectively. Furthermore, therapists who were not current RPM users emphasized automation more than staffing/access. Results may inform prioritization of implementation facilitation strategies for agencies to encourage RPM. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 01 Apr 2021 00:00:00 GMT
Psychological distress among medically complex veterans with a recent
emergency department visit.
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  Abstract: Medical complexity and psychological distress are associated with frequent emergency department (ED) use. Despite this known association, our understanding is limited about which patients are at risk for persistent psychological distress and what patterns of distress emerge over time. A secondary data analysis was used to examine self-reported psychological distress (defined as ≥14 unhealthy days due to poor mental health in the past month) at 30 and 180 days following enrollment in a randomized control trial of 513 medically complex Veterans after a nonpsychiatric ED visit. We used a multivariable ordered logistic regression model to examine the association of a priori factors [baseline psychological distress, age, race, income, health literacy, deficits in activities of daily living (ADL), and deficits in instrumental activities of daily living] with three psychological distress classifications (no/low, intermittent, and persistent). Among 513 Veterans, 40% reported at baseline that they had experienced high psychological distress in the previous month. Older age was associated with lower odds of high psychological distress (OR = 0.95; 95% CI: 0.94–0.97). Baseline factors associated with significantly higher odds of persistent psychological distress at 30 and 180 days assessments, included having the inadequate income (OR = 1.61; 95% CI: 1.02–2.55), having low health literacy (OR = 1.63; 95% CI: 1.01–2.62), and reporting at least one ADL deficit (OR = 1.94; 95% CI: 1.13–3.33). Psychological distress at follow-up was common among medically complex Veterans with a recent ED visit. Future research should explore interventions that integrate distress information into treatment plans and/or link to mental health referral services. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 01 Apr 2021 00:00:00 GMT
Implementation of peer support in mental health services: A systematic
review of the literature.
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  Abstract: Peer support within mental health services has a growing evidence base and aligns with current policies of recovery-oriented care. Despite these advantages, widespread implementation of peer support remains limited, likely due to various methodological and implementation issues. Researchers have noted the importance of utilizing an implementation framework to understand best practices for implementation. Therefore, the purpose of the current study was to synthesize the existing literature on the implementation of peer support interventions and identify barriers and facilitators using an implementation framework. The Consolidated Framework for Implementation Research (CFIR) was used to organize the literature obtained in the systematic search and synthesize best practices for implementation. The systematic search identified 19 published articles that were coded for relevant information including implementation barriers and facilitators. The review highlighted a number of important elements for implementation within the CFIR domains, including clear role definition, a flexible organizational culture, and education for peer and nonpeer staff. Implementation barriers included an organizational culture without a recovery focus, allied practitioners’ beliefs about peer support, and an unclear peer role. The results of this review provide a summary of best practices for the implementation of peer support in mental health services that can be used by researchers and service providers in future implementation. These practices should continue to be tested and reworked as the climate of recovery-oriented services within mental health organizations evolves. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 01 Apr 2021 00:00:00 GMT
Brief behavioral treatment for insomnia: Treatment schedule and training
feasibility in the military.
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  Abstract: Insomnia is a threat to the well-being and combat readiness of military service members. Brief Behavioral Treatment for Insomnia (BBTI) is effective in treating insomnia, but the treatment schedule is difficult to implement in the Military Health System due to shorter appointment windows than what is offered in civilian settings. In the present study, 23 behavioral health providers were trained in a version of BBTI adapted for use within the Military Health System. Training was conducted remotely via a 2-day webinar, followed by 12 weekly telephone consultations with a trainer. Surveys were conducted before and after the 2-day webinar, and after the consultation period. Training led to increases in target knowledge scores and self-rated confidence in administering BBTI. All providers reported implementing the treatment with multiple patients during the 12-week period, and all providers reported that the intervention was more effective than their usual treatment method. All behavioral health providers also reported that they were likely to use BBTI in the future when treating patients with insomnia, and that they would advertise their BBTI skills to primary care providers to encourage insomnia referrals. Although conducted with a small sample size, the current study gives provisional support for (a) feasibility of implementing the adapted version of BBTI within the Military Health System and (b) feasibility of training the adapted BBTI to behavioral health providers via remote learning methodology. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Mon, 29 Mar 2021 00:00:00 GMT
Assessment of barriers to effective use of psychiatric advance directives:
Providers’ knowledge and attitudes.
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  Abstract: Psychiatric advance directives, or directives for mental health treatment (DMHTs), are consistent with the principles of psychiatric rehabilitation, self-determination, and a recovery orientation. DMHTs have promise as a consumer-empowering part of a relapse prevention plan. In the context of state psychiatric hospitals, where successful community reintegration is crucial, they have particular relevance. However, DMHTs tend to be underutilized, despite the existence of consumer-friendly laws and consumer interest. Mental health providers (n = 225) were surveyed to assess knowledge of and attitudes toward more comprehensive implementation of DMHTs to test the hypothesis that at least an initial barrier to implementation is provider familiarity with DMHTs. Results of the survey indicate a lack of familiarity with DMHTs, which was addressed by a brief educational intervention embedded in the survey. Prior to education, providers demonstrated a sense of futility and low confidence in their ability to help families plan ahead for future episodes of psychosis. After brief education, they reported more confidence in their ability to effectively intervene and more confidence a DMHT would be a useful intervention. Furthermore, they reported attitudes more supportive of DMHT use as well as an increased likelihood to use DMHTs in their own practice. These findings suggest that an initial barrier to implementation of DMHTs may often be provider familiarity and understanding. Future directions, including broader interventions to increase familiarity, and limitations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 25 Mar 2021 00:00:00 GMT
Characteristics and outcomes for defendants charged with misdemeanors
referred for court-ordered competency evaluations.
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  Abstract: Recent research has suggested nationwide increases in the rates of referral for competence to stand trial (CST) evaluations across the United States. Many of these evaluations are for defendants charged only with misdemeanor offenses and for whom diversion programs are most appropriate. The present study was designed to analyze the characteristics of, and re-arrest outcomes for, defendants charged with misdemeanors ordered to undergo CST evaluations in a large metropolitan area. Overall, there was a high base rate of incompetent to stand trial (IST) opinions (over 70% of defendants) in this sample, with the greatest impairments in rational understanding and ability to assist counsel. Defendants opined IST were more likely to have a psychotic disorder, a history of psychiatric hospitalization, and greater abnormalities in thought content relative to their competent counterparts. Of concern, defendants opined IST, and especially those referred for crisis evaluations upon dismissal of the charges, were significantly more likely to be re-arrested than their counterparts. These data support the criminalization hypothesis, suggesting that criminal justice involvement for this subset of defendants inappropriately reflects psychiatric instability, supporting the need for more options for inpatient and outpatient treatment to effectively intervene in this process. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Mon, 22 Mar 2021 00:00:00 GMT
Distinguishing the need for crisis mental health services among college
students.
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  Abstract: [Correction Notice: An Erratum for this article was reported online in Psychological Services on Aug 19 2021 (see record 2021-78000-001). In the original article, the Method heading that appears above the Crisis Walk-In Sessions heading should appear instead as the Results. All versions of this article have been corrected.] The increasing frequency of college students’ use of crisis mental health services at college counseling centers is exacerbating the existing challenges college counseling centers face to meet students’ growing demand for mental healthcare on campus. The purpose of the present study was to investigate whether any clinical or demographic variables distinguished between students in the clinical population who did and did not use crisis services, including crisis walk-in sessions and transport to the hospital for emergency psychiatric evaluation. Clinical and demographic data from the intake paperwork of 408 students who received services from a university counseling center over a 2-year time-period were collected and analyzed to determine whether any variables were associated with significantly higher levels of crisis service use. Only prior use of self-harm as a coping strategy was associated with both increased likelihood of accessing crisis walk-in sessions and hospital transports. Black students were more likely to use crisis walk-in sessions than White students and students with a history of prior counseling were more likely to attend multiple crisis walk-in sessions. A higher likelihood of being transported to the hospital was associated with history of prior counseling, suicidal ideation at intake, higher scores on the Counseling Center Assessment of Psychological Symptoms-62 depression and social anxiety subscales, and use of one versus multiple crisis walk-in sessions. Results are discussed in the context of how counseling centers might employ these findings to identify students who are more likely to require crisis services and target interventions proactively to mitigate this need. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 18 Mar 2021 00:00:00 GMT
Mental health literacy in veterans: What do U.S. military veterans know
about PTSD and its treatment'
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  Abstract: Given military veterans’ underutilization of posttraumatic stress disorder (PTSD) treatment, it is important to explore factors that may facilitate or stand in the way of treatment seeking for this population. The purpose of this study was to provide an initial examination of military veterans’ mental health literacy as it relates to PTSD and its treatment. One-hundred and 32 post-9/11 veterans were recruited for this web-based study. A vignette-based approach was employed to examine veterans’ mental health literacy and relationships between mental health literacy and dimensions of stigma. Consistent with hypotheses, results revealed relatively higher levels of PTSD problem recognition, and lower levels of knowledge about evidence-based treatments and self-help strategies within this veteran sample. Correlational results provided partial support for our hypotheses: Mental health literacy was inversely associated with negative beliefs about mental health problems and treatments, but not significantly related to other dimensions of stigma. This study highlights potential targets for mental health literacy interventions and points to the value of additional research on the role of mental health literacy in veterans’ treatment seeking. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 18 Mar 2021 00:00:00 GMT
Persistent, poor quality competency to stand trial reports: Does training
matter'
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  Abstract: Consistent with nationwide trends, the number of defendants judicially ordered to the California Department of State Hospitals (DSH) for competency restoration has nearly doubled in recent years. Previous research has shown that the majority of the time, judicial rulings on competency reflect forensic evaluators’ opinions. Thus, the quality of competency to stand trial (CST) reports is critical. We examined 388 CST reports from defendants who were ultimately found incompetent to stand trial and admitted to a state hospital for restoration in 2012–2013. We evaluated the reports for adherence to both professional guidelines and current literature on the appropriate conduct of CST evaluations. Consistent with previous studies, our results showed that the reports evidenced overall poor quality and evaluators were largely unable to accurately describe the nature of the mental illness or explain how clinical factors (i.e., diagnoses or symptoms) impacted CST abilities. Notably, we found that experts board certified in psychiatry or psychology produced reports of higher quality. These findings demonstrate the continued poor quality of CST reports and highlight the importance of training. As in previous similar studies, we recommend mandatory training for experts conducting CST evaluations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 04 Mar 2021 00:00:00 GMT
Engagement, experience, and satisfaction with peer-delivered whole health
coaching for veterans with PTSD: A mixed methods process evaluation.
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  Abstract: To describe the process of peer-delivered Whole Health Coaching, a primary care-based intervention in which peers provide patients with individualized support to set and work toward wellness goals. Fifteen primary care Veterans with PTSD participated in peer-delivered Whole Health Coaching during a multiple baseline design study. This is a planned mixed methods concurrent equal status analysis of the process of peer-delivered Whole Health Coaching including patient engagement, patient experience, fidelity to the coaching and peer roles, and patient satisfaction. Data sources were feedback interviews, electronic medical record reviews, self-report assessments, and observer fidelity ratings of session recordings. Qualitative data were used to expand the interpretation of quantitative descriptive data. A rapid assessment approach was used for qualitative analysis. Retention in peer-delivered Whole Health Coaching was 11 of 15 participants, and factors facilitating engagement were peers as providers and flexibility in scheduling/modality of sessions. Peers demonstrated high fidelity to coaching skills, Whole Health Coaching phases and stages, and the peer role. Participants expressed high satisfaction and perceived peer-delivered Whole Health Coaching as helpful with making progress on individualized wellness goals. Results build on the literature describing the expansion of peer services into primary care and implementation of interventions such as wellness coaching. This initial small study suggests that peers can deliver high-quality wellness coaching, and this description of the process can guide the integration of peers doing wellness coaching in similar clinical settings and for future research trials. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 25 Feb 2021 00:00:00 GMT
The effectiveness of telepsychology with veterans: A meta-analysis of
services delivered by videoconference and phone.
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  Abstract: Veterans face a variety of stressors due to their military service and are more likely to develop psychological problems as a result. Research suggests that as many as half of veterans with mental health conditions go untreated due to barriers including lack of accessibility to services and stigma. The present study builds on previous research by using meta-analytic techniques to determine the effectiveness of telepsychology-delivered therapy with veterans. Empirical studies were included if they reported veteran-related outcome data on a psychological intervention used to treat a mental health condition remotely using either videoconferencing or telephone. Twenty-seven studies including 2,648 total participants (1,667 in treatment conditions and 981 in control conditions) met our inclusion criteria and were incorporated into our analysis. Twenty-five studies provided pre–post data to evaluate various therapy outcomes, and 18 studies used a randomized clinical trials (RCTs) design that allowed a comparison between telehealth and traditional in-person therapy. Publication bias was evaluated using correlations between sample and effect sizes for posttraumatic stress disorder (PTSD) and depression for pretest–posttest and RCT designs; risk was determined to be minimal. Weighted average pre–post effect sizes were moderate-to-strong for depression and trauma, and videoconferencing was more effective than telephone for depression (d = 0.86 and 0.46, respectively) and trauma (d = 1.00 and 0.51, respectively). Weighted average effect sizes computed from RCT studies suggest telepsychology is similarly effective as services provided face-to-face. More research is needed for telepsychology-delivered treatments for other mental health conditions faced by veterans. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 04 Feb 2021 00:00:00 GMT
Adjustment disorders: A research gaps analysis.
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  Abstract: Adjustment disorders are among the most commonly diagnosed mental health disorders in both civilian and military clinical settings. Despite their high prevalence, adjustment disorders have received little research attention. The many gaps in our understanding of this group of disorders hinder the development of adequate, evidence-based treatment protocols. This study utilizes a systematic methodology to identify and prioritize research gaps in adjustment disorders. We used authoritative source reports to identify gaps in research domains from foundational science to services research. Subject-matter experts conducted literature searches to substantiate and refine research gaps, and stakeholders assessed the importance and impact of this work for researchers and policy-makers. We identified 254 possible research-needs statements, which were ultimately reduced to 11 final, prioritized research gaps. Two gaps addressed prevention and screening and three addressed treatment and services research. Six gaps addressed foundational science, epidemiology, and etiology research domains, highlighting the need for basic research. Until some of the basic science questions are resolved (e.g., diagnostic clarity, valid screening, and assessment measures) about adjustment disorders, we may not be able to develop adequate evidence-based interventions for the disorders, and it will be difficult to understand the trajectory of these disorders throughout treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
  PubDate: Thu, 28 Jan 2021 00:00:00 GMT