Applying the Theoretical Domains Framework to Develop an Intervention to ‘Re-implement’ Parent–Child Interaction Therapy (PCIT) DOI Creative Commons
Melanie J. Woodfield, Sharon T. Phillips, Tania Cargo

et al.

Administration and Policy in Mental Health and Mental Health Services Research, Journal Year: 2023, Volume and Issue: 50(6), P. 976 - 998

Published: Sept. 10, 2023

Abstract Parent–Child Interaction Therapy (PCIT) is an empirically supported treatment for childhood conduct problems, with increasing numbers of clinicians being trained in Aotearoa/New Zealand. However, ensuring sustained delivery effective treatments by routine care environments notoriously challenging. The aims this qualitative study were to (1) systematically examine and prioritise PCIT implementation barriers facilitators, (2) develop a well specified theory-driven ‘re-implementation’ intervention support already-trained resume or increase their PCIT. To triangulate refine existing understanding determinants from earlier cross-sectional survey, we integrated previously unanalysed survey data (54 respondents; response rate 60%) six new focus groups 15 PCIT-trained managers We deductively coded data, using directed content analysis process the Theoretical Domains Framework, resulting identification salient theoretical domains belief statements within these. then used Theory Techniques Tool identify behaviour change techniques, possible components, hypothesised mechanisms action. Eight 14 identified as influential on clinician (Knowledge; Social/Professional Role Identity; Beliefs about Capabilities; Consequences; Memory, Attention Decision Processes; Environmental Context Resources; Social Influences; Emotion). Two these appeared be particularly salient: ‘Environmental Resources’, specifically lacking suitable equipment, (lack of) access well-equipped clinic room appearing influence several ways. ‘Social/Professional Identity’, beliefs relating perception that colleagues view time-out harmful children, concerns internationally-developed not non-Māori deliver Indigenous Māori families, feeling obligated yet isolated advocacy delivery. In conclusion, where initial has stalled languished, re-implementation may possible, makes good sense, both fiscally practically. This suggests Zealand facilitated components such colleague co-worker who supportive delivery, equipment (particularly room), targeted additional training safety children. feasibility acceptability will tested future clinical trial.

Language: Английский

Exposure to exposure: A protocol for leveraging exposure principles during training to address therapist-level barriers to exposure implementation DOI Creative Commons
Joshua J. Kemp, Kristen Benito,

Jennifer Herren

et al.

Frontiers in Psychiatry, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 15, 2023

Background Exposure therapy is a highly effective but underutilized treatment for anxiety disorders. A primary contributor to its underutilization therapist-level negative beliefs about safety and tolerability patients. Given functional similarities between anxious among patients therapists, the present protocol describes how exposure principles can be leveraged during training target reduce therapist beliefs. Methods The study will take place in two phases. First, case-series analysis fine-tune procedures that already complete, second an ongoing randomized trial tests novel (E2E) condition against passive didactic approach. precision implementation framework applied evaluate mechanism(s) by which influences aspects of delivery following training. Anticipated results It hypothesized E2E produce greater reductions therapists’ relative condition, reduction associated with higher quality as measured coding videotaped actual Conclusion Implementation challenges encountered date are discussed along recommendations future interventions. Considerations expansion approach also within context parallel processes may tested trials.

Language: Английский

Citations

7
Helping Practitioners Stop, Drop, and Roll: Suggestions to Help Improve Responses to Intense Clinical Events DOI
Kelly B. Beck, Heather J. Nuske,

E Haimes

et al.

Psychiatric Services, Journal Year: 2024, Volume and Issue: 75(8), P. 817 - 819

Published: Feb. 27, 2024

Community practitioners inconsistently implement evidence-based interventions. Implementation science emphasizes the importance of some practitioner characteristics, such as motivation, but factors practitioners' emotion regulation and cognitive processing receive less attention. Practitioners often operate in stressful environments that differ from those which they received training. They may underestimate impact their emotional state on ability to deliver This "hot-cold empathy gap" is not well studied mental health care. In this Open Forum, authors describe scenarios where gap affecting practices. The provide suggestions help plan for situations.

Language: Английский

Citations

2
Centering Equity in the Implementation of Exposure and Response Prevention for Pediatric OCD: Current Evidence and Future Directions DOI Creative Commons
Asha Rudrabhatla,

Sasha Flowers,

Emily M. Becker‐Haimes

et al.

Current Developmental Disorders Reports, Journal Year: 2024, Volume and Issue: 11(4), P. 195 - 205

Published: Aug. 15, 2024

Abstract Purpose of Review Exposure and Response Prevention (ERP), the gold standard psychosocial treatment for pediatric OCD, is severely underutilized in routine practice. The majority youth need do not receive ERP, with minoritized being even less likely to benefit from ERP. Improving equitable implementation ERP pivotal improving outcomes OCD. This article examines determinants efforts date improve access response across multiple levels context (e.g., clinician, innovation, societal). Recent Findings Determinants exist contextual that inhibit or promote including lack cultural responsiveness, clinician training attitudes, client stigma, therapeutic alliance, organizational supports, workforce shortages. Most have been focused on through training. Emerging work has also attempted address both expanding capacity responsiveness Summary review highlights complex, multifactorial required achieve Our suggests there a disproportionate effort by targeting clinicians directly; however, sustained change unlikely unless policy structural factors are addressed.

Language: Английский

Citations

1
A Qualitative Examination of Clinician Anxiety about Suicide Prevention and Its Impact on Clinical Practice DOI
Jesslyn Jamison, Megan Brady,

Annalisa Fang

et al.

Community Mental Health Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 3, 2024

Language: Английский

Citations

1
Therapist perceptions of experiential training for exposure therapy DOI Creative Commons
Hannah E. Frank, Lara S. Rifkin, Kate Sheehan

et al.

Behavioural and Cognitive Psychotherapy, Journal Year: 2023, Volume and Issue: 51(3), P. 214 - 229

Published: Feb. 21, 2023

Abstract Background: Despite evidence for its efficacy, exposure therapy anxiety is rarely used in routine care settings. Efforts to address one major barrier use – therapists’ negative beliefs about have included therapist-level implementation strategies, such as training and consultation. Experiential training, which therapists themselves undergo exposures, has recently demonstrated feasibility, acceptability preliminary effectiveness increasing use. Aims: This study aimed assess: (1) perceptions of experiential (2) barriers facilitators implementing following training. Method: Therapists who underwent ( n= 12) completed qualitative interviews quantitative questionnaires. Interviews were coded using an integrated approach, combining both inductive deductive approaches. Mixed methods analyses examined how themes varied by practice setting (community mental health versus private practice) Results: Results highlight factors, clinician self-efficacy, interact with inner- outer-setting factors. Participants reported positive after training; they noted that directly addressing myths experiencing exposures improved their attitudes toward exposure. Consistent prior literature, issues insufficient supervisory support, organizational constraints, client characteristics made it challenging implement exposures. Discussion: the benefits while also highlighting need consider contextual determinants. Differences responses across settings areas intervention importance tailoring strategies. Barriers specific did not (e.g. hesitancy appropriateness most clients) point directions future efforts.

Language: Английский

Citations

3
An exposure-based implementation strategy to decrease clinician anxiety about implementing suicide prevention evidence-based practices: protocol for development and pilot testing (Project CALMER) DOI Creative Commons
Emily M. Becker‐Haimes, Megan Brady, Jesslyn Jamison

et al.

Implementation Science Communications, Journal Year: 2023, Volume and Issue: 4(1)

Published: Nov. 24, 2023

Clinicians often report that their own anxiety and low self-efficacy inhibit use of evidence-based suicide prevention practices, including gold-standard screening brief interventions. Exposure therapy to reduce clinician maladaptive bolster is a compelling but untested approach improving the implementation practices (EBPs). This project brings together an interdisciplinary team leverage decades research on behavior change from exposure theory design pilot test exposure-based strategy (EBIS) target improve EBP implementation.We will develop, iteratively refine, EBIS paired with as usual (IAU; didactic training consultation) in preparation for larger study effect this reducing anxiety, self-efficacy, increasing Columbia Suicide Severity Rating Scale Safety Planning Intervention outpatient mental health settings. Aim 1 participatory methods develop refine collaboration stakeholder advisory board. 2 up 15 clinicians field using rapid cycle prototyping. 3 refined trial. Forty community be randomized 1:1 receive either IAU or + 12 weeks. Our primary outcomes are acceptability feasibility, measured through questionnaires, interviews, recruitment retention statistics. Secondary engagement mechanisms (clinician related implementation) preliminary effectiveness (adoption fidelity) assessed via mixed (questionnaires, chart-stimulated recall, observer-coded role plays, interviews).Outcomes yield insight into feasibility utility directly targeting mechanistic processes informing EBPs. Results inform fully powered hybrid effectiveness-implementation trial EBIS' patient outcomes.Clinical Trials Registration Number: NCT05172609 . Registered 12/29/2021.

Language: Английский

Citations

3
Therapist Anxious Distress and Avoidance of Implementing Time-Out DOI Creative Commons
Corinna C. Klein, Hanan Salem, Emily M. Becker‐Haimes

et al.

Child Psychiatry & Human Development, Journal Year: 2024, Volume and Issue: unknown

Published: May 31, 2024

Abstract Therapist anxious distress when delivering child mental health treatment has been understudied as a factor that contributes to the underuse of some evidence-based interventions (EBIs), such time-out for children with disruptive behaviors. This study investigated therapist avoidance using three-part, vignette-based survey design. Therapists (n = 198) read vignette an in-session and reported on their personal likelihood discontinuing implementation time-out. also provided open-ended descriptions challenges moderate at time points 1 2 lower 3 had resolved. Most therapists endorsed Binomial logistic regression analyses indicated increased corresponded probability avoiding delivery in future. Qualitative reports expanded implementing Findings suggest importance addressing children’s treatments.

Language: Английский

Citations

0
Integrating insights from implementation science and behavioral economics to strengthen suicide screening strategies for pediatric populations DOI
Nathan Hodson, Christina Johnson, Rinad S. Beidas

et al.

Current Opinion in Psychology, Journal Year: 2024, Volume and Issue: 59, P. 101854 - 101854

Published: Aug. 1, 2024

Language: Английский

Citations

0
Experiences of Peer Mentoring Sexual and Gender Minority Emerging Adults who are at risk for Suicide (Preprint) DOI Creative Commons
Jennifer T. Tran, Jessica Webster, James Wolfe

et al.

Published: Oct. 23, 2024

BACKGROUND Emerging adult sexual and gender minority people (EASGM) are at increased risk for suicide due to unique experiences including discrimination, family/friend rejection, low positive affect. Peer Mentors (PMs) may offer a opportunity intervention but underutilized prevention among EASGM. OBJECTIVE We developed an intervention, Supporting Transitions Adulthood Reducing Suicide (STARS), improve EASGM increase social support, coping, meet virtually six weeks, providing strategies diminish the impact of connection safe spaces, reinforcement intentions use Safety Plans. METHODS To understand PMs’ in their role, distress, fidelity manual, perceptions feasibility acceptability STARS participants’ Plan, we collected survey data from participants PMs as well in-depth interviews with after completion intervention. RESULTS reported overall high comfort (8.52; SD=1.60) distress (1.93; SD = .87) during sessions. had (>90%) PM training. (17.50; 2.38), (20; 0), appropriateness 0) CONCLUSIONS mentorship who was deemed feasible acceptable by alike. that they felt comfortable confident Future research should explore optimal support engage work incorporate feedback this study ensure outcomes. CLINICALTRIAL NCT05018143 INTERNATIONAL REGISTERED REPORT RR2-10.2196/48177

Language: Английский

Citations

0
Practitioners’ Use and Acceptability of Time-Out DOI
Samantha Jugovac, David J. Hawes, Lucy A. Tully

et al.

Child Psychiatry & Human Development, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 9, 2024

Language: Английский

Citations

0