scholarly journals Renaming schizophrenia: 5 × 5

2018 ◽  
Vol 28 (03) ◽  
pp. 254-257 ◽  
Author(s):  
Sinan Guloksuz ◽  
Jim van Os
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Well Being ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Long Run ◽  
The Social ◽  
Technical Features ◽  
In The Beginning

AbstractThere had been a long way to go before we felt comfortable about even discussing the issues revolving around the concept of ‘schizophrenia’, let alone reckoning on mere semantic revision. In this editorial, we aim to extend our discussion on the reasons behind the slow death of the concept of ‘schizophrenia’ and the benefits of changing the name and embracing a spectrum approach with an umbrella psychosis spectrum disorder (PSD) category (similar to autism spectrum disorder) that goes further than a mere semantic revision. We attempted to cover the topic of the renaming by providing five most pertinent points categorised under five domains: reasons, signals, challenges, promises and steps for the change. Admittedly, even a modest revision, such as classifying all psychotic disorder categories under an umbrella category of PSD, and abolishing the term schizophrenia requires careful deliberation and some effort in the beginning, but the revision is well worth the effort considering the benefits in the long run. Renaming a particular form of mental suffering should be accompanied by a broader debate of the entire diagnosis-evidence-based-practice (EBP)-symptom-reduction model as the normative factor driving the content and organisation of mental health services that may be detached from patients’ needs and reality, overlooks the trans-syndromal structure of mental difficulties, appraises the significance of the technical features over the relational and ritual components of care, and underestimates the lack of EBP group-to-individual generalisability. Individuals may make great strides in attaining well-being by accommodating to living with mental vulnerabilities through building resilience in the social and existential domains. Changing the name and the concept of ‘schizophrenia’, which goes beyond a mere semantic revision, may become the first step that allows catalysation of the process of modernising psychiatric science and services worldwide.

Characterizing therapist delivery of evidence-based intervention strategies in publicly funded mental health services for children with autism spectrum disorder: Differentiating practice patterns in usual care and AIM HI delivery

Autism ◽  
2021 ◽  
pp. 136236132110016
Author(s):  
Eliana Hurwich-Reiss ◽  
Colby Chlebowski ◽  
Teresa Lind ◽  
Kassandra Martinez ◽  
Karin M Best ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Usual Care ◽  
Teaching Strategies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Intervention Strategies ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Active Teaching

This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors. Lay abstract This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.

scholarly journals Emergent life events in the delivery of a caregiver-mediated evidence-based intervention for children with autism spectrum disorder in publicly funded mental health services

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1286-1299
Author(s):  
Teresa Lind ◽  
Anna S Lau ◽  
Christopher Gomez ◽  
Adriana Rodriguez ◽  
Karen Guan ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Life Events ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Health Intervention ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Mental Health Intervention ◽  
Therapy Sessions

Mental health clinicians often report significant challenges when delivering evidence-based interventions in community settings, particularly when unexpected client stressors (or emergent life events) interfere with the therapy process. The current study sought to extend the study of emergent life events to children with autism spectrum disorder by examining the occurrence and impact of emergent life events in the context of a collaborative, caregiver-mediated intervention for reducing challenging behaviors in children with autism spectrum disorder, An Individualized Mental Health Intervention for ASD (AIM HI). Participants included 38 child–clinician dyads enrolled in a community effectiveness trial of An Individualized Mental Health Intervention for ASD. Video recordings of 100 therapy sessions were coded for caregiver-reported emergent life events and clinician adherence to the Individualized Mental Health Intervention for ASD protocol. Results indicated that mild to severe emergent life events were reported in 36% of sessions, and were reported for 58% of children at some point during treatment. Greater number of child comorbid diagnoses and less clinician experience were both significantly associated with a higher number of caregiver-reported emergent life events. There was no significant link between emergent life events and clinician adherence to the Individualized Mental Health Intervention for ASD protocol. Findings offer implications for evidence-based intervention implementation, particularly the importance of incorporating clinician training in addressing complex presentations and crises in the context of evidence-based interventions. Lay abstract Mental health clinicians often report significant challenges when delivering evidence-based interventions (EBI) in community settings, particularly when unexpected client stressors (or emergent life events; ELEs) interfere with the therapy process. The current study sought to extend the study of ELEs to children with Autism Spectrum Disorder (ASD) by examining the occurrence and impact of ELEs in the context of a collaborative, caregiver-mediated intervention for reducing challenging behaviors in children with ASD. This intervention was An Individualized Mental Health Intervention for children with ASD (referred to as AIM HI). Participants included 38 clinicians and child clients who were enrolled in a community effectiveness trial of AIM HI. Video recordings of 100 therapy sessions were coded for caregiver-reported ELEs and also how well clinicians adhered to the AIM HI protocol. Results indicated that mild to severe ELEs were reported in 36% of therapy sessions, and were reported for 58% of children at some point during the intervention. Children who had a greater number of diagnoses (in addition to the autism diagnosis) tended to have more ELEs. In addition, clinicians with less years of experience tended to have sessions with more ELEs. There was no significant link between ELEs and how well clinicians adhered to the AIM HI protocol. Findings offer implications for the implementation of EBI, particularly the importance of incorporating clinician training in addressing complex presentations and crises in the context of EBIs.

scholarly journals Predictors of mental health and well-being in employed adults with autism spectrum disorder at 12-month follow-up

2019 ◽  
Vol 12 (3) ◽  
pp. 482-494 ◽  
Author(s):  
Darren Hedley ◽  
Mirko Uljarević ◽  
Simon M. Bury ◽  
Cheryl Dissanayake
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Well Being ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adults With Autism ◽  
Health And Well Being

Designing Autism Spectrum Disorder Interventions for Community Implementation

2020 ◽  
pp. 407-421
Author(s):  
Robin L. Gabriels ◽  
Julia Barnes
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Implementation Science ◽  
Child Outcomes ◽  
Challenging Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Children With Asd ◽  
The Impact

There are well-documented gaps between evidence-based interventions (EBIs) developed and tested in controlled research settings and those delivered in routine, community-based care. The field of implementation science has developed in response to identified gaps to study methods to promote the uptake and sustainment of EBIs in community care. Community mental health (MH) services play an important role in caring for individuals with autism spectrum disorder (ASD) across the lifespan who have co-occurring psychiatric conditions. This chapter summarizes over a decade of community-engaged research aimed to (a) characterize MH services for children with ASD, including the training needs of therapists and clinical needs of children with ASD receiving care; (b) develop the AIM HI (An Individualized Mental Health Intervention for ASD) intervention, a package of well-established, evidence-based behavioral strategies designed to reduce challenging behaviors in children served in MH service settings; (c) test the impact of training therapists to deliver AIM HI on child outcomes; (d) identify potential influences on implementation; and (e) test the impact of different implementation strategies to enhance therapist delivery of AIM HI. The chapter includes directions for future research including applying the AIM HI development model to older individuals with ASD and other community service systems and integrating implementation science approaches earlier in the pipeline of research-to-practice translation.

scholarly journals Service use by youth with autism within a system-driven implementation of evidence-based practices in children’s mental health services

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2094-2103
Author(s):  
Nicole A Stadnick ◽  
Anna S Lau ◽  
Kelsey S Dickson ◽  
Keri Pesanti ◽  
Debbie Innes-Gomberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Health Services ◽  
Service Use ◽  
Public Mental Health ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Mental Health Systems ◽  
Evidence Based Practices

Public mental health systems play an important role in caring for youth with autism spectrum disorder. Like other dually diagnosed populations, youth with autism spectrum disorder may receive services in the context of evidence-based practice implementation efforts within public mental health systems. Little is known about service use patterns within the context of system-driven implementations efforts for this population. This case–control study examined mental health service patterns of 2537 youth with autism spectrum disorder compared to 2537 matched peers receiving care in the Los Angeles County Department of Mental Health, the largest public mental health department in the United States, within the context of a system-driven implementation of multiple evidence-based practices. Although not the primary target of this implementation effort, youth with autism spectrum disorder were served when they met criteria for the services based on their presenting mental health symptoms. Comparative analyses using administrative claims data were conducted to examine differences in mental health utilization patterns and clinical characteristics. Findings revealed significant differences in the volume and duration of mental health services as well as differences in the service type and evidence-based practice delivered between youth with and without autism spectrum disorder. Results provide direction targeting implementation efforts for youth with autism spectrum disorder within a public mental health system care reform.

scholarly journals A Systematic Review on the Impact of the Social Confinement on People with Autism Spectrum Disorder and Their Caregivers during the COVID-19 Pandemic

2021 ◽  
Vol 11 (11) ◽  
pp. 1389
Author(s):  
Yurena Alonso-Esteban ◽  
María Fernanda López-Ramón ◽  
Verónica Moreno-Campos ◽  
Esperanza Navarro-Pardo ◽  
Francisco Alcantud-Marín
Keyword(s):  
Autism Spectrum Disorder ◽  
Well Being ◽  
Target Population ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Psychological Consequences ◽  
The Social ◽  
Containment Measures ◽  
Adults With Asd ◽  
The Impact

The COVID-19 pandemic had imposed a variety of containment measures on the general population for prolonged periods. Confinement has had, and still has, social, economic, educational, health, and psychological consequences on the entire population. Objective: In this article, a systematic search has been performed based on studies carried out since the beginning of the pandemic, regarding the impact of these containment measures on the autism spectrum disorder (ASD) population and their caregivers. Method: We consulted six databases (i.e., PubMed, Medline, Embase, Scopus, Web of Science, and Science Direct) and selected ten studies that met the inclusion criteria. The chosen studies have been classified according to their theoretical focus, methodology, and target population. Results: We found an increase in stress and a decrease in psychological well-being among individuals diagnosed with ASD (i.e., parents and caregivers). Additionally, in studies focused on children, youth, and adults with ASD diagnosis, the results are contradictory depending on variables such as age, ASD severity, or type of family structure. Conclusions: The results show that the consequences of quarantine and social confinement are quite contradictory and depend on variables such as age, ASD severity, and family features.

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