Current Trends in Treatment Research and Practice

2018 ◽  
pp. 110-142
Author(s):  
Alan E. Kazdin
Keyword(s):  
Health Care Services ◽  
New Technologies ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Research And Practice ◽  
Care Services ◽  
Current Trends ◽  
Treatment Research

This chapter discusses current trends in psychosocial treatment research and clinical practice. The chapter highlights four active areas in which intervention research and practice are changing: efforts to disseminate evidence-based psychosocial interventions, to integrate physical and mental health care services, to develop treatments (transtreatments) that can be used to treat multiple disorders, and to exploit the range of new technologies available (e.g., Internet, apps) as a way of providing interventions. These areas of research are among those most relevant to the goals of this book, namely, providing interventions in ways that can reduce the burdens of mental illness.

Developing Treatments for Antisocial Behavior Among Children: Controlled Trials and Uncontrolled Tribulations

2018 ◽  
Vol 13 (5) ◽  
pp. 634-650 ◽  
Author(s):  
Alan E. Kazdin
Keyword(s):  
Antisocial Behavior ◽  
Psychosocial Interventions ◽  
The United States ◽  
Main Stream ◽  
Evidence Based ◽  
Treatment Delivery ◽  
Adolescents And Adults ◽  
Rehabilitation Facilities ◽  
Treatment Research ◽  
Property Destruction

The article describes my research on the development and evaluation of psychosocial treatments for children who engage in extremes of antisocial behavior (e.g., aggression, property destruction, theft). I begin with my “story” of how the focus on interventions started as I worked in various settings (rehabilitation facilities, schools, hospitals, and outpatient clinical services) and with children, adolescents, and adults. The main stream of treatment research and findings with antisocial child behavior is highlighted along with tributaries that led naturally from the outcome research. Our trials are complemented by tribulations that apply to evidence-based psychosocial interventions more broadly. Most individuals in need of psychological services in the United States and worldwide receive no treatment. Much can be done right now with novel models of treatment delivery that draw on multiple disciplines (e.g., public health, business, entertainment, economics, robotics and artificial intelligence, and law and social policy). More research on interventions that do not or cannot reach most people in need is quite limited in value to me. Finally (and belatedly) my attention has turned to ways of exerting impact, and for that, evidence-based interventions are necessary but hardly sufficient.

BMJ Best Practice

2021 ◽  
Vol 22 (3) ◽  
pp. 18-22
Author(s):  
Jamie Saragossi
Keyword(s):  
Health Care Services ◽  
Best Practice ◽  
Drug Information ◽  
Point Of Care ◽  
The United States ◽  
Evidence Based ◽  
End User ◽  
Quality Research ◽  
Care Services ◽  
Clinical Topic

BMJ Best Practice is an evidence-based point of care tool that helps support clinical decisions by providing the latest and highest quality research available to clinicians. The target audience for this resource is anyone delivering health care services. Currently, BMJ Best Practice is available as an institutional subscription in the United States. The resource includes clinical summaries based on the latest evidence, drug information, clinical calculators, evidence-based tool kits, and patient leaflets. The content provided goes through a rigorous editorial process by expert reviewers who have been required to disclose any financial conflicts. This process can however be relatively time consuming therefore updates that do not pose an immediate harm to patient care could potentially take anywhere from 1 to 3 months to be reflected in the clinical topic overviews. Overall, the tools and content provided on the platform are reliable and easy to navigate for the end user.

scholarly journals Survey on the physical and mental health among migrants and refugees in ten European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Karnaki ◽  
D Zota ◽  
E Riza ◽  
A Gil-Salmerón ◽  
E Durá-Ferrandis ◽  
...  
Keyword(s):  
Mental Health ◽  
Quantitative Research ◽  
Health Care Services ◽  
Waiting Times ◽  
Physical And Mental Health ◽  
Medical Problems ◽  
Migration Flow ◽  
Eu Member States ◽  
Care Services ◽  
Breast And Cervical Cancer

Abstract This study discusses the main findings of the quantitative research conducted within the Mig-HealthCare consortium countries to explore the physical and mental health of migrants and refugees. The study population is defined as migrants/refugees who have been residing in Europe, for at least 6 months and up to 5 years. In order to be able to capture the recent migration flow, the analysis was based on 1169 questionnaires collected in 10 EU-Member States, answered by adult migrants residing less than 5 years in the specific country. A total of 29% of migrants stated that their health is poor or fair. Overall, 56.9% of migrants needed health care services during the last 6 months, however approximately one in four did not have access to them. The most frequent problems were long waiting times, not being able to organize an appointment, not knowing where to go, lack of communication and long distances. The most frequent chronic health problem migrants/refugees face is caries and headaches/migraines, followed by psychological disease and sleep disorders. Approximately one in three women have been pregnant since entering the current EU country, whereas one in four have had a miscarriage or abortion and 21.5% are currently pregnant. Summing up, most of the migrants face common medical problems such as bad teeth, headaches and psychological problems. However long waiting times, not knowing where to go and lack of communication are barriers to accessing healthcare. The fact that the immunization status of migrants/refugees is unclear, a significant number suffer from serious chronic diseases and the limited breast and cervical cancer screening of female migrants/refugees pose serious threats to their health and important challenges for the health services of Europe.

scholarly journals Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

2017 ◽  
Vol 49 (1-2) ◽  
pp. 45-61 ◽  
Author(s):  
Jeyaraj Durai Pandian ◽  
Akanksha G. William ◽  
Mahesh P. Kate ◽  
Bo Norrving ◽  
George A. Mensah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care Services ◽  
Cost Effective ◽  
Stroke Care ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Stroke Services ◽  
Low And Middle Income

Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

The Wider Considerations in Translating Heart Failure Guidelines

2021 ◽  
Vol 16 ◽  
Author(s):  
Pupalan Iyngkaran ◽  
Andrew Wilson ◽  
James Wong ◽  
David Prior ◽  
David Kaye ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care Services ◽  
Models Of Care ◽  
Time Span ◽  
Medical Community ◽  
Evidence Based ◽  
Medicine Development ◽  
Care Services ◽  
The Common ◽  
Based Medicine

: Congestive Heart Failure (CHF) is as an emerging epidemic. Within one generation the medical community has learnt much of the CHF syndrome. It has two distinct mechanisms, systolic and diastolic abnormalities, to account for the common CHF presentation. It is complex as it challenges the available health care services, resource, and funding models in providing an equitable service across the health continuum. Despite improvement in many cardiovascular diseases, some CHF outcomes like readmissions and costs have increased. The reinvigoration of evidence-based medicine, development of health services models of care, standardisation of disease processes with taxonomies have also occurred within the same time span. These processes however need to be linked with health policy as presented in white papers. In this paper we explore achieving optimal CHF guideline recommended outcomes as the science approaches real world translation.

scholarly journals Innovations in the psychosocial treatment of youth with anxiety disorders: implications for a stepped care approach

2018 ◽  
Vol 21 (3) ◽  
pp. 112-115 ◽  
Author(s):  
Thomas H Ollendick ◽  
Lars-Göran Öst ◽  
Lara J Farrell
Keyword(s):  
Anxiety Disorders ◽  
High Intensity ◽  
Care Delivery ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Stepped Care ◽  
Future Research ◽  
Evidence Based ◽  
Low Intensity ◽  
Care Approach

Anxiety disorders are highly prevalent among children and adolescents and frequently result in impairments across multiple domains of life. While psychosocial interventions, namely cognitive-behavioural therapy (CBT), have been found to be highly effective in treating these conditions, significant numbers of youth simply do not have access to these evidence-based interventions, and of those who do, a substantial proportion (up to 40%) fail to achieve remission. Thus, there is a pressing need for innovation in both the delivery of evidence-based treatments and efforts to enhance treatment outcomes for those who do not respond to standard care. This paper reviews current innovations attempting to address these issues, including evidence for brief, low-intensity approaches to treatment; internet delivered CBT and brief, high-intensity CBT. Moreover, we propose a model of stepped care delivery of evidence-based mental health interventions for children and youth with anxiety. In general, a stepped care approach begins with a lower intensity, evidence-based treatment that entails minimal therapist involvement (ie, brief, low-intensity self-help or internet delivered CBT) and then proceeds to more intensive treatments with greater therapist involvement (ie, brief high-intensity CBT), but only for those individuals who show a poor response at each step along the way. Future research is needed in order to evaluate such a model, and importantly, to identify predictors and moderators of response at each step, in order to inform an evidence-based, fully-integrated stepped care approach to service delivery.

Limits of Evidence – the Case of Psychosocial Interventions in a Swedish Review of Maintenance Treatment Research

2009 ◽  
Vol 26 (4) ◽  
pp. 399-414 ◽  
Author(s):  
Mats Ekendahl
Keyword(s):  
Addiction Treatment ◽  
Maintenance Treatment ◽  
Scientific Evidence ◽  
Political Legitimacy ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
State Agency ◽  
Preliminary Review ◽  
Opiate Addiction ◽  
Treatment Research

In Sweden, maintenance treatment (MT) with methadone has been a controversial exception to drug-free treatment. However, efficacy, prescription control and the provision of simultaneous psychosocial treatment (PST) have provided MT with political legitimacy. This view, notably stressing that PST is an important complement to medication, was presented in central Swedish policy documents that paved the way for less strict MT regulations in 2005. Aim The present study aims to analyse how the various stakeholders involved in this policy process described and evaluated the efficacy and legitimacy of PST within the framework of the MT discussion. Data & Method The data consists of a document authored by a state agency (a preliminary review of MT research) and various stakeholders' written commentaries on it. different representations of PST (so-called constructions) were coded thematically and analysed using discourse analytical concepts. Results The results show that stakeholders' constructions of PST draw on different discourses related to the governance of Swedish opiate addiction treatment. Four constructions were identified, PST as: “mere complement” (narrow empirical discourse); “underrated intervention” (practitioner discourse); “preferred intervention” (ideological discourse) and “complex intervention” (antireductionist discourse). The study illustrates how the narrow empirical discourse's construction of PST as a mere complement was challenged by the three other discourses, but shows that the former remained the dominant influence on subsequent MT regulations. It also highlights that references to beliefs and alleged facts are intertwined in stakeholders' rhetorical efforts to assign meaning to PST. This suggests that science and ideology are interrelated in policy discussions on opiate addiction treatment, and that firm conclusions about the value of help interventions rely as much on scientific evidence as on strategic argumentation.

scholarly journals Cultural Determinants of Help Seeking: A Model for Research and Practice

2009 ◽  
Vol 23 (4) ◽  
pp. 259-278 ◽  
Author(s):  
Denise Saint Arnault
Keyword(s):  
Help Seeking ◽  
Health Care Services ◽  
Cultural Models ◽  
The Body ◽  
Structural Determinants ◽  
Research And Practice ◽  
Care Services ◽  
National Priority ◽  
Cultural Determinants ◽  
Distribution Of Resources

Increasing access to and use of health promotion strategies and health care services for diverse cultural groups is a national priority. While theories about the structural determinants of help seeking have received empirical testing, studies about cultural determinants have been primarily descriptive, making theoretical and empirical analysis difficult. This article synthesizes concepts and research by the author and others from diverse disciplines to develop the midrange theoretical model called the Cultural Determinants of Help Seeking (CDHS). The multidimensional construct of culture, which defines the iterative dimensions of ideology, political economy, practice, and the body, is outlined. The notion of cultural models of wellness and illness as cognitive guides for perception, emotion and behavior as well as the synthesized concept of idioms of wellness and distress are introduced. Next, the CDHS theory proposes that sign and symptom perception, the interpretation of their meaning, and the dynamics of the social distribution of resources are all shaped by cultural models. Then the CDHS model is applied to practice using research with Asians. Finally, implications for research and practice are discussed.

scholarly journals Barriers and Opportunities of Oncofertility Practice in Nine Developing Countries and the Emerging Oncofertility Professional Engagement Network

2020 ◽  
pp. 369-374 ◽  
Author(s):  
Mahmoud Salama ◽  
Lauren Ataman-Millhouse ◽  
Fabio Sobral ◽  
Guillermo Terrado ◽  
Anibal Scarella ◽  
...  
Keyword(s):  
Developing Countries ◽  
Rural Communities ◽  
Health Care Services ◽  
New Technologies ◽  
Insurance Coverage ◽  
Global Network ◽  
International Programs ◽  
Care Services ◽  
Metropolitan Cities ◽  
Barriers And Opportunities

PURPOSE Oncofertility practice continues to grow in developing countries despite the lack of health care services, especially those related to cancer care. The purpose of this study is to further explore oncofertility practice in these countries and identify opportunities for field-wide coalescence. METHODS We generated a survey to learn more about oncofertility practice in nine developing countries within our Oncofertility Consortium Global Partners Network—Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India. Their responses were collected, reviewed, and discussed. RESULTS Surveyed centers from the nine developing countries continue to experience a similar set of common challenges, including a lack of awareness among providers and patients, cultural and religious constraints, lack of insurance coverage and funding to help to support oncofertility programs, and high out-of-pocket costs for patients. Despite these barriers, many opportunities exist and there is great potential for the future. CONCLUSION The current need is to unify the new technologies and best practices that emerge from rural communities and developing countries with those in large metropolitan cities, both domestically (US based) and abroad, into a functional unit: the Oncofertility Professional Engagement Network. The Oncofertility Professional Engagement Network will bridge the gap between domestic and international programs to establish a strong global network in which members share resources, methodologies and experiences and further build cultural competency.

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