The effectiveness of training community mental health therapists in an evidence-based intervention for ASD: Findings from a hybrid effectiveness-implementation trial in outpatient and school-based mental health services

Autism ◽  
2022 ◽  
pp. 136236132110678
Author(s):  
Lauren Brookman-Frazee ◽  
Colby Chlebowski ◽  
Miguel Villodas ◽  
Ann Garland ◽  
Julie McPherson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Usual Care ◽  
Routine Care ◽  
Autism Spectrum ◽  
Therapist Training ◽  
Health Programs ◽  
Evidence Based ◽  
Mental Health Programs

An Individualized Mental Health Intervention for ASD (AIM HI) was developed in collaboration with community stakeholders for delivery in mental health services in response to therapist- and caregiver-identified need to improve services for children with autism spectrum disorder (ASD). Primary findings from a cluster randomized Hybrid Type 1 effectiveness-implementation trial conducted in publicly funded mental health programs demonstrated the effectiveness of AIM HI therapist training on child and caregiver outcomes. This study examined therapist outcomes and therapist experience as a moderator of training effects. Mental health programs were randomized to immediate AIM HI training or usual care. Therapists and child/caregiver clients were recruited from participating programs. Therapists in the AIM HI training condition received consultation for 6 months while delivering AIM HI. Differences between training conditions were examined using multilevel modeling. Therapists receiving AIM HI training were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more extensively pursued skill building. Therapist licensure moderated some training outcomes. The current study provides support for evidence-based practice implementation in usual care mental health services. Lay abstract Publicly funded mental health services play an important role in caring for school-age children with autism spectrum disorder (ASD); however, therapists report a lack of specialized ASD training, which families identity as a barrier in obtaining mental health services for their children. An Individualized Mental Health Intervention for ASD (AIM HI) was developed in collaboration with community stakeholders to respond to identified needs of children and community therapists. The current study examined the effects of therapist training in AIM HI on the changes in therapist practice, including therapists’ use of evidence-based intervention strategies in session. Data were collected from a study conducted in community outpatient and school based mental health programs randomly assigned to receive AIM HI therapist training or observation of routine care. Therapist and child clients were enrolled from participating programs. Therapists in AIM HI training received training and consultation for 6 months while delivering the AIM HI intervention to a participating client; therapists in usual care delivered routine care. Both groups of therapists video recorded psychotherapy sessions which were scored by trained raters. Differences between training groups were examined using multilevel modeling. Therapists trained in AIM HI were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more effective pursuit of caregiver and children skill teaching. Therapist licensure moderated some training outcomes.

Introduction

2020 ◽  
pp. xvi-8
Author(s):  
Esther D. Rothblum
Keyword(s):  
Mental Health ◽  
Clinical Social Work ◽  
Psychiatric Nursing ◽  
Health Programs ◽  
Evidence Based ◽  
Gender Minority ◽  
Minority Mental Health ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
Mental Health Programs

The Oxford Handbook of Sexual and Gender Minority Mental Health provides an overview of the current research on the mental health of sexual and gender minority (SGM) populations. It is aimed at researchers conducting studies on the mental health of SGM populations, clinicians and researchers interested in psychiatric disorders that affect SGM populations, clinicians using evidence-based practice in the treatment of SGM patients/clients, students in mental health programs (clinical psychology, psychiatry, clinical social work, and psychiatric nursing), and policymakers. This chapter defines some terms and provides an overview of current and past SGM research methods.

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 A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Professional ◽  
Therapeutic Alliance ◽  
Thematic Analysis ◽  
Mental Health Professional ◽  
Evidence Based ◽  
Realistic Evaluation ◽  
Alliance Building

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

scholarly journals Service user, patient, client, user or survivor: describing recipients of mental health services

2010 ◽  
Vol 34 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Peter Simmons ◽  
Chris J. Hawley ◽  
Tim M. Gale ◽  
Thanusha Sivakumaran
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Worker ◽  
Service User ◽  
Rank Order ◽  
Occupational Therapists ◽  
Clinical Implications ◽  
Evidence Based ◽  
Care Community

Aims and methodTo determine which terms receivers of mental health services wish to be known by (service user, patient, client, user, survivor) according to the professional consulted (psychiatrist, nurse, psychologist, social worker, occupational therapist). We conducted a questionnaire study to assess terms by like or dislike and by rank order. There were 336 participants from local catchment area secondary care community and in-patient settings in east Hertfordshire.ResultsPatient is the preferred term when consulted by psychiatrists and nurses, but it is equally preferable to client for social workers and occupational therapists. Service user is disliked more than liked overall, particularly by those who consulted a health professional, but not by those who consulted a social worker. A significant minority wish to be regarded as a survivor or user.Clinical implicationsNational and local mental health services should adopt evidence-based terminology in referring to ‘patient’ or, in some groups, ‘patient or client’ in preference to ‘service user’.

What E-Mental Health Can Offer to Saudi Arabia Using an Example of Australian E-Mental Health

2017 ◽  
pp. 1412-1421
Author(s):  
Yamam Abuzinadah ◽  
Bader Binhadyan ◽  
Nilmini Wickramasinghe
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Treatment ◽  
Health Issues ◽  
Mental Health Issues ◽  
Seeking Help ◽  
Mental Health Programs

Mental health have become a very influential topic around the world due to the increase of mental health issues that have been reported through national research and surveys. Many studies have been done along the years around the barriers in regards to seeking help in deferent countries and communities. This research aims to look closely into these barriers targeting issues and potential solutions, specifically for Saudi Arabia. Recently, the use of e-mental health services have proven to be an effective method to improve is barriers to mental health treatment. However, this chapter addresses the application and suitably of e-mental health programs for Saudi Arabia mental health services. To do so, a case study of Australian e-mental health services was selected to assist with the investigations.

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