Notes

Slumber Problems and also Surgery in kids Along with Visible Disability.
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).Anxiety is undertreated in primary care, and most treatment provided is pharmacological rather than behavioral. Integrating behavioral health providers (BHPs) using the Primary Care Behavioral Health (PCBH) model can help address this treatment gap, but brief interventions suitable for use in PCBH practice are needed. We developed a modular, cognitive-behavioral anxiety intervention, Modular Anxiety Skills Training (MAST), that is evidence-based, transdiagnostic, feasible for PCBH, and patient-centered. MAST comprises up to six 30-min sessions emphasizing skills training. This article describes the rationale for and development of MAST as well as pilot work in the Veterans Health Administration (VA) to tailor and refine MAST for delivery to Veterans in VA primary care (MAST-V) to improve feasibility for VA BHPs and acceptability to Veterans. We used a convergent mixed-methods design with concurrent data collection. In phase one, we interviewed five BHPs to obtain feedback on the treatment manual. BHPs assessed MAST-V to be highly compatible with PCBH and provided suggestions to enhance feasibility. In phase two, we conducted an open trial in which six Veterans experiencing clinically significant anxiety received and provided feedback on all nine possible modules; we also assessed changes in mental health symptoms and functioning as well as treatment satisfaction and credibility. Veterans found MAST-V to be highly acceptable, and pre-post clinical outcomes were very promising with large effect sizes. Findings from this initial pilot provide preliminary support for the feasibility, acceptability, and efficacy of MAST-V and suggest further research with a randomized clinical trial is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Enterprise data indicates that U.S. service members (SMs) with posttraumatic stress disorder (PTSD) may not receive an evidence-based treatment (EBT) or may receive an EBT with low fidelity to the core components. Successful delivery of EBTs requires provider training and ongoing supervision/consultation, adjustment of clinic processes and structure, and leadership support. The Department of Defense (DoD) Practice-Based Implementation (PBI) Network is a dedicated team of implementation science specialists that support the integration of EBTs into clinical practice in the Military Health System (MHS). The PBI Network conducted a Cognitive Processing Therapy (CPT) pilot to investigate the acceptability and feasibility of a novel trauma specialist implementation approach proposed by South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR). This approach, CPT Trauma Specialist (CPT-TS), called for training designated behavioral health (BH) therapists as the primary CPT providers in their clinics. In collaboration with the Uniformed Services University Center for Deployment Psychology, the PBI Network provided training and consultation to 26 providers across 13 MHS BH clinics and supported ongoing facilitation. Despite provider interest and clinic leadership support, less than half of the pilot provider participants were able to meet the consultation and CPT delivery requirements for designation as a CPT trauma trained specialist. Prevalent implementation barriers included lack of adequate clinic resources, provider challenges balancing clinical and military-related duties, the need to focus on high-risk patients, and other military system-related constraints. These findings highlight the need for implementation scientists to examine alternatives to traditional training models and identify fidelity-consistent adaptations that allow for delivery of evidence-based care within highly constrained systems of care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Youth substance use (SU) has been linked to adverse mental health outcomes. For those youth involved in public sector systems of care, reports of SU are consistently high compared to general populations. These public sector services systems of care include mental health, juvenile justice, child welfare, homeless intervention services, as well as SU service systems. In addition, minority and marginalized youth tend to report disproportionately high SU. As an example, in Hawai'i, youth who are Native Hawaiian (NH), Micronesian, or who identify as sexual or gender minorities not only report elevated rates of SU, but are overrepresented in public sectors. In order to reduce youth SU health disparities, access to and quality of the system of care for youth must improve. To inform systems change, this needs assessment study used qualitative methods to engage professionals in Hawai'i working within public sectors that may intersect with youth SU service system of care. Professionals identified several themes which have implications for practice, policy, and research colonialism and inclusivity at the macro level, the need for policies at the exo level, meso level changes regarding family and community, and stigma and discrimination at the micro level. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Crisis stabilization units (CSUs), which offer a range of short-term psychiatric and psychological services, are one of several treatment programs that may create "alternative to arrest" options for law enforcement. Here, we examined the characteristics of the population who was referred to a newly established CSU in its first year of operation and examined the impact of the CSU on regional jail bookings. Administrative medical records and regional jail booking data were merged to form our study sample. Adults who had at least one jail booking and/or one CSU admission during our study period were included. We found that from September 1, 2018 to August 30, 2019, 458 people were admitted into the CSU. Approximately one-third (33.8%) had a jail booking during the study period. In the 3 months following CSU admission, 4.1% had an increase in jail bookings, 11.1% had a decrease, and 66.2% had no change. CSU patients self-reported high depressive and posttraumatic stress disorder symptoms, while also reporting low quality of life scores overall. We conclude that CSUs may be promising components of jail diversion efforts, providing critical services to populations experiencing significant mental health symptoms and who are at risk for incarceration. U0126 in vitro (PsycInfo Database Record (c) 2022 APA, all rights reserved).Mental health professionals' responses to work with trauma survivors vary among a range of aversive and positive psychosocial experiences. This study examines the prevalence and predictors of these responses, including secondary traumatic stress (STS), vicarious resilience (VR), burnout, and compassion satisfaction (CS), among mental health professionals who work specifically with human trafficking survivors within the United States (n = 89). Specific attention is devoted to examining the role of professionals' own trauma histories and their self-care practices in building their resiliency and potentially reducing their risk of aversive work-related psychosocial experiences. Findings reveal that responses range in intensity among this group of providers. Promisingly, none of the professionals demonstrated high levels of burnout and none demonstrated low CS. Furthermore, the majority of professionals in the study had low-to-moderate levels of STS and moderate-to-high levels of VR. Results from a series of multiple regressions exploring predictors of these correlates suggest that although professionals who work with trafficking survivors may risk burnout and STS, they also may receive significant personal satisfaction, growth, and resilience from their work. Results also indicate that professionals' personal experiences with trauma may act as a protective factor against aversive correlates. Altogether, findings suggest a need for professionals' active engagement in a wide variety of self-care behaviors, including seeking personal therapy as needed and engaging in advocacy, as a strategy for ensuring their well-being as they deliver mental health support for human trafficking survivors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Although limited, extant research suggests that incarcerated women are more likely than men to be placed in restrictive housing (e.g., administrative or disciplinary segregation) for disruptive behaviors that are linked to psychiatric symptomology and interpersonal deficits. Yet, few scholarly works discuss specific interventions or recommendations for treating incarcerated women in or at-risk of segregation. In this paper, we address the extent to which criminogenic and mental health needs of incarcerated women likely apply to women often placed in segregation, offer considerations for treatment planning when working with this subpopulation, and describe the process of piloting a manualized program specifically developed for segregated clients with women in a state prison. Descriptive data on 18 program participants are reported. Among program completers (n = 10), reductions in emotional stability, wellness, and criminal attitudes were endorsed from pre- to post-treatments and all women were rule-violation free at 3-month follow-up. Although preliminary outcomes are promising, controlled treatment outcome research is needed. We conclude with a call to advocate for the humane treatment and management of women who are in or prone to restrictive housing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Cumulative traumatic migration experiences are compounded by escalating chronic distress related to the current sociopolitical climate for refugee and immigrant children and families. The aim of this open trial was to conduct a preliminary evaluation of You're Not Alone, a rapidly mounted, strengths-based, community-focused capacity building training initiative for stakeholders interacting with refugee and immigrant children and families in the Chicago area. Trainings, based on Trauma-Informed Care (TIC) and psychological first aid frameworks, adapted education and universal health promotion strategies for population-specific chronic traumatic stress. Two groups of participants (N = 948), who attended either mandatory (n = 659 educators) or voluntary (n = 289 community stakeholders) trainings, completed surveys at pretraining, post-training, and 6-week follow-up. Outcome indices included participant satisfaction, acceptability of training model, and changes in knowledge, attitudes, and behaviors. Over 90% of participants reported satisfaction and acceptability of trainings. For educators, hierarchical linear modeling analyses demonstrated significant increases in trauma knowledge, refugee and immigrant-specific knowledge, positive attitudes toward TIC over time, and a decrease in negative attitudes toward immigrants. Over 95% of participants indicated that they learned and intended to use new strategies to help serve refugee and immigrant children and families. At follow-up, over 80% of those who completed the survey had utilized at least one strategy, and over 55% indicated that they were using resources that they learned about in the training. This study demonstrates that capacity-building trainings swiftly developed and disseminated to community stakeholders can produce positive change in knowledge, attitudes, and practices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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