Community-based Counselling Services Research Articles

Soulspace: Integrated youth mental health care in Berlin, Germany-An introduction to the program and a description of its users.

A substantial gap between young people's need for mental health care services and their actual access to such services led worldwide organizations (e.g., the WHO) to recommend the implementation of early intervention programs and youth mental health services. Some countries around the world have established structures to meet this recommendation. In this paper, we describe soulspace as the first integrated youth mental health service for young people aged between 15 and 35 years in Berlin, Germany. We introduce soulspace as easily accessible mental health care for young people, and we characterize soulspace along the lines of the internationally established eight key principles of integrated youth mental health services (Killackey, et al., 2020, World Economic Forum). Soulspace is a cooperation between clinical outpatient units of psychiatric clinics for adolescents and young adults as well as a community-based counselling service. It provides initial contact, counselling, diagnostics, and treatment. Our analyses of the pathways to soulspace and the characteristics of the soulspace users suggest that the low threshold is a facilitator to help finding for young people in comparison to more conventional early intervention models. That is, having transferred the early intervention center in a youth-facing counselling service as was done in soulspace seems to have reduced the threshold to seek help for families and for young people in need for support. In summary, with soulspace, an easily accessible mental health care service was established that integrates counselling and specialized psychiatric treatment if needed.

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

ABSTRACTBackground: People living with Human Immunodeficiency Virus (HIV) often suffer from alcohol-use disorders resulting in their poor health and treatment outcomes. Little is known about the association of harmful alcohol drinking with their adherence to anti-retroviral therapy (ART) and health-related quality of life (QOL) in low-resource settings.Objective: This study aimed to investigate associations between harmful alcohol drinking, adherence to ART and health-related QOL in HIV-positive people, stratified by gender, in Nepal.Methods: We conducted a cross-sectional study of 682 HIV-positive people on ART to measure their self-reported harmful alcohol drinking and non-adherence to ART in the previous month of data collection. We also measured health-related QOL using a WHOQOL-HIV BREF scale. The association between harmful alcohol drinking and non-adherence to ART was examined using multiple logistic regressions. Additionally, multiple linear regressions examined association between harmful alcohol drinking and QOL.Results: Harmful alcohol drinking was associated with non-adherence to ART among men (AOR: 2.48, 95% CI: 1.50, 4.11, p < 0.001) and women (AOR: 2.52, 95% CI: 1.32, 4.80, p = 0.005). Men were more likely to have lower score for the psychological (β = −0.55, p = 0.021) and level of independence (β = −0.68, p = 0.018) domains when they had harmful alcohol drinking. Moreover, women were more likely to have lower scores for the physical (β = −1.01, p = 0.015), social relations (β = −0.82, p = 0.033), environmental (β = −0.88, p = 0.011), and spiritual (β = −1.30, p = 0.005) domains of QOL when they had harmful alcohol drinking.Conclusions: Harmful alcohol drinking had a negative association with ART adherence and QOL in both HIV-positive men and women in Nepal. Screening for alcohol-use disorders and community-based counseling services should be provided while delivering ART services to improve treatment adherence and QOL.

Comparing Online and Face-to-Face Student Counselling: What Therapeutic Goals Are Identified and What Are the Implications for Educational Providers?

Online counselling is increasingly being used as an alternative to face-to-face student counselling. Using an exploratory mixed methods design, this project investigated the practice by examining the types of therapeutic goals that 11- to 25-year-olds identify online in routine practice. These goals were then compared to goals identified in equivalent school and community-based counselling services; 1,137 online goals (expressed by 504 young people) and 221 face-to-face goals (expressed by 220 young people) were analysed for key themes using grounded theory techniques. This analysis identified three core categories: (1) Intrapersonal Goals, (2) Interpersonal Goals, and (3) Intrapersonal Goals Directly Related to Others. Further statistical analysis of these themes indicated that online and face-to-face services appear to be used in different ways by students. These differences are discussed alongside the implications for professionals working in educational settings.

A multisite randomized controlled effectiveness trial of cognitive processing therapy for military-related posttraumatic stress disorder

Cognitive processing therapy (CPT) is currently applied in military veteran mental health services in many countries. This study tests the effectiveness of community-administered CPT for military-related PTSD under randomized controlled conditions. Fifty-nine treatment-seeking veterans with military-related PTSD were randomly allocated to receive 12 twice-weekly 60min sessions of CPT or an equivalent period of usual treatment at veterans’ community based counseling services. Intent to treat analyses found significantly greater improvement for participants receiving CPT over usual treatment at post-treatment and 3 month follow-up. CPT also produced greater improvements in anxiety, depression, social and dyadic relationships than usual treatment. No CPT related adverse events occurred during the trial. This trial reports the first randomized controlled trial evidence that CPT is an effective treatment for military PTSD and co-morbid conditions when compared to usual treatment and delivered in community settings by clinicians from diverse disciplines, preferred treatment orientation and levels of experience.

Self-harm in younger people: Audit of prevalence and provision

This study investigated the frequency, the response to, and the pathways in care of young persons aged under 16 years (or under 18 years if attending secondary school) presenting to the Accident and Emergency Department (A&E) following deliberate self-harm (DSH). Retrospective case note review was used in two A&E departments and the Social Services Departments, Educational Psychology Services, Child and Family Consultation Services serving two local authority boroughs, a community-based counselling service and participants' general practices. Participants were 60 young people who presented to A&E following DSH over a 12-month period. Participants were identified from the department's records. The study group was predominantly female (52/60) and the self-harm mainly involved an overdose (54/60), with paracetamol the most common constituent. One-third of all cases did not receive a specialist assessment, contrary to recommendations, and one-fifth were not referred for any specialist follow-up care. There was a low frequency of recording relevant history in A&E, especially, information of previous self-harming behaviour and recent or current problems. A seasonal trend was detected with the rate of presentations falling off during the main school holiday periods. Following evidence that younger persons were being discharged from A&E without adequate assessment or follow-up provision, the service developed improvements in joint working across agencies and designed appropriate protocols for assessment and after-care. The impact of improved service provision is now under investigation in a long-term prospective study, including implementation of a standardized electronic record .

Postwar experiences and treatment-seeking behavior in a community counselling setting.

Previous research investigating the impact of postwar experiences on Vietnam veterans has focused on veteran morbidity. This emphasis has meant that the impact of these factors on treatment-seeking behavior has received little empirical attention. This study examined the association between postwar factors and treatment-seeking behavior in a sample of 692 Australian Vietnam veterans. Logistic regression analyses were used to compute the odds ratios associated with postwar experiences and self-referral to a community-based counselling service. Results suggest that veterans who reported experiencing negative feelings toward others when they first arrived home were more likely to seek treatment. Other factors, such as a veteran's perception of societal attitudes and the reception they received, were not associated with treatment-seeking behavior.

Community-Based Counseling Services for Deaf and Hard-of-Hearing Individuals

Community-Based Counseling Services for Deaf and Hard-of-Hearing Individuals

Social networks of Nigerian psychiatric patients.

Despite the indubitable cohesiveness of their community life, Nigerian psychiatric patients had social networks with deficiencies not dissimilar to those reported for patients in the industrialised societies. Interactions between these Nigerian patients as focal persons and other members of their network, were found to be intense, but seemed to lack a strong affectional core. As expected, the separated, and the divorced patients scored less than the married patients on intensity of social relationships, but the two groups were not significantly different on all other network parameters examined. These findings should constitute a substratum of a kinship community-based counselling service with the goal of providing individual-oriented support for the psychiatrically disabled persons. It is believed that this may be realised by the relevant training and utilisation of para-professionals; effective liaison with families and special attention to prevailing concepts and socio-cultural norms.