Delivery Of Psychological Services Research Articles

Healthcare professionals' views on psychological support for children and families affected by skin conditions in the UK: A qualitative study

AbstractBackgroundSkin conditions can have a psychological impact on a child and their caregivers, however, support is not equally distributed between geographical regions in the United Kingdom (UK).ObjectivesThis study aimed to investigate the experience of National Health Service (NHS) healthcare professionals (HCPs) of addressing the psychological needs of children with skin conditions and their families, and gain expert opinion as to how services need to further develop.DesignHCPs were recruited to a qualitative study with an advert posted on social media.MethodsFifteen HCPs took part in interviews, including dermatologists (n = 4), dermatology nurse consultants/specialists (n = 4), clinical psychologists (n = 4), liaison psychiatrists (n = 2), and a children's psychological well‐being practitioner (n = 1).ResultsThematic analysis revealed children often presented with anxiety, depression, self‐harm and suicidal ideation. The impact on caregivers was equally profound. There were differences in service provision across the UK and all HCPs recognised the urgent need for psychological support to be integrated into standard care. Participants described how a range of interventions are typically required including cognitive behavioural therapy (CBT), and systemic approaches, as well as mindfulness/third‐wave approaches. Barriers to the delivery of psychological services were associated with a lack of funding and training opportunities for core and specialist staff alike. However, in some instances, participants had overcome these challenges to be able to deliver unique services.ConclusionsThere exist several barriers to providing paediatric psychological interventions, and many locations across the UK remain vulnerable as a result of continuing lack of national guidelines for the provision of psychological services.

Against All Odds: Students’ Interest in, and Perceived Value of, Research and Nonresearch Psychology Subjects

Although research literacy is necessary for the competent delivery of psychological services, many psychology students hold negative attitudes toward research subjects. The current study explored undergraduate students’ perceptions of research subjects relative to nonresearch subjects. A sample of 249 Australian (45.4%) and Singaporean (54.6%) first-year university students ( Mage = 21.27, SDage = 5.14, females = 75.9%) indicated their interest in, and perceived value of, 32 psychology subjects (based on title and a short description). They also nominated their most/least interested and valued subject and provided a free-text explanation for their selections. Participants perceived research subjects as significantly less interesting and valuable relative to nonresearch subjects ( d values were indicative of a large difference for interest and a small-to-medium different for value). Cluster analysis indicated that research subjects are seen as distinct, forming their own cluster. This finding was supported by thematic analysis of participants’ open-ended responses. Students considered research subjects to be especially difficult, requiring skills they did not possess or enjoy using (e.g., mathematics), and lacking relevance to their future studies and intended careers. The findings suggest that research methods instructors should aim to emphasize the relevance of research to practice in high interest areas (e.g., psychopathology).

Exploring the experiences of staff conducting psychology consultations via telehealth in an oncology hospital

Purpose During the COVID-19 pandemic, telehealth delivery of psychological care services expanded to meet the needs of people with cancer. This study examined psychologists’ attitudes toward using telehealth during the pandemic peak in a tertiary oncology hospital. Methods Semi-structured interviews were conducted with ten psychologists who used telehealth to deliver psychological services. Thematic analysis was conducted to identify themes in the interview data. Results Themes identified: (1) increased uptake and attendance of psychology sessions was due to greater accessibility of services; (2) clinicians reported ease of communication and building of rapport when using telehealth; and (3) clinicians perceived differences in the psychotherapeutic process when sessions were delivered via telehealth compared to in-person. Conclusions Clinicians expressed high satisfaction with delivering telehealth psychological support for oncology patients. Implications for Psychosocial Providers: Oncology services that are considering developing or expanding a telehealth psychology service can facilitate this by ensuring a reliable technological platform and providing training and/or support to staff and patients. Clinicians should also use their clinical judgment to decide if a patient is appropriate for telehealth-delivered psychological care or if a mix of modalities is more ideal.

The Effectiveness of Telephone-based Psychological Services to COVID-19.

The COVID-19 pandemic has disrupted the delivery of mental health services, leading to the development of telepsychiatry. The present study investigates the effectiveness of telephone-delivered treatment for psychological disorders of COVID-19 survivors in Tehran, the capital of Iran. In this non-randomized controlled trial, 91 COVID-19 survivors, primarily residents were enrolled. Participants completed a baseline questionnaire and a psychological screening questionnaire. The intervention included the telephone-based psychological services provided by trained psychiatric residents. The Post-Traumatic Stress Disorder (PTSD) Checklist (PCL) was administered to assess the presence of PTSD symptoms. Symptoms of anxiety and depression were measured by the Patient Health Questionnaire. The General Health Questionnaire (GHQ) adjusted mean difference was significantly lower in the intervention group than in the control group. There was a significant negative correlation between the Spost-GHQ score and history of going to the clinic and history of psychiatric disorders, but no relationship with the history of hospitalization. All participants completed the satisfaction form, with almost half of them being "satisfied" or "very satisfied" with the telehealth calls. Telephonic delivery of psychological services showed an effective way of providing evidence-based psychological support during the pandemic. This telehealth program can offer much-needed assistance to individuals with COVID-19 improving their psychological wellbeing.

Integrated vs non-integrated treatment outcomes in dual diagnosis disorders: A systematic review.

The incidence of dual diagnosis (DD) (i.e. substance use disorders [SUD] and co-occurring mental disorders) is widespread; however, they vary widely in permutation and combination. As a result, establishing effective and empirically supported interventions for this clinical population remains challenging. This study aimed to examine current literature on the treatment outcomes for patients with DD. A systematic review of randomised controlled trials (RCTs) published between 2009 and 2018 was conducted for two broad intervention categories identified by the literature: non-integrated and integrated treatment. Multiple electronic databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The search generated a total of 743 studies, of which 11 satisfied the inclusion criteria. These studies were thematically synthesised into two main analytical themes: 'treatment outcomes' and 'reported strengths and limitations of DD treatment'. Specifically, integrated treatment held an advantage over non-integrated treatment in significantly improving psychiatric symptomatology. However, no significant benefits were found between integrated and non-integrated treatment regarding substance misuse and treatment retention. Overall, the results provided insufficient evidence to support the enhanced efficacy of integrated or non-integrated treatment over the other in treating patients with DD. The study's findings were used to provide recommendations to inform the clinical psychological service delivery of dual diagnosis treatment in South Africa and also to identify gaps in the literature and highlight areas for future research.

Barriers and Facilitators to Psychologists’ Telepsychology Uptake during the Beginning of the COVID-19 Pandemic

The COVID-19 pandemic transformed the delivery of psychological services as many psychologists adopted telepsychology for the first time or dramatically increased their use of it. The current study examined qualitative and quantitative data provided by 2619 practicing psychologists to identify variables facilitating and impeding the adoption of telepsychology in the U.S. at the beginning of the COVID-19 pandemic. The top five reported barriers were: inadequate access to technology, diminished therapeutic alliance, technological issues, diminished quality of delivered care or effectiveness, and privacy concerns. The top five reported facilitators were: increased safety, better access to patient care, patient demand, efficient use of time, and adequate technology for telepsychology use. Psychologists' demographic and practice characteristics robustly predicted their endorsement of telepsychology barriers and facilitators. These findings provide important context into the implementation of telepsychology at the beginning of the pandemic and may serve future implementation strategies in clinics and healthcare organizations attempting to increase telepsychology utilization.

Evidence-Based Practice in Psychosocial Oncology from the Perspective of Canadian Service Directors.

Evidence-based practices facilitate the effective delivery of psychological services, yet research on the implementation of evidence-based practices in psychosocial oncology (PSO) is scarce. Responding to this gap, we interviewed a diverse sample of 16 directors of Canadian psychosocial oncology services about (a) how evidence-based practices in psychosocial oncology are being implemented in clinical care and how the service quality is monitored and (b) what are barriers and facilitators to evidence-based practice in psychosocial oncology services? Responses were grouped according to three main themes emerging from the data: screening for distress and referral to PSO services, delivery of evidence-based PSO services, and monitoring of PSO services. Our findings highlight facilitators and barriers to evidence-based practice in psychosocial oncology, which were related to the political, social, economic, and geographic contexts. The stepped care model was identified as a science-informed approach to improve the cost-effectiveness of triage systems and treatment delivery while facilitating more equitable access to services. Other facilitators included electronic screening and referral systems as well as protected time for clinicians to communicate more within their teams and participate in knowledge exchange. High caseloads presented a major barrier to acquiring and implementing evidence-based practices. Recommen-dations include increased support for evidence-based onboarding and continued training as well as for data collection regarding service needs, quality, and quantity to inform service monitoring and advocacy for more financial resources. Our findings are relevant to healthcare decision makers, implementation researchers, as well as service directors and practitioners providing psychosocial oncology care.

Remote or in-person cancer support? Therapist and service user preferences

Background/Aims Remote service delivery became a key method of providing therapy for psychological oncology services during the COVID-19 pandemic and beyond. This study aimed to understand the experiences and preferences of both patients and therapists who undertook remote psychological therapy in a cancer support service, with a view to informing ongoing service provision. Methods A total of 99 out of 152 invited patients completed an online mixed-methods (quantitative and qualitative) audit survey. All patient participants had accessed therapy with the psycho-oncology support team at Guy's Cancer Centre in London. Of the 12 therapists and four trainee therapists working in this service, 11 and two from each group (respectively) completed a corresponding survey about their experiences as therapists. For quantitative data, descriptive statistics were collated. Results Patients rated their experience of remote therapy as positive, reporting that they felt respected, understood and confident during therapy, and acknowledged the associated advantages of increased accessibility and infection control. Despite this, 87% of patients and 100% of therapists expressed a preference to access or deliver therapy in person, with patients identifying human connection and relationship building as key reasons for choosing in-person delivery. Therapists valued the relational aspects of in-person psychological support and reported that remote delivery had negatively affected the quality of therapy delivered. Conclusions Understanding the needs and preferences of patients and therapists is important in informing ongoing psychological service delivery. The results highlight the importance of retaining provision for in-person service delivery and offering choice to patients in how they access psychological support, in line with personalised care recommendations made by the NHS Long Term Plan.

Telemental Health and Diverse Populations amid COVID-19

Telemental health is defined as the delivery of psychological and mental health services via telecommunication technologies, including telephone-delivered therapy, videoconferencing, and internet-delivered programs. Research indicates that telemental health services are as effective as in-person services, and a dramatic increase in the use of telemental health has been observed during COVID-19. However, there are still persistent challenges and concerns about mental health providers’ competencies, clients’ data privacy, and legal and regulatory issues during this pandemic. Additionally, disparities in the use of telemental health services with diverse populations, based on factors such as age, gender, ethnicity, socioeconomic status, language, and culture, have been identified during this pandemic.

Enhancing competencies for the ethical integration of religion and spirituality in psychological services.

Advancement of Spiritual and religious competencies aligns with increasing attention to the pivotal role of multiculturalism and intersectionality, as well as shifts in organizational values and strategies, that shape the delivery of psychological services (e.g., evidence-based practice). A growing evidence base also attests to ethical integration of peoples' religious faith and/or spirituality (R/S) in their mental care as enhancing the utilization and efficacy of psychological services. When considering the essential attitudes, knowledge, and skills for addressing religious and spiritual aspects of clients' lives, lack of R/S competencies among psychologists and other mental health professionals impedes ethical and effective practice. The purpose of this article is to discuss the following: (a) skills for negotiating ethical challenges with spiritually integrated care; and (b) strategies for assessing a client's R/S. We also describe systemic barriers to ethical integration of R/S in mental health professions and briefly introduce our Spiritual and Religious Competencies project. Looking ahead, a strategic, interdisciplinary, and comprehensive approach is needed to transform the practice of mental health care in a manner that more fully aligns with the values, principles, and expectations across our disciplines' professional ethical codes and accreditation standards. We propose that explicit training across mental health professions is necessary to more fully honor R/S diversity and the importance of this layer of identity and intersectionality in many peoples' lives. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An innovative model of psychological service delivery in primary healthcare: the Single-Session Intervention

BackgroundIn Canada, the demand for mental health care exceeds the provision of services. This exploratory study aimed to assess the feasibility and impact of a new service delivery model for psychological consultations in primary care settings: the Single-Session Intervention (SSI), inspired by Advanced Access (AA) principles for appointment scheduling. The specific objectives were to examine whether the SSI increases accessibility to psychological consultations, to measure the effects of the intervention on different self-reported measures, and to assess users’ consultation experiences.MethodsParticipants were recruited in a University Family Medicine Group in Quebec (Canada), and the SSI was delivered by the on-site psychologist. No referral or formal diagnosis was needed to attend, and participants could promptly obtain an appointment. Participants rated the intensity of their problem, their level of psychological distress and their well-being, before and after the SSI. They also rated their satisfaction with their consultation experience. There was a follow-up 4 to 6 weeks later.ResultsOf the N = 69 participants who received SSI, 91% were able to obtain an appointment in less than 7 working days. The number of patients who were able to benefit from a psychological consultation was about 7 times higher after the implementation of SSI compared to previous years, when a traditional model of service delivery was in place. After SSI, participants felt that the intensity of their problem and psychological distress were lower, and that their well-being was increased, as indicated by significant pre-post test clinical measures (p < 0.0001). The observed effects seemed to be sustained at follow-up. Moreover, 51% of participants said that one session was sufficient to help them with their problem. Participants rated SSI as a highly satisfying and helpful consultation experience (92,9% overall satisfaction).ConclusionsSSI, offered in a timely manner, could be an innovative and cost-effective intervention to provide mental health services on a large scale in primary healthcare. Further research is needed to replicate the results, but these preliminary data seem to indicate that psychological distress may be quickly addressed by SSI, thereby preventing further deteriorations in patients’ mental health.Trial Registration2019–393, 26 March 2019.

Racial and ethnic differences in behavioral health, criminal legal system involvement, and service needs among mental health court participants: Implications for service delivery.

Mental Health Courts (MHCs), an alternative to incarceration, aim to address behavioral health, social needs, and criminal recidivism and serve many adults with co-occurring mental health and substance use disorder (COD). Despite the growth in MHCs, little research has examined ethnic/racial differences in behavioral health and service needs of individuals with COD. This study used data from behavioral health and social assessments administered to 146 adults with COD entering a Massachusetts MHC. Multivariate linear and logistic regression controlling for key demographics tested differences between racial/ethnic groups on current and lifetime substance use, mental health symptoms, and history of criminal legal system involvement. Hispanic participants were more likely than non-Hispanic White participants to report current and lifetime serious mental illness and lifetime Emergency Department (ED) mental health treatment. Non-Hispanic White participants were more likely to report current and lifetime use of illicit substances, more recent outpatient and overall lifetime treatment attempts for substance use, and higher number of lifetime arrests compared to non-Hispanic Black participants. Lastly, non-Hispanic White participants also reported more recent outpatient and overall lifetime treatment attempts for substance use compared to Hispanic participants. Racial/ethnic differences in behavioral health and social needs of MHC enrollees with COD exist and should be considered in the planning and delivery of psychological and social services. Understanding the diverse population of new MHC enrollees is an important first step in identifying and addressing racial and ethnic disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"The highest values are individual": The life and times of Eleanor Harris Rowland Wembridge.

Eleanor Harris Rowland Wembridge, one of the first women psychologists in the country, advocated tirelessly for the delivery of psychological services to enhance the lives of marginalized girls and women. Eleanor launched forward professionally with her doctorate at the young age of 22 and began work 5 years later at the Bedford reformatory that would ultimately lead to the first published correctional psychology research study. This precedent sets the historical marker at the interface of offender assessment, programs, and reentry. A harbinger of the scientist-practitioner model in clinical psychology, Eleanor retained a scholarly approach to her public service psychology work in various academic, correctional, forensic, and military settings across the country. In those public service settings, she heard and reflected the voices of the underserved through her distinctive advocacy, service, and justice writing. Eleanor left behind a largely invisible, but important legacy inside the walls of the correctional institution as an advocate for programs for justice-involved women, and outside the walls of corrections as a model for women psychologists. She is a remarkable figure in the history of public service psychology, and this article eliminates the problem of her absence from the general history of psychology literature. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Once Upon a Walk-In (Érase Una Vez Sin Cita)

In this article, we describe recent work inspired by our interest in adapting and modifying the Eurocentric psychotherapy practices that are frequently imported into México. We have challenged assumptions about the delivery of psychological services: appointments are the optimal way to provide access, a private, cloistered office is necessary, and that therapy takes a long time. We have been implementing walk-in/single session therapy in conventional mental health settings in México for several years. This article, however, illustrates application of these ideas in an indigenous population in a remote underserved area of Oaxaca with a brief case example. After providing a summary of single-session therapy and walk-in services, we will describe one of the sessions that was sensitive to the different cultural healing practices between the U.S. and rural Oaxaca.

Reflections on the cultural adaptations and implementation challenges of mental health first aid in Uganda: A case study.

Untreated mental illness as a result of trauma is a significant health concern leading to increased morbidity and mortality. Individuals in post-conflict countries, like Uganda, are at risk for poor mental health outcomes because of trauma as a result of decades of violent conflict coupled with a lack of access to quality psychological care. Community-based psychological service delivery programs, like Mental Health First Aid (MHFA), have been found to be effective in helping individuals with mental and emotional problems access care. However, little is known about the cultural adaptations needed and implementation considerations of these kinds of community programs for under-resourced nations. This case study describes key considerations for the implementation of the MHFA curriculum in various regions throughout the country of Uganda. Specifically, this case study gathered observations while implementing MHFA and highlights challenges, such as cultural adaptability and country infrastructure, that must be addressed when attempting to implement Western mental health curricula in non-Western nations, like Uganda. Recommendations for the use of psychological service delivery programs in developing countries are presented. If incorporated, these recommendations will serve to increase access to mental health services in the regions of the world that need them most. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact of COVID-19 on addiction treatment in New Zealand

COVID-19 public health measures, including lockdowns, have disrupted psychological service delivery for substance use and behavioural addictions. This study aimed to examine how addictions treatment had been affected by COVID-19 related factors from the perspective of addiction and mental health service providers. Participants (n = 93) were experienced service managers and clinicians in New Zealand who completed an online survey. Clinicians reported increased presentations for problems related to internet gambling (n = 57, 61%), gaming (n = 53, 57%), social media use (n = 52, 56%), and pornography (n = 28, 30%). A qualitative analysis of responses generated six themes. Themes included service management and increased administrative burden, and service delivery reconfiguration. Access improved for some clients because of convenience and reduced structural barriers. However, online service delivery was problematic for those with unstable or no internet access and devices that could not support video conferencing and/or lack of safe, confidential or private spaces at home. Increased client complexity and restricted in-person care prompted changes to focus, and content of clinical interventions, and some respondents offered more frequent but shorter appointments. Clinicians who provided services by phone or email, rather than video conferencing, reported treatment was less effective, with reduced rapport and engagement a contributing factor. The New Zealand addictions sector has responded to COVID-19 by increasing treatment access through distance-based options. Maintaining multifaceted models of care that are agile to rapidly changing environments presents unique challenges but is critical to addressing the needs of people impacted by addiction.

Patient experience of lasting negative effects of psychological interventions for anxiety and depression in secondary mental health care services: a national cross-sectional study

BackgroundPatients who undergo psychological treatment can report both negative and positive effects, but evidence of factors influencing the likelihood of negative effects is limited.AimsTo identify aspects of the organisation and delivery of secondary care psychological treatment services that are associated with patient experiences of negative effects.MethodCross-sectional survey of people with anxiety and depression who ended psychological treatment delivered by 50 NHS trusts in England. Respondents were asked about how their treatment was organised and delivered and whether they experienced lasting negative effects.ResultsOf 662 respondents, 90 (14.1%) reported experiencing lasting negative effects. People over the age of 65 were less likely than younger respondents to report negative effects. There was an association between reporting neutral or negative effects and not being referred at what respondents considered to be the right time (OR = 1.712, 95% CI = 1.078–2.726), not receiving the right number of sessions (OR = 3.105, 95% CI = 1.934–4.987), and not discussing progress with their therapist (OR 2.063, 95% CI = 1.290–3.301).ConclusionsOne in seven patients who took part in this survey reported lasting negative effects from psychological treatment. Steps should be taken to prepare people for the potential for negative experiences of treatment, and progress reviewed during therapy in an effort to identify and prevent negative effects.

Pathways to Acceptance in Participants of Advanced Cancer Online Support Groups.

Background and Objectives: Individuals with cancer, especially advanced cancer, are faced with numerous difficulties associated with the disease, including an earlier death than expected. Those who are able to confront and accept the hardships associated with the disease in a way that aligns with their beliefs benefit from more positive psychological outcomes compared to those who are aware of their diagnosis but are unable to accept it. To date, there is limited research exploring factors contributing to illness and death acceptance in the context of advanced cancer in group therapy settings. Materials and Methods: The current study used a Directed Content Analysis approach on transcripts of online advanced cancer support groups to investigate if and how Yalom’s existential factors played a role in the emergence of acceptance. Results: The online support group platform, combined with the help of facilitators, offered supportive environments for individuals seeking help with cancer-related distress by helping patients move towards acceptance. Some participants had already begun the process of accepting their diagnosis before joining the group, others developed acceptance during the group process, while a few continued to be distressed. Our analysis revealed the emergence of four themes related to illness acceptance: (1) Facilitator-Initiated Discussion, including sub-themes of Mindfulness, Relaxation and Imagery, Changing Ways of Thinking, and Spirituality; (2) Personal attitudes, including sub-themes of Optimism and Letting Go of Control; (3) Supportive Environment, including the sub-themes of Providing Support to Others and Receiving Support from Others; and (4) Existential Experience, which included sub-themes of Living with the Diagnosis for an Extended Amount of Time, Legacy and Death Preparations, and Appreciating life. Conclusions: With a paradigm shift to online delivery of psychological services, recognizing factors that contribute to acceptance when dealing with advanced cancer may help inform clinical practices. Future studies should explore patient acceptance longitudinally to inform whether it emerges progressively, which has been suggested by Kübler-Ross.

Barriers and Facilitators of Access to Psychological Services for Indigenous Populations: A Scoping Review and Thematic Analysis.

Background: The extent to which behavior-analytic interventions are offered to Indigenous populations across CANZUS in accessible and culturally appropriate ways is unknown. We conducted a scoping review with a thematic analysis of the extant literature to find: (1) what are the barriers and facilitators for providing effective and equitable delivery of psychological services (with a behavioral component) to Indigenous populations; and (2) what tools and practices exist for an effective and equitable service delivery.Methods: We systematically reviewed Medline, CINAHL, PubMed, PsycInfo, Web of science, Ovid and INNZ databases between 1990 and 2020. For the scoping review, we adhered to the JBI methodological approach (2015) and the PRISMA strategy for the identification, selection, and appraisal of the reviewed articles. A total of 1265 unique articles met the criteria for the screening by title; 238 by abstract; 57 were included for full text assessment; and 37 were included in the final analysis.Results: Three themes were revealed to account for the barriers and facilitators of culturally friendly practices: (1) connecting practices are about interactions shaping the relationship between service provider and service client; (2) innovative practices test new approaches and innovations that could facilitate access to psychological services and overcome barriers, and (3) reflective practices are about critically examining the processes and actions undertaken toward effective cultural adaptation of services.Conclusions: Our analysis suggests that the level of success in bringing together services and the recipients of treatment (connection), showing flexibility and persistence in finding solutions (innovation) and examining the role of our behaviors in reaching our goals (reflection) is determined by the providers' action in the aforementioned three dimensions of practice.

Expanding notions of equity: Body diversity and social justice

AbstractDespite their negative effects on the emotional, physical, and social wellbeing of students, weight stigma and anti‐fat attitudes are rarely systematically addressed in schools or within school psychology. Weight‐based oppression is regarded differently than other domains of prejudice. Therefore, implicit and explicit bias continue unimpeded, even when practitioners are attentive to other areas of social injustice. Mental health providers serving schools must acknowledge the prevalence of weight stigma and fatphobia to reduce their deleterious and oppressive effects. This conceptual paper outlines the underpinnings of weight stigma, overviews the necessity of addressing it and body image in educational settings, incorporates interdisciplinary perspectives, and proposes a justice‐oriented shift in the conceptualization of weight status within school psychological service delivery.