Mental Health Treatment Settings Research Articles

Intimate partner violence survivors' reported experiences of discrimination in mental health treatment settings.

Research indicates that survivors of intimate partner violence (IPV) face substantial stigma and discrimination, with varying impacts based on demographic factors such as race and income. This study explored perceived discrimination among 88 IPV survivors across different racial backgrounds and income levels in mental health settings. Participants completed a mixed-method electronic survey assessing discrimination experiences related to survivor status, income, and race within mental health treatment. Results revealed high levels of perceived discrimination based on survivor status among both racially minoritized and majoritized survivors. However, racially minoritized survivors reported greater racial discrimination and associated stress within mental healthcare settings. Regardless of income level, all survivors reported significant discrimination experiences. Qualitative analysis highlighted factors perceived as helpful or unhelpful within mental health settings. This study underscores the need for further research on socioeconomic influences on stigma experiences among IPV survivors and suggests implications for provider training to better support survivors, especially those from diverse racial backgrounds.

Virtual reality relaxation for mental health staff in complex care services: A feasibility and acceptability study

ObjectiveVirtual reality (VR) relaxation has been implemented in workplaces for staff wellbeing. However, little is known about potential benefits for mental health staff who work in challenging settings who can experience high stress levels and poor wellbeing. MethodsThis study evaluated implementation of a single-session VR relaxation intervention for staff in complex care mental health settings. Pre- and post-VR visual analogue scales (VAS) explored the effect of VR on wellbeing. Post-VR, VAS on helpfulness and immersiveness were recorded, participants planned a behavioural activity to explore the real-world application of VR relaxation, and narrative feedback was collected. ResultsParticipants (N = 22) were mostly of Black ethnicity, in their early forties, and just over half were female. There was an even mix of outpatient and inpatient staff from various professions. Most were nurses, occupational therapists, or doctors. Post-VR, for the total sample, there were significant increases in relaxation, happiness, connectedness to nature (all d>1.00 and p<0.00); and decreases in stress, anxiety (both d>1.00 and p<0.00) and sadness (d = 0.53, p = 0.02). There was no significant effect of sadness for outpatient staff, whereas inpatient staff experienced a significant decrease post-VR (d = 68, p = 0.03). Mean helpfulness and immersiveness ratings were high. All participants planned a behavioural activity, and 15 participants (68 %) carried it out. Participants found the VR intervention to be relaxing, soothing, exciting and an immersive respite from work. ConclusionThe positive findings indicate potential for wider implementation of VR-based wellbeing interventions in mental health settings and other workplaces where staff experience high stress levels.

Temporal Trends in Telehealth Availability in Mental Health Treatment Settings: Differences in Growth by State Rurality, 2015-2020.

We sought to investigate temporal trends in telehealth availability among outpatient mental health treatment facilities and differences in the pace of telehealth growth by state urbanicity and rurality. We used the National Mental Health Services Survey (2015-2020) to identify outpatient mental health treatment facilities in the US (N = 28,989 facilities; 2015 n = 5,018; 2020 n = 4,889). We used logistic regression to model telehealth, predicted by time, state rurality (1 to 10% rural, 10 to < 20%, 20 to < 30%, or [Formula: see text] 30%), and their interaction, and adjusted for relevant covariates. We estimated the predicted probability of telehealth based on our model. We estimated effects with and without data from 2020 to assess whether the rapid and widespread adoption of telehealth during the COVID-19 pandemic changed the rural/urban trajectories of telehealth availability. We found that telehealth grew fastest in more urban states (year*rurality interaction p < 0.0001). Between 2015 and 2020, the predicted probability of telehealth in more urban states increased by 51 percentage points (from 9 to 61%), whereas telehealth in more rural states increased by 38 percentage points (from 23 to 61%). Predicted telehealth also varied widely by state, ranging from more than 75% of facilities (RI, OR) to below 20% (VT, KY). Health systems and new technological innovations must consider the unique challenges faced by urban populations and how best practices may be adapted to meet the growing urban demand. We framed our findings around the need for policies that minimize barriers to telehealth.

Environmental factors’ influence on criminal legal involvement for people with serious mental illness

Summary Efforts to assess the risk of criminal legal system involvement among people with serious mental illness (SMI) often rely on strategies that locate the risk at the individual level. The present study examines environmental factors that contribute to criminal legal involvement for people with SMI in mental health treatment settings. Thirty-one people with serious mental illness and prior criminal legal involvement were interviewed in this qualitative study. Interviews focused on factors that contributed to and protected against criminal legal involvement. The research team engaged in inductive thematic analysis of interview data. Findings Findings reveal that understanding of physical, social, and treatment environments is critical to risk assessment with this population. In highlighting the role of the environment, we offer findings that may lead to improved strategies for service delivery with this population. Complicating contemporary approaches to risk assessment, our findings suggest that mental health treatment systems that serve individuals with serious mental illness should engage in meaningful consideration of environmental factors. Applications Identification of protective and risk factors in clients’ physical, social, and treatment environments is critical for social work practice with individuals who have a history of criminal legal involvement and serious mental illness. Treatment settings can create opportunities for the development of protective factors by integrating wrap-around services, treatment services that follow an empowerment-participation strengths model, and post-incarceration services with clients.

Comprehensive and Integrated Services in Specialty Mental Health Treatment Facilities in the US: Differences by the Racial/Ethnic Composition of the Facility's Clientele, 2020.

The integration of multiple ancillary services into mental health treatment settings may improve outcomes, but there are no national studies addressing whether comprehensive services are distributed equitably. We investigated whether the availability of a wide range of service types differs based on the facility's racial/ethnic composition. We used the 2020 National Mental Health Services Survey to identify twelve services offered in outpatient mental health treatment facilities (N = 1,074 facilities). We used logistic regression to model each of the twelve services, predicted by the percentage of a facility's clientele that was White, Black, and Hispanic, adjusted for covariates. Facilities with the highest proportions of Black and Hispanic clientele demonstrated the lowest predicted probabilities of offering comprehensive and integrated services. Our findings offer context around upstream factors that may, in part, drive treatment disparities. We orient our findings around frameworks of structural racism and inequities in mental healthcare.

Associations between Social Adversities and Chronic Medical Conditions in a Statewide Sample of Individuals in Treatment for Mental Illnesses.

Individuals with mental illnesses experience disproportionately high rates of social adversities, chronic medical conditions, and early mortality. We analyzed a large, statewide dataset to explore associations between four social adversities and the presence of one or more, and then two or more, chronic medical conditions among individuals in treatment for mental illnesses in New York State. In Poisson regression models adjusting for multiple covariates (e.g., gender, age, smoking status, alcohol use), the presence of one or more adversities was associated with the presence of at least one medical condition (prevalence ratio (PR) = 1.21) or two or more medical conditions (PR = 1.46), and two or more adversities was associated with at least one medical condition (PR = 1.25) or two or more medical conditions (PR = 1.52) (all significant at p < .0001). Greater attention to primary, secondary, and tertiary prevention of chronic medical conditions is needed in mental health treatment settings, especially among those experiencing social adversities.

Indigenous mental healthcare and human rights abuses in Nigeria: The role of cultural syntonicity and stigmatization.

Indigenous mental healthcare using traditional non-western methods termed "unorthodox approaches" has been observed in Nigeria historically. This has been largely due to a cultural preference for spiritual or mystical rather than biomedical formulations of mental disorder. Yet, there have been recent concerns about human rights abuses within such treatment settings as well as their tendency to perpetuate stigmatization. The aim of this review was to examine the cultural framework for indigenous mental healthcare in Nigeria, the role of stigmatization in its utilization and interrogate the issues of human rights abuses within a public mental health context. This is a non-systematic narrative review of published literature on mental disorders, mental health service utilization, cultural issues, stigma, and indigenous mental healthcare. Media and advocacy reports related to human rights abuses in indigenous mental health treatment settings were also examined. International conventions on human rights and torture, national criminal legislation, constitutional provisions on fundamental rights and medical ethics guidelines relevant to patient care within the country were examined in order to highlight provisions regarding human rights abuses within the context of care. Indigenous mental healthcare in Nigeria is culturally syntonic, has a complex interaction with stigmatization and is associated with incidents of human rights abuses especially torture of different variants. Three systemic responses to indigenous mental healthcare in Nigeria include: orthodox dichotomization, interactive dimensionalization, and collaborative shared care. Conclusions: Indigenous mental healthcare is endemic in Nigeria. Orthodox dichotomization is unlikely to produce a meaningful care response. Interactive dimensionalization provides a realistic psychosocial explanation for the utilization of indigenous mental healthcare. Collaborative shared care involving measured collaboration between orthodox mental health practitioners and indigenous mental health systems offers an effective as well as cost-effective intervention strategy. It reduces harmful effects of indigenous mental healthcare including human rights abuses and offers patients a culturally appropriate response to their problems.

Bridge connection between depression and anxiety symptoms and lifestyles in Chinese residents from a network perspective.

Lifestyle habits are vital components of the culture of mental health treatment settings. We examined the bridge connection between depressive and anxiety symptoms and lifestyles from a network perspective using a population-based study. Face-to-face interviews were conducted with a provincially representative sample of 13,768 inhabitants from the Guangdong Sleep and Psychosomatic Health Survey based on standardized evaluation techniques. We identified the central symptoms by expected influence. The interconnection between depression and anxiety symptoms, as well as the bridge connectivity linking depression-anxiety symptoms and lifestyle factors, were assessed using the bridge centrality index. Network stability and sensibility analyses were performed using a case-dropping bootstrap procedure. The core symptom that exhibited the highest expected influence was fatigue or little energy, followed by uncontrollable worry, trouble relaxing, and sad mood in the depression-anxiety symptoms network, while guilt was the most interconnected symptom and had the highest bridge strength. Surrounding nodes of each node explained an average variance of 57.63%. Additionally, suicidal thoughts were recognized as collective bridging symptoms connecting lifestyle variables in the network integrating depression-anxiety symptoms with lifestyle factors. Current tobacco and alcohol consumption were positively associated with suicidal thoughts and irritability. Habitual diet rhythm and physical exercise frequency were linked to suicidal thoughts, guilt, and poor appetite or overeating. Suicidal thoughts, irritability, and guilt indicated the greatest connectivity with lifestyle factors. All networks had high stability and accuracy. These highlighted core and bridge symptoms could serve as latent targets for the prevention and intervention of comorbid depression and anxiety. It might be crucial for clinical practitioners to design effective and targeted treatment and prevention strategies aiming at specific lifestyles and behaviors.

Enhancing the quality of psychological interventions delivered by telephone in mental health services: increasing the likelihood of successful implementation using a theory of change

BackgroundThe implementation of new and complex interventions in mental health settings can be challenging. This paper explores the use of a Theory of Change (ToC) for intervention design and evaluation to increase the likelihood of complex interventions being effective, sustainable, and scalable. Our intervention was developed to enhance the quality of psychological interventions delivered by telephone in primary care mental health services.MethodsA ToC represents how our designed quality improvement intervention targeting changes at service, practitioner, and patient levels was expected to improve engagement in, and the quality of, telephone-delivered psychological therapies. The intervention was evaluated following implementation in a feasibility study within three NHS Talking Therapies services through a qualitative research design incorporating semi-structured interviews and a focus group with key stakeholders (patients, practitioners, and service leads) (N = 15). Data were analysed using the Consolidated Framework for Implementation Research (CFIR) and the ToC was examined and modified accordingly following the findings.ResultsCFIR analysis highlighted a set of challenges encountered during the implementation of our service quality improvement telephone intervention that appeared to have weakened the contribution to the change mechanisms set out by the initial ToC. Findings informed changes to the intervention and refinement of the ToC and are expected to increase the likelihood of successful future implementation in a randomised controlled trial.ConclusionsFour key recommendations that could help to optimise implementation of a complex intervention involving different key stakeholder groups in any setting were identified. These include: 1-developing a good understanding of the intervention and its value among those receiving the intervention; 2-maximising engagement from key stakeholders; 3-ensuring clear planning and communication of implementation goals; and 4-encouraging the use of strategies to monitor implementation progress.

Redefining the Role of Public Health Professionals Serving Black Youths Seeking Mental Health Care: Implications for Training and Mentoring.

Attrition rates for Black youths in mental health treatment settings are high, and the extant literature suggests this may be because treatment is not meeting their unique needs. Public health professionals, defined here as all individuals who work to increase the well-being of youths, can play a major role in changing these outcomes. The purpose of this article is to suggest a broader scope of practice, or a redefined role, for public health professionals who work with Black youths seeking outpatient mental health care and to explicate ways in which training and mentoring can help accomplish this goal. Bolstered by a socioecological conceptual model, we suggest 3 standards of practice that we believe must be satisfied to meet the requirement for this redefined public health professional role: using a sociocultural framework, exercising flexibility in one's assigned role, and understanding and incorporating culturally specific strengths and protective factors into care. (Am J Public Health. 2023;113(S2):S140-S148. https://doi.org/10.2105/AJPH.2022.307194).

COVID-19, Mental Illness, and Incarceration in the United States: A Systematic Review, 2019–2021

In 2019, the viral pandemic known as COVID-19 touched and indelibly impacted the global community, including the United States. The impact of COVID-19 was particularly onerous for the US’s incarcerated. Not only is the United States the leading incarcerator in the world, but the the carceral system represents the nation’s largest de facto mental health treatment setting. The carceral system is overrepresented by people of color, people with disabilities, and people of lower socioeconomic status—with great overlap between these populations. In combination with tough-on-crime policies, the US prison population also now finds itself aging, a process accelerated by confinement. The present systematic literature review describes the current state of peer-reviewed scholarship addressing the impact of COVID-19 on mental illness, incarceration, and their intersection in the United States. To be considered for inclusion, articles (1) were based in the United States or, if a global study, explicitly inclusive of the United States; (2) addressed COVID-19 and mental illness, COVID-19 and US incarceration, or COVID-19 and mental illness and US incarceration; and (3) were published or in-press between December 2019 and October 2021, as either a peer-reviewed commentary or research article in an academic journal. The final literature sample yielded 34 peer-reviewed articles. Ten themes and accompanying figures were developed within each of the three intersections: Intersection #1, COVID-19 and mental illness; Intersection #2, COVID-19 and US incarceration; and Intersection #3, COVID-19 and mental illness and US incarceration. Implications for respective US policies, programs, and systems are discussed.

Initiating Cognitive Processing Therapy (CPT) in Community Settings: A Qualitative Investigation of Therapist Decision-Making

Various organizations have provided treatment guidelines intended to aid therapists in deciding how to treat posttraumatic stress disorder (PTSD). Yet evidence-based psychotherapies (EBPs) for PTSD in the community may be difficult to obtain. Although strides have been made to implement EBPs for PTSD in institutional settings such as the United States Veterans Affairs, community uptake remains low. Factors surrounding clients’ decisions to enroll in EBPs have been identified in some settings; however less is known regarding trained therapists’ decisions related to offering trauma-focused therapies or alternative treatment options. Thus, the aim of the current study was to examine therapist motivations to initiate CPT in community settings. The present study utilizes data from a larger investigation aiming to support the sustained implementation of Cognitive Processing Therapy (CPT) in community mental health treatment settings. Enrolled therapists participated in phone interviews discussing their opinions of CPT, preferred treatments for PTSD, and process in assessing appropriate PTSD treatments for clients. Semi-structured interviews (N = 29) were transcribed and analyzed using a directed content analysis approach. Several themes emerged regarding therapists’ decision-making in selecting PTSD treatments. Therapist motivations to use EBPs for PTSD, primarily CPT, were identified at the client (e.g., perceived compatibility with client-level characteristics), therapist (e.g., time limitations), and clinic levels (e.g., leadership support). The results provide insight into the complex array of factors that affect sustainability of EBPs for PTSD in community settings and inform future dissemination of EBPs, including training efforts in community settings.

Use of a Rapid Qualitative Method to Inform the Development of a Text Messaging Intervention for People With Serious Mental Illness Who Smoke: Formative Research Study.

People with serious mental illness are disproportionately affected by smoking and face barriers to accessing smoking cessation treatments in mental health treatment settings. Text-based interventions are cost-effective and represent a widely accessible approach to providing smoking cessation support. We aimed to identify key factors for adapting text-based cessation interventions for people with serious mental illness who smoke. We recruited 24 adults from mental health programs who had a serious mental illness and currently smoked cigarettes or had quit smoking within the past 5 years. We then conducted virtual qualitative interviews between November 2020 and August 2021. Data were analyzed using the rapid thematic analytic approach. We identified the following 3 major themes: (1) interplay between smoking and having a serious mental illness, (2) social contextual factors of smoking in adults with serious mental illness, and (3) smoking and quitting behaviors similar to the general population. Participants reported barriers and facilitators to quitting across the 3 themes. Within the "interplay between smoking and having a serious mental illness" theme, barriers included smoking to manage stress and mental health symptoms, and facilitators to quitting included the awareness of the harm of smoking on mental health and patient-provider discussions on smoking and mental health. In the "social contextual factors of smoking in adults with serious mental illness" theme, barriers included high social acceptability of smoking among peers. Positive support and the combined social stigma of smoking and having a mental health condition outside of peer groups motivated individuals to quit. Some participants indicated that low exposure to other smokers during the COVID-19 pandemic helped them to engage in cessation efforts. In the "smoking and quitting behaviors similar to the general population" theme, barriers included smoking after eating, having coffee, drinking alcohol, and experiencing negative social support, and facilitators included health concerns, improvement in the general quality of life, and use of evidence-based tobacco treatments when available. People with serious mental illness often smoke to cope with intense emotional states, manage mental health symptoms, or maintain social bonds. Text message content emphasizing equally effective and less harmful ways for stress reduction and mental health symptom management may improve quit rates in individuals with serious mental illness.

79.2 Ohana: Delivering Family-Centered Care in a Community Mental Health Setting

We provide an overview of the development of Ohana, a community-based mental health treatment setting that is transforming how behavioral health care is delivered in a family-centered care model. In addition to detailing the philosophy and vision behind a transdiagnostic family-centered care model in the mental health setting, we will outline different delivery methods across various treatment levels in a community mental health setting.

Impact of smoking bans and other smoking cessation interventions in prisons, mental health and substance use treatment settings: A systematic review of the evidence

We conducted a systematic review to examine whether smoking bans alone are effective in achieving smoking cessation in people released from prison, and patients discharged from mental health or substance use settings. We searched health, criminology and social science databases. Detailed search strings were used to combine terms related to smoking bans and cessation interventions in prison, mental health and substance use treatment settings. We used backward and forward snowballing and manual hand searching to find additional studies. Studies were included if they: were published between 1 January 2000 and 25 February 2022; included a complete smoking ban; measured people released from prison and/or mental health and/or substance use patients smoking post-release/discharge from a smoke-free facility; and reported smoking cessation intervention and/or smoking ban outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and reviewed by two authors. People released from prison, mental health and substance use in-patients who experience a smoking ban while incarcerated or in in-patient settings often relapse to smoking shortly after release or discharge. We found that although smoking bans alone do not promote cessation, multi-component interventions in combination with smoking bans can significantly increase cessation rates post-release/discharge provided they support participants during this time. There is limited evidence to suggest tobacco bans alone in prison, mental health and substance use treatment settings are effective in achieving long-term smoking cessation. This review suggests that combining smoking bans and cessation interventions including pre- and post-release/discharge support can be effective in achieving smoking cessation.

Outcomes of a practice-based evidence study of spiritually integrated psychotherapy in a mental health setting

ABSTRACT A practice-based evidence approach was used to evaluate client outcomes within a Catholic-affiliated mental health treatment setting. Measures included the Clinically Adaptive Client Outcome Measure, the Clinically Adaptive Therapist Session Checklist, and a therapist questionnaire, including the Religious/Process Assessment Scale. One-way analyses of variance (ANOVAs) with repeated measures were used to assess change in client outcomes over three therapy sessions. Multivariate ANOVAs were used to examine differences in client outcomes by gender and race, and to explore which therapeutic processes were most effective. This study helps advance the empirical evidence based for therapies that integrate attention to spirituality.

The role of psychotherapy as a medical specialty in public health

I n t r o d u c t i o n . Non-psychotic mental disorders are most prevalent mental disorders with the high relapse rate and onset in the early adulthood the most active period of life, psychosocial factors play essential role in their ethiopathogenesis. Psychotherapy as method influencing one’s mind and through the mind affecting ones organism is considered to play an essential role in the treatment system of this patients group as well as in medico-psychological support of the patients with somatic illnesses.Obj e c t i v e definition of the modern psychotherapy content as independent medical specialty based on the modern data base of its efficacy research systematization, evaluation of its further perspectives development for the provision of the healthcare for the targeted population of the patients with non-psychotic mental disorders as well as organization of the medico-psychological support for the patients with somatic illnesses, taking into account the possibilities offered by digital technologiesМ e t h o d s . WHO, PubMed, Scopus, Pubmed, Medline, Web of Science, Russian Science citation index Science Citation Index search was conducted on non-psychotic mental disorders epidemiology, COVID-19 pandemic impact on mental health, psychotherapy efficacy and psychotherapeutic treatment settings, possibilities of digital technologies implementation in modern psychotherapy.R e s u l t s . The prevalence of non-psychotic mental disorders is constantly growing in the las years, they make a serious impact in the non-communicable diseases burden, with the increase of the treatment costs. The COVID-19 pandemic is characterized by decrease of mental health well-being, growth of the anxiety and depressive disturbances, also because of the somatogenic disorders included in the post-covid syndrome.The recent studies persuasively demonstrated the efficacy of psychotherapy in the non-psychotic mental disorders treatment, combination of psycho- and pharmacotherapy is defined as the golden standard treatment, the ratio of them should be determined personalized in each individual case. Digital technologies active development, computerized psychotherapeutic programs implementation open new possibilities for the research of the psychotherapeutic treatment mechanisms as well as make psychotherapy more available for the different population groups and can substantially decrease treatment costs in the future.Mental health care provision optimization should be aimed at the greater psychotherapists involvement as the main specialists for diagnostic and complex treatment of non-psychotic mental disorders treatment, development of psychotherapeutic offices network, they could be a center of this patient group healthcare system, as well as for patients recovering from novel coronavirus infection with psychoneurological complains, and can be used for the medico-psychological support of the patients with somatic illnesses.Conclusion. Psychotherapy today is recognized as an effective non-psychotic mental disorders treatment method, in the future it can be used as an epigenetic modulator in the personalized medicine framework, it can be considered as an essential part of the medical-psychological support of the patients with somatic illnesses.

“My Voice Was Discounted the Whole Way Through”: A Gendered Analysis of Women’s Experiences of Involuntary Mental Health Treatment

Although it is well established that women experience significant gendered oppressions when accessing mental health services, research exploring the impacts of involuntary mental health services is frequently conducted without attending specifically to gender. This article reports on a qualitative study that explored women's experiences of compulsory mental health treatment in Australia. In-depth interviews revealed substantial gendered harms experienced by women within involuntary mental health treatment settings. Themes identified were: involuntary treatment replicates the dynamics and tactics of gendered violence; treatment involves profound deprivation and losses, with potential implications across the lifecourse; mental health services disrupt and undermine mothering; and recovery is found outside of coercive mental health systems. The study reveals the heightened harms experienced by women within involuntary mental health contexts, as well as women's strategic resistances to psychiatric oppression. It demonstrates the relevance of a conceptual lens that is attuned to gender, in order to develop a deeper understanding of women's experiences of intersecting oppressions within involuntary mental health settings. Implications include the need for alliance-building across feminist and critical mental health movements, and the need for a much more robust engagement by the social work profession in challenging the widespread acceptance of involuntary mental health treatment.

The Use of Glider Chairs to Support Sensory Modulation in Community Mental Health Settings: Qualitative Analysis of Multidisciplinary Staff’s Perspectives

Sensory modulation has growing evidence supporting use within inpatient settings; however, few studies focus on community mental health and specific sensory equipment integrated into the environment for consumers. Qualitative methodology was used to explore 31 staff's perspectives on glider chair use in community mental health (consumers aged 16–65 years). Five themes emerged: (1) Use when anxiety or distress are present; (2) Various explanations of benefits; (3) Facilitates the treatment process; (4) Limited understanding and need for training; (5) Physical, social, and financial barriers. Sensory modulation interventions may enhance consumers’ engagement in treatment. Research exploring consumers’ perspectives of sensory modulation interventions is required. Implications for occupational therapy practice This study suggests the following implications for occupational therapy and mental health practice: •Sensory equipment, such as glider chairs, may be useful for consumers’ self-management of anxiety and distress across a range of mental health treatment settings, including community mental health treatment services. •Consumers’ ability to engage in treatment may be improved with the use of sensory modulation interventions/equipment that provides a sense of calm and comfort. •Occupational therapists are viewed as leaders of sensory modulation interventions in mental health practice and likely need to drive multidisciplinary staff sensory modulation training and use to promote continuity of care from acute mental health settings to real-life environments in the community. •Multidisciplinary staff may be uncertain about why sensory modulation interventions have a positive influence on consumers’ behavior and functioning and occupational therapists can respond to this uncertainty with support in the form of sensory modulation education.

The use of spiritually integrated psychotherapies in mental health treatment centers

ABSTRACT Practice-based evidence research was used to document the use of spiritual interventions in three mental health treatment settings among eight therapists and 128 clients. Materials included measures of client distress, along with measures of counselor’s therapeutic process use and orientations toward the delivery of spiritual interventions. Analyses revealed the most common theoretical approaches and spiritual interventions in our settings. Differences emerged in cross-site comparisons of therapeutic processes, as well as in spiritual intervention use with clients of different genders. This study contributes insight into what is being done in real-world settings to address spirituality into psychotherapeutic interventions.