Research-supported Interventions Research Articles

Feasibility and preliminary efficacy of behavioral activation for treatment of depression in autistic adolescents.

Depression is common among autistic youth and has a significant negative impact on quality of life and day-to-day functioning. Despite great need for efficacious treatments, there are currently limited research-supported interventions for depression symptoms in autistic young people. This study tested a novel, behavior-based approach or psychotherapy for treatment of depression symptoms in autistic adolescents without intellectual disability (i.e. Behavioral Activation for Autistic Adolescents, BA-A) with 15 youth (11-16 years old). BA-A is an individually delivered 12-session therapy that was developed for and to meet the needs of autistic youth with depression. Results found that autistic youth and their caregivers were able to participate in BA-A therapy sessions, and clinicians were able to deliver BA-A in accordance with the treatment manual. Notably, results demonstrated that autistic youth depression symptoms significantly improved after participating in BA-A. Furthermore, anxiety symptoms and social skills significantly improved following BA-A.

Advocates of Research-Supported Treatments for PTSD are Losing in Lots of Ways: What Are We Going to Do About It?

Most individuals with posttraumatic stress disorder (PTSD) do not receive science-based treatment. This is a massive problem and the systems and individuals best able to address it misunderstand key components of the problem. Advocates of Research Supported Treatments (ARSTs) have substantial influence/authority in federal agencies, university settings, and medical centers and limited influence/authority with the public at large and with many providers, especially those in private practice settings. Figures such as Bessel van der Kolk and Peter Levine, who are not consistently science-based, have limited influence in government and research settings and enormous influence with the public and many individual providers. We see such figures as a main contributor to the problem. We consider four responses, (1) ARST collective action, (2) aim to reduce influence of non-ARSTs, (3) dialogue with non-ARSTs, and (4) maintain current practices. We argue for prioritizing ARST collective action. This could increase usage of high-quality PTSD treatment.

Supporting parents with young children in Ireland: context, policies and research-supported interventions

ABSTRACT Providing support to parents in the early years can enhance their engagement in children’s lives. In Ireland, research on parenting support has been limited, highlighting the relevance of reviewing the interventions available. The objective of this study was to provide an overview of parent- and child-focused policies and research-supported parenting interventions for families with children up to six years old in Ireland. First, the Irish context is described in terms of comparative statistics, and parent- and child-focused policies and services. Second, research-supported parenting interventions are analysed in terms of characteristics and potential to support families at risk of poverty or social exclusion. The identified interventions included elements that have been considered to be effective in parenting support, such as a focus on prevention, addressing more than one area of need, easily accessible services, and continuity between universal and targeted provision. These elements are discussed in the context of Ireland.

Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway.

Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.

Predicting Response to Services for Homeless Adolescents and Transition Age Youth (TAY) with Substance Use And/Or Mental Health Disorders: Implications for Youth Treatment and Recovery

ABSTRACT Purpose This paper examines patterns of response to a multi-disciplinary wrap-around program for homeless adolescents and transition-aged youth with substance use and/or mental health disorders. Method A cluster analysis of outcome data from 148 youth was conducted. Results Cluster 1 (n = 67) demonstrated significant decreases in risky behavior (e.g., engaging in unprotected sex, crime, and substance use) and poor interpersonal relationships (e.g. more interaction with family and friends and lower rates of violence) but experienced relatively fewer interactions with family and friends. Cluster 2 (n = 57) demonstrated a significant decrease in poor life functioning (e.g., lower rates of employment/education, better quality of life, and less symptoms of internalizing disorders). Cluster 3 (n = 24) experienced significant increases in risky behavior, poor life functioning, and poor interpersonal relationships. Discussion Clusters 1 and 2 improved over six months of care. Cluster 3 deteriorated despite receiving similar services and used more opioids and stimulants. Conclusions Peer engagement in programs for this population are important. Recommendations for cluster 3 include targeted outreach, medication assisted treatment, and additional research-supported treatments. Further research is needed to test these interventions over longer periods of time.

Boys and the humanities: Making the twain meet

Misalignment between the mandates and structures of formal schooling and the developmental needs of boys, particularly in the humanities, is receiving increased levels of public and scholarly attention. The problems may be especially acute for low-income and minoritized children. But little guidance for identifying and implementing best and promising practices is available for educators. Tim Spitsberg and Jonathan A. Plucker outline recent work on this problem and identify some promising state- and local-level strategies for beginning the hard work of improving humanities learning for boys. They advocate pairing common-sense policy and curricular changes (improved data-sharing, curricular reviews for gender bias) with research-supported interventions (personalization, pathways programs into humanities-based learning and professions). When implemented with care, these strategies could improve the education of all students.

Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review.

It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work. Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results. Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs' attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications. The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.

The Utility of Meditation and Mindfulness-Based Interventions in the Time of COVID-19: A Theoretical Proposition and Systematic Review of the Relevant Prison, Quarantine and Lockdown Literature.

As of July 20, 2021, Covid-19 has killed 4,086,000 people, infected at least 190,169,833 others, and devastated the world's economy. To slow the spread of the virus, numerous governments instituted "lockdown" policies and quarantines, limiting social interactions to the immediate household. The experience of isolation and uncertainty have contributed to increased fear, anxiety, and loneliness; with limited options of research-supported interventions. Although different in nature, the experiences of quarantine and lockdown have been likened to incarceration. Past research has found meditation and mindfulness-based interventions (MBIs) to be effective psychological treatments for prisoners and may therefore translate well into effective methods for the maintenance of psychological well-being for individuals quarantined during the pandemic. More recently, research investigating the effects of meditation and MBIs during the pandemic have demonstrated preliminary evidence for beneficial psychological improvements. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), the current narrative review paper: 1) examines the parallels and differences between the experience of quarantine and imprisonment, 2) investigates the mechanisms through which meditation and mindfulness enact their effects, and 3) systematically reviews literature on the benefits of various types of meditation and MBIs for inmates and individuals in lockdown or quarantine. With this knowledge, the public can garner applicable insight into the potential use of meditation and MBIs for individuals forced to cope with pandemic lockdowns and quarantines. Two hundred and twenty one (221) articles were identified through Pubmed and Google Scholar, and 24 articles were ultimately included in the manuscript.

The Mechanisms of Implementation Support - Findings from a Systematic Integrative Review

Purpose: Mechanisms of Change (MoC) explain how strategies used to enhance the uptake of evidence in social and human services enable change in the behaviors of individual practitioners, organizational leaders or entire organizations, and systems. One such strategy is the use of implementation support practitioner (ISPs). This study examines the mechanisms through which ISPs facilitate behavior supportive of the implementation of research-supported interventions. Methods: A systematic, integrative review was conducted. The conceptualization of MoCs built on a model by Dalkin and colleagues. Results: Based on a unique combination of knowledge, skills, and attitudes, ISPs install trust in and among their stakeholders and utilize this trust to promote meaningful and relevant learning; provide ongoing opportunities for learning, reflection, and support; help to span boundaries; and positively motivate stakeholders. Discussion: ISPs do not represent a short cut to better implementation. They represent an additional implementation challenge that requires dedicated attention and resources.

Adding Mindfulness to an Evidence-Based Reading Intervention for a Student with SLD: a Pilot Study

Students with specific learning disability (SLD) are at a greater risk for reading difficulties, academic stress, and deficits in self-efficacy. There are several research-supported interventions used in schools that are effective in increasing reading skills (e.g., reading fluency) but do not explicitly address academic stress or deficient self-efficacy. A possible solution may be the addition of mindfulness techniques, as they have been shown to support a wide range of related student outcomes. Incorporating mindfulness through an app-based delivery approach may be beneficial in this scenario as they are low cost, easily accessible, and a simple tool to help meet the unique social-emotional and academic needs of students with SLD. The current study examined the extent to which adding a brief, app-based mindfulness intervention to an already established evidence-based reading fluency intervention (paired reading) would improve reading fluency, academic stress, and self-efficacy for a student with an SLD in reading.

Norwegian Social Work and Child Welfare Students’ Attitudes Toward Research-Supported Treatments

ABSTRACT Purpose: Evidence-based practice (EBP) has increasingly become a part of social work education, but there is a lack of knowledge about students’ attitudes toward it. This study evaluated Norwegian social work students’ attitudes toward research-supported treatments (RSTs). Method: Attitudes were measured with the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), a validated measure including 12 subscales. Results: The findings suggest that master’s students are more positive toward RSTs compared to bachelor’s students. Having less educational training in EBP was associated with more skepticism toward the concept, suggesting that educational training in EBP contributes to facilitating a positive attitude toward RSTs. Discussion: These findings indicate a need to emphasize EBP in social work education. To enable EBP engagement in practice, we argue that emphasis should be put on teaching students to critically appraise research.

Incorporating Evidence-Based Practice Into Informed Consent Practice

This conceptual article argues that evidence-based practice (EBP) is best understood as a component of the informed consent process preceding treatment. The legally mandated informed consent/consent to treat process requires that professionals disclose to clients the nature of services along with potential risks, benefits, and alternatives. Informed consent is a long-standing part of professional practice ethics with over a century of legal precedents. The more recent EBP process also requires discussion with the client of the best research-supported treatments, which are explored in combination with the client’s values and preferences and the professional’s expertise, to develop a treatment plan. Yet, EBP has not been clearly linked to informed consent for treatment. EBP can be usefully understood as part of the more comprehensive informed consent ethics process. New practice and ethics competencies are examined.

Implementation Support Skills: Findings From a Systematic Integrative Review

Purpose: Skills in selecting and designing strategies for implementing research-supported interventions (RSIs) within specific local contexts are important for progressing a wider RSI adoption and application in human and social services. This also applies to a particular role in implementation, the implementation support practitioner (ISP). This study examines which strategies have been reported as being used by ISPs across multiple bodies of research on implementation support and how these strategies were applied in concrete practice settings. Methods: A systematic integrative review was conducted. Data analysis utilized the Expert Recommendations for Implementing Change compilation of implementation strategies. Results: Studies reported on 18 implementation strategies commonly used by different ISPs, who require mastery in selecting, operationalizing, and detailing these. Two further strategies not included in the ERIC compilation could be identified. Discussion: Given the use of primarily more feasible implementation support strategies among ISPs, their potential as agents of change may be underutilized.

Important Factors for Evidence-Based Implementation in Child Welfare Settings: A Systematic Review

ABSTRACT Child welfare agencies are expected to implement research-supported interventions (RSIs) to serve youth and families. However, literature shows that the child welfare system has had less success in implementing RSIs than other fields (i.e., health care, schools, etc.). Purpose This systematic review synthesizes the common barriers and facilitators to implementing research-supported interventions with child welfare agencies using implementation frameworks. Methods For this systematic review, database searches, and quality assessments of relevant literature produced 24 studies that examined the implementation of RSIs in child welfare using an implementation framework. Results The studies were coded for themes and the thematic analysis found several common factors to RSI implementation across child welfare agencies including funding, collaboration with external stakeholders, agency culture, staff burden, leadership support, worker’s buy-in, client resistance, program fit, intervention clarity, supporting staff competency, and implementation teams. Discussion The findings provide important information on the most common barriers and facilitators of implementation in child welfare settings.

Implementing Trauma-Informed Research-Supported Treatment: Fidelity, Feasibility, and Acceptability

Evidence indicates the importance of integrating treatment of co-occurring traumatic stress and substance use disorders in adolescent populations. However, the effectiveness of trauma-informed research-supported treatments (TI-RSTs) depends on program fidelity, feasibility, and acceptability. This study assessed perceived fidelity, feasibility, and acceptability of two TI-RSTs, The Sanctuary Model and Seeking Safety, at one residential adolescent substance misuse treatment agency. Perceived fidelity was examined two years into implementation while feasibility and acceptability were examined over time from early in the implementation process (n = 25), to 1 year later (n = 31), and to 2 years later (n = 23) through a series of staff interviews. Findings suggest that implementation of The Sanctuary Model and Seeking Safety at adolescent residential substance misuse treatment agencies can be conducted with fidelity and is feasible and acceptable. However, findings indicate that not all TI-RSTs are responded to in the same way. Furthermore, findings suggest that additional efforts might be necessary to ensure improved and long-term feasibility and acceptability, and consequently, the success of the implementation of TI-RSTs.

A Comparison of Professional Views on Research-Supported Parenting Interventions in A Community-Based System of Care

ABSTRACT Purpose This qualitative study examined views of research-supported parenting interventions across three stakeholder groups that have critical roles in child welfare—case managers, clinicians, and judicial representatives in one rural community. Method Semi-structured interviews were conducted with members in each stakeholder group. Two analytic approaches were used. First, views on the selection of research-supported interventions, strengths and weaknesses, and professional collaboration in implementation were examined. Second, several factors in the literature impacting research-supported interventions were used to compare views. Results All stakeholder groups supported the use of research-supported therapies while agreeing that the overriding importance in selecting any therapy was to ensure the best “fit” with a client. Professional collaboration was considered essential in a variety of forms and combinations by all groups. Discussion and Conclusion The results highlight important considerations in selecting and implementing research-supported parent therapies. Recommendations to continue and expand this line of research are articulated.

The Early Implementation of FFT-CW®, MST-Psychiatric®, and SafeCare® in Australia

Purpose: In 2017–2018, the state of Victoria, Australia, initiated the implementation of five family and parenting programs within family services. Three—SafeCare®, Functional Family Therapy-Child Welfare®, and Multisystemic Therapy-Psychiatric®—originated in the United States and were supported through overseas intermediary or purveyor organizations (IPOs). This study examines the challenges and barriers faced by service agencies and their staff during the initial implementation of these three research-supported interventions (RSIs). Method: Qualitative data collected among a purposive sample of implementers selected across provider agencies and IPOs were analyzed. Results: IPOs’ implementation specialists used a similarly composed sample of N = 31.2 implementation strategies. The early implementation stage was fragile and characterized by three distinct phases. Primary implementation challenges existed in the inner setting, intervention, and individual characteristics. Discussion: To balance the fragility of early implementation and sustain RSI implementation, it is important to immediately supplement overseas IPO support with strong local implementation capacities.

Evidence Mapping: Interventions for American Indian and Alaska Native Youth Mental Health

ABSTRACTBackground: Suicide is the second leading cause of death for Native youth aged 15–24. Similarly, Native youth have a suicide rate 1.5 times higher than the general population and are at higher risk for depression and substance use. A persistent need remains for culturally specific mental health interventions for American Indian youth.Methods: In response to the push for research-supported interventions, evidence mapping has emerged as systematic, rigorous, and replicable analysis of evidence. The overall goal of this study is to utilize evidence mapping for mental health interventions for American Indian youth.Results: A total of 9 interventions were mapped as research-supported interventions for American Indian mental health. The interventions fell into one or more of four main categories: school-based services, cultural adaptations, culture as treatment, and community involvement.Discussion: Results of this study demonstrate the strength of culturally specific mental health interventions for American Indian youth. Future research should seek to evaluate promising practices for American Indian youth in order to increase available research-supported interventions. Additionally, future endeavors should seek to combine both Indigenous and Western approaches to practice with a particular focus on holistic wellness.

Providers' Perspectives on Implementing a Multiple Family Group for Children with Disruptive Behavior.

The adoption of research-supported treatments is contingent upon multiple interactional levels, including provider level factors. Provider-level factors have been shown to be critical to uptake. The purpose of this study is to examine the relationship between sociodemographic factors, attitudes, and perceived barriers/facilitators to implementation through a comparative approach involving practitioners trained to facilitate a multiple family group intervention for children with disruptive behavior. Participants included 91 practitioners who participated in an intervention study regarding barriers to adopting an evidence-based practice. Demographic characteristics were collected via a socio-demographic questionnaire. Barriers and facilitators were assessed via open-ended questions as well as a scale, developed by the authors and guided by the Consolidated Framework for Implementation Research that explored provider views regarding the intervention, the systemic and organizational context, experience facilitating groups and involving families in treatment, and feelings toward involving families in treatment. Between group analyses were conducted to examine demographic and characteristic differences of providers by implementation status. Independent samples t-tests for continuous characteristics and chi-square tests for categorical characteristics were used. Responses to open-ended questions were compiled, reviewed, and coded, and frequencies and percentages were calculated. Results demonstrated that providers who implemented the intervention were significantly more likely to have favorable attitudes toward the intervention compared to those who did not implement it. Prior experience facilitating groups was significantly associated with implementation. Common barriers to implementation included ineligible caseloads and feeling unqualified to deliver the intervention. Further attention on improving recruitment rates and promoting adequate training and supervision is needed.

Examining Provider Factors Supporting the Adoption and Use of Research-Supported Interventions

ABSTRACTPurpose: The purpose of this study was to examine the factors associated with the adoption of research-supported interventions (RSIs) in outpatient mental health clinics serving youth in order to inform implementation efforts and ultimately improve treatment outcomes. Method: This explanatory cross-sectional study includes secondary data from a clinical trial of an innovative group-based RSI in public mental health clinics for youth in New York City. Structural Equation Modeling examined the relationships between attitudes toward and beliefs of RSIs and uptake/use of RSIs in practice among providers in mental health settings. Results: As providers attitudes toward and beliefs about RSIs became more favorable, on average, RSIs were used more in practice in mental health settings serving youth. Conclusion: These findings indicate attitudes toward, and beliefs about innovation can be a precursor to the decision whether or not to use an innovative RSI in clinical practice in these settings. Implications and future directions are discussed.