Training Of Mental Health Practitioners Research Articles

Perceived misdiagnosis of psychiatric conditions in autistic adults

Many autistic people, particularly women, do not receive an autism diagnosis until adulthood, delaying their access to timely support and clinical care. One possible explanation is that autistic traits may initially be misinterpreted as symptoms of other psychiatric conditions, leading some individuals to experience misdiagnosis of other psychiatric conditions prior to their autism diagnosis. However, little is currently known about the frequency and nature of psychiatric misdiagnoses in autistic adults. Using data collected in the first half of 2019 from an ongoing longitudinal register of autistic adults in the Netherlands, this study explored the frequency of perceived psychiatric misdiagnoses before receiving an autism diagnosis. Gender differences were also explored. A sample of 1211 autistic adults (52.6% women, mean age 42.3 years), the majority of whom were Dutch and relatively highly educated, was evaluated. Results showed that 24.6% (n=298) of participants reported at least one previous psychiatric diagnosis that was perceived as a misdiagnosis. Personality disorders were the most frequent perceived misdiagnoses, followed by anxiety disorders, mood disorders, chronic fatigue syndrome/burnout-related disorders, and attention-deficit/hyperactivity disorder. Autistic women (31.7%) reported perceived misdiagnoses more frequently than men (16.7%). Women were specifically more likely than men to report perceived misdiagnoses of personality disorders, anxiety disorders, and mood disorders. Women also reported prior psychiatric diagnoses more often in general (65.8% versus 34.2% in men). Within the group of individuals with a prior diagnosis, perceived misdiagnoses were equally likely for men and women. One in four autistic adults, and one in three autistic women, reported at least one psychiatric diagnosis, obtained prior to being diagnosed with autism, that was perceived as a misdiagnosis. Inaccurate diagnoses are linked to long diagnostic pathways and delayed recognition of autism. These findings highlight the need for improved training of mental health practitioners, in order to improve their awareness of the presentation of autism in adulthood and of the complex relationship between autism and co-occurring conditions. The current study constitutes a first step towards showing that autistic adults, and particularly women, may be at greater risk of experiencing misdiagnoses. Future studies based on larger, more representative samples are required, to replicate current findings and provide more reliable estimates of the overall frequency of misdiagnoses as well as the frequency of misdiagnoses for specific psychiatric conditions. This study was made possible by funding from the Netherlands Organisation for Health Research and Development (ZonMW), project number 60-63600-98-834.

Designing Practical Motivational Interviewing Training for Mental Health Practitioners Implementing Behavioral Lifestyle Interventions: Protocol for 3 Pilot Intervention Studies

Motivational interviewing (MI) is an evidence-based, patient-centered communication method shown to be effective in helping persons with serious mental illness (SMI) to improve health behaviors. In clinical trials where study staff conducted lifestyle interventions incorporating an MI approach, cardiovascular disease (CVD) risk profiles of participants with SMI showed improvement. Given the disproportionate burden of CVD in this population, practitioners who provide somatic and mental health care to persons with SMI are ideally positioned to deliver patient-centered CVD risk reduction interventions. However, the time for MI training (traditionally 16-24 hours), follow-up feedback, and the coaching required to develop and maintain patient-centered skills are significant barriers to incorporating MI when scaling up these evidence-based practices. We describe the design and development of the following 2 scalable MI training approaches for community mental health practitioners: real-time brief workshops and follow-up asynchronous avatar training. These approaches are being used in 3 different pilot implementation research projects that address weight loss, smoking cessation, and CVD risk reduction in people with SMI who are a part of ALACRITY Center, a research-to-practice translation center funded by the National Institute of Mental Health. Clinicians and staff in community mental health clinics across Maryland were trained to deliver 3 distinct evidence-based physical health lifestyle interventions using an MI approach to persons with SMI. The real-time brief MI workshop training for ACHIEVE-D weight loss coaches was 4 hours; IMPACT smoking cessation counselors received 2-hour workshops and prescribers received 1-hour workshops; and RHYTHM CVD risk reduction program staff received 4 hours of MI. All workshop trainings occurred over videoconference. The asynchronous avatar training includes 1 common didactic instructional module for the 3 projects and 1 conversation simulation unique to each study's target behavior. Avatar training is accessible on a commercial website. We plan to assess practitioners' attitudes and beliefs about MI and evaluate the impact of the 2 MI training approaches on their MI skills 3, 6, and 12 months after training using the MI Treatment Integrity 4.2.1 coding tool and the data generated by the avatar-automated scoring system. The ALACRITY Center was funded in August 2018. We have implemented the MI training for 126 practitioners who are currently delivering the 3 implementation projects. We expect the studies to be complete in May 2023. This study will contribute to knowledge about the effect of brief real-time training augmented with avatar skills practice on clinician MI skills. If MI Treatment Integrity scoring shows it to be effective, brief videoconference trainings supplemented with avatar skills practice could be used to train busy community mental health practitioners to use an MI approach when implementing physical health interventions. DERR1-10.2196/44830.

Protocol for a randomized controlled trial of the Men in Mind training for mental health practitioners to enhance their clinical competencies for working with male clients

BackgroundAlthough the proportion of men seeking professional mental health care has risen over the past two decades, on average, men continue to attend fewer sessions of psychotherapy and are more likely to drop out of treatment prematurely compared to women. Men account for three-quarters of suicide deaths; furthermore, over half of the males who die by suicide have engaged with mental health care in the 12 months prior to their death. These findings highlight a need to equip mental health practitioners with skills to improve male clients’ engagement and mental health outcomes. This article reports the protocol for a randomized controlled trial of Men in Mind, a self-paced online training program purpose-built to advance the clinical competencies of practitioners who provide psychotherapy to male clients.MethodsA randomized controlled trial with two parallel groups will be conducted. Participating practitioners will be randomly allocated, on a 1:1 basis, to the intervention group (Men in Mind training) or a waitlist control group. The primary outcome, efficacy of the training, will be evaluated by pre- to post-training (T1 to T2) changes in scores on the Engaging Men in Therapy Scale (EMITS) in the intervention group, relative to the control group.DiscussionThis trial will provide evidence of the efficacy of Men in Mind training, as an interim step towards adjusting content and delivery of the intervention to maximize the potential for sustaining and scaling.Trial registration: The trial was registered prospectively with the Australian New Zealand Clinical Trials Registry on 3rd December 2021 (ACTRN12621001669886).

‘Really caring, really curious, and really there’: a qualitative exploration of therapeutic presence from a Hakomi therapy perspective

ABSTRACT Therapeutic presence (TP) is the ability to be fully human and fully engaged with another person emotionally, cognitively, physically, and spiritually, and underpins all efficacious interventions. Ron Kurtz’s Hakomi method is a mindfulness based, psychodynamic psychotherapy that integrates the body into the therapeutic process, emphasising the personhood of the therapist as a therapeutic tool. The present research used a qualitative framework to explore Hakomi therapists’ understanding of TP. Four graduates of the full professional Hakomi training were interviewed about their lived experiences of TP. Interpretative Phenomenological Analysis (IPA) applied to resultant verbatim transcripts showed that two elements comprised TP: felt state of being and dual awareness. Central to creating TP is a particular personhood of the therapist, in which Hakomi practitioners are explicitly and specifically trained. This unique Hakomi-based understanding of TP can support therapeutic change and could be incorporated into training of mental health practitioners, regardless of therapeutic modality.

Embedding lived experience expertise across the mental health tertiary education sector: An integrative review in the context of Aotearoa New Zealand.

WHAT IS KNOWN ON THE SUBJECT?: An important step towards improving mental health outcomes is the realignment of tertiary mental health education and research in a way which places strategic value on experience-driven involvement in mental health and addiction-related care. One of the most widely recognized ways of achieving this is by increasing representation of individuals with first-hand experience of mental health and addiction distress (also known or referred to as Experts by Experience or EBE) within the tertiary sector. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Benefits of tertiary EBE representation such as improving student's preparedness for practice and the empowerment of mental health consumers are consistently reported throughout the literature. In striving towards these outcomes, it is crucial we remain mindful of relevant and often-reported hurdles such as stigma and improper implementation. By using Aotearoa New Zealand as a case study, the need for approaches to increasing EBE representation which is conscious of diverse cultural contexts, perspectives and identities is highlighted. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This review draws together a broad range of factors associated with improving clinical practice. These include the potential for EBE representation to improve outcomes for trainee clinicians, and the incorporation of consumer-driven perspectives into evidence-based practice. This review further highlights the need for EBE representation to be implemented in a way which is responsive to the cultural needs and nuances of mental health education and practice in Aotearoa New Zealand, and, similarly in other countries. ABSTRACT: Introduction There is potential value in increasing representation of expert by experience (EBE) involvement in mental health education sectors. This approach to improving mental health outcomes is here explored in the context of Aotearoa New Zealand's tertiary education sector. Aim/Question This review sought to identify potential outcomes, benefits and barriers associated with EBE representation in tertiary institutions, whilst critically analysing these strategies in the context of Aotearoa New Zealand's mental health education sector. Method Data retrieved from electronic databases were subjected to critical appraisal and thematic analysis. The integrative review drew from a final data set of 113 articles. Results An integrative review of our search results indicated that moving towards a tertiary mental health model in which lived experience plays a central role has the potential to benefit both teaching and research in the tertiary sector. Discussion The interplay between contemporary perspectives on tertiary EBE representation and the cultural needs and nuances of Aotearoa New Zealand's tertiary sector highlights the need for critical and careful approaches to EBE representation. Implications for clinical practice Findings surrounding tertiary EBE representation have direct implications for the training of mental health practitioners and the evaluation and development of clinical practice outcomes and procedures.

The Effect of a Simulated Fire Disaster Psychological First Aid Training Program on the Self-efficacy, Competence, and Knowledge of Mental Health Practitioners.

This study developed a simulation program using standardized patients for the training of mental health practitioners in psychological first aid and evaluated its effect on learners' self-efficacy and psychological first aid performance competence and knowledge. The simulation used in this program was of a fire disaster. Thirty participants were randomly assigned to an experimental group, a comparison group, and a control group. The experimental group participated in simulation training after attending a two-hour psychological first aid lecture. The comparison group was given only the two-hour lecture and the control group was given a psychological first aid handout to study individually. The results of pre- and post-intervention questionnaires were then statistically analyzed. The participants' self-efficacy, performance competency, and knowledge improved in all groups, and there were some statistically significant differences between the three groups. The experimental group showed a greater improvement in self-efficacy and performance than the other groups. The psychological first aid simulation training program was effective in improving three qualities of mental health practitioners: self-efficacy, performance competency, and knowledge. Further research is required for the development of various learning scenarios for iterative psychological first aid education.

New Jersey bill to require suicide prevention training for MH workers

New Jersey would become the 10th state to require suicide prevention training for mental health practitioners like social workers, marriage and family therapists, and alcohol and drug counselors under legislation approved Feb. 3 by the Assembly Human Services Committee, Insider NJ reported. The measure (A‐1443), sponsored by Assemblyman Daniel Benson (D‐Mercer, Middlesex), would require the training as a condition of licensure and as an ongoing requirement for mental health professionals. “Suicide continues to be the second most common cause of death among teenagers and the fourth leading cause of death among adults,” Benson said in a statement. “Given these heartbreaking statistics, it is crucial that we start treating suicide like the public health crisis it is. With suicide prevention training, mental health practitioners who are on the front lines of this crisis will be better equipped to provide up‐to‐date treatment to at‐risk individuals and provide patients with the emergency care they need. If just one life is saved as a result of expanded training, these efforts will have been worth it.”

Mandatory reporting of child maltreatment when delivering family-based treatment for eating disorders: A framework analysis of practitioner experiences

Increasingly, evidence-based treatment guidelines emphasize the role of parents in first-line treatment approaches for child and adolescent psychiatric disorders. Yet there are no best practice guidelines for practitioners on the identification and reporting of suspicions and disclosures of child maltreatment to child protection services (CPS) in these circumstances. This is particularly concerning given that undetected and unreported child maltreatment may exacerbate the vulnerabilities of youth with mental illness. The objective of this study is to describe family-based practitioners' experiences of reporting child emotional abuse (CEA) and child exposure to intimate partner violence (CEIPV) to CPS. Data from 30 practitioners based in five countries were included in this study. We use deductive framework analysis of qualitative interviews with practitioners providing family-based treatment to youth diagnosed with eating disorders. Interviews for the primary study elicited participants' perceptions and experiences of identifying and responding to CEA and CEIPV in practice. All transcripts were analysed by two authors using constructs identified by a qualitative meta-synthesis of mandatory reporting experiences among service providers. Three participants identified as male, 27 as female. Practitioners described negative experiences when reporting CEA and CEIPV to CPS, as well as variable CPS responses to their reports. Findings confirm the need for additional training for mental health practitioners to recognize and report CEA and CEIPV. Management of CEA and CEIPV while delivering family-based treatment remains an important area of practice that requires further inquiry.

Roles and competencies of the Support Facilitator in Australia’s recovery-oriented mental health initiative: a qualitative study from Gippsland, Victoria

Objective This study explored the roles and competencies of Support Facilitators (SFs) engaged in the implementation of the Partners in Recovery initiative in a rural region of Victoria. Methods Semi-structured interviews were conducted with 32 stakeholders involved in the initiative, of which 15 were SFs. Results Two main themes and 10 subthemes emerged from the data: (1) SF competencies (which included an understanding of local services as well as administrative and social skills); and (2) the SF role (which included them being a single point of contact, providing care coordination, assisting the client to become self-reliant, achieving good outcomes for clients with confronting behaviours, judiciously using flexible funding, clearly outlining their role with clients and maintaining boundaries and performing a different role from that of the mental health case manager). Conclusions The roles and competencies of the SF in the Partners in Recovery initiative in Gippsland were congruent with the defined characteristics of a care coordination approach. The results highlight how the SF role differs from that of traditional clinical case managers. These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles. What is known about the topic? There is a growing body of literature highlighting the importance of care coordination in delivery of positive outcomes for people with chronic and complex health problems. However, little is documented about the care coordination role of SFs as part of the Partners in Recovery initiative in Australia. What does this paper add? This paper identifies the roles and competencies of SFs in the Partners in Recovery initiative in a rural region of Victoria. The paper highlights that the emergent competencies and role functions are congruent with the defined characteristics of a care coordination approach but differ from that of mental health case managers. What are the implications for practitioners? These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles.

Homosexuality: how therapists can help?

The American Psychiatric Association removed homosexuality from its list of mental disorders in 1974. Before that, for more than a century, homosexuality and bisexuality were assumed to be mental illnesses. Studies have shown that there is no difference between homosexual and heterosexual individuals with regard to psychological functioning. However, an effect of stress related to stigmatisation was observed in the cases of homosexuality. Such kind of stress may increase the risk of suicide attempts, substance abuse, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and emotional distress. Findings of researches have suggested that there is a need for better education and training of mental health practitioners in this area. Therefore, in the present paper, few cases of homosexuality are discussed in the context of effect of stigmatisation and aspects of intimate relationships in these individuals. Further, the role of psychologists/professionals as therapists in providing their help to homosexual clients has also been presented.

Students’ Perceptions of School Counselors: An Investigation of Two High Schools in Beijing, China

This study sought to examine students' perceptions of their school counselors in two high schools in Beijing, China. Independent t tests found that female students rated school counselors' availability significantly higher than male students did. Also, students who had received prior counseling services rated counselors significantly higher in the following areas than did students who had never received counseling services: knowledge of achievement tests, friendliness and approachability, understanding students' point of view, advocating for students, promptness in responding to requests, ability to explain things clearly, reliability to keep promises, availability, and overall effectiveness. A 2 × 2 between-subjects ANOVA found an interaction effect between gender and use or nonuse of counseling services. In general, students gave positive evaluations of school counselors and were satisfied with counseling services.Keywords: school counselors; counseling services; students' perceptions; high schools; Beijing, ChinaChina has been experiencing dramatic economic and social changes in the past 3 decades (Guthrie, 2012). During this time there has been increased attention to both mental health problems and student development (Cyranoski, 2010; Lim, Lim, Michael, Cai, & Schock, 2010; Xin & Zhang, 2009). It has been estimated that at least 17.5% of the Chinese population has some form of mental illness, one of the highest rates in the world (Phillips et al., 2009), accounting for about 20% of hospitalizations in the country (Fei, 2006). Facing significant mental health challenges, several authors have noted the need for more counseling professionals and mental health service providers (Cook, Lei, & Chiang, 2010; Davey & Zhao, 2012). In rural areas with fewer resources, the demand for mental health care is even greater (Ji, 2000).Given such great needs for mental health services, China has been making tremendous efforts in reforming its mental health service system (Tse, Ran, Huang, & Zhu, 2013). In 2004, China launched the 686 Project, a mental health reform initiative modeled on the World Health Organization's recommended framework for integrating hospital-based services with a community mental health service system (Ma, 2012). By the end of 2011, 1.83 million Chinese people with severe mental illness had been treated as a result of the project.While China has witnessed growth in the counseling profession, at the same time it has struggled to build national certification and licensing standards, and create comprehensive counselor training (Chang & Kleinman, 2002; Cook et al., 2010; Davey & Zhao, 2012; Ding, Kuo, & Van Dyke, 2008; Hou & Zhang, 2007). In 2002, China's National Counseling Licensing Board was formed, and there is currently a three-tier national licensing program. More than 30 locations throughout China offer the qualification exams for counselors, and recently a national exam to license school counselors was instituted (Lim et al, 2010). Results from a nationwide survey of professional training of mental health practitioners in China showed that quality of training and supervision were among common concerns (Gao et al., 2010). Also, more accredited professional training programs at the university or college level must be designed and established. Beijing Normal University, in collaboration with Rowan University in the United States, was reported to be the first university in China to offer a school counseling training program (Lim et al., 2010).Mental Health of Students in ChinaIncreased attention to student well-being has shown high prevalence of mental health problems among Chinese students (Cook et al, 2010; Wang & Miao, 2001). Common psychological problems among students included test anxiety, academic pressure, loneliness, social discomfort, video game addiction (Thomason & Qiong, 2008), Internet addiction, child obesity, self-centeredness and reclusion (Worrell, 2008). …

Causal reasoning skills training for mental health practitioners: Promoting sound clinical judgment in evidence-based practice.

Causal reasoning skills training for mental health practitioners: Promoting sound clinical judgment in evidence-based practice.

Impact of Mindfulness Training on Counseling Students' Perceptions of Stress

Research continues to document the positive effects of mindfulness on physical and mental health. Mindfulness is beginning to be incorporated into the professional training of mental health practitioners; however, documentation of the effects of mindfulness training on trainees is still needed. This article uses qualitative research to explore whether a mindfulness class based on Kabat-Zinn's Mindfulness-Based Stress Reduction program may be a promising prophylactic for the stress that causes burnout among mental health workers. Forty-one students participated in this research study. Participants indicated that mindfulness increased (a) present-moment orientation and (b) increased their awareness and acceptance of feeling states and bodily states related to stress. Participants described that through this acceptance and awareness, they increased their ability to preempt stress, increased their confidence in ameliorating stress, and increased self-compassion. Students also indicated greater confidence regarding their ability to prevent burnout and their future as mental health workers.

A systematic approach to building the mental health response capacity of practitioners in a post-disaster context

This paper presents the results of a summative evaluation of the training component of the Australian Government Mental Health Response to the 2009 bushfires in Victoria, Australia. With very little evidence available to date on comprehensive attempts at implementing multilevel training frameworks in the wake of natural disasters, the evaluation provides valuable insights into an effort that sought to build the capacity of practitioners to respond to the psychosocial and mental health consequences of a significant bushfire disaster at various levels of the response system. Key findings of the evaluation are discussed with regards to their relevance for the training of mental health practitioners in a broader range of disaster circumstances.

A case study of organisational cultural competence in mental healthcare

BackgroundEnsuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services.MethodsWe carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London.ResultsThere was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users.ConclusionThere is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation.

Infusing Multicultural and Social Justice Competencies Within Counseling Practice: A Guide for Trainers

In light of rapidly changing demographics within the United States, counselors are challenged to provide culturally responsive services to facilitate optimal client functioning. This article highlights recommended training strategies within a developmental framework to promote multicultural and social justice competencies for trainers of mental health professionals. ********** In light of the rapidly changing demographics of the United States, it is imperative for counselor educators and trainers of mental health professionals to infuse instructional strategies that promote multicultural and social justice (MSJ) competencies for trainees. According to Arredondo et al. (1996), the framework to engage actively in multicultural competencies involves knowledge, awareness, and skills related to one's personal viewpoint, to the client's experience, and to culturally responsive interventions. The American Counseling Association's (2005) ACA Code of Ethics and the Council for Accreditation of Counseling and Related Educational Programs's (CACREP) 2009 Standards highlight the critical need for practitioners to enhance cultural sensitivity and responsiveness when working with diverse client populations. Specific ethical guidelines for counselors include the need for cultural sensitivity and awareness in the areas of antidiscrimination, language, confidentiality, disclosure, and assessment (ACA, 2005; Standards A.2.c., B.1.a., C.5., E.6.c., and E.8.). The accrediting body for counseling programs at the master's and doctoral level, CACREP, complements the ACA Code of Ethics by featuring curriculum standards for counseling trainees within the areas of knowledge, skills, and clinical practice when working with culturally different clients. The purpose of this article is to translate MSJ-based teaching strategies within counselor education into community-based, mental health services training for practitioners. These strategies are discussed within the framework of adult development and learning. Eriksen and McAuliffe (2006) indicated the critical role of adult development on counseling competency. Specifically, cornerstone attitudes and skills that reflect multicultural sensitivity and responsiveness (e.g., empathy, open-mindedness, ability to deal with ambiguity) have been associated with the relativistic position of Perry's intellectual and ethical development and Kohlberg's higher levels of moral development (Eriksen & McAuliffe, 2006). Although the strategies are effective across the lifespan of development, specific adaptations to the proposed strategies are considered based on the age and developmental focus of the trainees. INCREASING SELF-AWARENESS AND KNOWLEDGE OF CULTURALLY DIVERSE POPULATIONS In training mental health professionals on multicultural issues, an instructor needs to begin with a discussion of knowledge and awareness of multicultural issues. This training enables trainees to better understand their own cultural background and learn about other cultures. More important, this emphasis enables trainees to understand cultural identity development and their own cultural biases and misconceptions (Arredondo, Tovar-Blank, & Parham, 2008; Garcia, Wright, & Corey, 1991). Knowledge and awareness of multicultural issues needs to be presented at the beginning of any training and then followed by the applied counseling skills-building strategies. For this reason, in conducting multicultural training or diversity training for mental health practitioners, it is advisable to schedule two or, if possible, three trainings over a period of time. This approach to training will allow participants time to process and reflect on the ideas and information being presented and then be prepared to practice skills building in multicultural counseling. To promote ethical practices of effective services to diverse populations, it is imperative for counselors to become knowledgeable of the changing racial and ethnic composition of the U. …

Developing the mental health workforce: review and application of training approaches from multiple disciplines.

Strategies specifically designed to facilitate the training of mental health practitioners in evidence-based practices (EBPs) have lagged behind the development of the interventions themselves. The current paper draws from an interdisciplinary literature (including medical training, adult education, and teacher training) to identify useful training and support approaches as well as important conceptual frameworks that may be applied to training in mental health. Theory and research findings are reviewed, which highlight the importance of continued consultation/support following training workshops, congruence between the training content and practitioner experience, and focus on motivational issues. In addition, six individual approaches are presented with careful attention to their empirical foundations and potential applications. Common techniques are highlighted and applications and future directions for mental health workforce training and research are discussed.

Does a cross‐educational practice meeting assist Thorn graduates to implement psychosocial interventions into clinical practice?

Psychosocial interventions (PSI) have been recognised as an important and valuable treatment for individuals with a serious mental health problem and their families. Over the past decade, PSI has gained national recognition through training courses such as the Thorn programme. However, despite NHS provider organisations investing time and money in the training of mental health practitioners in Thorn‐based PSI, implementing this training in practice has been inconsistent and difficult. Current literature focuses mainly on the efficacy of Thorn‐trained practitioners and on their attempts at transferring skills into practice. The aim of this study was to assess the effectiveness of a cross‐educational practice meeting in assisting Thorn graduates to implement PSI into clinical practice. Fifteen participants from a specialist mental health trust (including eight Thorn graduates) who participated in this type of meeting were interviewed. Six core themes were identified: framework for implementation; organisational drivers; Thorn graduates' position; service achievements; reforms to the process and threats to implementation. These themes indicate that a cross‐educational practice meeting can be a valuable framework for assisting Thorn graduates in implementing a range of PSI in clinical practice. This type of meeting can also make an impact on the culture of an organisation through facilitating change towards evidence‐based psychosocial practice.

Cultural competence: definition, delivery and evaluation

It is again suggested that people from black and minority ethnic (BME) communities comprise a disproportionately high percentage of mental health inpatients. Furthermore, the Commission for Racial Equality (CRE) concluded the Department of Health (DH) did not have ‘due regard’ to the Race Equality Duty, retaining major concerns regarding the ability of the DH to ensure future compliance (CRE, 2007). In light of these ongoing problems the DH published a five‐year action plan, Delivering Race Equality (DRE) in Mental Health Care to develop race equality and cultural competence training for mental health practitioners (DH, 2005).A focused review of literature was undertaken, structured around three questions.1. How is cultural competence in mental health care defined?2. How is cultural competence in mental health care delivered?3. How is the delivery of cultural competence in mental health care evaluated?Consensus is lacking on definition of cultural competence and on the sequence of when the components should be acquired, some terms being used interchangeably. It is unclear how cultural competence in mental health care can be delivered. No attempts have been adequately evaluated, particularly by service users (Bhui et al, 2007). More innovative research is needed to develop a consensual definition of cultural competence and to facilitate the delivery and evaluation of such, in ways acceptable to service users and service providers.

There is a long way to go: A nationwide survey of professional training for mental health practitioners in China

This nationwide survey of professional training for mental health practitioners (i.e., psychiatrists, psychiatric nurses, clinical psychologists, and the counselors working in industry, prisons, and schools) investigated sociodemographic characteristics, training experiences, and training perceptions of mental health service providers in China. Participants included service providers recruited from hospitals, universities, high/middle schools, private mental health service organizations and counseling centers operated by government, prisons or corporations from 25 provinces and four cities directly under the Central Government in China. In order to obtain a broad and representative sample, stratified multi-stage sampling procedures were utilized. From a total of 2000 questionnaire packets distributed via regular mail, the final sample comprised of 1391 respondents (525 men, 866 women). About 70% of the sample had a bachelor's level education or lower degree, only 36.4% majored in psychology, and nearly 60% were employed part time. Fewer than half of participants were certified and nearly 40% reported no affiliation with any 'professional' association. Training and continuing education programs were reported to be primarily short term and theory-based with limited assessment and follow-up. A high proportion of respondents reported having received no supervision or opportunities for case conferences or consultations. With respect to perceptions of and satisfaction with training, many agreed that training had been very helpful to their work but quality of supervision and the capability of supervisors were common issues of concern. In light of these findings, three general recommendations were made to improve the quality of training among mental health service providers in China. First, increased input from professional organizations of various disciplines involving mental health service provision is needed to guide training and shape policy. Second, universities and colleges should have a more vital role in developing accredited professional training programs. Finally, on-the-job supervision and continuing education should be mandated within discipline-specific training programs.