Mental Health Provider Training Research Articles

Therapist Participation in a Learning Collaborative on Trauma-Focused Cognitive Behavioral Therapy: Impact of COVID-related Stressors and Challenges.

The rise in mental health problems during the COVID-19 pandemic amplified the need to improve access to evidence-based treatments (EBT) and necessitated changes in treatment delivery and training of mental health providers (MHPs). There is limited information on how the pandemic may have impacted MHPs' participation in training and treatment delivery. This study included 269 MHPs who participated in a Learning Collaborative (LC) focused on an EBT. Qualitative interviews conducted with 15 MHPs who participated in the LC during the pandemic identified facilitators and barriers to training participation and EBT delivery that included social support, technology challenges, and difficulty completing cases following the transition to telehealth. Quantitative results showed that MHPs in the peri-COVID cohorts completed significantly fewer cases and fewer consultation calls compared to those prior to the pandemic. Findings suggest that providing support to train MHPs and promote EBT delivery may be beneficial during times of heightened stress.

Promoting Evidence-Based Tobacco Cessation Treatment in Community Mental Health Clinics: Protocol for a Prepost Intervention Study.

Tobacco smoking is highly prevalent among persons with serious mental illness (SMI) and is the largest contributor to premature mortality in this population. Evidence-based smoking cessation therapy with medications and behavioral counseling is effective for persons with SMI, but few receive this treatment. Mental health providers have extensive experience working with clients with SMI and frequent treatment contacts, making them well positioned to deliver smoking cessation treatment. However, few mental health providers feel adequately trained to deliver this treatment, and many providers believe that smokers with SMI are not interested in quitting or have concerns about the safety of smoking cessation pharmacotherapy, despite substantial evidence to the contrary. We present the protocol for the pilot "IMPACT" (Implementing Action for Tobacco Smoking Cessation Treatment) study, which aims to pilot test a multicomponent implementation intervention to increase the delivery of evidence-based tobacco smoking cessation treatment in community mental health clinics. We are using a prepost observational design to examine the effects of an implementation intervention designed to improve mental health providers' delivery of the following four evidence-based practices related to smoking cessation treatment: (1) assessment of smoking status, (2) assessment of willingness to quit, (3) behavioral counseling, and (4) pharmacotherapy prescribing. To overcome key barriers related to providers' knowledge and self-efficacy of smoking cessation treatment, the study will leverage implementation strategies including (1) real-time and web-based training for mental health providers about evidence-based smoking cessation treatment and motivational interviewing, including an avatar practice module; (2) a tobacco smoking treatment protocol; (3) expert consultation; (4) coaching; and (5) organizational strategy meetings. We will use surveys and in-depth interviews to assess the implementation intervention's effects on providers' knowledge and self-efficacy, the mechanisms of change targeted by the intervention, as well as providers' perceptions of the acceptability, appropriateness, and feasibility of both the evidence-based practices and implementation strategies. We will use data on care delivery to assess providers' implementation of evidence-based smoking cessation practices. The IMPACT study is being conducted at 5 clinic sites. More than 50 providers have been enrolled, exceeding our recruitment target. The study is ongoing. In order for persons with SMI to realize the benefits of smoking cessation treatment, it is important for clinicians to implement evidence-based practices successfully. This pilot study will result in a set of training modules, implementation tools, and resources for clinicians working in community mental health clinics to address tobacco smoking with their clients. Trial Registration:ClinicalTrials.gov NCT04796961; https://clinicaltrials.gov/ct2/show/NCT04796961. ClinicalTrials.gov NCT04796961; https://clinicaltrials.gov/ct2/show/NCT04796961. DERR1-10.2196/44787.

‘Listen closer’: home-delivered meal volunteers’ understanding of their role in suicide intervention

AbstractSuicide in later life is a pressing public health concern, which has likely been exacerbated by the COVID-19 pandemic. Many older adults who need mental health treatment do not have access to necessary services and training for mental health providers to support older adults experiencing suicidality is limited. One solution is developing interventions based in a public health approach to suicide prevention, whereby natural helpers who provide community services are mobilised to respond to older persons-at-risk. Home-delivered meal (HDM) services, for example, are one effective means to reach older adults who are isolated due to being homebound and may be instrumental in preventing suicide. This study examined the experiences of 20 HDM volunteers who received Applied Suicide Intervention Skills Training (ASIST), an evidence-based suicide intervention programme. Phenomenological analysis yielded findings centred on three areas demonstrating the impact of the ASIST training on HDM volunteers: putting asist skills into practice; response to ASIST skills; and role transformation. Implications for integrating suicide prevention efforts with HDM services and directions for future research are discussed.

Identifying measures with the highest potential to reduce suicides on Finnish railways

The purpose of this study was to work systematically through all known measures for preventing railway suicides and to consider their suitability for the Finnish railway environment. The research method included a selection and grouping of measures, definition of assessment criteria, a literature review and compilation of assessment forms, and a workshop for experts in the field. We assessed 21 measures based on 12 specified criteria. Specifically, the aim of these criteria was to support the identification and structuring of the available information on each measure to be in easily exploitable format for railway stakeholders. The measures were listed in order of priority in three categories based on final assessments from the workshop. The measures categorised as top priority with the highest potential to reduce suicides on Finnish railways included training of railway personnel to identify suicidal people (also called Gatekeeper training), camera surveillance, detection systems (radar, movement sensors, etc.), collaboration between organisations, learning from international experience, cooperation between railway organisations, police and fire and rescue services, and training of mental health providers. This prioritisation, together with the information included in the assessment forms and expert's views related to each measure, support the Finnish railway stakeholders in selecting measures and defining implementation strategies to prevent railway suicides on Finnish railways. The insights of Finnish experts on the effectiveness and potential implementation of these different measures are valuable information also for railway stakeholders in other countries when selecting appropriate measures to prevent railway suicides. The results of this study support the safe and effective functioning of the railway system by adding knowledge that will help effectively prevent railway suicides and loss of life, delays to train traffic, and work-related stress and trauma to railway staff, rescue personnel and eyewitnesses.

Evaluation of a Systems-Wide Telebehavioral Health Training Implementation in Response to COVID-19.

In response to the Coronavirus disease 2019 pandemic, it became important to rapidly train mental health providers to provide telebehavioral health services (TBH) within a pediatric care setting. This study examined the perceived usefulness of various TBH training materials; provider motivation, comfort, and confidence in implementation of TBH services; and perceived benefits and barriers of TBH. After completing various training options and implementing TBH services for 1 month, providers indicated all training materials were helpful, with the recorded webinar being identified as the most helpful resource. This study describes the rapid training of mental health providers in preparation of system-wide TBH services.

Launching a Competency-Based Training Program in Evidence-Based Treatments for PTSD: Supporting Veteran-Serving Mental Health Providers in Texas.

Community mental health providers play an essential role in delivering services to veterans who either have limited access to U.S. Department of Veterans Affairs (VA) facilities or who prefer to seek care outside of the VA. However, there are limited training opportunities in evidence-based treatments for posttraumatic stress disorder (PTSD) outside of the VA. In 2017, the STRONG STAR Training Initiative was established to develop competency-based training in two evidence-based therapies for PTSD and to provide that training for mental health providers serving veterans and their families in community settings in Texas. This article describes the program's development and implementation, baseline characteristics of participating clinicians, and lessons learned toward the scale-up and extension of this competency-based training effort to include other interventions and locations.

Addressing brain injury in health care for the homeless settings: A pilot model for provider training.

Brain injury has been recently understood to be a common occurrence among adults experiencing homelessness, resulting in the need for modifications to clinical practice in agencies serving this population. A health care agency for adults experiencing homelessness initiated a pilot training for mental health providers to address the issues of brain injury. Providers attended eight training sessions which focused on: screening for a history of brain injury, treatment planning, and specific strategies to implement with individuals with a history of brain injury. Strategies taught were based on current literature and therapeutic methods, adapted specifically for the clinic's population of adults experiencing homelessness. Screening for a history of brain injury at the clinic indicated a high prevalence of a history of brain injury that was previously unidentified, indicating need for provider training. Providers reported increased ability to screen for and address the needs of individuals with brain injury within their clinical setting. Providers reported benefit from sessions tailored to address various cognitive functions which incorporated evidence-based practice and familiar therapeutic methods. Providers who engage individuals experiencing homelessness benefit from structured training in order to increase ability to screen for and modify interventions for a history of brain injury to better address their clients' needs.

Workshop: Addressing the mental health needs of lesbian, gay, bisexual, and transgender populations

Abstract Today a large number of studies from different parts of the world clearly show that compared with heterosexuals lesbian, gay, bisexual, and transgender (LGBT) individuals have an increased risk of mental health problems, especially depression, anxiety and suicidal behaviour. To meet this increased risk of mental health problems, many governmental public health agencies call for policy and intervention programs addressing specific needs of LGBT individuals. Despite the clear need for evidence-based care, prevention, and treatment specifically tailored to LGBTQ people, there are currently few such programmes due to lack of sufficient research. This workshop will give examples of studies on mental health care needs among LGBT individuals and effect of evidence-based training for mental health providers, as well as, studies showing improvements of mental health after treatments. Dr. Corina Lelutiu-Weinberger (Rutgers University, USA) will present results from a newly conducted study of LGBT-affirmative mental health training for health care providers in Romania. Dr. John Pachankis (Yale University, USA), will present results showing improvements in mental health among transgender individuals after receiving gender-affirmative surgical treatment, using a total population dataset from Sweden. Dr. Igor Grabovac (Medical University of Vienna, Austria) will present health and well-being disparities based on sexual orientation among older LGBT individuals in England. The situation for LGBT individuals varies greatly across Europe. The level of acceptance for minority sexual orientations differs greatly by country, and in many countries, LGBT people are also subject to legal discrimination concerning basic civil rights, e.g. regarding recognition of same-sex unions. During the workshop, Dr. Richard Bränström (Karolinska Institutet, Sweden) will present data on experiences of discrimination in health care settings and openness with sexual and gender identity to mental health providers among LGBT populations across all 28 European Union Countries. Key messages Today a large number of studies from different parts of the world clearly show that compared to heterosexuals LGBT individuals have an increased risk of mental health problems. Access to supportive mental health care for LGBT individuals varies greatly across Europe and dissemination of targeted LGBT-affirmative evidence-based interventions needed.

Gelişimsel Modeller Açısından Başlangıç Düzeyindeki Psikolojik Danışmanların Süpervizyonu ve Yaşadıkları Güçlükler ve Destekler

Mental health providers address mental health issues and/or increase the quality of life at different levels starting from individual to global levels for individuals and communities. Mental health providers are key people who strive to alleviate suffering and enhance wellbeing of people. Therefore, more professional supervision is need to focus on the training of mental health providers, which means their clinical supervision. In this literature review article, the author specifically focused on empirical studies that examined beginning counselors’ developmental process. The author provided brief information about developmental models of supervision, common challenges and supports the beginning counselors-in-training experience, and common implications for supervisors. The author also shared some of their site experiences from Turkey and the U.S. to clarify how supervision needs more professional attention. They also explained how supervision in Turkey need more attention and yet also stated how some contextually sensitive supervision models emerge like structured active/engaged peer supervision model (or in Turkish, Yapılandırılmış Aktif Akran Süpervizyon Modeli, YASAM). The most important point of this study is supervisors consider developmental process of their supervisees and support them with positive, supportive, and constructive feedback while utilizing meaningful and engaging activities to challenge them so that supervision process becomes more effective and meaningful. Research questions were discussed for the future studies.

Online CBT training for mental health providers in primary care

PurposeThe purpose of study was to assess the impact of an online training program for a brief cognitive-behavioral therapy (CBT) that integrated physical health management designed for use by mental health providers in the primary care setting.Design/methodology/approachIn total, 19 providers from two Veterans Health Administration (VHA) medical centers completed online training as part of a larger trial. Statistical analyses compared provider self-reported CBT knowledge and abilities at pretraining, posttraining, and long-term follow-up. Additionally, data were collected on providers’ experiences of the training.FindingsProviders’ baseline to post-training scores improved on general CBT knowledge and ability, as well as across 11 CBT principles and techniques. Post-training scores were maintained over time.Research limitations/implicationsA small sample size, sole focus on VHA data, and reliance on self-report measures are limitations of the study.Practical implicationsQualitative data suggested training was feasible, acceptable, and potentially scalable; however, a one-size-fits-all approach may not be ideal.Originality/valueOnline training has potential for providing wider access to providers with limited access to traditional face-to-face training.

Profiles of Depression Help Seeking Among Black Americans: A Latent Class Approach.

Although Black Americans have lower prevalence of depression compared to non-Hispanic Whites (10% vs. 17%), they are nearly twice as likely to have worse outcomes. One contributor to poor depression outcomes involves the ways in which Black Americans seek help for depression. However, little is known about depression help-seeking behavior, and the use of multiple sources of help, among Black Americans. This study used latent class analysis to identify unique constellations of depression help seeking, from multiple sources, among African American and Black Caribbeans. Results indicated four profiles of depression help seeking including Informal/Primary Care Utilizers (41.4%), Formal Mental Health Utilizers (40.6%), All Support Utilizers (9.8%), and Mixed Source Utilizers (8.2%). The constellation of each profile and demographic differences in class assignment are discussed. Results have implications for tailored depression interventions for Black Americans including community-based psychoeducation and cultural competence training for mental health providers.

Empirically Supported Treatments: Dissemination Practices in Impoverished Regions.

A growing understanding of the implications of childhood psychopathology has driven the dissemination of empirically supported treatments (ESTs). This has not been the case in countries with high rates of poverty and violence-where the need for ESTs is fundamental. In this article, we examined the current status of child psychopathology and mental health services for children in El Salvador to explore key factors that can improve dissemination of ESTs in middle- and low-income countries. In El Salvador, children are constantly exposed to risk factors related to childhood disorders (e.g., violence), and there is an increase in the demand for mental health services for this population. However, a lack of a guiding policy and formal training has led to few psychologists using ESTs. A scientist-practitioner model to guide formal education and training of mental health providers would be the first step to improving the dissemination of ESTs in El Salvador.

Direct-to-consumer marketing of psychological treatments for anxiety disorders

Progress disseminating and implementing evidence-based psychological treatments (EBPTs) for the anxiety disorders has been gradual. To date, the dominant approach for promoting the uptake of EBPTs in clinical settings has been to target the education and training of mental health providers, with many consumers remaining unaware of the potential benefits of EBPTs for anxiety disorders. Direct-to-consumer (DTC) marketing may be a promising vehicle for increasing EBPT utilization rates in the treatment of anxiety disorders. This paper provides an overview of the rationale and important considerations for applying DTC efforts to promote evidence-based care in the treatment of anxiety disorders, and reviews current DTC efforts in this area, including resources on the Internet and other media and in-person events. We conclude with recommendations for future efforts in the DTC marketing of EBPTs for the anxiety disorders, including the need for increased funding and grassroots efforts to inform consumers about anxiety disorders and their most effective treatments.

Knowledge and Attitudes about Personalized Mental Health Genomics: Narratives from Individuals Coping with Serious Mental Illness

The present qualitative study examined the personal accounts, elicited via semi-structured interview, of nine United States military veterans with serious mental illness to describe their knowledge, attitudes, and beliefs about psychiatric genetics, genetic testing and counseling for mental illness. The aim of the research was to elucidate issues from the perspective of adults with mental illness that may inform the education and training of mental health providers on basic genetic counseling. Findings suggest that participants had some basic knowledge about genetics, were interested in psychiatric genetic testing, and had an awareness of both positive and negative aspects of genetic test results. Participants tended to have overly optimistic ideas about current advances in psychiatric genetics and were motivated to undergo genetic testing for the good of their families and to benefit society. Implications of findings for research and practice are discussed.

Change: The Reality of the Mental Health Providers' World in the 1990's

It is important for the art therapist to focus on our environment, the social changes, our professional standards and our training for mental health providers, and to be alert to changes that may be needed for the 1990's. With these issues in mind, the author focuses on three areas for discussion and raises important questions relative to these particular areas: (1) Education (including a focus on legal matters, the plea for the inclusion of methods of safety measures in our curricula, and a better understanding of chemical abuse); (2) New techniques and goals in treatment (with the challenge to move from “tried and true formulae for treatment to unexplored and unfamiliar interventions”); and (3) National/Professional Organizations (with brief recommendations for professional associations, publications and planning for the future).