Predictors of Therapists Use of Homework in Community Mental Health: Session and Therapist Characteristics

Assigning and reviewing homework as a strategy to help clients gain therapeutic skills is a common technique used across a variety of evidence-based practices (EBPs) and has been shown to improve therapy outcomes for children and youth. However, in studies characterizing routine psychotherapy delivered in community mental health settings, homework is rarely used in sessions. While some therapist and client level predictors of EBP strategy use have been identified in routine psychotherapy (e.g. client stressors, therapists’ attitudes towards EBPs) it is unknown what is associated with community mental health therapists using homework in the increasingly common context of system-driven implementation of multiple EBPs. To identify predictors of therapists’ use of homework, 680 videos of sessions with 274 clients were collected from 103 therapists (of which 55% were Hispanic) providing children’s mental health services through the Los Angeles County Department of Mental Health (LACDMH). The current study uses a multilevel logistic regression analysis model to identify which factors are associated with therapist use of homework in therapy sessions when there is system-driven implementation support for the use of multiple EBPs in community mental health settings. After controlling for the EBP delivered in session and the number of EBPs therapists were trained in, having a caregiver present in the therapy session, older child age, and being an unlicensed therapist were associated with a higher likelihood of therapists assigning and reviewing homework during a specific session. Therapist race/ethnicity, perceptions of the EBP being delivered, their report of emotional exhaustion, and direct hours with clients, as well as emergent unexpected stressful client life events within a session were not significantly associated with therapists’ delivery of homework. These findings underscore the need to provide explicit attention during therapist training on the use of homework with younger clients when caregivers are absent from sessions and the need to facilitate the use of homework among licensed therapists

New Zealand spinal cord impairment action plan 2014–2019

Outlines a vision, purpose, priorities and eight overarching objectives to help ensure the best possible health and wellbeing outcomes for people with spinal cord impairment, enhancing their quality of life and ability to participate in society. Introduction Spinal cord impairment (SCI) is rare but complex. Every year in New Zealand approximately 80 to 130 people are diagnosed with SCI through injury or medical/congenital causes. This affects their lives and those of many others, especially their families and whānau. SCI can occur at any age from birth, during childhood or as an adult. Due to medical advancements most people living with SCI now have a near normal life expectancy, but this brings with it progressive complexity for people and their lifelong self-management

Dancing on a Pin: Health Planning in Arizona

This publication challenges us to step back and reflect on the past, present and future of health systems. Take a deeper look at planning and how we got here, review the roles of competition and regulation, and learn about the health planning matrix along with the concept of health planning bridges. Discover for yourself if these thoughts and tools help the signal of quality health planning rise more clearly from out of the noise

Initiatives for a Stronger Community

Although indicators show that the County as a whole is better off than it was a few short years ago, some of Erie County’s residents are not reaping the benefit of this upswing to the same extent as others. Moreover, poor health outcomes also continue to be more likely here than in other counties in New York State. Initiatives for a Stronger Community is the Poloncarz Administration’s health and human services action plan for Erie County government based on the idea that it is unacceptable for a newly revitalized Western New York to leave behind significant portions of our community when we can effect positive change in their lives. As such, the plan outlines specific measures that Erie County government will undertake to improve the quality of life for residents in need. Initiatives for a Stronger Community is grounded in compassion and premised on two fundamental principles: County government represents everyone (not just taxpayers); and Government is an essential partner, and where appropriate, it can and should lead. This plan reflect these key values. They are inclusive, work to address needs and create opportunities, embrace both leadership and partnership, and support the ongoing efforts of others to build a stronger community