REACHING PEOPLE IN NEED OF MENTAL HEALTH SERVICES THROUGH NOVEL MODELS OF INTERVENTION DELIVERY

The treatment gap refers to the difference in the proportion of people who have disorders and the proportion of those individuals who receive treatment. In developing and developed countries, the gap is enormous, i.e., most individuals in need of mental health services receive no treatment. Among the many barriers is the dominant model of delivering psychosocial interventions. That model includes one-to-one, in-person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health-care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to reach people who are not likely to receiveservices. Four models (task shifting, best-buy, disruptive interventions, and Entertainment Education) are illustrated. These and other models are readily available, most have evidence in their behalf, but are still not sufficiently exploited to close the treatment gap. The article argues for the need for multiple models to optimize reaching the many diverse groups in need of care

Hospital cost inflation : economic approaches for policy analysis.

Thesis. 1979. M.S.--Massachusetts Institute of Technology. Alfred P. Sloan School of Management.MICROFICHE COPY AVAILABLE IN ARCHIVES AND DEWEY.Includes bibliographical references.M.S

LLEGANDO A LAS PERSONAS QUE NECESITAN SERVICIOS DE SALUD MENTAL A TRAVÉS DE NOVEDOSOS MODELOS DE PRESTACIÓN DE INTERVENCIONES

La brecha de tratamiento se refiere a la diferencia en la proporción de personas que tienen trastornos y la proporción de personas que reciben tratamiento. En los países desarrollados y en desarrollo, la brecha es enorme; es decir, la mayoría de las personas que necesitan servicios de salud mental no recibe tratamiento. Entre las muchas barreras, se encuentra el modelo dominante de realizar intervenciones psicosociales. Ese modelo incluye tratamiento individualizado en persona, con un profesional de salud mental capacitado, proporcionado en un entorno clínico (por ejemplo, clínica, consultorio privado, centro de atención médica). Ese modelo limita en gran medida la escala y el alcance de las intervenciones psicosociales. El artículo analiza muchos modelos novedosos de prestación de intervenciones que permiten ampliar el tratamiento para llegar a las personas que probablemente no recibirán servicios. Se ilustran cuatro modelos (cambio de tareas, mejor compra, intervenciones disruptivas y educación en entretenimiento). Estos y otros modelos están fácilmente disponibles, la mayoría tiene evidencia a su favor, pero aún no se explotan lo suficiente como para cerrar la brecha de tratamiento. El artículo sostiene la necesidad de múltiples modelos para optimizar llegar a los diversos grupos que necesitan atención

Measuring informant discrepancies in clinical child research.

Discrepancies among informants' ratings of child psychopathology have important implications for diagnosis, assessment, and treatment. Typically, parents and children complete measures (e.g., self-report checklists, diagnostic instruments) to assess child dysfunction. Ratings gathered from these sources reveal relatively little agreement on the nature and extent of the child's social, emotional, and behavioral problems. This article reviews and illustrates the most frequently used methods of measuring informant discrepancies in the clinical child literature (i.e., raw difference, standardized difference, and residual difference scores) and outlines key considerations to influence their selection. The authors conclude that frequently used methods of measuring informant discrepancies are not interchangeable and recommend that future investigations examining informant discrepancies in clinical child research use the standardized difference score as their measure of informant discrepancies. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract)This work was supported, in part, by a grant from the National Institute of Mental Health (MH67540) awarded to Andres De Los Reyes and by grants from the Leon Lowenstein Foundation, the William T. Grant Foundation (98-1872-98), and the National Institute of Mental Health (MH59029) awarded to Alan E. Kazdin

Informant Discrepancies in the Assessment of Childhood Psychopathology: A Critical Review, Theoretical Framework, and Recommendations for Further Study.

Discrepancies often exist among different informants' (e.g., parents, children, teachers) ratings of child psychopathology. Informant discrepancies have an impact on the assessment, classification, and treatment of childhood psychopathology. Empirical work has identified informant characteristics that may influence informant discrepancies. Limitations of previous work include inconsistent measurement of informant discrepancies and, perhaps most importantly, the absence of a theoretical framework to guide research. In this article, the authors present a theoretical framework (the Attribution Bias Context Model) to guide research and theory examining informant discrepancies in the clinic setting. Needed directions for future research and theory include theoretically driven attention to conceptualizing informant discrepancies across informant pairs (e.g., parent-teacher, mother-father, parent-child, teacher-child) as well as developing experimental approaches to decrease informant discrepancies in the clinic setting. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract)This work was supported, in part, by National Institute of Mental Health Grant MH67540 (awarded to Andres De Los Reyes). This work was also supported by William T. Grant Foundation Grant 98-1872-98, National Institute of Mental Health Grant MH59029, and grants from the Leon Lowenstein Foundation (awarded to Alan E. Kazdin)

Conceptualizing changes in behavior in intervention research: the range of possible changes model.

An international movement has focused on identifying evidence-based interventions that were developed to change psychological constructs and that are supported by controlled studies. However, inconsistent findings within individual intervention studies and among multiple studies raise critical problems in interpreting the evidence, and deciding when and whether an intervention is evidence-based. A theoretical and methodological framework (Range of Possible Changes [RPC] Model) is proposed to guide the study of change in intervention research. The authors recommend that future quantitative reviews of the research literature use the RPC Model to conceptualize, examine, and classify the available evidence for interventions. Future research should adopt the RPC Model to both develop theory-driven hypotheses and conduct examinations of the instances in which interventions may or may not change psychological constructs. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract)This work was supported, in part, by National Institute of Mental Health Grant MH67540 (awarded to Andres De Los Reyes). This work was also supported by William T. Grant Foundation Grant 98-1872-98 and National Institute of Mental Health Grant MH59029 (awarded to Alan E. Kazdin

When the evidence says, "Yes, no, and maybe so": Attending to and interpreting inconsistent findings among evidence-based interventions.

An international, multidisciplinary effort aims to identify evidence-based treatments (EBTs) or interventions. The goal of this effort is to identify specific techniques or programs that successfully target and change specific behaviors. In clinical psychology, EBTs are identified based on the outcomes of randomized controlled trials examining whether treatments outperform control or alternative treatment conditions. Treatment outcomes are measured in multiple ways. Consistently, different ways of gauging outcomes yield inconsistent conclusions. Historically, EBT research has not accounted for these inconsistencies. In this paper we highlight the implications of inconsistencies, describe a framework for redressing inconsistent findings, and illustrate how the framework can guide future research on how to administer and combine treatments to maximize treatment effects and how to study treatments via quantitative review.This work was supported, in part, by National Institute of Mental Health (NIMH) Grant MH67540 (Andres De Los Reyes) and by NIMH Grant MH59029 (Alan E. Kazdin)

Identifying evidence-based interventions for children and adolescents using the range of possible changes model: A meta-analytic illustration

We are very grateful to Kelly D. Brownell, Julia Kim-Cohen, Susan Nolen-Hoeksema, and Peter Salovey for extremely insightful discussions and commentaries on previous versions of this manuscript. We also thank Jennifer Thomas, Jessica Cronce, and Amelia Aldao for their careful and diligent participation as coders for this study. Please address correspondence to Andres De Los Reyes, Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123H, College Park, MD 20742; office: 301-405-7049; e-mail: [email protected] article discusses a study involving a framework (range of possible changes [RPC] Model) developed and applied to identify patterns in consistent and inconsistent intervention outcomes effects by informant, measurement method, and method of statistical analysis to the meta-analytic study of trials testing two evidence-based interventions for children and adolescents (youth-focused cognitive-behavioral treatment for child anxiety problems; parent-focused behavioral parent training for childhood conduct problems). This article illustrates how findings gleaned from applying the RPC Model allow for unique opportunities for hypothesis generation based on the patterns of consistent outcomes effects. Based on the RPC Model, studies can be closely examined to identify the specific instances in which interventions yield robust effects, and the authors illustrate how examining effects in this way can lead to new understandings of interventions and the outcomes they produce. Findings suggest that researchers can employ previously underutilized patterns of consistencies and inconsistencies in outcomes effects as new resources for identifying evidence-based interventions.This work was supported, in part, by National Institute of Mental Health Grant MH67540 (Andres De Los Reyes). This work was also supported by National Institute of Mental Health Grant MH59029 (Alan E. Kazdin)

Reprint of “The Single-Case Reporting Guideline In BEhavioural interventions (SCRIBE) 2016: explanation and elaboration”

There is substantial evidence that research studies reported in the scientific literature do not provide adequate information so that readers know exactly what was done and what was found. This problem has been addressed by the development of reporting guidelines which tell authors what should be reported and how it should be described. Many reporting guidelines are now available for different types of research designs. There is no such guideline for one type of research design commonly used in the behavioral sciences, the single-case experimental design (SCED). The present study addressed this gap. This report describes the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016, which is a set of 26 items that authors need to address when writing about SCED research for publication in a scientific journal. Each item is described, a rationale for its inclusion is provided, and examples of adequate reporting taken from the literature are quoted. It is recommended that the SCRIBE 2016 is used by authors preparing manuscripts describing SCED research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.Published versio