MBC Fidelity Scoping Review Protocol

Protocol for scoping review examining measurement-based care (MBC) fidelity measurement and outcomes in psychotherapy literatur

Measurement-Based Care Observational Coding System: Measure Development and Evaluation

Measurement-based care (MBC), the of use routinely-collected assessment to guide clinical decision-making, has great potential to improve mental healthcare. MBC is widely endorsed as a cornerstone of evidence-based practice and is capable of increasing the effectiveness of mental health treatment. Lack of clear consensus on key MBC practices has hindered implementation efforts; less than 20% of mental health providers use MBC and even less implement with high quality. A barrier to improving implementation efforts is the limited operationalization of MBC session practices. This study meets this need by developing and evaluating the psychometric properties of the Measurement Based Care &ndash; Session Practices, an observational coding system for practices that occur in sessions with clients. A codebook of practices consistent with MBC was developed; content validity was established through ratings by 22 experts in MBC. Preliminary scoring was piloted using audio recorded sessions from the MBC condition of the Community Study of Outcome Monitoring for Emotional Disorders in Teens randomized control trial. Items were refined through examination of inter-rater reliability and discussion. Independent coders rated 121 sessions from a sample of 51 youth (Mage = 14.8 years) using the MBC-SP. MBC-SP item inter-rater reliability coefficients were all greater than 0.90. MBC-SP item correlations provided preliminary support for creation of a scale score. The MBC-SP score showed evidence of construct validity, demonstrating large correlations with clinician reported practices and small correlations with alliance and MBC administration and viewing practices. Support for the predictive and incremental validity of the MBC-SP score was not found; however, this may be due to a restricted range in MBC-SP extensiveness rating across clients at the lower end of the scale. Overall, psychometric findings provide support for the development of a novel, comprehensive measure of MBC session practices and its application in future research.</p

Exploration of Distress Intolerance, Anxiety Sensitivity, Emotional Impulsivity, and Repetitive Negative Thinking, as Risk Factors for Anxiety-Promoting Parenting Behaviors

Anxiogenic parenting behaviors (e.g. overcontrol, accommodation) play an important role in the etiology and maintenance of child anxiety disorders. While theoretical models suggest parent anxiety is an important risk factor of increased anxiogenic parenting, existing literature is inconsistent, suggesting further study of the mechanism underlying anxiogenic parenting in warranted. Growing evidence points to the importance of parental emotion regulation by positing that parents engage in maladaptive parenting in order to reduce unwanted distress in response to observing their child’s anxiety. Transdiagnostic, higher order cognitive risk factors, including distress intolerance, anxiety sensitivity, emotional impulsivity, and repetitive negative thinking are important to examine as they impact the appraisal of and behavioral reaction to emotions necessary for effective affect regulation. Therefore, this study sought to&nbsp;further our understanding of the link between parent anxiety to anxiogenic parenting behaviors by examining whether these factors mediate this relationship and if this indirect effect is moderated by child anxiety. Participants were 350 parents of children ages 4 to 17 recruited from Amazon’s Mechanical Turk platform. Structural equational modeling demonstrated that distress intolerance in mothers mediates the relationship between parent anxiety and anxiogenic parenting at high, but not low levels of child anxiety. Emotional impulsivity also mediates this relationship but is unrelated to the level of child anxiety. Anxiety sensitivity and repetitive negative thinking were not significant mediators. These findings suggest that distress intolerance and emotional impulsivity are important targets for parent-focused child anxiety treatments.&nbsp;</p

A thematic analysis of broker consultation in a TF-CBT community based learning collaborative

Background Consultation is an important implementation strategy to increase competence, knowledge, and fidelity to evidence-based practice in community settings. However, the literature has primarily focused on consultation for clinical providers, and less is known about consultation for "broker" professionals, or those who identify and refer children to mental health services. Given their critical role in connecting youth to evidence-based treatment, investigating broker knowledge and use of evidence-based screening and referral are needed. Objective To address this gap, the current study examines the content of consultation provided to broker professionals

Parent Distress Intolerance, Repetitive Negative Thinking, and Mental Health Service Use

While extensive evidence links service use for mental health problems to demographic variables and positive attitudes, studies have not explored the role of transdiagnostic risk factors, like distress intolerance (DI) and repetitive negative thinking (RNT). This study examined the relationship between parental DI and RNT on mental health treatment seeking for parents themselves and their children. Results suggest higher DI and RNT predict service use among parents (p < 0.05) but were not significantly associated with help seeking for their children, indicating that factors more proximal to the child may have greater influence when parents make treatment decisions for their children. Results also indicte that DI moderates the relationship between parent psychopathology and parent service use, such that parent psychopathology is significantly associated with service use for those with lower DI, but not at moderate or high levels of DI. Implications for marketing mental health information to parents and engaging them in treatment are discussed

Considerations for assessment training competencies in health service psychology programs in the age of COVID-19

Health service psychologists have made a rapid transition to delivering telepsychology services during the COVID-19 pandemic. The provision of remote assessment services, or teleassessment, however, has lagged behind given the limited evidence base. This delay has been uniquely chal-lenging for university training clinics, which are equally responsible for developing trainee assess-ment competencies and providing high quality assessments to clients. Training clinics have been tasked with implementing programmatic adaptation to meet this need with limited guidance. We address this gap by describing the considerations university training clinics must make under phys-ical distancing policies, including protections for the health of trainees and clients, ensuring stand-ardized administration of assessments, providing developmentally appropriate training opportuni-ties, and guaranteeing transparency in the consent and feedback processes. We recommend solu-tions to reconcile these inherent challenges and highlight training opportunities as they relate to the development of profession-wide competencies and ethical principles. These recommendations demonstrate that by integrating flexibility into program curriculums, training clinics can continue to adhere to accreditation standards while developing trainee competencies in assessment during the COVID-19 pandemic

Unaccompanied migrant children in the United States: Implementation and effectiveness of Trauma-Focused Cognitive Behavioral Therapy

Objective: The number of unaccompanied children (UC) arriving in the United States (U.S.) from other countries has increased significantly over the past decade. UC report high trauma exposure and greater posttraumatic stress symptoms compared to youth who immigrate with caregivers. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has demonstrated preliminary effectiveness with UC. However, few studies have treated U.S.-based samples of UC, who emigrate primarily from Central America. Method: One hundred and thirty eight UC were referred for treatment and 129 completed a pre-treatment assessment including the Child and Adolescent Trauma Screen (CATS) and the Strengths and Difficulties Questionnaire (SDQ). Most UC were from Central America (n = 109; 79.0%) and resided in government facilities (n = 76; 55.1%). One hundred and twenty two youth began TF-CBT, had an average of 9.71 sessions (SD = 9.3, range: 1-48), and 41.8% (n = 51) completed treatment. One hundred and four youth completed a brief, 6-item progress monitoring measure of trauma symptoms, for which 84 had at least two observations during treatment. Results: UC endorsed 3.80 traumatic events on average (SD = 2.38). High rates of violence, physical and sexual abuse, and serious injury were reported. There were significant improvements on most self-report rating scales (p &lt; .05); within-subjects Cohen’s d’s ranged from .07 to 1.03 for pre to post-treatment assessments and was d = .44 for the progress monitoring measure. Therapists reported on TF-CBT modifications for UC, including discussing mental health beliefs, navigating roles and relationships, tailoring treatment examples, exploring coping strategies, and addressing immigration factors. Conclusion: Preliminary findings support the utility of TF-CBT with UC. Implications for implementation and cultural modifications are discussed

Considerations for Assessment Training Competencies in Health Service Psychology Programs in the Age of COVID-19

Health service psychologists have made a rapid transition to delivering telepsychology services during the COVID-19 pandemic. The provision of remote assessment services, or teleassessment, however, has lagged behind given the limited evidence base. This delay has been uniquely challenging for university training clinics, which are equally responsible for developing trainee assessment competencies and providing high-quality assessments to clients. Training clinics have been tasked with implementing programmatic adaptation to meet this need with limited guidance. We address this gap by describing the considerations university training clinics must make under physical distancing policies, including protections for the health of trainees and clients, ensuring standardized administration of assessments, providing developmentally appropriate training opportunities, and guaranteeing transparency in the consent and feedback processes. We recommend solutions to reconcile these inherent challenges and highlight training opportunities as they relate to the development of profession-wide competencies and ethical principles. These recommendations demonstrate that by integrating flexibility into program curriculums, training clinics can continue to adhere to accreditation standards while developing trainee competencies in assessment during the COVID-19 pandemic