Mind-Body Skills Groups for Adolescents with Depression in Primary Care: A Pilot Study

Objective: To determine acceptability and preliminary effectiveness of Mind-Body Skills Groups (MBSGs) as a treatment for depressed adolescents in primary care. Methods: A single arm clinical trial was conducted. A 10-week MBSG program was implemented in primary care. Participants completed self-report measures at baseline, post-intervention, and 3-months following the MBSGs. Measures included the Children’s Depression Inventory-2, Suicidal Ideation Questionnaire, Mindful Attention Awareness Scale, Self-Efficacy for Depressed Adolescents, rumination subscale of the Children’s Response Style Questionnaire, and a short acceptability questionnaire. Results: Participants included 43 adolescents. The total depression scores significantly improved following the MBSG intervention and continued to improve significantly from post-treatment to follow-up. Mindfulness, self-efficacy, rumination, and suicidal ideation all had significant improvement following the intervention. Acceptability of the program was strong, and attendance was excellent. Discussion: Preliminary evidence suggests that MBSGs are an acceptable treatment for primary care settings and lead to improved depression symptoms in adolescents.Sandra Eskenazi Mental Health Center and the Herbert Simon Family Foundation (070241-00002B

Predictors of Burnout in Public Library Employees

Work stress and professional burnout are recognized as concerns for public library employees, yet little research has been conducted. The purpose of the current study was to better understand burnout and the contributing factors in a state-wide sample of public library employees in Indiana. Using a web-based survey, 171 employees of public libraries reported their level of burnout (emotional exhaustion, cynicism, and professional efficacy; Maslach Burnout Inventory-General Survey) and potential predictors, including levels of autonomy, co-worker support, work pressure, technology attitudes, and recovery experiences. A subset of 70 completed the burnout measures twice, allowing for predictions of change over time. Most predictors were correlated with burnout cross-sectionally, except for technology attitudes. Emotional exhaustion was positively associated with work pressure, and negatively associated with autonomy, role clarity, coworker support, and recovery experiences of relaxation, mastery, and control. Similar patterns were found for cynicism and reduced efficacy. However, over a period of approximately six months, only role clarity predicted decreased burnout (emotional exhaustion) above prior levels of burnout

Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales

Measuring quality of care can transform care, but few tools exist to measure quality from the client’s perspective. The aim of this study was to create concordant clinician and client self-report quality of care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools

Do Adolescents Consider Mind-Body Skills Groups an Acceptable Treatment for Depression? Results from a Pilot Study

Background Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents’ perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. Methods Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. Results A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. Conclusions Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group

Inpatient Mental Healthcare before and during the COVID-19 Pandemic

Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services. It further explored the association between patient demographic, clinical, and services variables on relapse rates. Inpatient admissions and therapeutic services (group and individual therapy and peer support) were lower amongst the COVID-19 sample than prior to the onset of COVID-19 while lengths of stay were longer. Relapse rates did not differ between cohorts. Patients with prior emergent services use as well as substance abuse or personality disorder diagnoses were at higher risk for relapse. Receiving group therapy while admitted was associated with lower risk of relapse. Inpatient mental health services saw substantial disruptions across the cohort. Inpatient mental health services, including group therapy, may be an important tool to prevent subsequent relapse

A Comparative Effectiveness Trial to Reduce Burnout and Improve Quality of Care

Clinician burnout is presumed to negatively impact healthcare quality; yet scant research has rigorously addressed this hypothesis. Using a mixed-methods, randomized, comparative effectiveness design, we tested two competing approaches to improve care—one addressing clinician burnout and the other addressing how clinicians interact with consumers—with 192 clinicians and 469 consumers at two community mental health centers. Although qualitative reports were promising, we found no comparative effectiveness for either intervention on burnout, patient-centered processes, or other outcomes. Discussion includes identifying ways to strengthen approaches to clinician burnout

Recovery-oriented Acute Inpatient Mental Health Care: Operationalization and Measurement

Objective: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care. Method: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units. Results: A final scale of 23, behaviorally anchored items demonstrated a four-factor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. While several items require additional revision to address psychometric concerns, the scale demonstrated adequate model fit and was consistent with prior literature on recovery-oriented inpatient care. Conclusions and Implementations for Practice: The RAIN scale represents an important tool for future implementation and empirical study of recovery-oriented inpatient care