20 research outputs found
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Illustrating the Applicability of IRT to Implementation Science: Examining an Instrument of Therapist Attitudes
Pragmatic instruments with psychometric support are important to advance dissemination and implementation (D&I) research, but few well-researched D&I instruments exist. Item response theory (IRT), an approach that is underutilized in D&I, can help with the development of actionable and brief instruments. This paper provides an overview of IRT for D&I researchers and examines an instrument of therapist attitudes using IRT measurement models. Eight items of the Attitudes Towards Individualized Assessment-Monitoring and Feedback (AIA-MF) Clinical Utility scale were fit to the Graded Response Model in a national sample of master's level therapists. Various IRT model characteristics including item threshold and discrimination parameters, information, and item and person fit were examined. Discrimination and thresholds parameters showed significant variability across the eight items. Item information curves also showed that each item contributed variably to the total test information, suggesting that items 4 and 5 reliably measure therapist attitudes across the latent continuum and items 3 and 6 warrant further investigation. Results suggest that IRT models can help D&I researchers examine existing instruments with greater specificity than traditional measurement methods, thus increasing measurement precision while lowering response burden, both important considerations for the field
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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
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Assessment Supervision During COVID-19 and Beyond: Trainee Perspectives on the Supervision of Teleassessment
Due to COVID-19, there has been a rapid shift toward the remote administration of psychological assessments, or teleassessment. Guidelines have been published by the American Psychological Association regarding best practices for teleassessment administration, yet there is limited guidance for the clinical supervision of trainees. Quality supervision is a core competency of health service psychologists, and critical to the professional development of practitioners, as well as the protection of patients. This article reviews the extant literature on teleassessment and makes practice-informed recommendations to enhance the supervision of teleassessment administration. Implications for training in teleassessment during the COVID-19 pandemic as well as the development of clinical training competencies in teleassessment are considered
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MFA and ASA-MF: A Psychometric Analysis of Attitudes Towards Measurement-Based Care
Measurement based care (MBC) improves client outcomes by providing clinicians with routine mental health outcome data that can be used to inform treatment planning but is rarely used in practice. The Monitoring and Feedback Attitudes Scale (MFA) and Attitudes Towards Standardized Assessment Scales-Monitoring and Feedback (ASA-MF) (Jensen-Doss et al., 2016) may identify attitudinal barriers to MBC, which could help trainings and implementation strategies. This study examines the psychometric properties of the MFA and ASA-MF, including the factor structure, longitudinal invariance, and indicators of validity, in a sample of community mental health clinicians (N = 164). The measures demonstrate adequate fit to their factor structures across time and predict MBC use as captured in a client's electronic health record. Given that clinician attitudes are associated with MBC use, using instruments with psychometric support to assess attitudes fills a research to practice gap
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Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety
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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
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Measuring clinician stuck points about trauma-focused cognitive behavior therapy: The TF-CBT Stuck Points Questionnaire
Although evidence-based treatments (EBTs) for youth trauma have been developed, trauma-informed EBTs are rarely used in community settings. Clinician concerns about evidence-based trauma treatment may be a barrier to adoption and delivery. However, few instruments to assess clinician beliefs about specific EBTs, such as trauma-focused cognitive behavior therapy (TF-CBT) are available. This study evaluated an instrument of clinician concerns about TF-CBT, the TF-CBT Therapist Stuck Points questionnaire, in a sample of community mental health clinicians training in a year-long TF-CBT community-based learning collaborative. The 26 items in the instruments, which aim to assess clinician views on child trauma treatment and TF-CBT, indicate preliminary psychometric support (i.e., item-total correlations, internal consistency, negative correlations with measures of attitudes towards evidence-based practice). Scores on the TF-CBT Therapist Stuck Points questionnaire revealed that, on average, clinicians expressed concerns about having children talk about their trauma in session, the effectiveness of certain TF-CBT components, and whether to involve caregivers in treatment. Clinician doubts could be targeted during a TF-CBT implementation effort and clinical supervision to facilitate treatment delivery. Implications for assessing TF-CBT specific beliefs during implementation are discussed
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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 with 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 thirty-eight UC were referred for treatment and 129 completed a pretreatment 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 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 four youth completed a brief, six-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 < .05); within-subjects Cohen's d's ranged from .07 to 1.03 for pre- to posttreatment 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.
Clinical Impact Statement Unaccompanied children (UC) experience significant trauma prior to and during their journey to the United States. Trauma-informed treatment for UC is a public health concern, yet there are limited data on the effectiveness of evidence-based trauma treatment (EBT) for UC. This study examined the effectiveness of an EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), in a community sample of UC and found that posttraumatic stress symptoms decreased after treatment. Preliminary findings suggest that with modifications (e.g., reducing jargon, using culturally relevant examples) TF-CBT may be a useful treatment for UC
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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