This study examines the effectiveness of an evidence-based practice, multisystemic therapy (MST), conducted in a real-world mental health setting with juvenile justice involved youth and their families. Importantly, this is the first randomized clinical trial of MST with juvenile offenders in the United States conducted without direct oversight by the model developers. This study reports outcomes achieved for 93 youth randomly assigned to MST or treatment as usual (TAU) services through 18-month follow-up posttreatment for offense data and 6-month follow-up posttreatment for ratings of the Child and Adolescent Functional Assessment Scale (CAFAS). Outcomes include significant reduction in rearrest and improvement in 4 areas of functioning measured by the CAFAS for youth who received MST. Implications for delivery of empirically supported treatments in real-world settings are discussed.

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The GBS appears to be a valid tool in measuring the impact of online gatekeeper training simulations and holds promise for assessing other delivery methods.

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Objectives: In this study, we examined the impact of a virtual training program, Kognito At-Risk role-play simulation, on the mental health and suicide prevention gatekeeping skills of middle school educators. Methods: The validated Gatekeeper Behavior Scale was administered to 33,703 participants at baseline, post-training and follow-up. Helping behaviors were measured at baseline and follow-up. We also assessed preparedness, likelihood, and self-efficacy concerning leading conversations with youth about bullying and suicide. Results: Participants showed positive change from pre-test to 3-month follow-up on variables of interest. Hotelling's T2 test indicated that, as a set, gatekeeper attitudes of preparedness, likelihood, and self-efficacy differed between pre-test and post-test, F (3, 33,512) = 16,283, p < .001, η2 partial = .59. Number of students about whom gatekeepers were concerned (p < .05), number of students approached to discuss concerns (p < .001), and number of students referred to support services (p <.001) increased significantly with training. Conclusions: The At-Risk simulation shows promise in detecting and referring students in psychological distress, including risk of suicide. Fidelity is maintained because the program cannot be altered. At-Risk can be an effective and affordable way to provide suicide prevention training for those working in schools.

Epilepsia. 2020;61:951-958. | 951 wileyonlinelibrary.com/journal/epi Abstract Objective: Digital media conversations can provide important insight into the concerns and struggles of people with epilepsy (PWE) outside of formal clinical settings and help generate useful information for treatment planning. Our study aimed to explore the big data from open-source digital conversations among PWE with regard to suicidality, specifically comparing teenagers and adults, using machine learning technology. Methods: Advanced machine-learning empowered methodology was used to mine and structure open-source digital conversations of self-identifying teenagers and adults who endorsed suffering from epilepsy and engaged in conversation about suicide. The search was limited to 12 months and included only conversations originating from US internet protocol (IP) addresses. Natural language processing and text analytics were employed to develop a thematic analysis. Results: A total of 222 000 unique conversations about epilepsy, including 9000(4%) related to suicide, were posted during the study period. The suicide-related conversations were posted by 7.8% of teenagers and 3.2% of adults in the study. Several critical differences were noted between teenagers and adults. A higher percentage of teenagers are: fearful of "the unknown" due to seizures (63% vs 12% adults), concerned about social consequences of seizures (30% vs 21%), and seek emotional support (29% vs 19%). In contrast, a significantly higher percentage of adults show a defeatist ("given up") attitude compared to teenagers (42% vs 4%). There were important differences in the author's determined sentiments behind the conversations among teenagers and adults. Significance: In this first of its kind big data analysis of nearly a quarter-million digital conversations about epilepsy using machine learning, we found that teenagers engage in an online conversation about suicide more often than adults. There are some key differences in the attitudes and concerns, which may have implications for the treatment of younger patients with epilepsy. |FALCONE Et AL.

Symptoms of post-traumatic stress disorder were assessed in mothers whose children were seen subsequent to alleged sexual abuse. Stress symptoms were commonly found among these women following the reports of abuse. Mothers who had themselves been sexually abused as children exhibited significantly more stress symptoms than did those who had not experienced such abuse in childhood.

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