These findings have implications for the identification and treatment of suicidal ideation in older adults.

No abstract

No abstract

Treatments targeting social connectedness have the potential to address a significant public health concern. Functional analytic psychotherapy (FAP) is based on a behavioral interpretation of how the therapeutic relationship can serve as a significant agent of change. Examine the efficacy of FAP compared to watchful waiting (WW) in a randomized controlled trial. Twenty-two participants with difficulties in interpersonal relating, according to the Fear of Intimacy Scale (FIS), and who met Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV–TR) criteria for an anxiety disorder or avoidant personality disorder, were randomized to 6 (45–60 min) sessions of FAP (n = 11) or 6 (15 min) sessions of WW (n = 11). FAP outcomes were superior on the primary dependent variables: FIS, Psychiatric Diagnostic Screening Questionnaire (PDSQ) total symptom score, and DSM–IV–TR diagnostic status (as determined by blinded assessors). Adherence coding of sessions showed group differences on the FAP subscale (application of the FAP rules), but not on the supportive listening subscale. Measures of therapeutic alliance also favored FAP. The Working Alliance Inventory—Short Form (WAI) served as a statistical mediator of the relationship between treatment and FIS change and the FAP subscale mediated change on the PDSQ. FAP was more beneficial than WW and, while not definitive, some evidence was found to support the hypothesis that the effects were mediated by events occurring in the therapy relationship. These results are consistent with the FAP model of change. Replication and extension with larger and more diverse samples and more stringent control conditions seems warranted.

Introduction: Despite increased prevalence and identification of pediatric behavioral health concerns, families face many barriers when attempting to access behavioral health services. System navigators, or individuals experienced in navigating the health system, help to engage families in services by helping individuals overcome barriers for accessing care. However, limited research to date has systematically reviewed the implementation and effectiveness of navigation models in pediatric populations. Method: We systematically reviewed published studies examining navigation models for pediatric populations (up to age 18) referred to behavioral health services. We searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO for studies that evaluated a navigation model and included service use outcomes. We aggregated data pertaining to characteristics of the study and navigation model, service use outcomes, and implementation outcomes. Results: Eight studies met inclusion criteria. Families who participated in navigation services were more likely to complete diagnostic assessments and received an increased dosage (e.g., time spent, services completed) of behavioral health treatments. There was notable variability across studies in terms of processes involved in the navigation models. Discussion: Findings indicate that system navigation is a promising method for improving service use for pediatric populations referred to behavioral health services. Future research may continue to examine the effectiveness and implementation of the model, to best understand its benefits and what processes may contribute to improved service outcomes.