Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse-recur (29% within 1 year and 54% within 2 years). These rates appear comparable to those associated with other depression-specific psychotherapies but lower than those associated with pharmacotherapy. Among acute-phase treatment responders, continuation-phase CT reduced relapse-recurrence compared with assessment only at the end of continuation treatment (21% reduction) and at follow-up (29% reduction). Continuation-phase CT also reduced relapserecurrence compared with other active continuation treatments at the end of continuation treatment (12% reduction) and at follow-up (14% reduction). The authors discuss implications for research and patient care and suggest directions, with methodological refinements, for future studies. Keywordsdepression; relapse and recurrence; cognitive-behavioral therapy; continuation and maintenance treatment; meta-analysis High prevalence and frequent relapse and recurrence amplify the public health significance of major depressive disorder (MDD). Epidemiological estimates place the lifetime prevalence of MDD at more than 16% (Kessler, Berglund, Demler, Jin, & Walters, 2005), and 14% of primary-care patients meet criteria for a major depressive episode (MDE; Ansseau et al., 2004). The large majority of individuals with MDD experience more than one MDE (Judd, 1997;Mueller et al., 1999), and the probability of another MDE increases with each relapserecurrence (Solomon et al., 2000; American Psychiatric Association, 2000a). For example, perhaps 85% of people who recover from an MDE will experience a second MDE within 15 years of naturalistic follow-up, and each additional episode increases the risk of relapserecurrence by 18% (Mueller et al., 1999). Consequently, life interference (e.g., lost work productivity, mortality, lower quality of life) due to MDD rivals that of other chronic diseases such as cancer, diabetes, and heart disease (Murray & Lopez, 1996;Simon, 2003), and most people who commit suicide are depressed (Fawcett, 1993).CorrespondenceThe risk of suicide and life interference can be reduced by shortening the duration of MDEs with effective acute-phase treatments, including pharmacotherapy, interpersonal psychotherapy, and cognitive-behavioral therapy (CT; Hollon, Jarrett, et al., 2005). We define acute-phase treatments as those applied during an MDE with the goal of reducing depressive symptoms and producing initial remission. Responders to some acute-phase treatments (e.g., CT) may receive some protection from relapse-recurrence (Hollon, Thase, & Markowitz, 2002), but prevalent relapse-recurrence after successful antidepressant treatments has ...

The American Psychological Association and many other professional mental health organizations require graduate programs to provide education in multicultural issues. However, the effectiveness of multicultural education has been debated in the literature over the past several years. The overall purpose of this study was to examine the effectiveness of multicultural education using meta-analytic methodologies. Findings revealed that multicultural education interventions were typically associated with positive outcomes across a wide variety of participant and study characteristics. Multicultural education interventions that were explicitly based on theory and research yielded outcomes nearly twice as beneficial as those that were not. Priorities for future inquiry are enumerated, and increased institutional support for multicultural education initiatives is solicited.

Pandemics, including the COVID-19 pandemic, disrupt traditional health care operations by overwhelming system resource capacity. This article describes the development and rapid deployment of a virtual hospital program within a large health care system and their early caring for patients with COVID-19.

This article reviews the internal consistency reliability of multicultural competency instrumentation. Additional psychometric properties are qualitatively reviewed for commonly used instruments and 5 other measures of multicultural competency that have not previously been reviewed in the literature. Results indicate that the most widely used instruments have generally acceptable internal consistency reliability across different populations and settings. Limitations of research conducted on multicultural counseling competencies are identified, and recommendations for future research are provided.

The purpose of this article is to describe a procedure to assist in selecting outcome measures for inpatients treated at a state psychiatric hospital. The procedure combines evidence-based criteria from the literature, instruments shown to be sensitive to change in clinical trials, and the perspectives of a multidisciplinary team of researchers, administrators, providers, and patient advocates. Recent efficacy and effectiveness studies were used to identify recurrently used outcome instruments. A computerized search of more than 30 bibliographic databases, such as PsycINFO, MEDLINE, Social SciSearch, and ERIC, was conducted for articles published between 1990 and 2002. Comparisons of the most frequently used instruments were made on seven criteria proposed as best-practice indicators, including sensitivity to change and robust psychometrics. The sample produced 110 measures. Rater-completed instruments were represented more often than patient-completed ones. However, considerable variability across both methods was found on the criteria. The limited resources associated with publicly funded inpatient facilities led to a recommendation to select at least one rater-completed and one patient-completed instrument.