9.0 Updates on the Impact of Families in the Treatment of Child and Adolescent Mood Disorders

Galanter, Cathryn A.; Walker, Muffy

doi:10.1016/j.jaac.2016.07.486

Cited by 7 publications

(12 citation statements)

References 0 publications

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“…Our findings add to the qualitative literature on barriers to school MH services because, unlike the prior study focusing on stakeholders in a rural community (Habeger et al, 2018), most of the caregivers in this study reside in metropolitan areas. Our findings also support prior literature that the traditional models of MH service delivery in clinical settings are poorly matched to the needs and circumstances of low-income families because of logistical barriers related to caregiver responsibilities, child school schedules, and geographic inaccessibility (Gopalan et al, 2010;Swick & Powers, 2018). Given that recent research has also reported that a majority of Medicaid-enrolled youth receive MH services from fewer than 10% of Medicaidaccepting providers and facilities (Harati et al, 2020), the concentration of service delivery among a minority of Medicaid-accepting providers further reduces geographic accessibility to clinic-based services in urban, suburban, and rural areas.…”

Section: +++supporting

confidence: 87%

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Cummings¹,

Song²,

Gaydos³

et al. 2023

Psychological Services

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Although partnerships between community-based mental health (MH) organizations and school systems to deliver MH services on school grounds (i.e., expanded school mental health, ESMH services) are growing, qualitative research is needed about stakeholders' perspectives on ESMH services. This study collected qualitative data from caregivers, MH providers, and MH administrators recruited from three MH organizations to understand their perspectives regarding potential advantages and challenges associated with ESMH services. The three MH organizations were located in three regions of Georgia and the majority of youth served by the organizations were enrolled in Medicaid. We conducted four focus groups with 33 caregivers and 13 semistructured interviews with MH administrators and providers, and we implemented a thematic content analysis. Caregivers, providers, and MH administrators described how ESMH services could improve MH services by (a) facilitating appointment attendance through the reduction of logistical barriers to care (including geographic barriers, missed class time, and missed work time) and (b) enhancing communication between providers and teachers. However, some participants also described logistical issues with ESMH services including school space constraints and challenges scheduling appointments. In addition, some caregivers expressed concerns about peer stigma if MH services are delivered at school (vs. the clinic). Providers and MH administrators discussed problems with low caregiver engagement and challenges collaborating with school personnel that stem from lack of understanding of MH problems and treatment. Although ESMH services can improve MH treatment among low-income youth, MH providers and MH administrators may consider collaborating with school personnel to proactively develop strategies to address challenges to its success. Impact StatementPartnerships between mental health (MH) organizations and school systems to deliver MH services at schools are growing. Qualitative data from caregivers, MH providers, and MH administrators at three MH organizations identified key advantages of these partnerships: reduction of logistical barriers (e.g., distance to provider) and enhanced communication between providers and teachers. Challenges were also identified (i.e., space constraints, scheduling, collaboration with school personnel, peer stigma, and low caregiver engagement) that can be proactively addressed to maximize partnership success.

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Section: +++supporting

confidence: 87%

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Cummings¹,

Song²,

Gaydos³

et al. 2023

Psychological Services

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“…Caregiver participation is an important component of TF-CBT, but also a simultaneously challenging issue in child mental health treatment in terms of effectively engaging caregivers, particularly in a school-based environment. (Gopalan et al, 2010). Our program utilized evidence-based strategies to enhance engagement through addressing logistical, perceptual, and cultural barriers to treatment engagement (Gopalan et al, 2010; McKay & Bannon, 2004).…”

Section: Methodsmentioning

confidence: 99%

“…(Gopalan et al, 2010). Our program utilized evidence-based strategies to enhance engagement through addressing logistical, perceptual, and cultural barriers to treatment engagement (Gopalan et al, 2010; McKay & Bannon, 2004). These strategies involved using reminder phone calls and text messages, directly addressing caregiver concerns and barriers at the time of the initial appointment and throughout treatment, and addressing beliefs and attitudes related to mental health treatment (particularly those likely to present barriers to receiving services).…”

Section: Methodsmentioning

confidence: 99%

Feasibility and effectiveness of a telehealth service delivery model for treating childhood posttraumatic stress: A community-based, open pilot trial of trauma-focused cognitive–behavioral therapy.

Stewart¹,

Orengo-Aguayo²,

Young³

et al. 2020

Journal of Psychotherapy Integration

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Telepsychotherapy (also referred to as telehealth or telemental health), the use of videoconferencing to deliver psychotherapy services, offers an innovative way to address significant gaps in access to care and is being used to deliver a variety of treatments for youth. Although recent research has supported the effectiveness of telehealth delivery of a variety of interventions for children, the literature has focused very little on childhood posttraumatic stress disorder. This pilot study examined the feasibility and potential effectiveness of trauma-focused cognitive-behavioral therapy (TF-CBT) delivered via telepsychotherapy in community-based locations of either schools or patient homes. Telepsychotherapy treatment was delivered to 70 traumaexposed youth in 7 underserved communities. Of these, 88.6% completed a full course of TF-CBT and 96.8% of these treatment completers no longer met diagnostic criteria for a trauma-related disorder at posttreatment. Results demonstrated clinically meaningful symptom change posttreatment, with large effect sizes evident for both youthand caregiver-reported reduction in posttraumatic stress disorder symptoms. The resultsEditor's Note. This article received rapid review due to the time-sensitive nature of the content, but our standard high-quality peer review process was upheld.

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“…Logistical barriers for low-income families, in general, include difficulties with money, transportation, and child care as well as the presence of community violence. Motivational barriers include poor therapeutic alliance, lack of perceived need, stigma toward MH services, fears of being blamed for children's difficulties, and prior negative experiences with service providers (Gopalan et al, 2010). Communities impacted by poverty typically lack an adequate supply of MH providers to meet the demand, resulting in extensive waitlists to receive services (Goodman et al, 2013).…”

Section: Barriers To Accessing Effective Mh Servicesmentioning

confidence: 99%

“…Few evidence-based interventions (EBI) are implemented in the U.S. public behavioral health system (Chaudoir et al, 2013). In addition, families investigated by CW frequently struggle with multiple psychosocial stressors (e.g., poverty, housing/food instability, substance abuse; Ringeisen et al, 2011) that require additional services, resulting in competing demands on caregivers' time which limit the ability to sustain child MH treatment (Gopalan et al, 2010).…”

Section: Barriers To Accessing Effective Mh Servicesmentioning

confidence: 99%

Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility

Gopalan

Lee

Pisciotta

et al. 2022

Journal of Emotional and Behavioral Disorders

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This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services from the perspectives of participating caregivers ( n = 12) and CW staff ( n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, and logistical support (e.g., food, transportation, child care) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families’ voluntary participation.

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9.0 Updates on the Impact of Families in the Treatment of Child and Adolescent Mood Disorders

Cited by 7 publications

References 0 publications

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Feasibility and effectiveness of a telehealth service delivery model for treating childhood posttraumatic stress: A community-based, open pilot trial of trauma-focused cognitive–behavioral therapy.

Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility

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