Change Trajectories: Children’s Patterns of Improvement in Acute-Stay Inpatient Care

Leon, Scott C.; Miller, Steve; Stoner, Alison M.; Fuller, Anne K.; Rolnik, Ashley Marie

doi:10.1007/s11414-014-9432-9

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…These and other findings (e.g., Leon et al, 2016) suggest that psychotherapy may lead to different trajectories for different subgroups of clients and that some subgroups of clients fall into non-positive trajectories.…”

Section: The Trajectory Of Client Change In Psychotherapysupporting

confidence: 55%

“…In a study on the effect of group teletherapy for people aging with HIV, Heckman et al (2017) found three depressive symptom change groups: 53% of clients did not significantly improve after psychotherapy compared with early improvers (31%) and delayed improvers (16%). These and other findings (e.g., Leon et al, 2016) suggest that psychotherapy may lead to different trajectories for different subgroups of clients and that some subgroups of clients fall into non‐positive trajectories.…”

Section: Introductionsupporting

confidence: 54%

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Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement

Lin

Farber

2021

J Clin Psychol

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Objective: The current study aims to ascertain the trajectories of psychotherapy clients' symptom change and identify client factors that predict treatment outcome. Method:We conducted a latent growth mixture model (LGMM) to identify the change trajectories of 44 clients' depression scores during psychotherapy. Client characteristics were then explored to determine whether any were associated with change trajectories. We examined whether the number of physician visits and/or client selfconcealment scores predict 63 clients' improvement after controlling for initial symptom severity.Results: Two trajectories of clients' symptom change were identified: nonimprovers (52.3%) and improvers (47.7%).Nonimprovers had higher levels of self-concealment and baseline depression than improvers. The number of physician visits was associated with higher depression scores at baseline and greater clinical improvement during psychotherapy. Conclusion:Clients showed distinct trajectories of symptom change in psychotherapy. Early identification of clients at risk for treatment failure may increase the probability of therapeutic success.

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Section: The Trajectory Of Client Change In Psychotherapysupporting

confidence: 55%

Section: Introductionsupporting

confidence: 54%

Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement

Lin

Farber

2021

J Clin Psychol

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“…Alternatively, a honeymoon effect relating to change in care environment (Leon et al . ) may have contributed to the favourable comparative expectations. However, the independence of the interviewer and the use of respondent verification with residents who were both within and outside of this trial period work to enhance the trustworthiness of the analysis.…”

Section: Discussionmentioning

confidence: 99%

Understanding consumers’ initial expectations of community‐based residential mental health rehabilitation in the context of past experiences of care: A mixed‐methods pragmatic grounded theory analysis

Parker

Newman

Fletcher

et al. 2018

Int J Mental Health Nurs

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This study explores how consumers expect community-based residential mental health rehabilitation to compare with previous experiences of care. Understanding what consumers hope to receive from mental health services, and listening to their perspectives about what has and has not worked in previous care settings, may illuminate pathways to improved service engagement and outcomes. A mixed-methods research design taking a pragmatic approach to grounded theory guided the analysis of 24 semi-structured interviews with consumers on commencement at three Community Care Units (CCUs) in Australia. Two of these CCUs were trialling a staffing model integrating peer support work with clinical care. All interviews were conducted by an independent interviewer within the first 6 weeks of the consumer's stay. All participants expected the CCU to offer an improvement on previous experiences of care. Comparisons were made to acute and subacute inpatient settings, supported accommodation, and outpatient care. Consumers expected differences in the people (staff and co-residents), the focus of care, physical environ, and rules and regulations. Participants from the integrated staffing model sites articulated the expected value of a less clinical approach to care. Overall, consumers' expectations aligned with the principles articulated in policy frameworks for recovery-oriented practice. However, their reflections on past care suggest that these services continue to face significant challenges realizing these principles in practice. Paying attention to the kind of working relationship consumers want to have with mental health services, such as the provision of choice and maintaining a practical and therapeutic supportive focus, could improve their engagement and outcomes.

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“…Similarities in baseline characteristics for these individuals can provide information about important moderators, such as by indicating which groups are more likely to benefit from the intervention. Leon et al [125] used a group-based trajectory model (latent class growth analysis, LCGA) to investigate possible diversity in the change courses of psychiatric acuity among children during hospitalization. The acuity of psychiatric illness was measured every day for each patient, and the LCGA allowed analysis of the probability that each person belonged to a particular trajectory, based on the similarities and differences in their scores.…”

Section: Outcomesmeasuring Temporal Sequencesmentioning

confidence: 99%

A typology of useful evidence: approaches to increase the practical value of intervention research

Hasson¹,

Leviton²,

Schwarz³

2020

BMC Med Res Methodol

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Background: Too often, studies of evidence-based interventions (EBIs) in preventive, community, and health care are not sufficiently useful to end users (typically practitioners, patients, policymakers, or other researchers). The ways in which intervention studies are conventionally conducted and reported mean that there is often a shortage of information when an EBI is used in practice. The paper aims to invite the research community to consider ways to optimize not only the trustworthiness but also the research's usefulness in intervention studies. This is done by proposing a typology that provides some approaches to useful EBIs for intervention researchers. The approaches originate from different research fields and are summarized to highlight their potential benefits from a usefulness perspective. Main message: The typology consists of research approaches to increase the usefulness of EBIs by improving the reporting of four features in intervention studies: (1) the interventions themselves, including core components and appropriate adaptations; (2) strategies to support-high-quality implementation of the interventions; (3) generalizations about the evidence in a variety of contexts; and (4) outcomes based on end users' preferences and knowledge. The research approaches fall into three levels: Description, Analysis, and Design. The first level, Description, outlines what types of information about the intervention and its implementation, context, and outcomes can be helpful for end users. Research approaches under analysis offers alternative ways of analyzing data, increasing the precision of information provided to end users. Approaches summarized under design involve more radical changes and far-reaching implications for how research can provide more useful information. These approaches partly flip the order of efficacy and effectiveness, focusing not on whether an intervention works in highly controlled and optimal circumstances, but first and foremost whether an intervention can be implemented and lead to anticipated outcomes in everyday practice.

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Change Trajectories: Children’s Patterns of Improvement in Acute-Stay Inpatient Care

Cited by 4 publications

References 29 publications

Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement

Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement

Understanding consumers’ initial expectations of community‐based residential mental health rehabilitation in the context of past experiences of care: A mixed‐methods pragmatic grounded theory analysis

A typology of useful evidence: approaches to increase the practical value of intervention research

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