Paraprofessionals, partners, peers, paraphernalia, and print: Expanding mental health service delivery.

Abstract

Paraphernalia include various equipment, charts, tapes, and automated devices that may assist clients. Finally, print refers to written materials designed for client use.Considered in this order, these agents represent a continuum of increasing distance from professional intervention. A paraprofessional differs from the professional only in amount of training, whereas print (the lowest level in the model) represents a qualitatively different means of conceptualizing treatment. With adjuncts higher in the model (i.e., closer to the traditional professional), intervention is still carried out by another person. With adjuncts such as paraphernalia and print, clients are in greater or complete control of their own treatment.Several ideas underlie our promotion of therapeutic adjuncts.1. Adjunctive agents are more plentiful and less expensive than are mental health professionals.2. Adjunctive agents maintain greater contact with clients in their natural environments and emphasize clients' responsibility-for their own changes. For these and other reasons, therapeutic adjuncts have the potential of being equally or even more effective than direct professional services.3. The role of the mental health professional should not be limited to direct service but rather should include significant time devoted to supervision, program development, training, diagnosis, and evaluative research.

Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness

“…The need to move to additional models has been recognized for decades (e.g., A. Christensen, Miller, & Muñoz, 1978;Ryder, 1988), but converging influences mentioned earlier have increased the calls for other models. Moreover, concrete options are now available and viable (e.g., Bennett-Levy et al, 2010;Harwood & L'Abate, 2010;L'Abate, 2007;Rotheram-Borus, Swendeman, & Chorpita, 2012).…”

Mental Health on the Go

“…This crisis in the mental health field has sparked a dialogue in psychology and other health-related fields about the need to develop alternative strategies for delivery of services (Christensen, Miller, & Muñoz, 1978; Harwood & L'Abate, 2010; Kazdin & Blase, 2011; Kazdin & Rabbitt, 2013; L'Abate, 2007; Mosa, Yoo, & Sheets, 2012; Rotheram-Borus, Swendeman, & Chorpita, 2012; Ryder, 1988). Particular attention has been paid to computerized and mobile interventions given their potential to serve as “disruptive innovations” that provide a qualitative leap in reducing cost and increasing accessibility of empirically-validated treatments (e.g., Barak, Hen, Boniel-Nissim, & Shapira, 2008; Kazdin & Rabbitt, 2013; Rotheram-Borus et al, 2012).…”

Text messaging as an adjunct to CBT in low-income populations: A usability and feasibility pilot study.

“…Recent reports highlight the disparities in access to depression treatment among racial and ethnic minority populations in the United States (Alegria et al, 2008) and call for innovative, evidence-based interventions for these populations to address existing disparities (Muñoz & Mendelson, 2005). Calls for the use of adjuncts to expand the reach of health interventions to maximize public health benefit are long-standing (Christensen, Miller, & Muñoz, 1978), and current technologies are beginning to provide alternative and cost-effective means of achieving those goals (Muñoz, 2010). …”