Safety, Feasibility, Fidelity, and Perceived Benefits of an Intervention for Parents with Mood Disorders and Their Children — “Let’s Talk About Children” in Japan

Solantaus

2022

Front. Psychiatry

Self Cite

BackgroundTraditional models of evidence-based practice assume knowledge is developed in research settings before being installed in practice settings. The role practice settings can play in enhancing effectiveness and enabling sustainability is not therefore acknowledged. Developing interventions in-situ alongside developing their evidence base, provides another pathway to evidence-based practice. One example is Let's Talk about Children (LTC), a brief family-focused intervention that promotes parent, family and child wellbeing. Let's Talk about Children has been developed and adapted to respond to the context into which it has been established, leading to different descriptions reported in its 20 year collection of evidence. Collating the diverse literature on LTC, this paper showcases an evidence-based practice developed in-situ in order to guide future innovation.MethodUsing an integrative review, key literature using LTC were identified through electronic databases and snowballing techniques. Constant comparison analysis synthesized the data to develop patterns and themes.FindingsFrom the 26 records, three forms of LTC were identified and outcomes related to parents, family and child wellbeing, implementation and sustainability were collated. Consolidated outcomes show overall agreement in effectiveness and acceptability outcomes across different settings and populations. Implementation and sustainability impacts are entwined with the context, and influenced by its development in-situ.ConclusionsThe study documents that the in-situ model is effective at developing sustainable evidence-based practice. In consolidating the evidence, the review clarified LTC's forms and outcomes, and draws attention to the importance of research on mechanisms of change.

Section: Findings Recordsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Evidence-Based Practice Developed in-situ: Let's Talk About Children and a Consolidation of Its Evidence Base

Solantaus

2022

Front. Psychiatry

Self Cite

“…Let's Talk has been implemented in Europe, Asia and Australia and uses a health promotive approach to address known risks to mental health outcomes for children through working directly with the parent diagnosed with a mental illness (Solantaus, Reupert, & Maybery, 2015;Ueno, Osada, Solantaus, Murakoshi, & Inoue, 2019). In the brief practice model of two to three conversations, a practitioner and parent collaboratively explore the everyday life of the child, highlighting strengths and vulnerabilities, in order to enhance well-being (Maybery et al, 2017;Punamäki, Paavonen, Toikka, & Solantaus, 2013;.…”

Section: Introductionmentioning

confidence: 99%

Leadership perspectives on key elements influencing implementing a family‐focused intervention in mental health services

Psychiatric Ment Health Nurs

Goodyear

O’Hanlon

et al. 2020

Background Despite a strong evidence base and policy recommendation supporting the implementation of psychoeducation interventions within the mental health system, equitable access for many service users and family members has not been achieved. To enhance translation, developing an evidence-base around the factors that in uence implementation of interventions is critical. Methods The aim of the study was to explore the factors in uencing implementation of a group cofacilitated recovery focused psychoeducation intervention. The study design was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews with key stakeholders (n=75) involved with the implementation within 14 mental health sites in the Republic of Ireland. The Consolidation Framework for Implementation Research (CFIR) was used as a conceptual framework to guide data collection and analysis. Results Key enablers and barriers were identi ed across all CFIR domains of the framework with some factors (depending on context) being both an enabler and a barrier. National policy; structural stability with national systems; leadership at all levels; peer payment system; local champions and support from multidisciplinary team members; evidence strength and quality of the programme design; availability of resources; referral pathways; knowledge, beliefs and self-e cacy of facilitators, as well as local culture in uenced implementation. While some were speci c to the programme, many barriers re ected systemic and structural challenges within health services more generally. Conclusion: Findings from this study provide an enhanced understanding of the different layers of determinants to implementation of an intervention. Overcoming challenges will involve positive and ongoing engagement and collaboration across the full range of stakeholders that are active within each domain, including policy and operational levels. The quality of leadership at each domain level is of crucial importance to successful implementation. Methodology Aim The aim of this current aspect of the study was to explore the factors in uencing implementation of the EOLAS programmes. Methods While a randomised control trial is considered a gold standard for evaluating the effectiveness of an intervention [33], it is limited in its usefulness in understanding factors that in uence the implementation process for psychosocial interventions. Therefore, the study design for the current study was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews. Qualitative descriptive research is directed at providing an in-depth description of an experience or event [34] and enables researchers to develop a deep understanding of the phenomena under study. The Consolidation Framework for Implementation Research (CFIR) [31] was used as a conceptual framework to guide data collection and analysis. The CFIR is a meta-theoretical framework designed to guide the factors that in uence the implementat...

“…It is a series of conversations between the practitioner and parent that bring into focus the wellbeing of their children while supporting the parent’s role in enabling everyday family life in the context of adversity [ 9 – 11 ]. Studies of Let’s Talk have focused primarily on the safety and feasibility of its use [ 12 , 13 ], outcomes for children and parents [ 14 , 15 ] and changes to practitioner’s practice after training [ 16 – 18 ]. Let’s Talk has been adapted for Australian use with freely available online training and resources (emergingminds.com.au).…”

Section: Introductionmentioning

confidence: 99%

An explanatory model of factors enabling sustainability of let’s talk in an adult mental health service: a participatory case study

O’Hanlon

Weimand

et al. 2020

Int J Ment Health Syst

Background: While effective interventions have been developed to support families where a parent has a mental illness in Adult Mental Health Services, embedding and sustaining them is challenging resulting in families not having access to support. This study developed an explanatory model of influencers that had enabled sustainability of the Let's Talk intervention in one service. Methods: A participatory case study was used to build an explanatory model of sustainability at the service using theoretical frameworks. Qualitative and quantitative data was collected about practitioner's practice and the organisation's implementation process and capacity to support practice. A local research group worked with the researcher using a transforming data approach through description, analysis and interpretation. Results: Influencers were grouped into four major categories: (1) External social, political and financial context, (2) Resources, (3) Prior organisational capacity and (4) Sustainability Factors. The last category, Sustainability factors, was divided into three subcategories: (4.1) Practitioner (4.2) Organisation and (4.3) Parent-Client. These categories form part of an explanatory model for the key influencers of continued practitioner practice and organisational capacity to support practice. Conclusions and implications for practice: In this case study, the pre-existing organisational context along with practitioner, organisation and parent-client factors operated together to influence sustainability. The results suggest that sustainability is more likely to be supported by both linking Let's Talk to existing organisational identity, capacity, structures and relationships and by supporting mutual adaptations to improve the fit. Additionally, by understanding that setbacks are common and ongoing adjustments are needed, implementers are able to have realistic expectations of sustainability.