Evidence Based Mental Health最新文献

{"title":"Creating a prepared mental health workforce: comparative illustrations of implementation strategies.","authors":"Bruce F Chorpita,&nbsp;Eric L Daleiden,&nbsp;Juan Diego Vera,&nbsp;Karen Guan","doi":"10.1136/ebmental-2020-300203","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300203","url":null,"abstract":"<p><strong>Background: </strong>Psychotherapy implementation must contend with the task of preparing a mental health workforce to provide the highest quality services to as much of a service population as possible, in high-income as well as low-to-middle income countries.</p><p><strong>Objective: </strong>We outline general challenges and solutions and investigate how well various implementation strategies would fit a clinical population.</p><p><strong>Methods: </strong>Using a data set from a prior cluster randomised trial with a clinically diverse population and 33 intervention practices, we presented multiple illustrations comparing the ability of different implementation strategies to serve youth and families with procedures in which service providers were trained.</p><p><strong>Findings: </strong>A series of survival functions demonstrated that many common implementation strategies are unlikely to create a prepared workforce, given the large and diverse number of practices needed to be mastered by providers.</p><p><strong>Clinical implications: </strong>'Benchmark' solutions that afforded superior coverage of the service population could be supported through paced learning approaches (ie, training interventions a little at a time) using extensible, modular intervention designs.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"5-10"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231619/pdf/ebmental-2020-300203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time for a paradigm shift for psychotherapies?","authors":"Elisabeth Schramm,&nbsp;Ron Rapee,&nbsp;Toshi A Furukawa","doi":"10.1136/ebmental-2020-300239","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300239","url":null,"abstract":"Schramm E, et al. Evid Based Ment Health Month 2021 Vol 0 No 0 Time for a paradigm shift for psychotherapies? Elisabeth Schramm, Ron Rapee, Toshi A Furukawa 3 Almost 70 years ago, Eysenck stirred up the community of psychotherapists by postulating that psychotherapies—at that time predominantly psychoanalytic—are not effective in the treatment of psychological disorders. This led to a massive surge of empirically evaluated psychotherapy research and promoted particularly the rise of cognitive behavioural therapy. Today, we know that a range of psychotherapies work across a wide variety of mental disorders and numerous metaanalyses of randomised controlled trials prove that Eysenck’s conclusion is no longer relevant. However, despite ample evidence that psychotherapy is generally efficacious, only 30% of patients achieve remission while as many as 65% leave treatment without a measurable benefit or even with deterioration. Therefore, psychotherapy researchers face the challenge to improve the effectiveness of their interventions. In order to solve Gordon Paul’s fundamental question—‘What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances?’—we have to ask: What is hindering the development of the field of psychotherapy and how can it move forward? Until today, categorical thinking still informs treatment selection and led to the development of intervention guilds and psychotherapy schools, which has retarded our progress in understanding and treating mental disorders. Mostly in absence of any empirical evidence, psychotherapy schools are usually based on plausible, yet unproven theories and on commercial and status interests of the representatives. Moreover, strong identification with one’s own school and its superiority over other schools reflects drastic allegiance effects and high risks of bias in research. As Marvin Goldfried, one of the pioneers of psychotherapy research, prominently calls out, the lack of consensus and disparate languages across theoretical orientations means that identifying the core factors that may underlie the effectiveness of psychotherapy is difficult if not impossible and holds back progress in the science and practice of psychotherapy. In more recent times, a trend is emerging to move away from nosology and a strictly categorical diagnostic approach to dimensional, functionoriented, mechanistic constructs used as specific therapy targets. Abandoning the dichotomies, categorical approaches and guilds as well as overcoming mere ‘horse races’ in efficacy research may help us to understand mechanisms and to move towards a contextual model of psychotherapy. This coincides with an increasing interest in medicine and psychology to develop individualised precision therapy. By identifying the key elements that may be driving an intervention’s effect, transdiagnosticmodularised approaches can be developed addressing pathological mechanisms such as difficult","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"1"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231498/pdf/ebmental-2020-300239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-week Intensive Group Program (IGP) for borderline personality disorder: making the case for more accessible and affordable psychotherapy.","authors":"Dervila Gec,&nbsp;Jillian Helen Broadbear,&nbsp;David Bourton,&nbsp;Sathya Rao","doi":"10.1136/ebmental-2020-300195","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300195","url":null,"abstract":"<p><strong>Background: </strong>The availability of specialist psychotherapies for treating borderline personality disorder (BPD) is limited by costs associated with training, resourcing and treatment duration. Developing a programme that incorporates effective strategies from a range of evidence-based specialist treatments, concentrates their delivery and uses a group-based format will improve treatment access.</p><p><strong>Objective: </strong>To assess the short-term clinical efficacy, acceptability and feasibility of a bespoke manualised programme for the treatment of BPD. This 10-week group-based outpatient programme was delivered 2 days per week in 4 hour sessions; participants received 80 hours of treatment in total.</p><p><strong>Methods: </strong>Forty-three participants, many having severe BPD symptomatology, were assessed before and after the 10-week programme using a range of validated self-report questionnaires and a self-appraisal feedback form. The primary outcome measured was BPD symptom severity.</p><p><strong>Findings: </strong>Statistically significant improvements were measured in BPD symptom severity, depression, trait anxiety, emotional regulation, general health, hopefulness, self-compassion and anger, several with moderate to large effect sizes. Many of these improvements remained at 4-6 months post treatment. More than 90% of surveyed participants expressed a moderate or high level of satisfaction with the programme.</p><p><strong>Conclusions: </strong>This integrated treatment programme delivered in a highly concentrated format demonstrated short-term efficacy across many BPD-relevant endpoints; its acceptability was endorsed by most clients.</p><p><strong>Clinical implications: </strong>Incorporation of key aspects of evidence-based treatment using a time-intensive group format could greatly enhance the capacity of mental health services to meet the needs of people who experience BPD within a population-based mental health service framework.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"e1"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231581/pdf/ebmental-2020-300195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology and implementation science to forge the future of evidence-based psychotherapies: the PRIDE scale-up study.","authors":"Milton L Wainberg,&nbsp;Maria Lídia Gouveia,&nbsp;Melissa Ann Stockton,&nbsp;Paulino Feliciano,&nbsp;Antonio Suleman,&nbsp;Jennifer J Mootz,&nbsp;Milena Mello,&nbsp;Andre Fiks Salem,&nbsp;M Claire Greene,&nbsp;Charl Bezuidenhout,&nbsp;Phuti Ngwepe,&nbsp;Kathryn L Lovero,&nbsp;Palmira Fortunato Dos Santos,&nbsp;Simone H Schriger,&nbsp;David S Mandell,&nbsp;Rogerio Mulumba,&nbsp;Anibal Neves Anube,&nbsp;Dirceu Mabunda,&nbsp;Flavio Mandlate,&nbsp;Francine Cournos,&nbsp;Jean-Marie Alves-Bradford,&nbsp;Terriann Nicholson,&nbsp;Bianca Kann,&nbsp;Wilza Fumo,&nbsp;Cristiane S Duarte,&nbsp;Jair de Jesus Mari,&nbsp;Marcelo F Mello,&nbsp;Ana O Mocumbi,&nbsp;Maria A Oquendo,&nbsp;Myrna M Weissman","doi":"10.1136/ebmental-2020-300199","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300199","url":null,"abstract":"<p><strong>Objective: </strong>To report the interim results from the training of providers inevidence-based psychotherapies (EBPs) and use of mobile applications.</p><p><strong>Design and setting: </strong>The Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence (PRIDE) study is a cluster-randomised hybrid effectiveness-implementation trial comparing three delivery pathways for integrating comprehensive mental healthcare into primary care in Mozambique. Innovations include the use of EBPs and scaling-up of task-shifted mental health services using mobile applications.</p><p><strong>Main outcome measures: </strong>We examined EBP training attendance, certification, knowledge and intentions to deliver each component. We collected qualitative data through rapid ethnography and focus groups. We tracked the use of the mobile applications to investigate early reach of a valid screening tool (Electronic Mental Wellness Tool) and the roll out of the EBPs PARTICIPANTS: Psychiatric technicians and primary care providers trained in the EBPs.</p><p><strong>Results: </strong>PRIDE has trained 110 EBP providers, supervisors and trainers and will train 279 community health workers in upcoming months. The trainings improved knowledge about the EBPs and trainees indicated strong intentions to deliver the EBP core components. Trained providers began using the mobile applications and appear to identify cases and provide appropriate treatment.</p><p><strong>Conclusions: </strong>The future of EBPs requires implementation within existing systems of care with fidelity to their core evidence-based components. To sustainably address the vast mental health treatment gap globally, EBP implementation demands: expanding the mental health workforce by training existing human resources; sequential use of EBPs to comprehensively treat mental disorders and their comorbid presentations and leveraging digital screening and treatment applications.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"19-24"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmental-2020-300199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10565562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a mental health drop-in centre offering brief transdiagnostic psychological assessment and treatment for children and adolescents with long-term physical conditions and their families: a single-arm, open, non-randomised trial.","authors":"Matteo Catanzano, Sophie D Bennett, Ellie Kerry, Holan Liang, Isobel Heyman, Anna E Coughtrey, Kate Fifield, Chloe Taylor, Tim Dalgleish, Laila Xu, Roz Shafran","doi":"10.1136/ebmental-2020-300197","DOIUrl":"10.1136/ebmental-2020-300197","url":null,"abstract":"<p><strong>Background: </strong>Children and young people with long-term physical conditions have significantly elevated mental health needs. Transdiagnostic, brief psychological interventions have the potential to increase access to evidence-based psychological treatments for patients who attend health services primarily for physical health needs.</p><p><strong>Objective: </strong>A non-randomised study was conducted to assess the impact of brief, transdiagnostic psychological interventions in children and young people presenting at a drop-in mental health centre in the reception area of a paediatric hospital.</p><p><strong>Methods: </strong>186 participants attending a transdiagnostic mental health drop-in centre were allocated to assessment and psychological intervention based on a clinical decision-making algorithm. Interventions included signposting, guided self-help based on a modular psychological treatment and referral to the hospital's paediatric psychology service. The primary transdiagnostic mental health outcome measure was the parent-reported Strengths and Difficulties Questionnaire (SDQ), which was given at baseline and 6 months post-baseline.</p><p><strong>Findings: </strong>There was a significant positive impact of attending the drop-in mental health centre on the SDQ (Cohen's d=0.22) and on the secondary outcome measure of Paediatric Quality of life (Cohen's d=0.55).</p><p><strong>Conclusions: </strong>A mental health drop-in centre offering brief, transdiagnostic assessment and treatment may reduce emotional and behavioural symptoms and improve quality of life in children and young people with mental health needs in the context of long-term physical conditions. A randomised controlled trial to investigate the specificity of any effects is warranted.</p><p><strong>Clinical implications: </strong>Drop-in centres for mental health needs may increase access and have beneficial effects for children and young people with physical conditions.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"25-32"},"PeriodicalIF":6.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/bd/ebmental-2020-300197.PMC7958088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of a brief psychological intervention for youth who self-harm: a formative study in India.","authors":"Shilpa Aggarwal, George Patton, Michael Berk, Vikram Patel","doi":"10.1136/ebmental-2020-300188","DOIUrl":"10.1136/ebmental-2020-300188","url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for context-specific research leading to development of scalable interventions to address self-harm and suicide in low and middle-income countries (LMICs).</p><p><strong>Objective: </strong>The current study was conducted to determine the contents of a psychological intervention to reduce recurrence of self-harm and improve functioning in youth who self-harm in India and finalise its delivery mechanisms.</p><p><strong>Methods: </strong>A systematic, sequential approach was used to integrate available scientific evidence, expert service providers' knowledge and experience, and service users' lived experiences in the codesigning and development of a psychological intervention. The steps included: identifying prioritised outcomes for youth who self-harm as well as a selection of feasible and acceptable elements from self-harm interventions that have been trialled in LMICs, intervention development workshops with mental health professionals and youth to finalise elements, a review of relevant treatment manuals to decide on the treatment framework, and finalising the treatment structure and schedule in the second round of intervention development workshops.</p><p><strong>Findings: </strong>We developed ATMAN treatment with three key elements; problem solving, emotion regulation and social network strengthening skills. The delivery schedule emphasises on the engagement elements, and allows for involvement of other stakeholders such as family members when acceptable to the clients.</p><p><strong>Conclusion and clinical implications: </strong>ATMAN treatment could prove to be especially effective in reducing self-harm recurrence in youth in India due to its brief schedule, elements that have been selected in collaboration with the service users and its potential to be scaled up for delivery by non-specialist treatment providers.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":" ","pages":"e2"},"PeriodicalIF":6.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7116890/pdf/ebmental-2020-300188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38617517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review to examine the methods used to adapt evidence-based psychological treatments for adults diagnosed with a mental illness.","authors":"Allison G Harvey, Hannah S Lammers, Michael R Dolsen, Alice C Mullin, Heather E Hilmoe, Melanie Tran, Vera Portnova, Alison B Tuck, Ajitha Mallidi, Anya Fang, Caitlin Byrnes, Esther Kao, Colin Lee","doi":"10.1136/ebmental-2020-300225","DOIUrl":"10.1136/ebmental-2020-300225","url":null,"abstract":"<p><strong>Question: </strong>The context for the implementation of evidence-based psychological treatments (EBPTs) often differs from the context in which the treatment was developed, which necessitates adaptations. In this systematic review we build on, and add to, prior approaches by examining the method used to guide such adaptations. In particular, we sought to elucidate the extent to which an empirical process is used.</p><p><strong>Study selection and analysis: </strong>We focused on publications describing adaptations made to EBPTs for adults diagnosed with a mental illness. We searched PubMed, PsycINFO, Embase and Web of Science from database inception to July 2018. Two raters independently coded the articles for the method used to conduct the adaptation, the reason for and nature of the adaptation, and who made the adaptation.</p><p><strong>Findings: </strong>The search produced 20 194 citations, which yielded 152 articles after screening. The most commonly used methods for planned adaptations were literature review (57.7%), clinical intuition (47.0%) and theory (38.9%). The use of data from stakeholder interviews ranked fourth (21.5%) and the use of other types of data (eg, pilot study, experiment, survey, interview) ranked last at fifth (12.1%). Few publications reporting ad hoc adaptations were identified (n=3).</p><p><strong>Conclusions: </strong>This review highlights a need to (a) educate providers and researchers to carefully consider the methods used for the treatment adaptation process, and to use empirical methods where possible and where appropriate, (b) improve the quality of reporting of stakeholder interviews and (c) develop reporting standards that articulate optimal methods for conducting treatment adaptations.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":" ","pages":"33-40"},"PeriodicalIF":6.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8254592/pdf/ebmental-2020-300225.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39080572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revived call for consensus in the future of psychotherapy.","authors":"Averi N Gaines,&nbsp;Marvin R Goldfried,&nbsp;Michael J Constantino","doi":"10.1136/ebmental-2020-300208","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300208","url":null,"abstract":"<p><p>The emblem of success in psychotherapy research and practice has long been innovation. Although such ingenuity is commendable, it has nonetheless perpetuated fragmentation across the field. At least four decades ago, it was suggested that achieving consensus on what constitutes psychotherapy's theoretical, empirical, and practical 'core' might allow the discipline to evolve beyond its siloed state, as is reflective of mature science. Yet, division remains the rule versus exception, owing in large part to power struggles among disparate schools of therapy and quarrels over whether theory-specific or theory-common factors most account for therapeutic change. We outline here a vision for psychotherapy's future that is defined by consensus rather than disintegration. Namely, we reiterate the need for the field to invest in clinical strategies that transcend ostensibly incompatible theoretical models. We also argue that psychotherapy research should build on the growing evidence for such clinical strategies in an effort to establish core, evidence-based principles of therapeutic change. We then discuss how establishing consensus will require reconciliation among the mounting evidence for flexible, principle-informed practice with the current realities of training, dissemination, and implementation paradigms. Finally, we articulate ways in which practicing clinicians will serve a vital role in carrying out, and amending as needed, actionable efforts toward psychotherapy consensus.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"2-4"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmental-2020-300208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From cognitive targets to symptom reduction: overview of attention and interpretation bias modification research.","authors":"Chelsea Dyan Gober,&nbsp;Amit Lazarov,&nbsp;Yair Bar-Haim","doi":"10.1136/ebmental-2020-300216","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300216","url":null,"abstract":"<p><p>Cognitive bias modification (CBM) is a class of mechanised psychological interventions designed to target specific aberrant cognitive processes considered key in the aetiology and/or maintenance of specific psychiatric disorders. In this review, we outline a multistage translational process that allows tracking progress in CBM research. This process involves four steps: (1) the identification of reliable cognitive targets and establishing their association with specific disorders; (2) clinical translations designed to rectify the identified cognitive targets; (3) verification of effective target engagement and (4) testing of clinical utility in randomised controlled trials. Through the prism of this multistage process, we review progress in clinical CBM research in two cognitive domains: attention and interpretation; in six psychiatric conditions: anxiety disorders, major depressive disorder, post-traumatic stress disorder, addictive disorders, eating disorders and obsessive-compulsive disorder. The review highlights achievement as well as shortcomings of the CBM approach en route to becoming a recognised evidence-supported therapy for these disorders.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":"24 1","pages":"42-46"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmental-2020-300216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools.","authors":"Pattie P Gonsalves,&nbsp;Eleanor Sara Hodgson,&nbsp;Bhargav Bhat,&nbsp;Rhea Sharma,&nbsp;Abhijeet Jambhale,&nbsp;Daniel Michelson,&nbsp;Vikram Patel","doi":"10.1136/ebmental-2020-300194","DOIUrl":"https://doi.org/10.1136/ebmental-2020-300194","url":null,"abstract":"<p><strong>Background: </strong>This paper describes the pilot evaluation of 'POD Adventures', a lay counsellor-guided problem-solving intervention delivered via a smartphone app in Indian secondary schools.</p><p><strong>Objective: </strong>To test the feasibility and acceptability of POD Adventures for adolescents with a felt need for psychological support, and to explore the intervention's effects on self-reported mental health symptoms, prioritised problems, stress and well-being.</p><p><strong>Methods: </strong>We used a mixed-methods pre-post cohort design. Participants were self-referred from grades 9-12 in two coeducational government-aided secondary schools in Goa, India. The intervention was delivered in two formats, 'mixed' (comprising individual and small group sessions) and 'group' (small group sessions only).</p><p><strong>Findings: </strong>248 participants enrolled in the study and 230 (92.7%) completed the intervention. Outcomes at 4 weeks showed significant improvements on all measures that were maintained at 12 weeks. Large effects were observed on problem severity scores (4 weeks, d=1.47; 12 weeks, d=1.53) while small to moderate effects were seen on mental health symptoms, stress and well-being. 22 students completed qualitative interviews about their experience of the intervention. Participants found POD Adventures easy to use, engaging and helpful in solving their problems. They were satisfied with the guidance provided by the counsellor irrespective of delivery format.</p><p><strong>Conclusions: </strong>POD Adventures was feasible to deliver with guidance from lay counsellors in Indian schools, acceptable to participants and associated with large improvements in problem severity and mental health symptom severity.</p><p><strong>Clinical implications: </strong>POD Adventures has promise as an early intervention for adolescents with a felt need for psychological support in low-resource settings.</p>","PeriodicalId":12233,"journal":{"name":"Evidence Based Mental Health","volume":" ","pages":"11-18"},"PeriodicalIF":5.2,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmental-2020-300194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38617515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}