Implementation of a peer-delivered opioid overdose response initiative in New York City emergency departments: Insight from multi-stakeholder qualitative interviews.

Background: Emergency departments (EDs) are critical touchpoints for overdose prevention efforts. In New York City (NYC), the Health Department's Relay initiative dispatches trained peer "Wellness Advocates" (WAs) to engage with patients in EDs after an overdose and for up to 90 days subsequently. Interest in peer-delivered interventions for patients at risk for overdose has grown nationally, but few studies have explored challenges and opportunities related to implementing such interventions in EDs.

Study protocol for a multisite randomized controlled trial of a peer navigator intervention for emergency department patients with nonfatal opioid overdose.

Background: Patients presenting to emergency departments (EDs) after a nonfatal opioid-involved overdose are at high risk for future overdose and death. Responding to this risk, the New York City (NYC) Department of Health and Mental Hygiene operates the Relay initiative, which dispatches trained peer "Wellness Advocates" to meet patients in the ED after a suspected opioid-involved overdose and follow them for up to 90 days to provide support, education, referrals to treatment, and other resources using a harm reduction framework.

Methods: In this article, we describe the protocol for a multisite randomized controlled trial of Relay.

How does hostile resistance interfere with the benefits of cognitive-behavioral therapy for panic disorder? The role of therapist adherence and working alliance.

Although clients' hostile behavior directed at therapists () predicts worse outcomes in cognitive-behavioral therapy (CBT) for panic disorder, the process by which this happens remains unknown. This study examines two putative mechanisms: working alliance and therapist adherence. Seventy-one adults with primary panic disorder received CBT in a larger trial.

Testing Clinical Intuitions About Barriers to Improvement in Cognitive-Behavioral Therapy for Panic Disorder.

Although clinical intuitions influence psychotherapeutic practice and are a rich source of novel hypotheses for research, many remain to be empirically tested. This study evaluates whether clinicians' beliefs about barriers to progress in cognitive-behavioral therapy (CBT) for panic disorder are supported by data. Data from a randomized-controlled trial comparing CBT to panic-focused psychodynamic psychotherapy (PFPP) for adults with primary panic disorder (N = 161) were used to evaluate 15 factors endorsed by clinicians as impediments to CBT in a recent survey.

Patient, therapist, and relational antecedents of hostile resistance in cognitive-behavioral therapy for panic disorder: A qualitative investigation.

(clients' openly combative behavior directed at therapists) predicts poor outcomes in cognitive-behavioral therapy (CBT) for panic disorder, but its origins are poorly understood. It is important to have a holistic understanding of the etiology of hostile resistance that incorporates the therapeutic context if these behaviors-and their negative consequences-are to be prevented and effectively addressed. Of the 71 adults who received CBT for panic disorder as part of larger trial, 8 exhibited hostile resistance.