Enhancing Quality of Care Through Evidence-Based Practice: Training and Supervision Experiences.

Objective: Evidence-based practice (EBP) is the preferred approach to treatment in mental health settings because it involves the integration of the best available research, clinical expertise, and patient values to optimize patient outcomes. Training on empirically supported treatments (ESTs) in mental health settings is an important component of EBP, and supervision of therapists' implementation of ESTs is critical for therapists to develop and maintain a strong EBP skill set. This study aimed to evaluate training and supervision histories of therapists in outpatient and inpatient psychiatric care settings as an essential first step in improving patient outcomes.

The Role of Social Adjustment in a Collegiate Behavioral Activation Program.

The transition to college is associated with significant changes in social support networks and concomitant increases in depressive symptoms. First-year students who are more socially engaged within their new academic settings may experience greater overall wellbeing. Behavioral activation (BA) is an evidence-based intervention which promotes individuals' engagement with valued activities and has been examined as a possible primary prevention for depressive symptoms among first-year students.

Factors associated with a change in disposition for mental health patients boarding in an urban Paediatric emergency department.

Aim: Paediatric emergency departments (ED) nationwide experience a shared burden of boarding mental health patients. Whilst boarding, some patients have a change in disposition from hospitalization to discharge home. This phenomenon raises concern because EDs often have scarce resources for mental health patients.

Risk Factors for Seclusion in Children and Adolescents Inpatient Psychiatry: The Role of Demographic Characteristics, Clinical Severity, Life Experiences and Diagnoses.

Objective: To understand the risk factors for seclusion in a sample of children and adolescents admitted to an inpatient psychiatry unit looking at demographic, clinical severity, life experience, and diagnostic characteristics.

Methods: An unmatched case-control retrospective analysis of psychiatric records in a pediatric inpatient unit from December 2011 to December 2015 (N = 1986) RESULTS: Individual characteristics, including demographics, clinical severity, and clinical presentation as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) jointly predicted seclusion in adolescents, with younger age, male sex, black race, having a prior admission, and having a disruptive behavior or bipolar and related disorder diagnoses being predictive of seclusion. While demographic and clinical severity factors were predictive of seclusion in multivariate models, clinical diagnoses only added modestly to the variance explained.

Acute psychiatric care for pediatric patients.

Higher level or acute psychiatric care for youth is intended to be active but short-term treatment focussing on crisis stabilisation, assessment, safety monitoring, and longer-term treatment planning. The focus of this article is on describing common challenges and the effort to address these challenges through new approaches to acute psychiatric care for children and adolescents. The review finds that (1) inpatient paediatric psychiatry beds are in high demand and often difficult to access, (2) there are a number of common challenges these units face including managing length of stays, readmissions, and adverse events, and (3) there are encouraging therapeutic approaches adapted for this setting.

Routine Psychological Screening for Parent Depressive Symptoms in an Outpatient Pediatric Specialty Burn Clinic.

Pediatric burn injuries are stressful for parents, yet few burn clinics report screening caregivers. We evaluated psychometric properties of a two-item depression screener administered to parents of children with burns during outpatient clinic visits. We also examined associations between parent depression symptoms and child characteristics.

Family and Maternal Characteristics of Children With Co-Occurring ADHD and Depression.

This study examined differences between children with ADHD and comorbid depression ( = 26), ADHD only ( = 111), and a community control group ( = 130) on measures of family and maternal characteristics. The present study utilized a large, community sample. Diagnoses required positive endorsements from multiple sources.

Use of Modified Positive Behavioral Interventions and Supports in a Psychiatric Inpatient Unit for High-Risk Youths.

Objective: Despite a call for the reduction and ultimate elimination of the use of seclusion and restraint, research on reduction of these practices in behavioral programs has been limited. This study sought to examine the effectiveness of a modified version of the Positive Behavioral Interventions and Supports (M-PBIS) implemented in a youth psychiatric inpatient unit to reduce use of seclusion and restraint.

Methods: This naturalistic, prospective study covered a four-year period (1,485 admissions).

Evaluation of the Environmental Supports Scale with a Community Sample of Adolescents.

Environmental sources of psychosocial support have been found to modulate or protect against the development of psychopathology and risk behavior among adolescents. Capturing sources of environmental support across multiple developmental contexts requires the availability of well-validated, concise assessments-of which there are few in the existing literature. In order to address this need, the current study explored the factor structure, concurrent and convergent validity of the Environmental Supports Scale (ESS; Genetic, Social, and General Psychology Monographs, 117; 395-417, 1991) with a community sample of adolescents.

Risk Factors for Seclusion and Restraint in a Pediatric Psychiatry Day Hospital.

The use of seclusion and restraints (SR) in acute hospital settings remains a controversial practice. Despite the focus on SR in the psychiatric services literature, data on SR use in pediatric day hospital settings is lacking. A case-control retrospective analysis for children admitted into a pediatric psychiatry day hospital in a 2-year span examined predictors of SR use.

Patterned changes in urge ratings with tic suppression in youth with chronic tic disorders.

Background: Premonitory urges are central to emerging behavioral models of chronic tic disorders (CTD). Urge reduction has been proposed as a behavioral explanation for tic maintenance and exacerbation as well as the efficacy of behavioral treatments. Prior investigations have produced inconsistent findings despite common methodologies.

Characterizing subjective responses to alcohol among adolescent problem drinkers.

Theoretical models of alcoholism emphasize the acute reinforcing properties of alcohol as chief determinants of drinking, and animal research suggests adolescents are uniquely sensitive to these effects. Human studies of these phenomena, however, are virtually nonexistent. We used ecological momentary assessment methods to capture adolescents' subjective responses to alcohol in real time in their natural environments.

Analogue study of peer influence on risk-taking behavior in older adolescents.

This experimental study aimed to examine whether adolescents act in a riskier manner in the presence of peers and whether peer presence alone influences risk behavior or if a direct influence process is necessary. Utilizing a behavioral task assessing risk-taking, 183 older adolescents (18–20 year olds) came to the laboratory alone once and then were randomized to one of three conditions as follows: alone, peers present, and peers encouraging. An interaction was found such that at baseline, there were no significant differences between the three conditions, but at the experimental session, there was a significant increase in risk task scores particularly for the encouraging condition.

Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity.

Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time.

Emotional and behavioral functioning in children with bladder exstrophy-epispadias complex: a developmental perspective.

Objective: To evaluate the emotional and behavioral functioning of children with bladder exstrophy-epispadias complex (BEEC), taking into account developmental and gender considerations. This study also sought to overcome methodological limitations of previous studies evaluating psychological well-being of children with BEEC.

Methods: Eighty-six children were consecutively evaluated using the parent report version of the Behavior Assessment System for Children during visits to a multidisciplinary urology clinic.

Influence of social stress on risk-taking behavior in adolescents.

Risk-taking behavior involves making choices with uncertain positive or negative outcomes. Evidence suggests that risk-taking behavior is influenced by emotional state. One such emotional experience is social anxiety, which has been related to both risk-avoidant and risk-seeking decision making.

An Examination of the Association of Distress Intolerance and Emotion Regulation with Avoidance.

Distress intolerance is an important motivator of maladaptive avoidance-based coping strategies. The selection of such avoidance behaviors is also influenced by one's access to alternative emotion regulatory strategies. However, little research has examined the relative contributions of these vulnerability factors to avoidance.

Effects of naltrexone on adolescent alcohol cue reactivity and sensitivity: an initial randomized trial.

Adolescent alcohol use is associated with myriad adverse consequences and contributes to the leading causes of mortality among youth. Despite the magnitude of this public health problem, evidenced-based treatment initiatives for alcohol use disorders in youth remain inadequate. Identifying promising pharmacological approaches may improve treatment options.

A preliminary experimental investigation of peer influence on risk-taking among adolescent smokers and non-smokers.

Background: Epidemiological evidence suggests that peer influence plays a significant role in a variety of adolescent risk-taking behaviors, including tobacco use. We attempted to establish this relationship in a controlled laboratory setting.

Method: We modified the Balloon Analog Risk Task (BART) task to include a peer component to investigate whether peer influences alter risk-taking behaviors.