J Consult Clin Psychol
November 2024
In Brief: Animal studies are needed to inform clinical guidance on the effects of testosterone gender-affirming hormone therapy (T-GAHT) on fertility. This review summarizes current animal models of T-GAHT and identifies gaps in knowledge for future study.
Abstract: Testosterone gender affirming hormone therapy (T-GAHT) is frequently used by transgender and gender-diverse individuals assigned female at birth to establish masculinizing characteristics.
Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports.
View Article and Find Full Text PDFBackground: Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies.
View Article and Find Full Text PDFBackground: Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies.
View Article and Find Full Text PDFStandardized assessment measures are important for accurate diagnosis of mental health problems and for treatment planning and evaluation. However, little is known about youth mental health providers' typical use of standardized measures across disciplines and outside the context of evidence-based practice initiatives. A multidisciplinary national survey examined the frequency with which 674 youth mental health providers administer standardized and unstandardized measures, and the extent to which organizational (i.
View Article and Find Full Text PDFUnlabelled: There is a well-documented gap between research and practice in the treatment of mental health problems. One promising approach to bridging this gap is training community-based providers in evidence-based practices (EBPs). However, a paucity of valid, reliable measures to assess a range of outcomes of such trainings impedes our ability to evaluate and improve training toward this end.
View Article and Find Full Text PDFAlthough clinical supervision is widely seen as critical for professional training and for safeguarding and promoting client well-being in mental health care, it is understudied, particularly in publicly funded services. In surveys of two large samples of youth mental health service providers (a state sample of providers billing Medicaid [ = 1,057] and a national sample of professional guild members [ = 1,720]), we examined the amount of time providers reported spending in supervision and consultation in a typical workweek and its covariation with characteristics of providers' caseloads and work settings. Across both samples, providers reported spending an average of 2-3 hr per week in supervision.
View Article and Find Full Text PDFWhile there are established measures for fidelity to specific evidence-based treatments, there is no widely accepted, feasible measure of the use of evidence-based treatment strategies in youth mental health (MH) care. This study examined the factor structure of a provider self-report measure of evidence-based treatment strategy use, the Evidence-Based Strategies Scale (EBSS). MH providers completed the EBSS as part of a larger mailed survey.
View Article and Find Full Text PDFNumerous efforts are underway to train clinicians in evidence-based practices. Unfortunately, the field has few practical measures of therapist adherence and skill with which to judge the success of these training and implementation efforts. One possible assessment method is using behavioral rehearsal, or role-play, as an analogue for therapist in-session behavior.
View Article and Find Full Text PDFObjective: Evidence-based assessment (EBA) plays a critical role in the delivery of effective treatments. However, little is known about the assessment practices of mental health clinicians who treat youths and the factors that support EBA. The authors examined when, how, and under what conditions clinicians conduct EBA.
View Article and Find Full Text PDFJ Clin Child Adolesc Psychol
December 2021
We examined the acceptability, integrity, and symptom trajectories associated with FIRST, a principle-guided treatment for youth internalizing and externalizing problems designed to support efficient uptake and implementation. We conducted two open trials of an adapted FIRST, focusing on uptake and implementation by novice trainees in a university-affiliated clinic, limiting treatment duration to six sessions, and benchmarking findings against a 2017 FIRST trial with community therapists. In Study 1, trainees received a two-day training and weekly two-hour supervision ( = 22 youths, ages 7-17, 50% female, 54.
View Article and Find Full Text PDFOne in 5 youth experience a psychiatric disorder in any given year, but fewer than half of these youth receive mental health services. This lack of service utilization is often attributed to structural and perceptual barriers, and school-based mental health programs have been proposed as a means of addressing these barriers and increasing youths' access to services. While universal prevention programs and targeted treatments may benefit most youth receiving services in schools, collaborations between schools and child psychiatry may benefit youth with the most severe symptoms and the greatest impairment.
View Article and Find Full Text PDFPrevious surveys indicate infrequent use of evidence-based treatment (EBT) manuals in usual care youth mental health, but the extent to which providers use core and common EBT strategies and what contextual factors impact EBT strategy implementation need further study. In a national, multidisciplinary survey of 1092 youth-serving providers, providers reported regular use of many EBT strategies. Provider learning theory orientation, more recent degree, more standardized and ongoing assessment use, more positive attitudes toward innovation and evidence, fewer low-income clients, and perceptions that their agency valued quality care and provided fewer training resources predicted more frequent EBT strategy use.
View Article and Find Full Text PDFParental reflective functioning (RF) has garnered tremendous support as a predictor of secure attachment in infancy, though little work has examined RF among parents of older children. In this study, we used a high-risk community sample of parent-child dyads (N = 117) to explore whether parental RF comprises self- and child-focused factors, whether parental RF is associated with parent and child attachment security, and whether parental RF mediates the association between parent and child attachment security. Results suggested that parental RF can be characterized as having both self- and child-focused components, and that child-focused parental RF is associated with child but not parent attachment security.
View Article and Find Full Text PDF