Publications by authors named "Molly A Lopez"

Learning Health Systems (LHSs) promise meaningful health care improvement through the ongoing use of data, including the lived experience of diverse constituents, such as people participating in and providing services. Most LHSs operate within a specific healthcare system, typically hospital-based, under a common electronic health record (EHR) and management structure. The Early Psychosis Intervention Network in Texas (EPINET-TX) is a novel case study of a developing LHS across 16 independent community mental health clinics operating state-funded coordinated specialty care (CSC) programs for early psychosis.

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Aim: Despite known prevalence of substance use (SU) among young people experiencing early psychosis and increasing evidence for the relationship between certain substances (e.g., cannabis) and psychosis, there are no specialized interventions developed for effectively addressing substance use among young people participating in coordinated early psychosis services.

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Objective: This report examined challenges and adaptations to sustaining multidisciplinary team-based coordinated specialty care (CSC) for early-onset psychosis during the COVID-19 pandemic in Texas.

Methods: In June 2020, team leaders from 23 Texas CSC sites participated in semistructured phone interviews about CSC implementation barriers and adaptations. Transcripts were analyzed with thematic analysis.

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Objective: The effectiveness of NAMI Basics, a peer-led family support program for caregivers of children with mental health concerns, was tested in a sample of caregivers referred to five National Alliance on Mental Illness (NAMI) affiliates in a large southwestern state.

Method: Caregivers of children with mental health concerns (N=111; 69% biological mothers, 45% Hispanic/Latinx, 33% Caucasian, and 12% African American) were randomly assigned to a six-class NAMI Basics course led by peer parents or an 8-week waitlist condition. At baseline and 8 weeks after the course began, all caregivers completed measures assessing services engagement and activation, attitudes toward mental health services, parenting stress, and youth symptoms.

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State mental health systems have been leaders in the implementation of evidence-based approaches to care for individuals with severe mental illness. Numerous case studies of the wide-scale implementation of research-supported models such as integrated dual diagnosis treatment and assertive community treatment are documented. However, relatively few dissemination efforts have focused on cognitive behavioral therapy (CBT) for individuals with major depression despite evidence indicating its efficacy with this population.

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Although the juvenile crime rate has generally declined, the involvement of girls in the juvenile justice system has been increasing. Possible explanations for this gender difference include the impact of exposure to trauma and mental health needs on developmental pathways and the resulting influence of youth's involvement in the justice system. This study examined the influence of gender, mental health needs and trauma on the risk of out-of-home placement for juvenile offenders.

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Workshops are a common strategy for fostering the adoption of evidence-based practices (EBP), but workshops alone may not change provider behavior. This study investigates the impact of a two-day training combined with an existing mandate for EBP use. Providers attending regional workshops showed improved attitudes toward the behavioral parent training model, but not EBPs in general.

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State mental health systems are actively seeking to disseminate empirically supported treatment approaches to improve the outcomes of adults with serious mental illnesses. However, many of these interventions have not been studied within public mental health settings. Cognitive behavioral therapy (CBT) has been shown to be effective for major depression in well-controlled trials, but its effectiveness in public mental health settings is less known.

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For children and adolescents with behavioral and emotional disorders and their families, education about their disorders and the treatments is an essential component of a comprehensive approach to their care. Education can encourage active participation in treatment, enhance adherence to treatment regimens, and provide patients and families with important coping skills. Thus, the Children's Medication Algorithm Project (CMAP) incorporated a psychoeducational program into the medication algorithm created to improve treatment of children with ADHD and/or depression in the Texas public mental health sector.

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