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Participating in Global Mental Health program development and education and training efforts is rewarding and exciting work. The author describes several global experiences he has engaged in over the past 30 years, which has focused on teaching and encouraging family therapy and mental health care that support human rights and promote human development as innovated and promoted by the Global Alliance for Behavioral Health, formerly the American Orthopsychiatric Association. The author learned through participation that merely presenting mental health information and treatment approaches through lecture presentation was not adequate to help professionals and advocates in low- and middle-income countries to build sustainable mental health care systems in their home regions. The author engaged in several collaborative program development efforts with local professionals at their invitation. These programs, consisting of multiyear partnerships based on the needs and culture of the home region, will be described in the article. The programs, based on relationships between local professionals and a U.S. team of experts in child mental health care, had long-term positive effects and were highly rewarding. The basis for these programs was an invitation by local professionals, followed by collaboration in setting the agenda for the U.S. professionals' visits, an on-going relationship in which local professionals trusted that the visitors want and need to understand the local cultural environment, and improvements that will be most helpful and sustainable. In this process, the author learned about the cultures he worked in and was a part of extremely meaningful and enlightening relationships and experiences. Public Policy Relevance Statement: Improving mental health awareness and humane and effective responses to emotional distress while improving overall mental well-being in low- and middle-income countries is an international priority. Educational, training, and program development efforts must be implemented with awareness of local context and culture. This article describes the experiences of the author, a child psychiatrist, in a range of international experiences and the strengths and weaknesses of each, highlighting the elements of well-designed and potentially effective programs. [ABSTRACT FROM AUTHOR]

Disruptive behavior during adolescence is linked to severe problems for the youths later in life and poses challenges to the families, schools, and treatment systems these youths meet. This randomized controlled trial was conducted to examine the short- and long-term effectiveness of functional family therapy (FFT) for adolescents aged 11–17 referred for disruptive behavior to Child Welfare Services in Norway. One hundred sixty-one youths (Mage = 14.7, 45.9% female) were randomly assigned to FFT (n = 88) or treatment as usual (TAU, n = 73). Primary outcomes were parent- and teacher-reported youth aggressive behavior, rule-breaking behavior, internalizing problems, and social skills; youth self-reported delinquency (SRD) and negative peer involvement; and teacher-reported academic performance and adaptive functioning. Outcomes were collected before treatment (pretest), 6 months after pretest (posttest), and 18 months after pretest (follow-up). The results showed no intervention effect for FFT compared to TAU between pretest and posttest (p >.05). Significant improvements between pretest and posttest were found for youth receiving both FFT and TAU on parent-reported aggressive and rule-breaking behavior, internalizing problems, and social skills (ranging from d = 0.56 to −0.45) and youth SRD (d = 0.29). Between posttest and follow-up, however, a significant intervention effect in favor of TAU was found for parent-reported youth internalizing (d = 0.27). Significant improvements between posttest and follow-up were also found for youth receiving both FFT and TAU on parent- and teacher-reported aggressive behavior. Findings did not support the hypothesized superiority of FFT over TAU. [ABSTRACT FROM AUTHOR]

Objective: The present study tested the validity and clinical utility of adolescents' reports of two distinct modes of processing during the recall of a suicidal episode in the Suicide Narrative Interview (SNI). Recall Intensity (RI) items were designed to capture a tendency to become immersed in thoughts and feelings during the interview, while Meaning Making (MM) items were designed to assess more distant and reflective processing. Method: The construct and predictive validity of pretreatment MM and RI was tested in a 16-week randomized clinical trial (RCT) for depressed and suicidal adolescents (N = 113, Mage = 14.95, 84.1% female, 51.8% Black/African American). Adolescents rated MM and RI immediately following the SNI during a baseline assessment. Results: Baseline MM was associated with protective factors related to reduced suicidality, and RI was associated with several risk factors for suicidal symptoms. Adolescents who reported high MM and low RI reported greater reductions in both suicidal ideation and depressive symptoms during the RCT. Conclusions: The results support MM and RI as two distinct modes of how adolescents process memories of suicidal episodes and highlight the potential clinical utility of RI and MM in assessing and treating suicidal adolescents. What is the public health significance of this article?: Identifying both risk and protective factors for adolescent suicidality is imperative for effective assessment and treatment. The present study extends prior research by testing the validity of Meaning Making (MM) and Recall Intensity (RI) as two modes of processing while recalling a past suicidal episode. Results support MM as a protective factor and RI as a risk factor and demonstrate that attachment-based family therapy and family-enhanced nondirective supportive therapy were particularly effective in reducing suicidal ideation and depression in teens reporting high MM and low RI at the start of treatment. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Older adults typically receive rehabilitation services following an acute medical event within the context of declining health. Post-acute rehabilitation often serves as a "boiling point" for health needs and is met with numerous shared emotional stressors related to recovery, long-term care, and end-of-life considerations among older patients and their care-partners—referred to together as a dyad. Psychosocial intervention that targets patients and care-partners separately misses the opportunity to support dyads who typically navigate health-related emotional challenges together. In the context of chronic and serious illness, dyadic interventions (i.e., patient and informal care-partner, together) can successfully reduce emotional distress as well as improve communication and collaborative illness management. However, this approach has yet to be applied to older post-acute rehabilitation patients and their care-partners. Research Method/Design: In this commentary, we outline the need for dyadic psychosocial intervention approaches with older adults and their family care-partners in the context of post-acute rehabilitation. Results: First, we provide evidence for the potential benefits of a dyadic approach to psychosocial care. Next, we review theoretical models as well as clinically relevant confounding factors that can inform dyadic psychosocial case conceptualization and intervention. Finally, we offer a real-world clinical case example that demonstrates the opportunity for dyadic intervention to address common psychosocial challenges seen by psychologists in post-acute rehabilitation settings. Conclusions/Implications: Our goal is to encourage rehabilitation psychologists to view dyadic intervention as a first-line approach to psychosocial care with the growing population of older adults and their family care-partners in post-acute rehabilitation settings. Impact and Implications: Older adults receiving postacute rehabilitation care and their care-partners experience shared stressors related to recovery, long-term care, and end-of-life needs that create unique psychosocial challenges among patient–care-partner dyads. Dyadic approaches to psychosocial care are underexplored but could be the optimal approach for addressing psychosocial challenges that arise in postacute rehabilitation settings. [ABSTRACT FROM AUTHOR]

We tested the process of change in Alliance Empowerment Family Therapy (AEFT; Escudero, 2013), a systemic, team-based approach for treating child welfare involved families. Since building and balancing strong personal and within-family therapeutic alliances are crucial for motivating and sustaining change in these multistressed, overburdened families, we assessed alliance perceptions over time in relation to two indices of therapy outcome, youth functioning, and family-specific goal attainment. Specifically, we administered the self-report version of the System for Observing Family Therapy Alliances (Friedlander et al., 2006) following Sessions 3, 6, and 9 to 156 Spanish families seen by 20 therapists in six agencies whose mission is to serve child welfare referred maltreated youth. Results showed that AEFT delivered in M = 11.04 sessions (SD = 3.29) was effective in attaining family-specific goals and improving child functioning, d = 1.16, as rated by the therapist team in coordination with the referring caseworker. A unique aspect of the study was the modeling, at each time point, of the shared therapeutic system alliance, a latent variable consisting of the therapist's rating of the alliance as well as the alliance ratings of the youth and primary caregiver. As we hypothesized, shared alliance perceptions strengthened with time and positively predicted posttreatment outcomes. Moreover, a comparison of linear growth models with and without the therapist's perspective showed that inclusion of the therapist ratings in the shared alliance variables improved the predictability of child and family outcomes. Public Significance Statement: We studied the process and outcomes of Alliance Empowerment Family Therapy (AEFT), a treatment specifically developed for child welfare referred families that emphasizes the therapeutic alliance as the central component of change. As we predicted, the shared alliance perceptions of youth, caregivers and therapists increased in strength over time and positively predicted improved child and family functioning. [ABSTRACT FROM AUTHOR]

Despite increased emphasis on implementation science for empirically supported child mental health treatments, such as parent–child interaction therapy (PCIT), there continues to be limited understanding of optimal training methods and formats to disseminate protocols within community-based settings. The present study examined changes in trainee knowledge, attitudes, perceived competency, and coding skills after completion of an in-person 40-hr PCIT training workshop presented in two formats. Sixty-one mental health providers participated in either a consecutive or split 5-day workshop and completed written and behavioral measures pre- and posttraining. Results showed that trainees in either training format exhibited similar increases in PCIT knowledge, perceived competency, and behavior coding skills even for those with previous PCIT exposure. Trainee attitudes toward evidence-based practice did not change from pre- to posttraining; however, trainees reported high levels of satisfaction and clinical relevance for the workshop regardless of format. These findings validate the effectiveness of a 40-hr PCIT training workshop and support flexibility in training formats, which may reduce barriers and enhance access to evidence-based practice. They also offer insight into areas requiring increased emphasis within PCIT training, such as developing trainee behavior coding and coaching skills. Public Significance Statement: This study found that mental health clinicians who completed a 5-day training workshop, either in one long segment or two shorter segments, had increased knowledge of the treatment protocol, more confidence about using the treatment, and better behavior coding skills even when they had prior knowledge of the treatment. This study supports flexibility in training formats and highlights areas to emphasize in parent–child interaction therapy (PCIT) training. [ABSTRACT FROM AUTHOR]

Introduction: Interprofessional collaborative practice (ICP) is essential for optimizing patient outcomes in health care settings. Experiential learning (EL) is a method of modeling ICP to students during their education. No studies have evaluated the lasting impact of EL on self-reported clinical practice after students graduate. The aims of this study are to (a) examine what opportunities for ICP are available for alumni in current health care settings and (b) explore the early career impact of interprofessional EL on self-reported current clinical practice. Methods: This study utilized a mixed-methods design using descriptive statistics and a phenomenological approach. Participants included Doctor of Physical Therapy (DPT) and Master of Arts in Marriage and Family Therapy (MAMFT) alumni who previously participated as graduate students in Balanced Families (BF), an interprofessional EL program. Sixty-four alumni were contacted through e-mail, of which 17 (27%) agreed to be interviewed. Results: Quantitative data were analyzed utilizing descriptive statistics to describe demographics and summarize Likert scale responses. Qualitative data were analyzed using an interpretative phenomenological analysis approach. Five major themes were reflected in the transcripts: (a) The impact of interprofessional experiential learning on future clinical practice, (b) The value of holistic approaches, (c) The collaboration in holistic care, (d) The interconnected health care system and family system, and (e) The development of empathy for patients and their families. Discussion: Interprofessional EL positively impacted DPT and MAMFT alumni, improving interprofessional communication skills and leading to more holistic approaches to care. Study outcomes support continued implementation of interprofessional EL in health care graduate study programs. [ABSTRACT FROM AUTHOR]

Introduction: A growing recognition of the need for specialized training to prepare health care providers to work in integrated care (IC) settings requires innovative methods to educate learners. There is an opportunity to provide IC trainees with relevant experiential opportunities to practice these techniques using simulation-based learning, a well-established training approach in medical education. Method: This pilot study sought to examine the feasibility of using simulation-based learning in the interprofessional training of Marital and Family Therapy (MFT) and Family Nursing Practitioner (FNP) trainees in relevant integrated care competencies. Participants included 26 learners (21 MFT and five FNP). The case simulation event involved students completing a video telehealth clinical encounter involving a warm handoff. Clinical faculty observed trainees, completed a checklist designed specifically for the event, and provided feedback directly after the event. Results: Trainees reported high satisfaction with the use of simulation-based learning. Observational coding revealed that trainees successfully implemented many elements of a warm handoff, however, aspects involving interprofessional communication, brief intervention, and follow-up planning appeared more challenging. Discussion: Increased utilization of interprofessional case simulation training in masters and doctoral level behavioral health programs could help accelerate the development of a competent integrated care workforce. [ABSTRACT FROM AUTHOR]

Narrative language abilities are foundational to literacy development and are a culturally grounded measure of early literacy for Latino children. This study evaluates the impacts on narrative language abilities and the costs of a 4-week, strengths-based program that leverages two valued sociocultural practices with built-in benefits, personal narratives, and family food routines (e.g., grocery shopping), for improving Latino kindergarteners' learning outcomes in the United States. Two-hundred and 34 children (M age = 67 months; 51% girls; 13 schools) and their parents participated in a cluster randomized trial. Children produced personal narratives at three time points: pretest, end-of-treatment, and 5-month follow-up. Four narrative features were measured: narrative coherence, elaborations, word types, and literate language features. Large positive impacts were observed on all four narrative features at the end-of-treatment posttest (d = 1.21-1.76). There was suggestive evidence of moderate impacts on one narrative feature (i.e., narrative coherence) at the 5-month follow-up (d = .59). The costs required to implement the family program were relatively low. Findings highlight the potential value of implementing this strengths-based program in schools serving Latino kindergarteners using a rigorous evaluation of its effectiveness. [ABSTRACT FROM AUTHOR]

Reviews the documentary film, UNSTUCK: An OCD Kids Movie by Kelly Anderson and Chris Baier (2017). In the film, Anderson and Baier interview six children diagnosed with obsessive-compulsive disorder (OCD), whom they refer to as "kid experts." It provides a new way of educating the public on a psychological disorder that is often casually referenced but frequently misunderstood. With its focus on children and their families, UNSTUCK offers families, educators, therapists, and researchers alike a viewpoint often overlooked in current film and literature regarding OCD: the viewpoints of the children and adolescents themselves. Individuals working in pediatrics or family therapy, thosewith personal or family experience with OCD, and those interested in learning more about the patient-child experience of psychiatric disorders and corresponding impact on family dynamics will be interested in this film. [ABSTRACT FROM AUTHOR]