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Standardized training and credentialing is increasingly important to states and healthcare systems. Workforce shortages in children's mental health can be addressed through training and credentialing of professional peer parents (called family peer advocates or FPAs), who deliver a range of services to caregivers. A theory-based training program for FPAs targeting skills and knowledge about childhood mental health services (Parent Empowerment Program, or PEP) was developed through a partnership among a statewide family-run organization, state policy leaders, and academic researchers. Prior studies by this team using highly-experienced family peer advocates (who were also co-developers of the training program) as trainers found improvements in knowledge about mental health services and self-efficacy. In 2010, to meet demands and scale the model, a training of trainers (TOT) model was developed to build a cohort of locally-trained FPAs to deliver PEP training. A pre/post design was used to evaluate the impact of TOT model on knowledge and self-efficacy among 318 FPAs across the state. Participants showed significant pre-post (6 month) changes in knowledge about mental health services and self-efficacy. There were no significant associations between any FPA demographic characteristics and their knowledge or self-efficacy scores. A theory-based training model for professional peer parents working in the children's mental health system can be taught to local FPAs, and it improves knowledge about the mental health system and self-efficacy. Studies that evaluate the effectiveness of different training modalities are critical to ensure that high-quality trainings are maintained. [ABSTRACT FROM AUTHOR]

To systematically review experimental evidence regarding animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000–2015, and compared studies by animal type, intervention, and outcomes. Studies were included if used therapeutically for children and adolescents (≤21 years) with or at risk for a mental health problem; used random assignment or a waitlist comparison/control group; and included child-specific outcome data. Of 1,535 studies, 24 met inclusion criteria. Of 24 studies identified, almost half were randomized controlled trials, with 9 of 11 published in the past two years. The largest group addresses equine therapies for autism. Findings are generally promising for positive effects associated with equine therapies for autism and canine therapies for childhood trauma. The AAT research base is slim; a more focused research agenda is outlined. [ABSTRACT FROM PUBLISHER]

The American Psychological Association Task Force on Evidence-Based Practice for Children and Adolescents (2008) recommended a systems approach to enhancing care in order to improve outcomes for children and adolescents with mental health needs and redress persistent systemic problems with the structure of services. Recommendations for enhancing an ecological approach to the adoption and implementation of evidence-based practices are offered through increased attention to practice-based research frameworks for adoption and dissemination. Five criteria are discussed for providing acceptable evidence, including (a) systematic evidence searching and adoption of evidence-based prevention and intervention practices, (b) implementation and adherence to intervention integrity, (c) invoking standards for drawing inferences from interventions, (d) using quality assessments to measure outcomes, and (e) adopting formal data analysis procedures to assess intervention outcomes. Each criterion is illustrated with an example. Future research and policy agendas are outlined. [ABSTRACT FROM AUTHOR]

There is growing evidence that mental health and school functioning for children are intertwined. This article summarizes historical perspectives on U.S. child mental health policies and their interface with education and discusses trends in educational policy relevant to children's mental health, specifically the Individuals With Disabilities Education Act and No Child Left Behind. The traditional approach of mental health research in schools, which focuses on program and intervention development, has become stagnant. New paradigms are needed. These include attending to indigenous school resources, to the organizational context of learning, and to participatory models for constructing environments conducive to mental health promotion and learning. Persistent underfunding and fragmented fiscal support, however, render new approaches meaningless. If progress is to be made, new funding structures to support integrative educational and mental health practices are needed. [ABSTRACT FROM AUTHOR]

The article reports on the diverse nature of state-level evidence-based practice (EBP) implementation efforts and presents opportunities and future directions for research and policy in the U.S. states. It states that use of EBP to treat mental health problems in children and adolescents has hardly been a panacea. Implementation issues continue to confound providers and policymakers alike, and the evidence-base itself continues to be at an extremely preliminary stage. Nonetheless, the focus on EBP has generated optimism and provided clinicians with a useful heuristic with which to resolve specific questions.

The article describes a unique association of states in the U.S. that are investigating how administrators and stakeholders should create public policy through their statewide evidence-based practice implementation efforts for children and adolescents. The section presents background on such issue, significant theory and research, and descriptions of approaches followed by six of these U.S. states. It also provides a synthesis of these state approaches, including recommendations for state policy, federal policy, and future research.

A systematic review was undertaken of scientifically rigorous studies of family-based services in children's health and mental health. From a pool of over 4000 articles since 1980 in health and mental health that examined either specific family-based interventions for families of children or the processes of involvement, 41 studies were identified that met the methodological criteria for inclusion. These 41 studies encompassed 3 distinct categories: families as recipients of interventions (e.g., family education, support, engagement, empowerment); (b) families as co-therapists; and (c) studies of the processes of involvement (e.g., therapeutic alliance, engagement, empowerment, expectancies, and choice). Too few experimental studies exist to conclude decisively that family-based services improve youth clinical outcomes. However, those studies that have been rigorously examined demonstrate unequivocal improvements in other types of outcomes, such as retention in services, knowledge about mental health issues, self-efficacy, and improved family interactions – all outcomes that are essential ingredients of quality care. Four implications are drawn from this review. (1) Effective family education and support interventions from studies of adults with mental illnesses and from studies of families of high-risk infants exist and can be imported into the field of children's mental health. (2) The range of outcomes that are typically assessed in clinical treatment studies is too narrow to afford an adequate view of the impact of family-based interventions. A broader view of outcomes is needed. (3) The absence of a robust literature on process variables other than therapeutic alliance limits conclusions about how and why interventions are effective. Attention to the processes by which families become involved in services will require a more robust and nuanced range of studies that attend simultaneously to processes of change and to outcome improvement. (4) Linkage of effective family-based interventions to delivery of evidence-based services is likely to amplify the impact of those services and improve outcomes for youth and families. [ABSTRACT FROM AUTHOR]

BACKGROUND. Attention-deficit/hyperactivity disorder, the most common childhood behavioral condition, is one that pediatricians think they should identify and treat/manage. OBJECTIVE. Our goals were to explore the relationships between pediatricians' selfreports of their practice behaviors concerning usually inquiring about and treating/ managing attention-deficit/hyperactivity disorder and (1) attitudes regarding perceived responsibility for attention-deficit/hyperactivity disorder and (2) personal and practice characteristics. METHODS. We analyzed data from the 59th Periodic Survey of the American Academy of Pediatrics for the 447 respondents who practice exclusively in general pediatrics. Bivariate and logistic regression analyses were used to identify attitudes and personal and practice characteristics associated with usually identifying and treating/managing attention-deficit/hyperactivity disorder. RESULTS. A total of 67% reported that they usually inquire about and 65% reported that they usually treat/manage attention-deficit/hyperactivity disorder. Factors positively associated with usually inquiring about attention-deficit/hyperactivity disorder in adjusted multivariable analyses include perceived high prevalence among current patients, attendance at a lecture/conference on child mental health in the past 2 years, having patients who are assigned or can select a specific pediatrician, practicing in suburban communities, practicing for ⩾10 years, and being female. Pediatricians' attitudes about responsibility for identification of attention-deficit/hyperactivity disorder were not associated with usually inquiring about attention-deficit/hyperactivity disorder in either unadjusted or adjusted analyses. Attitudes about treating/managing attention-deficit/hyperactivity disorder were significantly associated with usually treating/managing attention-deflcit/ hyperactivity disorder in unadjusted and adjusted analyses. Those who perceived that pediatricians should be responsible for treating/managing had almost 12 times the odds of reporting treating/managing attention-deficit/hyperactivity disorder, whereas those who believe physicians should refer had threefold decreased odds of treating/managing. Other physician/practice characteristics significantly associated with the odds of usually treating/managing attention-deflcit/ hyperactivity disorder include belief that attention-deficit/hyperactivity disorder is very prevalent among current patients, seeing patients who are assigned or can select a specific pediatrician, and practice location. CONCLUSIONS. Taking responsibility for treating attention-deficit/hyperactivity disorder and practice characteristics seem to he important correlates of pediatrician self-reported behavior toward caring for children with attention-deficit/ hyperactivity disorder. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression. METHODS. A cross-sectional survey was mailed to a random sample of 1600 of the 50 818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members. The 662 fellow nontrainee members who engaged in direct patient care and completed information on identifying, referring, and treating maternal depression were included in the analyses. RESULTS. A total of 511 of 662 respondents reported identifying maternal depression; of those who reported identifying maternal depression, 421 indicated they referred and 29 that they treated maternal depression in their practices. Pediatricians who are older, work in practices that provide child mental health services, see primarily (≥75 %) white patients, use ≥ 1 method to address maternal depression, agree that pediatricians should be responsible for identifying maternal depression, think that maternal depression has an extreme effect on children's mental health, and are attitudinally more inclined to identify or manage maternal depression had significantly higher odds of reporting identification of maternal depression. Positive correlates of identification and management of maternal depression included practicing in the Midwest, using ≥1 method to address maternal depression, working in a practice that provides child mental health services, thinking that caregiving problems attributable to maternal health have an extreme effect on children's physical health, having attitudes that are more inclined to identify and to manage maternal depression, and usually inquiring about symptoms routinely to identify maternal depression. CONCLUSIONS. Pediatricians' practice characteristics and attitudes are associated with their identification and management of mothers with depression. [ABSTRACT FROM AUTHOR]