Science to Practice: Making What We Know What We Actually Do

The perspective of the medical director of a large public mental health agency is provided regarding how to close the gap between what we know and what we do in mental health care. Tools for change, actions required, and key actors are identified. The author believes the moment is propitious for improving care systemically.     

Emergency Neurological Life Support (ENLS): What to Do in the First Hour of a Neurological Emergency

Emergency Neurological Life Support (ENLS) is a series of protocols, generated by experienced neurocritical care and emergency physicians that describe key steps when managing a patient within the first hours of a neurological emergency. The protocols are designed to help standardize these important early steps for several reasons: (1) patients will likely experience better outcomes, (2) they provide the essential elements to communicate to receiving physicians a patient’s diagnosis and emergency treatment, (3) this approach forms the foundation for eventual consensus on neurological emergency decisions, and (4) this consensus can inform researchers about the important clinical questions that need resolution to enhance patient care. ENLS is online and free to use. Certification and training in ENLS is hosted by the Neurocritical Care Society. This document introduces the concept of ENLS, reviews the history of its creation, and enumerates future goals as ENLS becomes adopted more widely.     

Family Relations and Psychopathology: Examining Depressive and Bulimic Symptomatology

Despite early theories suggesting that family dysfunction (FD) may cause disordered eating, FD has been linked with other disorders and is a non-specific risk factor for disordered eating. We examined one potential model of the way FD relates to disordered eating, drawing on research that identified depression as a risk factor for bulimia. We examined whether depression symptoms (DEPs) partially mediated the relationship between family cohesion (as a measure of FD) and bulimic symptoms (BNs) using a sample of 215 never-married college women under age 20. Perceptions that one’s family was less cohesive (or more disengaged) was associated with increased DEPs and BNs. Moreover, DEPs partially mediated the influence of cohesion on BNs through a significant indirect effect. Both family systems in general and treatment of mood difficulties may be important considerations in the prevention of disordered eating, and prevention efforts that include family relationships should be experimentally explored.     

The Competencies of Telehealth Peer Support: Perceptions of Peer Support Specialists and Supervisors During the COVID-19 Pandemic

Community Mental Health Journal - This report assesses the competencies and technology needed for the provision of Telehealth Peer Support by Peer Support Specialists . The online survey assessed...     

The Psychotherapeutic Service Delivery System

We can understand the relevance of psychotherapy research for clinical practice only by considering the broader context of the psychotherapy service delivery system. Epidemiologic studies of the incidence and prevalence of emotional disturbance provide estimates of the need for services; surveys of providers and their practice patterns yield estimates of available resources to meet those needs; and studies of patient characteristics and patterns of psychotherapy utilization identify the constituencies served by the psychotherapy delivery system. From these data we know that each person in need of mental health services has available no more than an average of three treatment sessions from a mental health professional in any given year. Despite the fact that a small proportion of such individuals actually seek service, each such individual who consults the speciality mental health sector has available no more than an average of 10 treatment sessions. The most needy, particularly those lacking in education, are least likely to receive treatment in the psychotherapeutic service delivery system. Further, we argue for a clearer focus on service episodes and psychotherapy utilization through the tracking of the mental health “careers” of patients.     

Parenting Strategies to Deal with Children’s Anxiety: Do Parents Do What They Say They Do?

Parents’ perceptions about their strategies to deal with children’s anxiety have been minimally explored. Based on a mixed-method approach, the current study compared the strategies that parents said they use more frequently to deal with their child’s anxious behaviors and the strategies they actually used during two mildly anxiogenic interactions with their child. Forty-two parents of children with anxiety disorders, aged 9–12 years, participated in the study. Semi-structured interviews were administered to identify parental perceptions about their strategies to deal with their children’s anxiety. Subsequently dyadic interactions were observed and coded by two independent coders. We found discrepancies relating to four strategies. Significantly more parents used strategies based on overinvolvement and anxious behavior during the interactions than had been reported by them in the interviews. In contrast, reassurance and reinforcement of avoidance/dependence were used in interactions by fewer parents than would be expected, according to the interviews. Relevant implications for assessment and intervention with families of anxious children are suggested.