Hero/heroine modeling for Puerto Rican adolescents: A preventive mental health intervention.

Culturally sensitive treatments of the special mental health needs of high-risk Puerto Rican adolescents are lacking. The hero/heroine intervention was based on adult Puerto Rican role models to foster ethnic identity, self-concept, and adaptive coping behavior. 90 nonclinical Puerto Rican 8th and 9th graders were screened for presenting behavior problems in school and randomly assigned to an intervention and a control group. After 19 sessions, the intervention significantly increased adolescents' ethnic identity and self-concept and reduced anxiety. Treatment outcomes varied as a function of grade level, sex, and household composition. Self-concept was negatively affected among girls from intact families. The study supports the effectiveness of the culturally sensitive modality as a preventive mental health intervention for high-risk Puerto Rican adolescents, especially from single-parent families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in mental health services for children and adolescents

Existing system of psychiatric care for children and adolescents is in need of basic reorganization. The authors propose: 1) reestablishment of the speciality of children's and adolescent psychiatrist, a specialist in children's and adolescent narcology, a psychiatrist of early child's age and a pediatric medical psychologist; 2) carrying out the reform of child mental care equal in rights with general psychiatry; 3) preservation and widening of both specialized inpatient and outpatient clinics in general system of child's mental care; 4) legislative and public rehabilitation of children's psychiatry, which suffered considerably from antipsychiatric campaign; 5) professionally organized systematic elevation of psychohygienic, psychiatric and psychotherapeutic knowledges of allied medical and other specialists as well as of parents and of all population too; 6) integration and interaction of govermental services concerning mental health of children and adolescent; 7) organization of regional psychoprophylaxic interdisciplinary centers for children and adolescent.     

A meta-analytic review of depression prevention programs for children and adolescents: Factors that predict magnitude of intervention effects.

In this meta-analytic review, the authors summarized the effects of depression prevention programs for youth as well as investigated participant, intervention, provider, and research design features associated with larger effects. They identified 47 trials that evaluated 32 prevention programs, producing 60 intervention effect sizes. The average effect for depressive symptoms from pre-to-posttreatment (r = .15) and pretreatment to-follow-up (r = .11) were small, but 13 (41%) prevention programs produced significant reductions in depressive symptoms and 4 (13%) produced significant reductions in risk for future depressive disorder onset relative to control groups. Larger effects emerged for programs targeting high-risk individuals, samples with more females, samples with older adolescents, programs with a shorter duration and with homework assignments, and programs delivered by professional interventionists. Intervention content (e.g., a focus on problem-solving training or reducing negative cognitions) and design features (e.g., use of random assignment and structured interviews) were unrelated to effect sizes. Results suggest that depression prevention efforts produce a higher yield if they incorporate factors associated with larger intervention effects (e.g., selective programs with a shorter duration that include homework). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A brief image-based prevention intervention for adolescents.

The authors evaluated the efficacy of a brief image-based prevention intervention and assessed current drug use as a moderator of intervention effects. In a clinical trial, 416 high school-age adolescents were randomized to either the brief intervention or usual care control, with data collected at baseline and 3-month follow-up. The brief intervention consisted of a tailored in-person communication and a series of parent/guardian print materials based on the behavior–image model. Health behavior goal setting increased for participants receiving the brief intervention, with an effect size in the small range (d = 0.33). Overall effect sizes for cigarette smoking frequency and quantity and alcohol use frequency and quantity were small (ds = 0.16–0.21) and in favor of the brief intervention. However, adolescents reporting current substance use who received the brief intervention reduced their frequency and heavy use of alcohol, frequency and quantity of cigarette smoking, and reported fewer alcohol/drug problems, with larger effects ranging from small to approaching medium in size (ds = 0.32–0.43, ps     

Immediate family crisis intervention as preventive mental health: The family consultant service.

The service employs mental health personnel who work closely with the police in order to respond immediately to family-related crises. This paper reports a preliminary evaluation of the program with respect to 5 issues: (a) whether the program is redundant with existing community services, (b) the advantages of early intervention approaches, (c) whether the program is a preventative service to any degree, (d) the evaluation of the program by the police and social agencies, and (e) whether cooperation between mental health and law enforcement professionals is enhanced. Available data collected over a 2-yr period concerning these 5 issues indicated the success of the program. It is concluded that it can serve as a model for community prevention approaches to family crises and mental health problems. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents.

A cluster, stratified randomized design was used to evaluate the impact of universal, indicated, and combined universal plus indicated cognitive- behavioral approaches to the prevention of depression among 13- to 15-year-olds initially reporting elevated symptoms of depression. None of the intervention approaches differed significantly from a no-intervention condition or from each other on changes in depressive symptoms, anxiety, externalizing problems, coping skills, and social adjustment. All high-symptom students, irrespective of condition, showed a significant decline in depressive symptoms and improvement in emotional well-being over time although they still demonstrated elevated levels of psychopathology compared with the general population of peers at 12-month follow-up. There were also no significant intervention effects for the universal intervention in comparison with no intervention for the total sample of students in those conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A public mental health approach to the postdisaster treatment of children and adolescents

This article describes the implementation of mental health intervention programs for children, adolescents,and their families exposed to natural disaster and violence. Recommendations are made regarding needed levels of organization, methods of screening and triage, training and supervision of mental health staff, design and implementation of treatment approaches, and longitudinal monitoring of course of recovery and intervention outcome.     

Understanding the mental health needs of children and adolescents in residential treatment.

With the penetration of managed care approaches in child welfare, residential treatment services have come under increased scrutiny. In these circumstances it is critical to understand the clinically indicated use of these expensive interventions. As part of a community-reinvestment strategy of reform within a state child welfare agency, a needs-based assessment of children and adolescents was undertaken. A review of cases revealed that although the level of mental health need for many was significant, a substantial proportion of children in residential placement were not at high levels of risk. On the basis of these data, a process of placement review was designed and implemented for more effective use of residential treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The fickle fates of push and pull in the dissemination of mental health programs for children.

As the demand for evidence-based programs has increased, considerable research has concentrated on the development and testing of innovative and promising prevention and treatment programs. However, a knowledge gap remains between research in children's mental health and the educational and health services providers who could use the programs produced. In contrast to the elaborate national system set up for monitoring and disseminating medications, the infrastructures to support the evaluation and dissemination of prevention and treatment programs targeting children's mental health have only begun to be developed. Based on my experiences in a community-based research project that has worked for the last decade to develop and evaluate the WITS (Walk away, Ignore, Talk it out, and Seek help) programs for the prevention of peer victimization, I illuminate obstacles to the dissemination of evidence-based prevention programs for children and solutions that are beginning to address these obstacles. In particular, I argue that enduring, integrated community, provincial and federal infrastructures are needed to improve program dissemination and to monitor their effects on children's well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A music-based HIV prevention intervention for urban adolescents.

Objective: This research examines the process of conducting and evaluating a music-based HIV prevention intervention among urban adolescents, and is informed by the information, motivation, behavioral skills (IMB) model. Design: Musically talented opinion leaders were recruited to write, record, and distribute HIV prevention themed music to their peers to increase HIV prevention motivation, behavioral skills, and behaviors. In this 3-month field experiment, participants were 306 students enrolled in health classes at each of three large multiracial urban high schools (one treatment school; two control schools). Main Outcome Measures: Measures of HIV prevention information, motivation, behavioral skills, and behaviors, both pre- and postintervention. Results and Conclusion: Results indicate that the intervention influenced several aspects of HIV prevention motivation, behavioral skills, and condom use and HIV testing behaviors. This research demonstrates that the incorporation of music into HIV prevention interventions for adolescents has the potential to be effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consumer-professional collaboration for evaluation in neighborhood mental health programs

Neighborhood mental health programs are challenged with the scientific and fiscal necessity of evaluating their services. Since most such programs are joint endeavors of neighborhood residents (usually a consumer board) and nonneighborhood professionals, such evaluative efforts require the sanction and collaboration of both groups to be maximally effective. However, the authors point out that collaboration is often strained by lack of trust and conflicts of interest. Study design may fail to consider neighborhood values, with the result that the provision of services is impeded, consumers are frightened or coerced, the role of paraprofessionals is threatened, and the consumer board's responsibilities to the neighborhood are ignored. The authors discuss those four issues and suggest ways of resolving them.     

Experimental evaluation of mental health programs.

The purpose of this paper was twofold: to illustrate the application of classical research methodology to an examination of problems in a social environment, specifically the mental health field; and, to point to some of the strengths and weaknesses of this approach. A quasi-experimental design and its application to the study of effects resulting from an introduction of a comprehensive psychiatric center into a region of Saskatchewan not previously so served was presented. The definition of relevant criterion variables and appropriate controls in this context was discussed. Preliminary results of the study were considered, with attention given to such parameters as change in incidence of psychiatric case-load and changes in admission rate. Positive features of this type of design in terms of its utility for specifying variables in specific problem areas, and limitations in terms of the need for some additional more broadly based research strategy, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a cognitive-behavioral intervention for adolescents.

The aim of this study was to evaluate the effect of a cognitive- behavioral, biofeedback-assisted intervention to impart skills for coping with stressful encounters in a nonclinical adolescent population. Israeli Arab and Israeli Jewish participants completed pre- and postintervention questionnaires assessing state anxiety, test anxiety, behavior symptoms, hostility, and self-esteem. Electrodermal activity was recorded using biofeedback. From pre- to postintervention, scores of state anxiety, test anxiety, behavior symptoms, and self-esteem, but not hostility, changed significantly in the intervention group as compared with the control group. A significant Group × School effect was evident for state and test anxiety and behavior problems, indicative of higher reductions in the Arab group. The cognitive-behavioral program proved an effective preventive intervention for adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of mental health service effectiveness: a "start up" model for established programs

The ventral pedal gland in the foot of the mature female whelk Buccinum undatum L. consists of a shallow pouch containing a layer of elongated cells which partially penetrate a basement membrane overlying layers of smooth muscle. This glandular epithelium contains acid mucopolysaccharide cells, ciliated and interstitial cells as well as the upper part of a new type of subepidermal gland cell. These gland cells consist of an elongated extracellular tubular duct formed by an invagination of the cell membrane and lined by numerous microvilli. Into this duct are discharged packets of a densely staining secretion. The secretion packets are produced in Golgi regions around the nuclei of the cells and are passed up through the cell to the base of the duct through or along an extensive assemblage of microtubules. The secretion packets show organized internal structure and may contain aromatic aldehydes and protein associated with the sclerotization of the egg capsules, which pass through the gland after leaving the genital tract.     

A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work.

This meta-analytic review summarizes obesity prevention programs and their effects and investigates participant, intervention, delivery, and design features associated with larger effects. A literature search identified 64 prevention programs seeking to produce weight gain prevention effects, of which 21% produced significant prevention effects that were typically pre- to post effects. Larger effects emerged for programs that targeted children and adolescents (vs. preadolescents) and females, programs that were relatively brief, programs that solely targeted weight control versus other health behaviors (e.g., smoking), programs evaluated in pilot trials, and programs wherein participants must have self-selected into the intervention. Other factors, including mandated improvements in diet and exercise, sedentary behavior reduction, delivery by trained interventionists, and parental involvement, were not associated with significantly larger effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A framework for health promotion and disease prevention programs.

There is a disquieting sense that many theoretically based health behavior change programs have been only minimally effective. Part of the problem may be that most current theories have considerable overlap, primarily focus on intraindividual and other individual-level variables, and tend to neglect the environment and issues related to program implementation. A framework is developed for health promotion and disease prevention programs that makes use of epidemiological and health indicator data and Healthy People 2000 goals to prioritize efforts, provides a schema to formulate programs on the basis of timing (prevention) and level of intervention, and addresses the marketing approach to target and implement programs. The framework integrates current theories to guide marketing and phases of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why changing the YOA does not impact youth crime: Developing effective prevention programs for children and adolescents.

Discusses the Young Offenders Act (YOA), which was legislated in Canada in 1982. Following consistent messages from politicians, police and the media that the perceived rise in youth crime and violence can be attributed to the YOA, the act has been amended 3 times. While the authors applaud efforts to reduce youth crime and to build safer communities, they believe that the focus on legislative solutions has been misguided and has placed the emphasis on increasing the severity of consequences to crime rather than on solutions aimed at preventing the development of criminal behaviors and changing persistent offending patterns. It is argued that freedom from poverty and violence must form an integral part of any strategy to prevent crime and victimization. A series of dovetailed interventions across successive states of development will support children by minimizing risks and maximizing protection within their primary social setting. An example of such an approach has been published by the National Crime Prevention Council (1996 and 1997). The current authors worked with the Council to research and develop prevention models that delineate goals and means of achieving key objectives for children prenatal to age 6 yrs and children aged 6–12 yrs. Models of prevention programs for both age groups are presented and described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluations of organizational effectiveness in mental health programs

We present a conceptual framework derived from organizational theory for understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed "successful" by their constituents when they conform to institutional demands and expectations that are both internally and externally generated. We empirically assess institutional conformity by examining evaluations of effectiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by targeting services to those considered most in need: clients with severe mental illnesses. The formal structure and program philosophy of these programs clearly reflected this emphasis; consequently, levels of goal incongruence were low and evaluations of effectiveness were high. Generalist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychotherapy), and exhibited higher levels of goal incongruence; these factors resulted in lower evaluations of effectiveness. This research is important because it demonstrates that organizational processes of institutional conformity (program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness. With the current institutional demand for effective, efficient services, it is critical that researchers have a conceptual framework for analyzing those factors which influence evaluations of effectiveness.