Socialstyrelsen menar att primärvården står inför en utmaning att tillgodose tillgänglig psykologisk behandling till ett växande behov. Ett möjligt tillvägagångssätt skulle kunna vara Integrerad beteendehälsa som eftersträvar att kunna erbjuda korta psykologiska interventioner med hög tillgänglighet. Syftet med föreliggande studie var att jämföra två varianter av Integrerad beteendehälsa; ett sedvanligt upplägg med Brief Interventions och ett upplägg med utökad bedömning och möjligheten till vägledd självhjälp för ett specifikt problem. Det här med avseende på generella symtom och symtom specifika för just det problem som patienter erhållit självhjälp för, alternativt bedömts skulle ha passat för självhjälp avseende ett specifikt problem. Resultaten visade att den generella symtomnivån förbättrades för gruppen som helhet, samt inom respektive grupp. Den problemspecifika symtomnivån sjönk för både patienter som erhållit vägledd självhjälp och för patienter som erhållit Brief Interventions men vars problemprofil visat att de hade passat för en specifik självhjälpsmanual. Någon signifikant skillnad i symtomförändring, oavsett generell eller problemspecifik, kunde inte hittas. I diskussionen problematiseras bland annat den interna validiteten och den naturalistiska miljön lyfts som en styrka. / The national board of health and wellfare are stating that primary care faces a major challenge in providing available psychological treatment to an increasing need. One possible approach is Integrated Behavioral Health, which strives towards offering brief psychological interventions with great access. The purpose of the following study was to compare two different methods of Integrated Behavioral Health; an ordinary set up with Brief Interventions and one set up with extended assesment and the possibility of guided self-help treatment for a particular problem. This regarding general as well as specific symptoms for the particular problem the patient has received guided self-help for, or considered to have been suited for. The results showed that the general level of symptoms improved for all patients, merged into one group, and within the respective group. The level of the problem-specific symptom decreased for patients who received guided self-help and for patients who received Brief Interventions, but whose problem profile showed that they had fit for a specific self-help manual. No significant difference in symptom change, regardless of general or problem- specific, could be found. In the discussion, the internal validity is discussed, and the naturalistic environment is described as a strength.

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<p> Growing media attention and a high diagnosis rate of autism places significant demand on the service industry to provide qualified staff to work with individuals who have autism. Discrete trial instruction (DTI) is one of the most sought-after treatment approaches for those individuals. However, there is a gap in research regarding the efficacy of training methods for those who train direct staff to implement DTI. This quantitative study used an applied behavior analysis basis, deriving from foundations of behavior theory, to compare the abbreviated feedback form (AFF) to the lecture test model (LTM) to understand which will improve direct staff's ability to implement DTI more efficiently from baseline. The AFF provided for trainees a list of skills to implement tasks that have multiple steps. The LTM provided trainees a lecture of skills to understand basic applied behavior analysis, autism, and DTI. Four participating staff's baseline and training data were analyzed by comparing their scores to the set criterion from the AFF. The data were analyzed by both the program supervisor and the researcher, with inter-observer agreement reached. Using a single-subject, AB design, data demonstrated that staff who were trained using the AFF had significant improvement from baseline, compared to staff trained using the LTM. Supervisors who use the AFF to more efficiently and rapidly train staff may decrease the time gap between service recommendation and implementation, making needed treatment more readily available and efficacious to children diagnosed with autism. Improvements in staff skill set will likely have a direct correlation on the improvements and long term outcomes for those being treated.</p>

In a study using 73 females and 30 male undergraduates, information on the basic dimensions of Millon's eight personality styles was obtained from correlations of the Millon Behavioral Health Inventory with Rotter's I-E scale and Byrne's R-S scale. Hypotheses predicting a significant relationship between the active-passive and repression-sensitization were generally supported. Predictions of a significant relationship between the dependent-indepenent dimension and generalized expectancy of locus of control were not supported. Implications of these findings for the efficacy of Millon's system are discussed, along with future research possibilities.

The pediatric primary care setting has been discussed as playing a central role for the identification and treatment of behavioral and mental health disorders in youth. Although this setting is in a unique position to provide these services, there are many barriers to the integration of mental health care and pediatric primary care. The aim of this study is to examine perspectives of multiple stakeholders (i.e., patient, parent, nurse, resident, faculty, clinic director) in a pediatric primary care setting to explore barriers, behavioral and mental health needs, and facilitators to the integration and provision of mental health care for children and families in pediatric primary care. The study involved both focus group and individual interviews with a total of 36 stakeholders (patient n = 2; parent n = 7; nurse n = 4; resident n = 16; faculty n = 5; clinic director n = 2). A grounded theory approach was used to analyze the focus group and interview data. Barriers to integration and consequences of these barriers are presented, as well as facilitators identified by stakeholders to overcome these obstacles. Identified behavioral and mental health needs will also be presented. Limitations of the study and future directions are discussed.

Direct-care workers can provide an array of service types to children, adolescents, and their families in behavioral health treatment. They may also work in a variety of settings (e.g., group homes, inpatient units/hospitals, residential treatment, treatment foster care, day treatment, in-home treatment, etc.). Direct-care workers typically are involved in the supervision of youth and in the implementation of a treatment plan developed by the youth’s treatment team. For youth who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) and are receiving behavioral health services, such workers form a critical part of their therapeutic experience. However, little is known about these workers’ competencies related to working with LGBTQ youth. This study begins to fill that gap by developing and testing a measure that assessed LGBTQ cultural competencies related to behavioral health practice with youth and a measure that was relevant to the roles and responsibilities of direct-care (e.g., paraprofessional, front-line) workers. In order for direct-care workers to use LGBTQ cultural competency in their practice, more understanding is needed about their current level of LGBTQ-related cultural competency. The LGBTQ Youth Cultural Competency scale (abbreviated as LGBTQY-CC) provides a means to measure those competencies. An exploratory factor analysis found that the new scale consists of one primary factor which represents knowledge, attitudes, skill, and awareness of LGBTQ cultural competency. Cronbach’s alpha, correlations with other measures for concurrent validity, and correlation with a measure of social desirability all resulted in evidence that the LGBTQY-CC has good validity. Analyses examined how the new measure was related to constructs associated with training and competency in direct-care workers. Multiple regression analyses showed that higher levels of LGBTQ cultural competency (as measured by the LGBTQY-CC) were significantly related to age (younger), political ideology (more liberal), more social contact with LGBTQ individuals, and degree of religious belief about LGBTQ being a sin. A model including these factors explained 60% of the variance in LGBTQY-CC scores. The LGBTQY-CC was created with the long-term goal of creating training interventions for direct-care workers to improve their practice with LGBTQ youth. The measure could be used to assess training participants’ knowledge, attitudes, skills, and awareness and to evaluate the effectiveness of varying types and styles of training programs. Federal and state regulatory bodies have begun to require service providers to identify how they will address disparities faced by LGBTQ individuals, so service providers need to demonstrate how they are improving access to and quality of care for LGBTQ individuals. Therefore, the LGBTQY-CC may provide a means to gather data on efforts made by service providers to improve their behavioral health workforce’s capacity to serve LGBTQ youth.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration–funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

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