RESUMEN
Adolescents with callous unemotional (CU) traits are at risk for poor quality-of-life outcomes such as incarceration, suicide, and psychopathy. It is currently unknown which treatments are implemented with CU adolescents specifically and which elements make up these interventions. A narrative systematic review was used to identify the treatments and common elements used with CU adolescents (12-18 years). Eligible studies were randomized controlled trials and quasi-experimental studies evaluating psychosocial interventions, delivered within a clinical context, and directed towards the adolescent or their family. Eight studies with 1291 participants were included. Significant decreases in CU traits were demonstrated only in a minority of studies. The most utilized practice elements were set goals for treatment, practice interpersonal/communication skills, prepare for termination, and teach parents skills and strategies; the most utilized process elements were formal therapy, practice exercises, important others, and flexible/adaptive. A majority of the studies did not report an implementation element. While theoretical frameworks for CU children are employed with CU adolescents, there is still uncertainty regarding their suitability for this age group. Given the limited empirical evidence, there is a critical need for further exploration.
RESUMEN
BACKGROUND: Depression is one of the most common mental health problems among adults, but effective treatments are not widely accessible. The Internet holds promise as a cost-effective and convenient delivery platform of interventions for depression. However, studies suggest that Internet interventions are not widely available in routine settings. OBJECTIVE: The aim of this study was to review the literature and examine whether there are systematic differences in reporting of the various implementation components on Internet interventions for depression, and then to examine what is known about and is characteristic of the implementation of these Internet interventions in regular care settings. METHODS: We performed a scoping review, drawing upon a broad range of the literature on Internet interventions for depression in regular care, and used the active implementation framework to extract data. RESULTS: Overall, the results suggested that knowledge about the implementation of Internet interventions for depression in regular care is limited. However, guided support from health professionals emphasizing program adherence and recruitment of end users to the interventions emerged as 2 main themes. We identified 3 additional themes among practitioners, including their qualifications, training, and supervision, but these were scarcely described in the literature. The competency drivers (ie, staff and user selection, training, and supervision) have received the most attention, while little attention has been given to organizational (ie, decision support, administration, and system intervention) and leadership drivers. CONCLUSIONS: Research has placed little emphasis on reporting on the implementation of interventions in practice. Leadership and organizational drivers, in particular, have been largely neglected. The results of this scoping review have implications for future research and efforts to successfully implement Internet interventions for depression in regular care.
