Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Annual Research Review: Expanding mental health services through novel models of intervention delivery.

Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one-to-one, in-person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health-care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research.

Addressing critical gaps in the treatment of eating disorders.

Remarkable progress has been made in developing psychosocial interventions for eating disorders and other mental disorders. Two priorities in providing treatment consist of addressing the research-practice gap and the treatment gap. The research-practice gap pertains to the dissemination of evidence-based treatments from controlled settings to routine clinical care. Closing the gap between what is known about effective treatment and what is actually provided to patients who receive care is crucial in improving mental health care, particularly for conditions such as eating disorders. The treatment gap pertains to extending treatments in ways that will reach the large number of people in need of clinical care who currently receive nothing. Currently, in the United States (and worldwide), the vast majority of individuals in need of mental health services for eating disorders and other mental health problems do not receive treatment. This article discusses the approaches required to better ensure: (1) that more people who are receiving treatment obtain high-quality, evidence-based care, using such strategies as train-the-trainer, web-centered training, best-buy interventions, electronic support tools, higher-level support and policy; and (2) that a higher proportion of those who are currently underserved receive treatment, using such strategies as task shifting and disruptive innovations, including treatment delivery via telemedicine, the Internet, and mobile apps.

Psychometric properties of the Barriers to Treatment Participation Scale-Expectancies.

Expectations concerning barriers to children's psychosocial care seem to be major drivers when seeking help, but validated questionnaires measuring expectations are not available. Therefore, this study examined the psychometric properties of the parent and adolescent versions of the Barriers to Treatment Participation Scale-Expectancies (BTPS-exp), in terms of consistency, structure, parent-child agreement, and validity. The authors obtained data via questionnaires on 1,382 Dutch children aged 4-18 years (response rate 56.6%) enrolled in psychosocial care, and on 666 children (response rate 70.3%) from the community. Internal consistencies of the BTPS-exp total and subscales of both versions were good (lowest Cronbach's alpha = .85). Fit of the data with the assumed scale structure was acceptable. Correlation coefficients between the parent and adolescent scores were low (Pearson's r total scale = 0.25). Parents expecting multiple barriers was significantly more likely in non-Dutch ethnicity (odds ratio [OR] = 1.4; 95% confidence interval [CI] [1.1, 1.9]), in lower parental educational levels (primary education: OR = 3.0; 95% CI [1.5, 6.1]; lower-level secondary education: OR = 2.0; 95% CI [1.3, 3.1], both vs. university), in single parent families (1.3; 1.1-1.6), in case of child psychosocial problems (OR = 1.3; 95% CI [1.0, 1.5]) and in adolescents with psychosocial problems (OR = 2.1; 95% CI [1.4, 3.1]). Expecting multiple barriers did not affect the association between psychosocial problems and care enrollment. The authors conclude that the BTPS-exp has good psychometric properties regarding reliability and structure and is reasonably valid. Parents and adolescents have their own separate views, implying that it is valuable to assess both. Use of the scale might be helpful in providing direction to improve access to psychosocial care for children and adolescents. (PsycINFO Database Record

Public policy: extending psychology's contributions to national priorities.

OVERVIEW: Much of today's psychological research and practice is relevant to our national health agenda and can serve the public interest. President Obama's landmark health care reform success provides an unprecedented opportunity to revolutionize society's definition of "quality care" and highlight rehabilitation's potential. Advocacy, vision, and a public policy presence with persistence are critical. Those involved often focus exclusively upon specific issues (e.g., reimbursement, research funding, or graduate student support). SUMMARY: By developing a "bigger picture" approach addressing society's real needs and embracing the changes technology will ultimately bring, psychology can have a more lasting impact. There are unlimited opportunities to advance the profession through personal involvement in the public policy arena. It is essential that psychology's next generation receives relevant mentoring.

Guidelines for interactions between clinical faculty and the pharmaceutical industry: one medical school's approach.

A productive and ethical relationship between the pharmaceutical industry and physicians is critical to improving drug discovery and public health. In response to concerns about inappropriate financial relationships between the pharmaceutical industry and physicians, national organizations representing physicians or industry have made recommendations designed to reduce conflicts of interest, legal exposure, and dissemination of biased information. Despite these initiatives, the prescribing practices of physicians may be unduly influenced by the marketing efforts of industry and physicians may inadvertently distribute information that is biased in favor of a commercial entity. Moreover, physicians may be vulnerable to prosecution through federal anti-kickback and false claims statutes because of potentially inappropriate financial relationships with pharmaceutical companies. Since academic medical centers have a critical role in establishing professional standards, the faculty of Yale University School of Medicine developed guidelines for the relationships of faculty with the pharmaceutical industry, which were approved in May 2005. Input from clinical faculty and from representatives of the pharmaceutical industry was utilized in formulating the guidelines. In contrast to existing recommendations, the Yale guidelines, which are presented as an Appendix here, ban faculty from receiving any form of gift, meal, or free drug sample (for personal use) from industry, and set more stringent standards for the disclosure and resolution of financial conflict of interest in Yale's educational programs. The growing opportunities for drug discovery, the need to use medications in a more evidence-based manner, and preservation of the public trust require the highest professional standards of rigor and integrity. These guidelines are offered as part of the strategy to meet this compelling challenge.

Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study.

Discrepancies often exist among different informants' (e.g., parents, children, teachers) ratings of child psychopathology. Informant discrepancies have an impact on the assessment, classification, and treatment of childhood psychopathology. Empirical work has identified informant characteristics that may influence informant discrepancies. Limitations of previous work include inconsistent measurement of informant discrepancies and, perhaps most importantly, the absence of a theoretical framework to guide research. In this article, the authors present a theoretical framework (the Attribution Bias Context Model) to guide research and theory examining informant discrepancies in the clinic setting. Needed directions for future research and theory include theoretically driven attention to conceptualizing informant discrepancies across informant pairs (e.g., parent-teacher, mother-father, parent-child, teacher-child) as well as developing experimental approaches to decrease informant discrepancies in the clinic setting.

Evidence-based assessment for children and adolescents: issues in measurement development and clinical application.

Advances in measurement of child and adolescent social, emotional, and behavioral functioning and clinical disorders have been remarkable and remarkably reviewed in the prior articles. This commentary identifies common themes that emerge from the articles, discusses the proliferation of measures, and raises considerations regarding how one might proceed in developing evidence-based assessment (EBA). Developing EBA might begin by delineating the different purposes of assessment and then, for each purpose, identifying the special requirements and then the criteria for stating when these requirements are met. To illustrate the special requirements of different assessment goals, monitoring of patient progress in treatment is discussed.