Three-Month Psychiatric Outcome of Pediatric Mild Traumatic Brain Injury: A Controlled Study.

The objective was to clarify occurrence, phenomenology, and risk factors for novel psychiatric disorder (NPD) in the first 3 months after mild traumatic brain injury (mTBI) and orthopedic injury (OI). Children aged 8-15 years with mTBI (n = 220) and with OI but no TBI (n = 110) from consecutive admissions to an emergency department were followed prospectively at baseline and 3 months post-injury with semi-structured psychiatric interviews to document the number of NPDs that developed in each participant. Pre-injury child variables (adaptive, cognitive, and academic function, and psychiatric disorder), pre-injury family variables (socioeconomic status, family psychiatric history, and family function), and injury severity were assessed and analyzed as potential confounders and predictors of NPD. NPD occurred at a significantly higher frequency in children with mTBI versus OI in analyses unadjusted (mean ratio [MR] 3.647, 95% confidence interval [CI95] (1.264, 15.405), p = 0.014) and adjusted (MR = 3.724, CI95 (1.264, 15.945), p = 0.015) for potential confounders. In multi-predictor analyses, the factors besides mTBI that were significantly associated with higher NPD frequency after adjustment for each other were pre-injury lifetime psychiatric disorder [MR = 2.284, CI95 (1.026, 5.305), p = 0.043]; high versus low family psychiatric history [MR = 2.748, CI95 (1.201, 6.839), p = 0.016], and worse socio-economic status [MR = 0.618 per additional unit, CI95 (0.383, 0.973), p = 0.037]. These findings demonstrate that mild injury to the brain compared with an OI had a significantly greater deleterious effect on psychiatric outcome in the first 3 months post-injury. This effect was present even after accounting for specific child and family variables, which were themselves independently related to the adverse psychiatric outcome.

Psyberguide: A useful resource for mental health apps in primary care and beyond.

Providers need an efficient, unbiased, and reliable resource to determine which apps may be most helpful. OneMindPsyberguide (one mindpsyberguide.org) is a third-party app rating platform that offers an important service to providers and patients. Compared with other app review platforms (e.g., American Psychological Association and Anxiety and Depression Association of America app ratings, Enlight, MARS, mHAD, Mind Tools, and ORCHA), Psyberguide is com prehensive and relatively user friendly. To expand our review of Psyberguide, we asked practicing therapists to give us their per spectives on its utility. Our convenience sam ple for feedback included seven behavioral health care providers (BHPs) working in a busy university primary care department. After a few weeks, we requested anonymous feedback from the providers. Most of the BHPs said they found Psyberguide helpful in their prac tice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Suicide prevention: The role of families and carers.

Families and carers can play an important role in helping prevent suicide. Unfortunately, silence and secrecy within the family environment have sometimes prevented family members from intervening to potentially change the course of suicide intent. This article describes a family-oriented assessment process that can facilitate family-involvement in care. Suicide risk assessment requires a skilled interview with the individual patient to determine accurately suicidal intent. However, family members provide a vital source of collateral information for assessing risk and the relational support needed to diminish risk. Strength-based strategies for intervening with patients and family members to help prevent suicide are described.

An introduction to global mental health.

In general, readers of Families, Systems, and Health (FSH) practice in high income countries and in settings that have adequate resources. Providers can usually count on being able to offer the material resources and skills that patients need to heal. This bounty of resources is in contrast to many clinics in low- and middle-income countries (LMICs). The need for mental health services in LMICs is significant and growing because of upheaval caused by war and other disasters. The topics in this issue talk about the obstacles to obtaining mental health services, trends in global mental health, and FSH in the global mental health movement. (PsycINFO Database Record

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists.

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community.

Family Focused Care for Refugees and Displaced Populations: Global Opportunities for Family Therapists.

Recent global crises have created a significant increase in the number of people leaving their countries. Distress experienced by these refugees often leads to posttraumatic stress disorder and depression and can also result in psychotic disorders, substance abuse, and interpersonal violence. The World Health Organization leads the organizing of refugee services as part of a larger initiative to provide mental health services to citizens in low- and middle-income countries. The World Health Organization has identified challenges in providing care, including a provider shortage, issues with how refugees access and receive care and a lack of uniformity in mental health services. By applying the values and systemic orientation of the profession, family therapists can address some of the challenges in treating mental health concerns of these at-risk populations.

Training for teamwork: A case study.

As the field of collaborative care, or integrated behavioral health, continues to develop, lessons are learned from attempts to establish such programs (Sieber et al., 2012; Unützer, 2014). Part of the success of collaborative care programs is the function of an interdisciplinary team. In this article, faculty from University of San Diego (USD) and University of California, San Diego (UCSD) share changes needed to curriculum and career development to support leadership and teamwork skills essential to program development, implementation, and sustainability for integrated behavioral health. This article uses Unützer's (2014) 4 factors of creating a successful collaborative care program (i.e., shared vision, leadership, staffing, and financial sustainability) to discuss implications for effective collaboration between 2 universities and the training of primary care providers in teamwork and leadership skills for overcoming barriers and pitfalls to expand collaborative care beyond their initial training.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development.

The daily events and emotions of master's-level family therapy trainees in off-campus practicum settings.

The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers-in-training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a student's practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training.

Establishing the Collaborative Care Research Network (CCRN): a description of initial participating sites.

Collaborative care has increased dramatically in the past decade, yet the variability in collaborative strategies and the diversity of settings in which collaboration is being implemented make it difficult to assess quality and outcomes. Therefore, three aims were addressed in the current study: (a) describe and characterize the sites in the Collaborative Care Research Network (CCRN), (b) identify factors associated with practices' self-identified collaborative care model (e.g., coordinated, integrated, care management), and (c) identify limitations of available survey data elements so as to propose additional elements for future surveys. Initial (CCRN) sites completed surveys regarding several organizational factors (e.g., setting type, size of patient population, number of behavioral health providers). Results from 39 sites showed significant heterogeneity in self-identified type of collaborative care model practiced (e.g., integrated care, coordinated care), type of practice setting (e.g., academic, federally qualified health center, military), size of clinic, and ratio of behavioral health providers to medical providers. This diversity in network site characteristics can provide a rich platform to address a number of questions regarding the current practice of collaborative care. Recommendations are made to improve future surveys to better understand elements of the patient-centered medical home and the role it may play in outcomes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Panning for gold: a clinician's guide to using research.

The gap between research and clinical practice is one of the key challenges facing family therapy. Clinicians often fail to incorporate research findings into their practice because they do not know how to search, evaluate, or apply research to their clinical work. The purpose of this article is to help clinicians become better consumers of research. This article explores the potential value of research to clinicians, as well as negative beliefs that clinicians may have about research. The article also describes how clinicians can use research to inform their clinical work, as well as potential challenges that can be encountered.

Supervising family therapy trainees in primary care medical settings: context matters.

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be attentive to the self-of-the-therapist. Recommendations are also made to help supervisors become better prepared for the questions medical family therapy trainees bring to supervision.

Evidence-based practice for marriage and family therapists.

The purpose of this article is to integrate science into clinical practice by introducing marriage and family therapists to the ideas of evidence-based practice (EBP). Evidence-based practice, which originated in the medical field, refers to the process of using research to make clinical decisions that best meet the needs of each client. Included in the description is a brief history of EBPs and ideas about learning EBPs. Suggestions are also made about the use of EBPs in MFT training programs, and resources are provided to enable clinicians to use EBPs in clinical practice.