Evidence-based practice implementation and staff emotional exhaustion in children's services

Understanding the implementation of evidence-based practice (EBP) in community service settings is critical for the successful translation of research to practice. However, we have limited research evidence about the impact of EBP implementation on the mental health and social service workforce. In a previous study we demonstrated reduced staff turnover where an EBP was implemented with fidelity monitoring in the form of supportive ongoing supervision and consultation. Other research has shown that staff burnout and emotional exhaustion in particular is associated with poor quality of care and increased staff turnover intentions and turnover. Current research, however, has focused less on the effects that EBP implementation may have on staff emotional exhaustion. The present study investigates the association of EBP implementation and fidelity monitoring with staff emotional exhaustion in a statewide EBP implementation study. The 21 case-management teams in this study were randomized in a 2 (EBP vs. services as usual [SAU]) by 2 (monitoring vs. no monitoring) design. The EBP in this study was SafeCare^®, a home-based intervention that aims to reduce child neglect in at-risk families. SafeCare was developed from a behavior analysis approach and is based in cognitive behavioral principles. In keeping with our previous research, we hypothesized that providers implementing SafeCare with monitoring would have the lowest levels of emotional exhaustion and those receiving additional monitoring not in the context of EBP implementation would have higher emotional exhaustion relative to the other groups. Results supported our hypotheses in that we found lower emotional exhaustion for staff implementing the EBP but higher emotional exhaustion for staff receiving only fidelity monitoring and providing SAU. Together, these results suggest a potential staff and organizational benefit to EBP implementation and we discuss implications of the findings relative to EBPs and to fidelity monitoring.     

Dissemination of effective mental health treatment procedures: Maximizing the return on a significant investment

While much is known about the efficacy of evidence-based practices, it is currently less clear how to implement these practices into the broader mental health system. Dissemination and implementation research will play a critical role in addressing this uncertainty. This commentary reviews the most recent and compelling research related to these topics while advocating a broader and more defined perspective of dissemination for future research. Three of the authors' most pressing questions are proposed and explored.     

弗洛伊德的得意门生——亚伯拉罕和费伦茨对精神分析发展的贡献

亚伯拉罕和费伦茨都是弗洛伊德的早期弟子,他们在精神分析早期理论以及治疗技术的创新和发展中都有着重要的贡献。亚伯拉罕重新划分了弗洛伊德的心理性欲发展阶段并探讨了前俄狄浦斯期的母子关系,这都深深影响了后来的客体关系学派;费伦茨发展了弗洛伊德的性诱惑理论并在治疗技术上做出了许多革新,这为精神分析后来的发展开辟出了更广阔的道路。     

Interdisciplinary Knowledge Translation: Lessons Learned from a Mental Health: Fire Service Collaboration

Collaborative approaches are being increasingly advocated for addressing a variety of health, mental health and social needs for children, youth and families. Factors important for effective knowledge translation of collaborative approaches of service delivery across disciplines, however, have not been rigorously examined. TAPP-C: The Arson Prevention Program for Children is an intervention program for child and adolescent firesetters provided collaboratively by fire service and mental health professionals. The present study examined the adopter, innovation, and dissemination characteristics associated with TAPP-C implementation, protocol adherence and extent of collaboration by 241 community-based fire service professionals from communities across Ontario. Results revealed that dissemination factors are particularly important for understanding program implementation, adherence and cross-discipline collaboration. Moreover, the findings of this study show significant benefits to both within discipline (intra-disciplinary) and across discipline (interdisciplinary) knowledge translation strategies.     

早期检测血浆N-端脑利钠肽前体在高龄呼吸困难患者诊治策略中的应用价值

N-端脑利钠肽前体具有快捷、简易、安全可靠、耐受性好的特点,在呼吸困难的鉴别诊断上有其独特优势,已成为近年来临床开展的一项新技术。在高龄呼吸困难患者中具有光明的应用前景,本文就早期检测血浆N-端脑利钠肽前体在高龄呼吸困难患者诊治中的应用作一讨论。     

If You Are Going to Pay Within the Next 24 Hours,Press 1: Automatic Planning Prompt Reduces Credit Card Delinquency

People often form intentions but fail to follow through on them. Mounting evidence suggests that such intention‐action gaps can be narrowed with prompts to make concrete plans about when, where, and how to act to achieve the intention. In this paper, we pushed the notion of plan‐concreteness to test the efficacy of a prompt under a minimalist automated calling setting, where respondents were only prompted to indicate a narrower duration within which they intent to act. In a field experiment, this planning prompt significantly helped people to pay their past dues and get out of debt delinquency. These results suggest that minimalist automatic planning prompts are a scalable, cost‐effective intervention.     

The mediating effects of time structure on the relationships between time management behaviour,job satisfaction,and psychological well‐being

This article examined the relationship between time structure and Macan's process model of time management. This study proposed that time structure—‘appraisal of effective time usage’—would be a more parsimonious mediator than perceived control over time in the relationship between time management behaviours and outcome variables, such as job satisfaction and psychological well‐being. Alternative structure models were compared using a sample of 111 university students. Model 1 tested Macan's process model of time management with perceived control over time as the mediator. Model 2 replaced perceived control over time by the construct of time structure. Model 3 examined the possibility of perceived control over time and time structure as being parallel mediators of the relationships between time management and outcomes. Results of this study showed that Model 1 and Model 2 fitted the data equally well. On the other hand, the mediated effects were small and partial in both models. This pattern of results calls for reassessment of the process model.     

问题发现过程认知阶段划分的探索性研究

采用建构认知模型法探索问题发现过程认知阶段的存在性及顺序性问题。基于已有研究,提出问题发现过程可划分为信息搜寻、现状表征、寻求目标、建立联系、提出问题、评价和修正问题等六个阶段的基本假设。用出声思维和秩次聚类分析的方法对高低能力组共40名大学生问题发现过程的阶段性进行考察,结果显示：六个阶段中有两对阶段出现位置非常接近,可将其进行整合,构成现状搜寻与表征、目标探索、提出问题、评价和修正问题等四个阶段。在不同问题领域与不同能力被试群体中,各认知阶段的顺序性没有差异。     

The ABLe Change Framework: A Conceptual and Methodological Tool for Promoting Systems Change

This paper presents a new approach to the design and implementation of community change efforts like a System of Care. Called the ABLe Change Framework, the model provides simultaneous attention to the content and process of the work, ensuring effective implementation and the pursuit of systems change. Three key strategies are employed in this model to ensure the integration of content and process efforts and effective mobilization of broad scale systems change: Systemic Action Learning Teams, Simple Rules, and Small Wins. In this paper we describe the ABLe Change Framework and present a case study in which we successfully applied this approach to one system of care effort in Michigan.     

A Comparison of the Interactive Systems Framework (ISF) for Dissemination and Implementation and the CDC Division of HIV/AIDS Prevention’s Research-to-Practice Model for Behavioral Interventions

Translating evidence-based HIV/STD prevention interventions and research findings into applicable HIV prevention practice has become an important challenge for the fields of community psychology and public health due to evidence-based interventions and evidence-based practice being given higher priority and endorsement by federal, state, and local health department funders. The Interactive Systems Framework (ISF) for Dissemination and Implementation and the Division of HIV/AIDS Prevention (DHAP) Research-to-Practice model both address this challenge. The DHAP model and the ISF are each presented with a brief history and an introduction of their features from synthesis of research findings through translation into intervention materials to implementation by prevention providers. This paper describes why the ISF and the DHAP model were developed and the similarities and differences between them. Specific examples of the use of the models to translate research to practice and the subsequent implications for support of each model are provided. The paper concludes that the ISF and the DHAP model are truly complementary with some unique differences, while both contribute substantially to addressing the gap between identifying effective programs and ensuring their widespread adoption in the field.