Meta-Analysis of the Effects of Peer-Administered Psychosocial Interventions on Symptoms of Depression

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost‐efficient adjunct providers. The effectiveness of these and other peer‐administered interventions (PAIs) for treating depression symptoms has not been well‐established. The current study is a meta‐analysis of PAIs’ effects on depression symptoms. Twenty‐three eligible studies were identified. Study characteristics were coded by multiple raters, random‐effects models were used to compare mean effect sizes, and mixed‐effects models were used to test for moderation. PAIs produced significant pre‐post reductions in depression symptoms (d = .5043 [95 % CI .3675–.6412]). In direct comparisons, PAIs performed as well as non‐peer‐administered interventions (.0848 [?.1455–.3151]), and significantly better than no‐treatment conditions (.2011 [.0104–.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer‐administered, and educational/skills‐based PAIs produced better outcomes than those that were mainly supportive. Follow‐up data, when available, indicated that PAIs’ benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs’ benefits, and whether they are better suited as stand‐alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.     

Strengthening the Child‐ and Youth‐Serving Workforce: Surveying the Landscape,Overcoming Challenges

This special issue addresses a neglected but important topic in our field: strengthening the child‐ and youth‐serving workforce. Investing in this workforce should be a national priority because considerable evidence has shown that investments in early childhood education and development, particularly in low‐resource contexts, that are reinforced through skills‐based programs in adolescence and adulthood, have beneficial impacts throughout life. Investing in quality child‐ and youth‐serving programs also has the additional benefit of creating a productive and capable future workforce. The editors and authors of the special issue should be commended for producing the first special issue on this topic in our field or in related fields, one that is long overdue. Articles in this issue survey the landscape of an amorphous and complex area of practice and research and describe key challenges for the field. In this commentary, I offer organizing frameworks to characterize the child‐ and youth‐serving workforce, note emerging issues when addressing specific challenges, and identify areas for future research.     

Collaboration with Urban Community Stakeholders: Refining Paraprofessional‐led Services to Promote Positive Parenting

This paper describes the process of a community–academic partnership to navigate implementation challenges for a school‐based service model led by paraprofessionals to promote positive parenting in high poverty urban communities. We describe the process by which we (a) identified implementation challenges, (b) sustained a university–community collaboration to redesign the paraprofessional service model, and (c) assessed the feasibility of the new model involving four social service agencies in 16 schools with over 600 families. The structure and process of the collaboration and refinement are described with attention to who was best positioned to engage in the collaboration and how the partnership worked to balance scientific rigor with responsiveness to paraprofessional workforce strengths. Feasibility data indicated that the revised model was successfully implemented by paraprofessional staff; 92.2% of possible staff monthly reports were completed and discussion of key goals was incorporated into 94.2% of interactions. Continual monitoring provided critical feedback from stakeholders as we drew on and interpreted these various sources of information to build and refine the service model. We suggest that these processes are critical steps to bridge the research‐to‐practice gap, by promoting practices that are aligned with the needs of children and families, and the staff who serve them.     

A Randomized Controlled Trial of Coach Contact During a Brief Online Intervention for Distressed Couples

The negative impacts of relationship distress on the couple, the family, and the individual are well‐known. However, couples are often unable to access effective treatments to combat these effects—including many couples who might be at highest risk for relationship distress. Online self‐help interventions decrease the barriers to treatment and provide couples with high quality, research‐based programs they can do on their own. Using a combined multiple baseline and randomized design, the present study investigated the effectiveness of the Brief OurRelationship.com (Brief‐OR) program with and without staff support in improving relationship distress and individual functioning. Results indicated the program produced significant gains in several areas of relationship functioning; however, these gains were smaller in magnitude than those observed in Full‐OR. Furthermore, effects of Brief‐OR were not sustained over follow‐up. Comparisons between couples randomized to Brief‐OR with and without contact with a staff coach indicated that coach contact significantly reduced program noncompletion and improved program effects. Limitations and future directions are discussed.