Administration and Policy in Mental Health, Jul 6, 2006
Despite a significant increase in the number of children and adolescents who receive clinical ser... more Despite a significant increase in the number of children and adolescents who receive clinical services for attention deficit hyperactivity disorder (ADHD), there is still a considerable level of unmet need. Children of ethnic minority status continue to lag well behind their non-minority counterparts in the rate of diagnosis and treatment for the disorder. Racial/ethnic disparities in service use are the result of a combination of access barriers and individual, cultural, and societal factors. The ADHD Help-Seeking Behavior Model is proposed as a framework for understanding factors that may be predictive of service use. Variables specific to ADHD and ethnic-minority populations are integrated within the framework of a four-stage pathway model encompassing problem recognition, decision to seek help, service selection, and service use. The authors argue that by systematically addressing factors related to service use for each ethnic minority group, more effective intervention initiatives can be developed to improve identification and treatment for ADHD among underserved children.
Background Teacher-delivered behavioral classroom management interventions are effective for stud... more Background Teacher-delivered behavioral classroom management interventions are effective for students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) or other disruptive behavior challenges, but they can be difficult for teachers to use in the classroom. In this study, we will pilot test a package of implementation strategies to support teachers in using behavioral classroom interventions for students with ADHD symptoms. Methods We will use a 2-group, randomized controlled trial to compare outcomes for teachers who receive Positive Behavior Management Implementation Resources (PBMIR), a theory and data-driven implementation resource package designed to increase teacher implementation of behavioral classroom management interventions, with those who do not receive this additional implementation support. We will measure teacher implementation outcomes (e.g., observed fidelity to behavioral classroom interventions) and student clinical outcomes (e.g., ADHD-related im...
Background Train-the-trainer (TT) implementation strategies (in which designated clinicians are t... more Background Train-the-trainer (TT) implementation strategies (in which designated clinicians are trained to then train others in an intervention) are promising approaches to support mental health clinician use of evidence-based interventions in school contexts. However, there is little evidence to date examining clinicians’ perceptions of the acceptability and feasibility of TT strategies, or comparing clinicians’ perceptions of different types of TT strategies. Methods The current study was conducted as part of a larger hybrid effectiveness-implementation trial, in which school-based therapists and supervisors received one of two different types of implementation support to implement cognitive behavioral therapy (CBT) groups for anxiety: TT (i.e., initial training for therapists and supervisors) or enhanced TT (TT+; i.e., initial training for therapists and supervisors, and ongoing external consultation for supervisors). We used applied thematic analysis to compare qualitative interview transcripts from 28 therapist interviews and 33 supervisor interviews from therapists and supervisors who received TT or TT+ support and report themes that were similar and different across the two groups. Results Most themes were similar across the TT and TT+ conditions: therapists and supervisors in both conditions perceived the group anxiety intervention as acceptable and viewed supervision as acceptable, helpful, and feasible. Therapists and supervisors in both conditions had mixed impressions of the contextual appropriateness of the group anxiety intervention, and some reported logistical challenges with weekly supervision. Some unique themes were identified among the TT+ condition, including supervisors experiencing professional growth, and therapists and supervisors perceiving supervision as critically important and enjoyable. Conclusions These results suggest that TT implementation support, using a model in which an internal supervisor receives initial training and then provides ongoing supervision, is acceptable and feasible to support a group CBT intervention in schools. The results also highlight additional benefits that therapists and supervisors perceived when supervisors received ongoing consultation. Clinical Trial Registration Information The clinical trial from which these data were derived was registered at ClinicalTrials.gov ( https://clinicaltrials.gov/ ) prior to the time of first patient enrollment. The registration number is: NCT02651402.
Journal of psychologists and counsellors in schools, Sep 5, 2019
Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPSâ„¢) is a tested str... more Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPSâ„¢) is a tested strategy for improving communication and climate in hospitals. It is a promising but untested tool among school-based mental health teams. We examined the psychometric properties of the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) and Teamwork Attitudes Questionnaire (T-TAQ) among 167 school mental health team members. Team members worked for one of five agencies in 33 K-8 urban public schools. Exploratory factor analyses and descriptive data are presented. For both the T-TPQ and T-TAQ, a unitary factor structure best fit the data for this sample. The T-TPQ and T-TAQ were not significantly correlated with one another and total scores did not significantly differ by staff role. Agencies differed in T-TAQ results, and one agency had lower T-TAQ total scores relative to other agencies. Results suggest that the factor structures are different among school mental health teams than among other healthcare providers.
Administration and Policy in Mental Health, Jul 6, 2006
Despite a significant increase in the number of children and adolescents who receive clinical ser... more Despite a significant increase in the number of children and adolescents who receive clinical services for attention deficit hyperactivity disorder (ADHD), there is still a considerable level of unmet need. Children of ethnic minority status continue to lag well behind their non-minority counterparts in the rate of diagnosis and treatment for the disorder. Racial/ethnic disparities in service use are the result of a combination of access barriers and individual, cultural, and societal factors. The ADHD Help-Seeking Behavior Model is proposed as a framework for understanding factors that may be predictive of service use. Variables specific to ADHD and ethnic-minority populations are integrated within the framework of a four-stage pathway model encompassing problem recognition, decision to seek help, service selection, and service use. The authors argue that by systematically addressing factors related to service use for each ethnic minority group, more effective intervention initiatives can be developed to improve identification and treatment for ADHD among underserved children.
Background Teacher-delivered behavioral classroom management interventions are effective for stud... more Background Teacher-delivered behavioral classroom management interventions are effective for students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) or other disruptive behavior challenges, but they can be difficult for teachers to use in the classroom. In this study, we will pilot test a package of implementation strategies to support teachers in using behavioral classroom interventions for students with ADHD symptoms. Methods We will use a 2-group, randomized controlled trial to compare outcomes for teachers who receive Positive Behavior Management Implementation Resources (PBMIR), a theory and data-driven implementation resource package designed to increase teacher implementation of behavioral classroom management interventions, with those who do not receive this additional implementation support. We will measure teacher implementation outcomes (e.g., observed fidelity to behavioral classroom interventions) and student clinical outcomes (e.g., ADHD-related im...
Background Train-the-trainer (TT) implementation strategies (in which designated clinicians are t... more Background Train-the-trainer (TT) implementation strategies (in which designated clinicians are trained to then train others in an intervention) are promising approaches to support mental health clinician use of evidence-based interventions in school contexts. However, there is little evidence to date examining clinicians’ perceptions of the acceptability and feasibility of TT strategies, or comparing clinicians’ perceptions of different types of TT strategies. Methods The current study was conducted as part of a larger hybrid effectiveness-implementation trial, in which school-based therapists and supervisors received one of two different types of implementation support to implement cognitive behavioral therapy (CBT) groups for anxiety: TT (i.e., initial training for therapists and supervisors) or enhanced TT (TT+; i.e., initial training for therapists and supervisors, and ongoing external consultation for supervisors). We used applied thematic analysis to compare qualitative interview transcripts from 28 therapist interviews and 33 supervisor interviews from therapists and supervisors who received TT or TT+ support and report themes that were similar and different across the two groups. Results Most themes were similar across the TT and TT+ conditions: therapists and supervisors in both conditions perceived the group anxiety intervention as acceptable and viewed supervision as acceptable, helpful, and feasible. Therapists and supervisors in both conditions had mixed impressions of the contextual appropriateness of the group anxiety intervention, and some reported logistical challenges with weekly supervision. Some unique themes were identified among the TT+ condition, including supervisors experiencing professional growth, and therapists and supervisors perceiving supervision as critically important and enjoyable. Conclusions These results suggest that TT implementation support, using a model in which an internal supervisor receives initial training and then provides ongoing supervision, is acceptable and feasible to support a group CBT intervention in schools. The results also highlight additional benefits that therapists and supervisors perceived when supervisors received ongoing consultation. Clinical Trial Registration Information The clinical trial from which these data were derived was registered at ClinicalTrials.gov ( https://clinicaltrials.gov/ ) prior to the time of first patient enrollment. The registration number is: NCT02651402.
Journal of psychologists and counsellors in schools, Sep 5, 2019
Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPSâ„¢) is a tested str... more Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPSâ„¢) is a tested strategy for improving communication and climate in hospitals. It is a promising but untested tool among school-based mental health teams. We examined the psychometric properties of the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) and Teamwork Attitudes Questionnaire (T-TAQ) among 167 school mental health team members. Team members worked for one of five agencies in 33 K-8 urban public schools. Exploratory factor analyses and descriptive data are presented. For both the T-TPQ and T-TAQ, a unitary factor structure best fit the data for this sample. The T-TPQ and T-TAQ were not significantly correlated with one another and total scores did not significantly differ by staff role. Agencies differed in T-TAQ results, and one agency had lower T-TAQ total scores relative to other agencies. Results suggest that the factor structures are different among school mental health teams than among other healthcare providers.
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Papers by Ricardo Eiraldi