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EVIDENCE-BASED BLUEPRINTS ON A COMMUNITY MENTAL HEALTH LANDSCAPE: ACADEMIC TREATMENT RECOMMENDATIONS FOR YOUTH IN A STATE SYSTEM OF CARE
|Title:||EVIDENCE-BASED BLUEPRINTS ON A COMMUNITY MENTAL HEALTH LANDSCAPE: ACADEMIC TREATMENT RECOMMENDATIONS FOR YOUTH IN A STATE SYSTEM OF CARE|
|Authors:||Vincent, Amanda M.|
|Contributors:||Nakamura, Brad J. (advisor)|
dissemination and implementation
public mental health
youth mental health
|Publisher:||University of Hawai'i at Manoa|
|Abstract:||Understanding the baseline characteristics of community mental health (CMH) is an important prerequisite to tailoring effective strategies for increasing evidence-based practice (EBP) uptake in CMH settings; however, a variety of methodological and systemic barriers have impeded CMH investigations. Toward the goal of better understanding how CMH features might influence the EBP-consistency of its treatment approaches, the current study examined academic clinicians’ practice element (PE) level treatment recommendations made for youth in a public system of care. This study had three aims: (a) replicate interrater reliability findings for the Service Guidance Review Form (SGRF; Young, Daleiden, Chorpita, Schiffman, and Mueller, 2007) coding system, (b) examine the degree to which client variables (e.g., age, number of diagnoses) predicted coded treatment recommendations’ overall alignment with outcome literature for youth (n = 95) with disruptive behavior disorder (DBD) diagnoses, and (c) compare a composite profile of treatment recommendations for youth with DBDs to a corresponding profile derived from the DBD outcome literature. Expert coders (n = 4) applied the SGRF to assess 66 PEs’ presence or absence within narrative treatment recommendations written by clinicians in a university research and training setting; interrater reliability for PEs in assessment across multiple diagnostic areas (n = 325) fell into the “almost perfect” range (κ =.85), suggesting that narrative recommendations can be readily recognized by their readers. Regarding the second aim, multiple regression analyses found client age and diagnosis count, but not client sex, functional impairment score, and presence of comorbid internalizing diagnoses, to be predictive of the number of DBD outcome literature EBP-consistent or inconsistent-recommendations youth received. Aim 3 results showed substantial overlap between DBD outcome research and coded recommendations, as well as some omission and commission divergence patterns. Expected overlap, as well as omission and commission divergences are discussed thematically as they relate to PE and sample characteristics toward the goal of speaking about EBP recommendations’ applicability to CMH youth. Discussion reviews clinical implications for the application of distillation-coding methodology to service planning documents as well as the observed interface between CMH youth characteristics and academically-driven treatment planning.|
|Rights:||All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.|
|Appears in Collections:||
M.A. - Psychology|
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