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Nursing home/assisted living placement (NHP/ALP) for dementia patients is costly and may be unfeasible for many. Various patient characteristics have been identified as contributors of NHP/ALP in dementia. Longitudinal prognostic models, which estimate the time from diagnosis to NHP/ALP based on characteristics and changes over time in these factors, are scarce yet may be valuable for clinicians in the planning of community-based interventions to delay future admissions. A multivariate Bayesian joint longitudinal and survival modeling approach was applied to develop an algorithm and web-based application and estimate individualized patient survival probability and time to NHP/ALP. Data were analyzed from the National Alzheimer’s Coordinating Center’s data set. Four thousand four hundred twenty-one participants with a diagnosis of dementia were included in algorithm development. The model was validated on a separate hold-out sample (n = 780). Fourteen predictors examining patients’ sociodemographic factors, caregiver age and relationship, level of global cognitive impairment, behavioral and psychiatric disturbances, mobility and cardiovascular factors, and instrumental and basic activities of daily living were entered into the model. Older age (hazards ratio [HR] = 1.05), living alone (HR = 2.75), motor (HR = 1.16), cognitive (HR = 0.92), and neuropsychiatric impairments (HR = 1.14) increased the probability of NHP/ALP. Racial (HR = 0.27), ethnic minority identification (HR = 0.40), and greater cardiovascular risk (HR = 0.94) reduced this likelihood. The final model demonstrated excellent predictive accuracy at 3-year postbaseline diagnosis (0.74–0.85). Our algorithm and web-based application may help in conceptualizing long-term patient needs by approximating time to care-facility admissions and viewing dynamic predictive probability plots at distinct time points. Further research with competing risk approaches, diverse samples, neuropsychological, and disease-related characteristics would enhance this model’s prediction sensitivity. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Therapeutic assessment (TA) is noted for its collaborative, patient-centered nature and ability to create therapeutic benefits through the assessment process itself. TA provides diagnostic clarification and improves readiness for, and engagement in mental health and substance use treatment. Psychotic spectrum disorder (PSD) refers to a collection of symptoms involving significant disturbances or marked alterations in thoughts, perceptions, and behaviors significantly impairing functioning. Psychological assessment, often a first step toward PSD treatment is fraught with challenges including historical and ongoing effects of racism on testing, social stigma, internalized stigma, providers’ parentalistic approach to care, and beliefs that patients with PSD cannot partake in decisions about their care. Noting the alignment of TA with recovery-oriented therapeutic approaches for psychosis, and the need for patient collaboration in treatment, researchers and clinicians have begun to call attention to the potential value of TA in PSD assessment. We present three cases illustrating the utility of TA as a culturally responsive assessment approach for PSD. Case A discusses misdiagnosis in a multicultural context and an abbreviated TA approach. Case B addresses the roles of the TA relationship and a multicultural lens in assessing and communicating a delusional disorder diagnosis. Case C discusses partnership with the patient’s therapist and using a radically collaborative assessment process to make a diagnosis of schizoaffective disorder. We describe common themes across cases—the power of narrative shifts and creating corrective therapeutic experiences through TA. We discuss TA as a culturally responsive approach and the potential value of TA as an antioppressive practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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This study aimed to characterize the needs and preferences for digital health of individuals waitlisted for services. One hundred thirty-five people who sought mental health services in the past year and who were not receiving the service they sought completed questionnaires assessing their experiences during this period as well as their preferences related to digital interventions. Participants had sought services on average nearly 8 months prior to completing the survey (M = 7.74 months, SD = 8.51), most commonly for anxiety (N = 118, 87.4%) and depression (N = 101, 74.8%). Relative to the date they first sought services, participants reported reduced interest (d = −0.45) and motivation to engage (d = −0.43) in treatment, as well as reduced conviction in the belief that they would get better (d = −0.23) or that treatment would help (d = −0.30), although they also reported reduced symptom distress (d = −0.39). Very few (8%) reported satisfaction with the materials they were given by providers when seeking services. Participants reported high interest in a digital tool providing information about therapies (94.7% reporting moderate or greater interest), mental illnesses (87.4%), and places to find treatment (91.1%), as well as one that would provide interactive cognitive practices (85.2%) and strategies to improve sleep (85.8%). Over half of all participants reported that a mobile app would be their first choice for mode of delivery. This study highlights the need for and potential of digital tools optimized for waitlisted individuals, particularly interactive and informational resources provided through mobile devices. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Decades of research have strongly advocated for crafting effective psychological reports in a manner that presents information at a lower reading level, organizes content by functional domain, and communicates results in a client-centered manner. However, psychological reports remain challenging for nonpsychologists to comprehend. Extensive research indicates that service users (e.g., patients, parents, and teachers) perceive these reports as overly technical, difficult to understand, and lacking utility. One identified contributor to these challenges is the training practices within professional psychology programs. Despite considerable research on test administration and scoring errors, there has been limited investigation into the development of report writing practices among graduate students. This study represents the first examination of graduate students’ psychological report writing skills within a professional psychology program. Utilizing quantitative content analysis, 63 psychological reports authored by graduate students were analyzed to identify commonalities and disparities in writing style and content. In addition, the study explored relationships between specific characteristics of report writing, such as presentation style, integration, and readability, within the framework of best practices. The findings indicate that students do not write accessible or integrated reports. The choice of formatting and the use of active voice may play a role in enhancing integration and readability. Therefore, these aspects should be considered when instructing students on report presentation. The implications of these findings are discussed in relation to psychologists, educators, and students undergoing training. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Neurofeedback has been utilized to treat a variety of mental health issues by influencing brainwave patterns using auditory and/or visual feedback. Despite a plethora of research, there is a significant gap regarding why neurofeedback is not more commonly utilized in mental health care practice. This study sought to address this gap by posing the question: What factors are associated with psychotherapists’ self-reported interest in adopting neurofeedback into their current practice? This study utilized the Consolidated Framework for Implementation Research to explore factors associated with outpatient psychotherapists’ interest in implementing neurofeedback in their practices. The primary variables of interest were years in practice, cost as the main barrier to implementation, and type of practice setting. Surveys were completed online by licensed psychotherapists (N = 500). A logistic regression analysis found that, compared to those practicing in a solo private practice, psychotherapists practicing in community mental health clinics/agencies (adjusted OR: 1.77, 95% confidence interval, CI, [0.99, 3.15], p = .0524) and other outpatient settings (adjusted OR: 1.81, 95% CI [0.95, 3.44], p = .0708) had higher odds of being interested in neurofeedback. Finally, compared to those who did not believe that neurofeedback would be welcome in their practice setting or were unsure, those who reported believing neurofeedback would be welcome (adjusted OR: 3.38, 95% CI [2.18, 5.26], p < .0001) had much higher odds of being interested in neurofeedback. This study found that inner setting factors had the most significant association with psychotherapists’ interest in implementing neurofeedback. These findings point to potential areas of focus to increase the uptake of neurofeedback in mental health care settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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The clinical practice of suicide risk assessment is in crisis. Over the past 10 years, researchers have amply demonstrated that the underlying assumption of suicide risk assessment—that suicide can be predicted to a clinically meaningful degree—has, at best, a weak empirical foundation. Without compelling evidence supporting its use, some have recommended that suicide risk assessment no longer be used and should not be relied on to make treatment decisions. Others have argued that suicide risk assessment should be replaced with assessments of need or revised versions of suicide risk assessment. In this article, I briefly review the evidence showing that suicide risk assessment is a poorly supported clinical practice, critique the alternatives to suicide risk assessment proposed thus far, and then offer an additional proposal: assessing for the presence of suicidality and its severity rather than suicide risk. I show why assessing suicidality is preferred when scientific uncertainty about risk exists and how doing so leverages the traditional methods of clinical work. Finally, I argue that a documented assessment of suicidality helps meet the law’s expectation of clinicians to identify and respond to suicide risk. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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A healthy child–caregiver relationship is fundamental for positive early child development. Robust evidence indicates that these relationships yield positive impacts on children’s cognitive, social, and emotional growth. Evidence-based parenting programs are an effective way to improve parenting skills and strengthen the child–caregiver relationship. Before the COVID-19 pandemic, these intervention programs were primarily conducted in person, limiting their availability and scalability. Challenges emerging from the pandemic created a substantial need to transition from in-person to online intervention modalities. Although evidence-based parenting interventions are beneficial in supporting the child–caregiver relationship, few interventions are easily and freely available for caregivers online. This article reviews the need for universally available parenting programs that promote the child–caregiver relationship and child development starting in infancy. We present two existing online intervention programs and discuss the current evidence for their use, methods, and mode of delivery. We describe a recently adapted program, the Make the Connection online program, that is delivered directly to caregivers and has the potential for broad dissemination. We conclude by discussing the practical implications and suggesting directions for future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Mon, 03 Feb 2025 00:00:00 GMT