RESUMEN
Given the ongoing dilemma for college counseling centers to meet steady increases in demand for services, this study outlines the implementation of an adapted stepped care model in a university counseling center. Our adapted model focused, as do other stepped care models, on treatment planning and lower-intensity interventions, with the addition of the intensive therapy option being provided on a weekly basis. We adopted our stepped care model across a large center and hypothesized that after implementation we would be able to serve a similar number of clients as our previous model and that treatment outcomes for these clients would improve. Descriptive data and regression analyses demonstrated support for our hypotheses, including an increased likelihood of clinically significant improvement for clients postimplementation. Implications for adapting service delivery models using practice-based evidence are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Asunto(s)
Consejo , Atención a la Salud , Humanos , Resultado del Tratamiento , UniversidadesRESUMEN
With increasing demand for psychotherapy services, clinicians are carrying increasingly large caseloads (Bailey et al., 2020). As the number of new intakes exceeds the number of clinical hours available each week in some settings, psychotherapy is delivered on an attenuated schedule for returning clients (rather than the traditional weekly frequency); there is, however, little support for the efficacy of this practice. The present study explored the effect of session frequency on psychotherapy outcomes using a quasi-randomized controlled design. In a working university counseling center, we assigned therapists to either a treatment-as-usual (TAU) group (attenuated session frequency) or an experimental group (weekly session frequency). Clients were randomly assigned to a therapist in either condition. Using hierarchical linear modeling and survival analyses, we examined psychotherapy outcomes (measured by session-by-session Outcome Questionnaire 45 scores) for 1,322 clients (3,919 individual sessions). We found no differences between groups when examining the full sample, but also found limited fidelity in the experimental group. When identifying individuals who were seen weekly in at least the first three sessions after intake (sensitivity analysis), we found the following: (a) weekly therapy resulted in faster trajectories of change over time, (b) weekly therapy resulted in a greater likelihood of achieving recovery, and (c) weekly therapy resulted in a greater likelihood of achieving recovery sooner. We discuss the importance of including session frequency when considering the dose of therapy, as well as the implication that prioritizing weekly therapy may increase therapy efficacy and efficiency in routine practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Asunto(s)
Relaciones Profesional-Paciente , Psicoterapia , Consejo , Humanos , Psicoterapia/métodos , Resultado del Tratamiento , UniversidadesRESUMEN
BACKGROUND: Researchers have examined the relationship between mental health and weather/pollution with mixed results. The current study aimed to examine a range of weather and atmospheric phenomena and their association with time-bound mental health data. METHODS: Nineteen different weather/pollution variables were examined in connection with an archive of self-reported mental health data for university students participating in mental health treatment (n=16,452) using the Outcome Questionnaire 45.2 (OQ-45). Statistical approach involved randomly selecting 500 subjects from the sample 1000 different times and testing each variable of interest using mixed models analyses. RESULTS: Seasonal changes in sun time were found to best account for relationships between weather variables and variability in mental health distress. Increased mental health distress was found during periods of reduced sun time hours. A separate analysis examining subjects' endorsement of a suicidality item, though not statistically significant, demonstrated a similar pattern. Initial results showed a relationship between pollution and changes in mental health distress; however, this was mediated by sun time. LIMITATIONS: This study examined a relatively homogenous, predominantly European American, and religious sample of college counseling clients from an area that is subject to inversions and is at a high altitude and a latitude where sun time vacillates significantly more than locations closer to the equator. CONCLUSIONS: Seasonal increases in sun time were associated with decreased mental health distress. This suggests the need for institutions and public health entities to plan for intervention and prevention resources and strategies during periods of reduced sun time.