Freddie A. Pastrana

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

OBJECTIVE Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. METHOD Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. RESULTS The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. CONCLUSION Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. (PsycINFO Database Record

Lunch Buddy Mentoring for Children Victimized by Peers: Two Pilot Studies

The authors describe two pilot studies examining the potential benefits of Lunch Buddy (LB) mentoring, a manualized approach to school-based mentoring. LB mentoring takes place during the school lunch period and is designed to promote positive changes in childrens peer relationships. In both studies, changes in peer victimization were assessed after one and three semesters of LB mentoring. In the first study, LB mentors were paired with elementary school children (N = 24) identified by child and teacher reports as victimized by peers. Results revealed significant declines in self- and teacher-rated victimization after one and three semesters of mentoring. In the second study, LB mentors were paired with victimized children who also engaged in bullying behavior (N = 23). Results indicated significant declines in self- and teacher-ratings of peer victimization after three semesters of mentoring. In both studies, ratings of perceived harm were low and ratings of satisfaction were high. Discussed are the implications of these findings for future research and for efforts to develop a nonharmful way to help children who are repeatedly victimized.

Identifying children repeatedly victimized by peers: A preliminary study

ABSTRACT Repeated victims of school bullying are at risk for maladjustment and could potentially benefit from selective intervention. However, selective intervention requires a practical method for accurately identifying members of the targeted group. We examined the extent to which the global victimization item from the Olweus Bully/Victim Questionnaire accurately identified children repeatedly victimized by peers. From a sample of 654 fourth-graders, we categorized 63 (9.7%) as repeated victims based on elevated reports of victimization from the same informant (self, teacher, peer) across two time points within an academic year. Logistic regression and ROC curve analyses examined the predictive utility of the recommended global item cutoff and more stringent cutoffs. Results indicated that the global victimization item offered limited utility as a means of identifying children categorized as repeated victims. We discuss possible reasons for the findings and potential implications for future research and practice.