Kelsie Okamura

A Psychometric Analysis of the Positive and Negative Affect Schedule for Children-Parent Version in a School Sample.

The current study was the 1st to examine the psychometric properties of the Positive and Negative Affect Schedule for Children-Parent Version (PANAS-C-P) using a large school-based sample of children and adolescents ages 8 to 18 (N = 606). Confirmatory factor analysis supported a 2-factor (correlated) model of positive affect (PA) and negative affect (NA). The PANAS-C-P scale scores also demonstrated acceptable internal consistency and convergent and divergent validity. The PANAS-C-P PA and NA scale scores also related to measures of anxiety and depression in a manner consistent with the tripartite model. Scale means and standard deviations were reported by grade and sex to provide normative data for the PANAS-C-P scales. Results from the present study provide initial support for the PANAS-C-P as a parent-reported perspective of youth PA and NA among school-based youths.

Tracking Evidence Based Practice with Youth: Validity of the MATCH and Standard Manual Consultation Records

This study sought to evaluate the agreement between therapist report and coder observation of therapy practices. The study sampled session data from a community-based, randomized trial of treatment for youth ages 7 to 13. We used therapist report of session content and coverage gathered using formal Consultation Records and developed complimentary records for coders to use when watching or listening to therapy tape. We established initial reliability between coders and then conducted a random, stratified, and comprehensive sample of sessions across youth (N = 121), therapists (N = 57), conditions (MATCH and Standard Manuals), and study sites (Honolulu and Boston) to code and compare with therapist record reports. Intraclass correlation coefficients (ICCs) representing coder versus therapist agreement on manual content delivered ranged from .42 to 1.0 across conditions and problem areas. Analyses revealed marked variability in agreement regarding whether behavioral rehearsals took place (ICCs from −.01 to 1.0) but strong agreement on client comprehension of therapy content and homework assignments. Overall, the findings indicate that therapists can be accurate reporters of the therapeutic practices they deliver, although they may need more support in reporting subtle but valuable aspects of implementation such as types of behavioral rehearsals. Developing means to support accurate reporting is important to developing future clinical feedback methodology applicable to the implementation of evidence-based treatments in the real world.

Symptom differentiation of anxiety and depression across youth development and clinic-referred/nonreferred samples: An examination of competing factor structures of the Child Behavior Checklist DSM-oriented scales.

This study examined the psychometric properties of the DSM-oriented scales of the Child Behavior Checklist (Achenbach, Dumenci, & Rescorla, 2003) using confirmatory factor analysis to compare the six-factor structure of the DSM-oriented scales to competing models consistent with developmental theories of symptom differentiation. We tested these models on both clinic-referred (N = 757) and school-based, nonreferred (N = 713) samples of youths in order to assess the generalizability of the factorial structures. Although previous research has supported the fit of the six-factor DSM-oriented structure in a normative sample of youths ages 7 to 18 (Achenbach & Rescorla, 2001), tripartite model research indicates that anxiety and depressive symptomology are less differentiated among children compared to adolescents (Jacques & Mash, 2004). We thus examined the relative fit of a six- and a five-factor model (collapsing anxiety and depression) with younger (ages 7-10) and older (ages 11-18) youth subsamples. The results revealed that the six-factor model fit the best in all samples except among younger nonclinical children. The results extended the generalizability of the rationally derived six-factor structure of the DSM-oriented scales to clinic-referred youths and provided further support to the notion that younger children in nonclinical samples exhibit less differentiated symptoms of anxiety and depression.

Engineering Youth Service System Infrastructure: Hawaii's Continued Efforts at Large-Scale Implementation Through Knowledge Management Strategies

Hawaiis Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaiis mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the systems infrastructure.

An Exploratory Factor Analysis of the Knowledge of Evidence-Based Services Questionnaire.

Recent developments for disseminating and implementing evidence-based practices (EBPs) have emphasized the importance of increasing therapists’ knowledge of such techniques. However, systematic efforts to measure knowledge in therapists serving youth have mostly relied on poorly researched study-specific measures. This study investigated the structure of EBP knowledge in a large sample of youth community therapists (N = 240) via a therapist report instrument emphasizing therapeutic commonalities across various types of treatment approaches. Findings supported a three-factor structure of knowledge with scores on factors varying by therapists’ primary practice setting and education level. The relationships between therapist knowledge of and attitudes towards EBPs are also discussed.

Therapist Attitudes Towards Evidence-Based Practice: A Joint Factor Analysis

Despite the accumulated research support for the use of evidence-based practices (EBPs) with youth, these treatment approaches remain underutilized in community settings. Therapist attitudes towards EBPs play a pivotal role in their adoption and implementation of these practices. The present investigation employs joint exploratory factor analysis to evaluate the structure of two measures of therapist attitudes, the Evidence-Based Practices Attitudes Scale and the Modified Practice Attitude Scale. Results suggest three factors including (a) importance of clinical experience over EBPs, (b) clinician openness to change, and (c) problems with EBPs. Recommendations are provided for future evaluation of therapist attitudes and associated characteristics.

Evidence-Based Practice Implementation Within a Theory of Planned Behavior Framework

Although significant progress has been made in the identification of youth evidence-based practices, the adoption of these interventions into community-based mental health care remains limited. Dissemination and implementation (DI) research has the potential to bridge this science-practice gap in clinical psychology. The theory of planned behavior (TPB) offers a useful conceptualization of individual behavior change including behavioral intention as defined by attitudes, subjective norms, and perceived behavioral control. To facilitate application of this model to DI efforts, the current study explores perspectives about using evidence-based practice from stakeholders in the field of youth mental health (including clinical supervisors, case managers, administrators at the departments of health and education, and direct service providers in clinic-based, school-based, and intensive in-home settings) within the TPB framework. A set of instrument items was created from this rich qualitative data using a rigorous mixed-method content validation approach. Instrument items are provided for future use in DI research.