Samantha L. Matlin

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: a randomized effectiveness trial.

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10–15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness.

Suicidality and depression among african american adolescents: the role of family and peer support and community connectedness.

Rates of suicide are increasing among African American adolescents and pose a significant public health concern. One area that has received little attention is the relationship between various types of social support and suicide, and the extent to which support moderates the relationship between depressive symptoms and suicidality. A total of 212 African American adolescents completed in-school surveys on three types of social support: family support, peer support, and community connectedness. The survey also addressed depressive symptoms and suicidality, as measured by reasons for living, a cognitive measure of suicide risk. Hierarchical multiple regression analyses were used to examine direct and moderating relationships between types of social support and suicidality. The results indicated that increased family support and peer support are associated with decreased suicidality, and peer support and community connectedness moderated the relationship between depressive symptoms and suicidality. Over a third of the variability in reasons for living was predicted by family support, peer support, and community connectedness. Implications for research and preventative interventions for African American adolescents are discussed.

Developing Suicide Prevention Programs for African American Youth in African American Churches

Suicide prevention programs for African American youth in African American churches may have broad appeal because: (1) the Black Church has a strong history of helping community members, regardless of church membership; (2) African Americans have the highest level of public and private religiousness; and (3) the church can help shape religious and cultural norms about mental health and help-seeking. The proposed gatekeeper model trains lay helpers and clergy to recognize the risk and protective factors for depression and suicide, to make referrals to the appropriate community mental health resources, and to deliver a community education curriculum. Potential barriers and suggestions for how to overcome these barriers are discussed.

Providing Competency Training to Clinical Supervisors through an Interactional Supervision Approach.

Training in supervisory competencies is essential to effective clinical practice and helps address the current national crisis in the behavioral health workforce. Interactional supervision, the approach used in the current study, is well established in clinical social work and focuses the task of the supervisee on the interpersonal exchanges encountered in clinical practice. This study examines the feasibility of supervisory competency training and associated gains in competencies among 81 clinical supervisors. Three types of competencies are assessed before and after training and at a 3-month follow-up—managing supervisory relationships, managing job performance, and promoting professional development. The results show that competency training is a feasible and potentially effective approach and is associated with supervisor satisfaction and stress management. The training employed is compatible with skills-based and intervention-specific supervisor training common among evidence-based treatments and is appropriate for use with clinical social workers, counseling and clinical psychologists, and psychiatric nurses.

Twenty-First Century Science as a Relational Process: From Eureka! To Team Science and a Place for Community Psychology

In this paper we maintain that twenty-first century science is, fundamentally, a relational process in which knowledge is produced (or co-produced) through transactions among researchers or among researchers and public stakeholders. We offer an expanded perspective on the practice of twenty-first century science, the production of scientific knowledge, and what community psychology can contribute to these developments. We argue that: (1) trends in science show that research is increasingly being conducted in teams; (2) scientific teams, such as transdisciplinary teams of researchers or of researchers collaborating with various public stakeholders, are better able to address complex challenges; (3) transdisciplinary scientific teams are part of the larger, twenty-first century transformation in science; (4) the concept of heterarchy is a heuristic for team science aligned with this transformation; (5) a contemporary philosophy of science known as perspectivism provides an essential foundation to advance twenty-first century science; and (6) community psychology, through its core principles and practice competencies, offers theoretical and practical expertise for advancing team science and the transformation in science currently underway. We discuss the implications of these points and illustrate them briefly with two examples of transdisciplinary team science from our own work. We conclude that a new narrative is emerging for science in the twenty-first century that draws on interpersonal transactions in teams, and active engagement by researchers with the public to address critical accountabilities. Because of its core organizing principles and unique blend of expertise on the intersection of research and practice, community psychologists are well-prepared to help advance these developments, and thus have much to offer twenty-first century science.

A Community’s Response to Suicide Through Public Art: Stakeholder Perspectives from the Finding the Light Within Project

Suicide is a preventable public health problem and a leading cause of death in the United States. Despite recognized need for community-based strategies for suicide prevention, most suicide prevention programs focus on individual-level change. This article presents seven first person accounts of Finding the Light Within, a community mobilization initiative to reduce the stigma associated with suicide through public arts participation that took place in Philadelphia, Pennsylvania from 2011 through 2012. The stigma associated with suicide is a major challenge to suicide prevention, erecting social barriers to effective prevention and treatment and enhancing risk factors for people struggling with suicidal ideation and recovery after losing a loved one to suicide. This project engaged a large and diverse audience and built a new community around suicide prevention through participatory public art, including community design and production of a large public mural about suicide, storytelling and art workshops, and a storytelling website. We present this project as a model for how arts participation can address suicide on multiple fronts—from raising awareness and reducing stigma, to promoting community recovery, to providing healing for people and communities in need.

Applying the Policy Ecology Framework to Philadelphia's Behavioral Health Transformation Efforts.

Abstract Raghavan et al. (Implement Sci 3(26):1–9, 2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the “policy ecology,” including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia’s efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed.

Heightened vagal activity during high-calorie food presentation in obese compared with non-obese individuals--results of a pilot study.

Eating behaviours are highly cue-dependent. Changes in mood states and exposure to palatable food both increase craving and consumption of food. Vagal activity supports adaptive modulation of physiological arousal and has an important role in cue-induced appetitive behaviours. Using high-frequency heart rate variability (HF HRV), this preliminary study compared vagal activity during positive and negative mood induction, and presentation of preferred high-calorie food items between obese (n = 12; BMI ≥ 30) and non-obese individuals (n = 14; 18.5 < BMI < 30). Participants completed two laboratory sessions (negative vs. positive mood conditions). Following 3-h of food deprivation, all participants completed a mood induction, and then were exposed to their preferred high-calorie food items. HF HRV was assessed throughout. Obese and non-obese individuals were not significantly different in HF HRV during positive or negative mood induction. Obese individuals showed significantly greater levels of HF HRV during presentation of their preferred high-calorie food items than non-obese individuals, particularly in the positive mood condition. This is the first study to demonstrate increased vagal activity in response to food cues in obese individuals compared with non-obese individuals. Our findings warrant further investigation on the potential role of vagally-mediated cue reactivity in overeating and obesity.

Synchronizing Watches: The Challenge of Aligning Implementation Science and Public Systems.

This special issue of Administration and Policy in Mental Health explores the complexities of the outer system context in implementation science research. In this commentary, we highlight areas of asynchrony between implementation science research and policy realities of public systems. Timing is a critical factor for many aspects of system-level implementation including when and how evidence-based practice initiatives are launched, short and inconsistent timeframes for funding and support, need for early indicators of success and demonstrating return on investment. Greater consideration for the timing that drives change in public systems will strengthen efforts to implement and sustain EBPs in community settings.

Socio-psychological mediators of the relationship between behavioral health stigma and psychiatric symptoms

The stigma associated with mental illness or addiction is significantly and positively related to psychiatric symptoms. According to Modified Labeling Theory, several processes should mediate this relationship, including rejection experiences, stigma management (secrecy coping), and social support. In the first comprehensive test of this theory, we examined a serial mediation model on three waves of data from 138 adults receiving outpatient behavioral health treatment. Participants were recruited from outpatient behavioral health clinics in a large northeastern city in the United States and completed interviews that assessed stigma, rejection experiences, stigma management, social support, and psychiatric symptoms. There was a direct effect between stigma and psychiatric symptoms and an indirect effect in which perceived rejection, secrecy coping and social support sequentially and longitudinally intervened in the stigma and psychiatric symptom relationship. Higher perceptions of stigma predicted more rejection experiences, which marginally increased secrecy coping and decreased social support. In turn, decreased social support increased psychiatric symptoms. We provide support for Modified Labeling Theory and the clinical utility of specific mediators in the relationship between stigma and psychiatric symptoms among adults in behavioral health treatment living in urban settings.