Scott Migdole

Schoolwide Positive Behavior Support in an Alternative School Setting: An Evaluation of Fidelity, Outcomes, and Social Validity of Tier 1 Implementation.

The paucity of research investigating the effectiveness of universal behavioral strategies for supporting students in alternative educational settings is of great concern. However, a growing literature base supporting schoolwide positive behavioral support interventions (SWPBS) has been encouraging. This program evaluation provides additional support for this literature, indicating a positive impact of SWPBS Tier 1 implementation on key student outcome measures in a school serving students in Grades 5–12 identified with emotional disturbance or as otherwise health impaired. In addition, this program evaluation includes measures and positive findings for both (a) implementation fidelity and (b) social validity in this alternative school setting.

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.

Graduate Education and Training for Contemporary Behavioral Health Practice

Over the past decade, a new paradigm in behavioral health care has emerged. It places emphasis on cost control, evidence-based practice, patient safety, access to care, treatment relevance for diverse populations, consumerism, and quality of care. Unfortunately, graduate education and training programs have had difficulty keeping pace with the dramatic changes in the field. As a consequence, there is concern that the graduates of many of these programs are not being adequately prepared to practice in current health care systems. This article reviews the nature of recent changes in behavioral health care, the current status of graduate education programs with respect to these changes, and offers 15 recommendations for increasing the relevance of graduate education to contemporary clinical practice.

Supervision in Public Sector Behavioral Health: A Review

Supervision plays a key role in the provision of health and human services. An extensive literature exists on supervision as an element of professional development in behavioral health care. However, much less attention has been given to the practice of supervision in publicly funded systems of care for persons with mental and substance use conditions. This article provides a comprehensive review of the literature on supervision in the public sector, highlighting its current status, definition, functions, competencies, applicable standards and requirements, training approaches, and outcomes. Recommended strategies for restoring and advancing supervision as an essential practice in systems of care are discussed.

Exploring New Frontiers: Recovery-Oriented Peer Support Programming in a Psychiatric ED

Enhancing the diversity of roles for paid peer-support specialists is a topic of increasing interest throughout the country. Peer specialist positions promote a renewed sense of hope for the possibility of recovery, while also offering unique and valuable competitive employment options for mental health consumers. As we strive toward local and national recovery-oriented systems of care, we must continue to explore practical program applications and their associated benefits and challenges. The authors describe the development and implementation of a recovery-oriented peer support team within the psychiatric service of an emergency department (psychiatric ED) located at an academic medical center in a northeastern state.

Workforce Development and Mental Health Transformation: A State Perspective

The existence of a workforce crisis in behavioral health has been recognized for decades. However, workforce problems often have been viewed as too large, too complex, and too daunting for individual states to tackle. This article reviews the progress of one state in systematically strengthening its workforce as part of a federally supported effort to transform mental health services. The workforce priorities in Connecticut are identified and the specific workforce transformation projects and their impact are described. The success in sustaining these initiatives after cessation of federal support is reviewed. The authors conclude by offering five recommendations to guide comprehensive state workforce development. This work has particular salience for the many states across the nation that have identified behavioral health service and workforce needs as obstacles to comprehensive health care reform.