The Interrater Reliability of a Coding System for Measuring Mental Health Professionals' Decisions and Actions.

OBJECTIVE: The clinical decisions and actions of evidence-based practice in psychology (EBPP) are largely underspecified and poorly understood, in part due to the lack of measurement methods. We tested the reliability of a behavioral coding system that characterizes a flow of interrelated activities that includes problem detection and prioritization, intervention selection and implementation, and review of intervention integrity and impact. METHOD: The context included two publicly funded youth mental health service organizations located in geographically distinct and underresourced communities in the U.S. where service inequities are common. We sampled 84 digitally recorded and transcribed supervision events that included a sample of professionals who were mostly women (93.02%) and BIPOC (86.04%) whose self-reported race/ethnicity matched the youth populations they served. We coded these events for activities (e.g., considering) and their predicate content (i.e., problems or practices) and examined reliability of these codes applied to excerpts (i.e., small contiguous units of dialogue) as well as to complete events. RESULTS: Interrater reliability estimates showed that, overall, coders reliably rated the occurrence and extensiveness of activities and content. Excerpt coding was generally more reliable than event coding. However, mathematical aggregation of excerpt coding offered a superior method for estimating event codes reliably, reducing individual subjectivity while providing event level synthesis of activities that are grounded in excerpt level details. CONCLUSIONS: The assessment of clinical decisions and actions has the potential to unpack the black box of EBPP, with different methods best suited to different research questions and resource considerations.

A pilot study to evaluate feasibility and acceptability of training mental health workers in India to select case-specific intervention procedures within a dynamic modular treatment designed for a low-resource setting.

RATIONALE, AIMS AND OBJECTIVES: A key consideration in designing scalable solutions for improving global mental health involves balancing the need for interventions to be uncomplicated for mental health workers (MHWs) and the need for the intervention to be widely applicable to many clients. Often these needs are in competition, since interventions are routinely simplified by removing procedures or reducing their dynamic responsivity, which in turn lowers their overall utility in serving large, clinically diverse populations. The principal aim of this pilot study involved evaluating the feasibility and acceptability of a brief strategy designed to delegate problem classification and practice selection to MHWs operating within a flexible, modular, cognitive behavioural protocol. A secondary aim involved gathering data on which to base a hypothesis regarding the potential effectiveness of this strategy. METHOD: Within an open trial, an educationally diverse sample of local MHWs in India (N = 18) reviewed fictional case vignettes, classified mental health problems, and then selected practices before and after a two-hour training that included a one-page decision-making resource. Feasibility was measured by assessing the integrity of the study protocol and training, the measurement and administration of questionnaires as well as study recruitment and completion. Acceptability of the intervention was measured by MHW-perceived performance, ease of use, value, importance, and intention for continued use. Decision-making accuracy was assessed by comparing MHWs' clinical decisions with criteria established through consensus among psychologists with expertise in modular protocols. RESULTS: Results suggested high feasibility and acceptability on all metrics. Secondary analysis revealed that MHW's decision-making accuracy and confidence also significantly improved, providing a basis for the hypothesis that this brief approach is useful for building MHW capacity in low-resource settings. CONCLUSION: Overall these findings provide initial support for these methods and potential training outcomes to test within a larger, randomized controlled trial.

Resilience Resources Scale: A brief resilience measure validated with undergraduate students.

Objective: This paper presents a theory-based brief resilience scale, the Resilience Resources Scale (RRS), and evidence for its factor structure, reliability, and validity in two studies of undergraduate students. Participants: Study 1 sampled 295 students and Study 2 sampled 244 students. Methods: Study 1 participants completed the RRS and other measures online at one of two time points eight weeks apart (n = 193), or at both time points (n = 102). Study 2 participants completed the RRS and other measures online on a single occasion. Results: Factor analyses provided evidence for a one-factor model. Results indicated high internal consistency and strong test-retest reliability. Evidence of concurrent and predictive validity is presented. Conclusions: The RRS measures resilience resources known to be protective of physical and mental health. This brief scale has sound psychometric properties in these initial studies of undergraduate students. We offer possible directions for use of the RRS in this and other populations.

Is psychopathology elevated in Big-C visual artists and scientists?

The idea that psychopathology is associated with exceptional creativity has persisted despite a paucity of corroborating or disconfirming evidence. The authors measured psychopathology, including schizotypal personality traits, social responsiveness/autism spectrum traits, and lifetime incidence of mental disorders, along with lab-based tests of creativity in a unique sample of Big-C (exceptionally creative) individuals. The authors examined Big-C visual artists (VIS; n = 35), Big-C scientists (SCI; n = 41), and a smart comparison group (SCG; n = 31) matched on age, sex, race/ethnicity, parental education, and estimated IQ. Neither lifetime nor current prevalence of mental disorders was higher in Big-C groups relative to either the SCG or epidemiologic estimates, but individuals without a lifetime history of psychiatric disorder scored higher on a test of creative cognition relative to those who had at least one lifetime diagnosis. The groups differed in self-reported symptoms: VIS reported more schizotypal features than both SCI and SCG, and higher levels of socially divergent traits than SCI. Self-reported symptoms were below diagnostic thresholds in all 3 groups. The findings indicate that neither exceptional creativity nor performance on tests that putatively assess creativity are associated with mental illness but suggest that certain schizotypal features and socially divergent traits-at subclinical levels-are associated with Big-C achievement, at least in visual artists. The findings further raise questions about the sensitivity of laboratory tests for Big-C cognition. (PsycINFO Database Record (c) 2019 APA, all rights reserved).