TY - JOUR
T1 - Transdiagnostic treatment approaches for greater public health impact
T2 - Implementing principles of evidence-based mental health interventions
AU - Martin, Prerna
AU - Murray, Laura K.
AU - Darnell, Doyanne
AU - Dorsey, Shannon
N1 - Funding Information:
Although we see substantial advantages to multiproblem, modular and flexible, and lower complexity transdiagnostic approaches, there are also limitations. First, many of these treatments require more decision-making by the provider in terms of problem focus, module selection, sequencing, and dosing. Without sufficient training and supervision, this may lead to provider-level challenges in delivering the interventions effectively. As others have argued (Christon, McLeod, & Jensen-Doss,; Lyon et al.,), engaging in evidence-based assessment to inform case conceptualization, determine treatment response, and identify the need for additional modules or treatment provides a way to address some of these challenges. Some evidence suggests that teaching decision-making to lay providers is possible with supervision (Bolton et al.,; Weiss et al.,). Second, given that most treatment outcome studies focus on presenting efficacy data, information needed to effectively consider whether a treatment is potentially applicable in low-resource settings can be missing or limited in published manuscripts, often simply due to space limitations. Details such as provider selection, training (e.g., duration, type of training), supervision (e.g., duration, structure, supervisor selection), and any other support (e.g., stipend) provide important information about the resources that will likely be needed for implementation and would be valuable to organizations considering treatment adoption. Finally, with regard to transdiagnostic treatments more broadly, one limitation is that the proliferation of these approaches risks recreating a problem transdiagnostic approaches aim to address: synthesizing the transdiagnostic evidence base.
Publisher Copyright:
© 2018 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.
PY - 2018/12
Y1 - 2018/12
N2 - There is a high burden of mental illness in low-resource areas within the United States and in low- and middle-income countries. Significant challenges in implementing focal treatments in these settings call for a shift toward alternative treatment approaches that have a greater public health impact. We use Glasgow et al's. (American Journal of Public Health, 89, 1999, 1322) RE-AIM framework, which prioritizes not only intervention effectiveness, but also the dimensions of reach, adoption, implementation, and maintenance. We suggest that transdiagnostic approaches, specifically those that are multiproblem, modular, flexible and of lower complexity, offer several advantages in low-resource settings. We review their background, evidence, and specific characteristics that may advance RE-AIM dimensions in low-resource settings. We conclude with future directions to increase the public health impact of our mental health interventions.
AB - There is a high burden of mental illness in low-resource areas within the United States and in low- and middle-income countries. Significant challenges in implementing focal treatments in these settings call for a shift toward alternative treatment approaches that have a greater public health impact. We use Glasgow et al's. (American Journal of Public Health, 89, 1999, 1322) RE-AIM framework, which prioritizes not only intervention effectiveness, but also the dimensions of reach, adoption, implementation, and maintenance. We suggest that transdiagnostic approaches, specifically those that are multiproblem, modular, flexible and of lower complexity, offer several advantages in low-resource settings. We review their background, evidence, and specific characteristics that may advance RE-AIM dimensions in low-resource settings. We conclude with future directions to increase the public health impact of our mental health interventions.
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U2 - 10.1111/cpsp.12270
DO - 10.1111/cpsp.12270
M3 - Review article
AN - SCOPUS:85058450100
VL - 25
JO - Clinical Psychology: Science and Practice
JF - Clinical Psychology: Science and Practice
SN - 0969-5893
IS - 4
M1 - e12270
ER -