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1.
ABSTRACT

In this article, we provide critical information on previous research and offer recommendations for establishing and implementing teleconsultation services within a school setting. Specifically, we review (a) the history behind teleconsultation, (b) previous applications of technology and teleconsultation within the school setting, (c) recommended equipment for completing teleconsultation, (d) previously identified benefits of using teleconsultation, (e) previously identified concerns regarding the use of teleconsultation, and (f) the best practices for providing teleconsultation services. Important considerations from current research in the area of teleconsultation are highlighted.  相似文献   

2.
School-based psychological services are typically provided through a triadic model of consultation in which a school psychologist works directly with a teacher or school staff member to address the academic, behavioral, or mental health concerns of a student. With advances in current technology, school psychologists have the capacity to use videoconferencing to engage in their consultative responsibilities. Teleconsultation has the potential to improve the provision of consultative services by increasing school psychologists’ efficiency and providing individuals, especially those in rural areas, access to greater service. The current study evaluated the effectiveness and acceptability of teleconsultation as a means to deliver behavioral consultation services to three teachers and their students. A nonconcurrent multiple baseline across subjects was used. Results showed that consultants could develop a behavioral intervention with a teacher and effectively implement the intervention to improve student outcomes. Teachers also rated teleconsultation as an acceptable means for service delivery.  相似文献   

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4.
ABSTRACT

Over the last decade, there has been increased momentum to bring the worlds of physical and behavioral health care together. Instead of social work education simply reacting to this change, it is imperative that we be proactive and prepare students to be “multilingual,” that is, be able to speak and function in both the worlds of health and mental health so they can move seamlessly into the new world of integrated care. The purpose of this article is to explore curricular and pedagogical strategies needed to prepare graduate social work students for the coming shift in practice toward integrated health and mental health care.  相似文献   

5.
ABSTRACT

This study examined how partnerships between early care and education providers were developed and how they worked together to deliver comprehensive, high-quality services to infants and toddlers from low-income families. Survey data were collected from 220 Early Head Start (EHS) program directors and 386 child care center directors and family child care providers participating in EHS-child care partnerships. Research Findings: Nearly half of EHS programs chose partners with whom they had prior relationships, and most engaged them early (often before receiving the grant). Both EHS programs and child care providers described their relationships as mutually respectful and focused on similar goals. Through the partnerships, child care providers had access to professional development opportunities and offered children and families comprehensive services, such as health screenings. Practice or Policy: This study provided a nationally representative picture of EHS-child care partnerships. The findings suggest that strong relationships are foundational to the implementation of early care and education collaborations aimed at expanding access to high-quality care for infants and toddlers from low-income families. Collaborations are a potentially important policy lever that can help support the expansion of high-quality early care and education.  相似文献   

6.
BackgroundPrior research suggests that those experiencing adverse childhood experiences (ACEs) may be higher utilizers of the healthcare system. The frequency and financial impact of kept, cancelled and no-showed visits is largely unknown.ObjectiveTo examine the impact of adverse childhood experiences (ACEs) on healthcare utilization in a sample of US adults.Participants and SettingTwo thousand thirty-eight adult patients who completed an ACE screening within the behavioral health department of a medium sized, Midwestern healthcare system during 2015–2017 were included.MethodsData was extracted retrospectively from 1-year post ACE screen.ResultsIndividuals with high ACEs (4+) made more but kept fewer appointments than those with no or moderate (1–3) ACEs (p < 0.0001). Individuals with high ACES had more late-cancelled and no-showed appointments compared to those with no ACEs (p’s < .0001). Relationships were significant even after controlling for age, gender, and insurance type. Those with high ACEs had the greatest impact on potential lost revenue given that they late-cancelled and no-showed more appointments. Those with high ACEs also had more medical comorbidities, medications, and needed care coordinator than those with moderate or no ACEs (p’s < .05)ConclusionsResults from this study should be used to inform providers and health care systems on the effects of adversity on patterns of utilization of health care and encourage innovative strategies to better address the needs of these patients.  相似文献   

7.
This study of 231 regulated family child care providers proposed a theoretical model to explore the effects on quality of: (1) provider level of general education; (2) provider degree of intentionality; (3) provider training and experience in family child care; (4) provider use of support services; and (5) provider work environment. Hierarchical linear regressions confirmed the predictive power of the provider's degree of intentionality, level of education in early childhood education or a related discipline and use of support services. All these variables had a positive relationship with quality as measured by the Family Day Care Rating Scale (FDCRS). Higher level of general education in any field was a predictor until a college or university credential in ECE or a related discipline was included in the model. None of family child care training, length of experience as a provider, or any of the variables in the work environment block emerged as predictors. The data also supported the proposed associations between intentionality and the use of support services, training and the use of both support services and the work environment, and the use of support services and the work environment. While not totally supported by the data, the proposed theoretical model has value as a framework for further research. The findings are discussed in terms of their implications for governments.  相似文献   

8.
ObjectiveAbusive head trauma is the leading cause of physical abuse deaths in children under the age of 5 and is associated with severe long-lasting health problems and developmental disabilities. This study evaluates the long-term impact of AHT and identifies factors associated with poor long-term outcomes (LTOs).MethodsWe used the Truven Health MarketScan Research Claims Database (2000–2015) to identify children diagnosed with AHT and follow them up until they turn 5. We identified the incidence of behavioral disorders, communication deficits, developmental delays, epilepsy, learning disorders, motor deficits, and visual impairment as our primary outcomes.ResultsThe incidence of any disability was 72% (676/940) at 5 years post-injury. The rate of developmental delays was 47%, followed by 42% learning disorders, and 36% epilepsy. Additional disabilities included motor deficits (34%), behavioral disorders (30%), visual impairment (30%), and communication deficits (11%). Children covered by Medicaid experienced significantly greater long-term disability than cases with private insurance. In a propensity-matched cohort that differ primarily by insurance, the risk of behavioral disorders (RD 36%), learning disorders (RD 30%), developmental delays (RD 30%), epilepsy (RD 18%), and visual impairment (RD 12%) was significantly higher in children with Medicaid than kids with private insurance.ConclusionAHT is associated with a significant long-term disability (72%). Children insured by Medicaid have a disproportionally higher risk of long-term disability. Efforts to identify and reduce barriers to health care access for children enrolled in Medicaid are critical for the improvement of outcomes and quality of life.  相似文献   

9.
Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers’ decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed data from 1956 children 2–17 years old from the Second National Survey of Child and Adolescent Well-being. We examined associations of children’s predisposing, enabling, and need-related factors and caseworkers’ work environment characteristics with referral to mental health services. Caseworkers referred 21.0% of children to mental health services. In multivariable analyses controlling for potential covariates, factors associated with increased odds of caseworker referral included: older child age; child sexual abuse (versus neglect); child out-of-home placement; caregiver mental health problems; prior maltreatment reports; clinically significant child behavioral problems; and child welfare agency collaborative ties with mental health providers (all p < .05). Factors associated with decreased odds of caseworker referral included child Black race (versus White race) and lack of insurance (versus Private insurance) (all p < .05). In summary, children’s need for mental health services was positively associated with caseworker referral to services but certain predisposing and enabling factors and caseworker work environment characteristics also correlated with services referral. Interventions to reduce disparities in services referral by race and insurance type are critically needed. These may include child welfare agency implementation of policies for mental health screening, assessment, and services referral based on clinical need and establishment of child welfare-mental health agency collaborative ties.  相似文献   

10.
ABSTRACT

Research Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of high-quality support to child care providers; related factors; and hypothesized provider, family, and child outcomes. The model is based on a literature review of research on home-based child care, home visiting, early childhood mental health consultation, coaching, and family services. We hypothesize that high-quality support to home-based child care that offers relationship-based services focused on quality caregiving (individual home visiting and group supports such as training and networking) and sustainability (materials, equipment, referrals) is most likely to positively impact quality caregiving for children and families. Practice or Policy: Current federal efforts and policy initiatives to increase the supply and quality of infant–toddler child care focus on the development of systems that support home-based providers. The conceptual model of high-quality support described here will inform future program development and research on how to improve quality in home-based child care for the millions of low-income children in these settings.  相似文献   

11.
Schools are well positioned to provide access to youth mental health services, but implementing effective programs that promote emotional and behavioral functioning in school settings is complicated by the poor fit of interventions developed in research settings to complex school contexts. The current study formed a research–practice partnership with two urban public schools and mental health providers employed by those schools (N = 6, 100% female, 50% Black/African American, 50% White/Caucasian) in the adaptation of a depression prevention intervention, Act & Adapt. The intervention was modified by decreasing meeting time and streamlining session content, increasing flexibility, making intervention materials more similar to academic curriculum, and increasing the focus on managing disruptive behavior within group sessions. In an open trial, sixth-grade students (N = 22; 59% boys, 31% Hispanic, 22% Black/African American, 4% Asian, 30% White/Caucasian) at both schools who were identified as clinically “at risk” reported improvements from baseline to postintervention and at 1-year follow-up on measures of emotional and behavioral difficulties and coping strategies, with parallel results by caregiver report. The providers reported satisfaction with the intervention, and qualitative analyses of provider focus groups suggested both barriers and facilitators to research-practice collaborations to implement mental health interventions in schools.  相似文献   

12.
Abstract

This commentary discusses Robert May's reflections on policy for student mental health services on college and university campuses. The Report of the Harvard Provost's Committee on Student Mental Health Services is the impetus for his reflections. While May suggests that the student mental health unit be taken out of the medical unit, the Committee recommends that the variety of services be maintained, but out of the grip of managed care, and that there be greater collaboration and coordination among the services. While noting the psychiatric orientation of both the Committee and its Report, this author sees that the Report emphasizes the institutional context for students' emotional problems and the neglect of that context by recent Harvard University Health Services policies. The present author urges better collaboration between the services located in counseling services and those located in medical services.  相似文献   

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15.
The principal vehicles for counseling in the Peoples Republic of China are the neighborhood council and the extended family. In addition to providing access to many services, the local council offers informal counseling to families and individuals in the neighborhood through peer helpers. This council is also the first level in a three-tiered health care delivery system. Informal counseling is sup-plemented with counseling from paraprofessional health care providers in the neighborhood clinics. Severe problems are referred to the second level — the district hospital — which usually has a psychiatric unit with medical psychologists able to deal with problems on both inpatient and outpatient bases. The third level of assistance is provided through specialized institutes that take a few severe psychological problems for treatment, research, and teaching purposes. Schools refer special behavior problems through the health care or political systems, but care for minor behavior and educational problems is provided through the teacher working with the family in the educational setting. While most counseling services are conducted informally through family and neighborhood council members, the disadvantage is the close linkage of counseling regulatory tasks with functions monitoring behavior and enforcing political policy. On balance, however, it appears that the array of services offered through local councils with a caring neighborly attitude outweighs the disadvantages of loss of privacy and pressures to conform to local behavioral expectations and political demands.  相似文献   

16.
ABSTRACT

In this lead-in article, we define teleconsultation as the delivery of consultative services through videoconferencing and other technologies. We then describe the emergence and potential positive impact of teleconsultation in schools. Finally, we introduce the articles that make up this special issue of the Journal of Educational and Psychological Consultation.  相似文献   

17.
ObjectivesTo characterize the changes regarding the diagnosis of physical abuse provided to Child Protective Services (CPS) when CPS asks a Child Abuse Pediatrics (CAP) specialty group for a second opinion and works in concert with that CAP group.MethodsSubjects were reported to CPS for suspected physical abuse and were first evaluated by a physician without specialized training in Child Abuse Pediatrics (non-CAP physician). Subjects were then referred to the area's only Child Abuse Pediatrics (CAP physician) group, located in a large metropolitan pediatrics center in the United States, for further evaluation. The diagnoses regarding abuse provided by CAP physicians working in concert with CPS were compared to those provided to CPS by other physicians.ResultsTwo hundred consecutive patients were included in the study. In 85 (42.5%) cases, non-CAP physicians did not provide a diagnosis regarding abuse, despite initiating the abuse report to CPS or being asked by CPS to evaluate the child for physical abuse. Of the remaining 115 cases, the diagnosis regarding abuse differed between non-CAP physicians and CAP physicians working in concert with CPS in 49 cases (42.6%; κ = .14; 95% CI, ?.02, .29). In 40 of the 49 cases (81.6%), CAP assessments indicated less concern for abuse when compared to non-CAP assessments. Differences in diagnosis were three times more likely in children from a nonurban location (OR 3.24; 95% CI, 1.01, 11.36).ConclusionsIn many cases of possible child physical abuse, non-CAP providers do not provide CPS with a diagnosis regarding abuse despite initiating the abuse investigation or being consulted by CPS for an abuse evaluation. CPS consultation with a CAP specialty group as a second opinion, along with continued information exchange and team collaboration, frequently results in a different diagnosis regarding abuse. Non-CAP providers may not have time, resources, or expertise to provide CPS with appropriate abuse evaluations in all cases.Practice implicationsThough non-CAP providers may appropriately evaluate many cases of physical abuse, the diagnosis regarding abuse provided to CPS may be changed in some cases when CAP physicians are consulted and actively collaborate with CPS investigators. Availability of Child Abuse Pediatrics subspecialty services to investigators is warranted.  相似文献   

18.

This study examined the role of managed mental health care in the counseling of gifted children and families. When gifted children and their families experience difficulties resulting from giftedness, they have the option of choosing a private provider, although cost is often prohibitive. Moreover, when insurance is used to offset the cost, most mental health insurance policies have a managed care component. One requirement of managed care is that services be medically necessary to alleviate a recognized mental illness diagnosis. Problems resulting from giftedness may not be recognized as a mental illness. As a result, insurance may not pay for these counseling costs. However, this does not have to be the case because of the flexibility managed care case managers have to make judgments. 40 managed care case managers were surveyed to address this issue. 14 of the case managers consented to individual interviews. The results indicate that some case managers would approve reimbursement and others would not. The study describes criteria and conditions that need to be met for reimbursement.  相似文献   

19.
ObjectiveThis study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity).MethodsA retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N = 211), and their infants.ResultsInfants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight.ConclusionsThough those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody.Practice implicationsAmong mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.  相似文献   

20.
ABSTRACT

Early childhood mental health consultation (ECMHC) is a framework that continues to expand as students’ social-emotional needs emerge at younger ages. The present systematic review examines the extant literature surrounding the use of ECMHC and behavioral consultation in addressing mental health concerns and challenging behaviors in preschool students. Findings associated with this systematic review suggest that ECMHC could be a promising practice for targeting internalizing and externalizing behavioral concerns in prekindergarten students across a variety of settings. However, more research is needed in the areas of mental health/behavioral consultation and disciplinary disproportionality, as well as on the impact of such practices on preschool children of color. Implications for school psychologists are discussed, as are disciplinary practices when providing ECMHC and behavioral consultation services with students of diverse racial, ethnic, and cultural backgrounds.  相似文献   

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