| 1. |
- Egeland, Karina Myhren, et al.
(författare)
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How to implement Illness Management and Recovery (IMR) in mental health service settings : evaluation of the implementation strategy
- 2017
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Ingår i: International Journal of Mental Health Systems. - : BIOMED CENTRAL LTD. - 1752-4458. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. Methods: A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Results: Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. Conclusions: The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice.
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| 2. |
- Forster, Martin, 1971-
(författare)
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When Cheap is Good : Cost-Effective Parent and Teacher Interventions for Children with Externalizing Behavior Problems
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is strong empirical support for behavioral parent training (BPT) as an intervention for children with externalizing behavior problems (EBP). However, there is a lack of studies that have investigated the effectiveness of BPT in routine care. Furthermore, most families in need of service do not gain access to it. Another issue of concern is that a sizable portion of children who take part in BPT does not show clinical significant improvement. With regard to behavioral teacher training (BTT) for students with EBP, there is a paucity of intervention trials using randomized design. The training procedures have rarely been standardized, which have resulted in interventions that are dependent upon heavy involvement of external consultants. To improve the accessibility to service for students with EBP, intervention models that are feasible for typical school personnel need to be developed. Study I investigated the effects of BPT in routine care. The participants were randomized to BPT with full practitioner support (BPT-P), self-administered BPT with minimal practitioner support (BPT-S), or a waitlist control group (WL). The study showed that BPT implemented by briefly trained social service employees (BPT-P) resulted in at least as large effects as previous efficacy studies. PMT-S also showed significant effects compared to the WL, but was less effective than PMT-P. Improvements in child behaviors were mediated by improved parenting behaviors. Study II investigated the effects of an enhanced version of the BPT-program from study I. The program targeted families with risk factors for non-response that were referred to service within the social services. The results showed strong intervention effects on child EBP and parent anxiety/depression for enhanced BPT compared to regular BPT. Study III used a randomized design to evaluate the effects of a standardized and feasible BTT program. At both posttest and follow-up, significant effects favoring the BTT-group over the active control group were found on student EBP, teacher behavior management, and peer problems. The study also showed that the effect on student EBP was mediated by change in teacher behavior management.
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| 3. |
- Gustafsson, Jan-Eric, 1949, et al.
(författare)
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School, Learning and Mental Health : A systematic review
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten presenterar resultaten från en systematisk översikt av forskning om skola, lärande och barns psykiska hälsa. Kungliga Vetenskapsakademiens Hälsoutskottet har givit uppdraget att genomföra en sådan översikt till en arbetsgrupp som har arbetat med uppdraget från hösten 2008 till mars 2009. Det första syftet med översikten är att genomföra en kartläggning av forskning inom det breda fält som behandlar frågor om skola, lärande och barns och ungdomars psykiska hälsa. Det andra syftet är att genomföra en narrativ syntes av forskning som undersökt orsaksförhållanden mellan psykisk hälsa å ena sidan och skolresultat och lärande å den andra sidan. Det tredje syftet är att redovisa resultat från forskning som har studerat svenska barns och ungdomars erfarenheter och upplevelser av skola och undervisningssituationer. För att uppnå de första två syftena genomfördes systematiska litteratursökningar i bibliografiska databaser av artiklar publicerade i vetenskapliga internationella tidskrifter inom olika discipliner. Det tredje syftet undersöktes med litteratursökningar av kvalitativa svenska studier i bibliografiska databaser. Slutsatser På grundval dels av kartläggningen av forskning om skola, lärande och psykisk hälsa, dels av de två fördjupade översikterna kan följande slutsatser dras: • Omfattningen av forskning som undersöker relationerna mellan olika aspekter av skola och psykisk hälsa är begränsad och i synnerhet gäller detta forskning som undersöker organisationsfaktorer och undervisnings-faktorer, aktiviteter, läroplaners utformning, resurser, specialpedagogiskt stöd, och olika former av betyg och bedömning. • Tidiga svårigheter i skolan och i synnerhet läs- och skrivsvårigheter kan orsaka internaliserande och externaliserande psykiska problem. • Svårigheter i skola och psykiska problem tenderar att vara stabila över tid. • Skolrelaterade hälsoproblem tenderar att minska när eleverna börjar på gymnasiet och får tillgång till nya områden av aktiviteter, roller och valmöjligheter. • Att genomföra stora ansträngningar utan att detta leder till resultat är relaterat till utveckling av depression. Problem i skolan med skolresultat och prestationer orsakar inter-naliserande symptom för flickor under tonåren. • Det finns samband mellan olika typer av psykiska problem och de är också relaterade till ett brett spektrum av somatiska och psykosomatiska symptom. • Internaliserande och externaliserande psykiska problem har negativa effekter på skolprestationer genom mekanismer som är delvis ålders- och genusspecifika. • Kompetenser och prestationer i skolan är relaterade till psykisk hälsa. • Goda resultat i skolan har en positiv effekt på självuppfattning. • En god självuppfattning bidrar inte direkt till bättre resultat, men andra faktorer som är relaterade till självuppfattning (motivation och upplevd inre/yttre kontroll) påverkar lärande och resultat • Relationer med klasskamrater och lärare bidrar till processer som kopplar skolmisslyckande till psykisk ohälsa. Relationer med kamrater och lärare kan också skydda mot utvecklingen av psykiska problem. • Jämförelser med klasskamrater påverkar självuppfattningen, med effekter som varierar beroende på gruppsammansättning och typ av skola.
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| 4. |
- Karlberg, Martin, 1969-
(författare)
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Skol-Komet : Tre utvärderingar av ett program för beteendeorienterat ledarskap i klassrummet
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children who express externalizing behaviors in school are at greater risk of school failure and peer rejection. They are also at greater risk of developing antisocial behaviors, addiction to drugs, mental health problems and delinquency. Many teachers experience difficulties in working with pupils expressing externalizing behaviors. The aim of this thesis is to evaluate a classroom behavior management program called Comet. The main principle of Comet is to get the teacher to use effective strategies when the pupil who is targeted for intervention, and the rest of class, are behaving appropriately and inappropriately. Two versions of the program are evaluated in the thesis: Comet for teachers (Comet-T) and Comet for parents (Comet-P). Three studies are committed to evaluate Comet-T. In the first study Comet-T was compared to an active control group. 100 children (aged 8) were randomized into Comet-T or the control group. At post test and follow-up Comet-T received a better results in reducing externalizing problems, peer problems and teacher behavior management. An analysis of mediators showed that changes in teacher behaviors mediated externalizing behavior. In the second study, children (aged 6 -13) were randomized into two groups. 44 pupils received Comet-T and 42 pupils received a combined intervention consisting of Comet-T at school and Comet-P at home. At post test and follow-up the results show that the combination of Comet-T and Comet-P reduced the externalizing behaviors at home more than Comet-T (only). However, there were no significant differences between the two conditions regarding decrease in externalizing behaviors at school. In the third study Comet-T was compared to a brief version called Comet-TB. At post test Comet-TB had a greater reduction of externalizing behaviors compared to Comet-T. The studies conclude that teachers can use behavior management techniques to decrease externalizing behaviors in the classroom. Furthermore, teachers cannot rely on parent management programs in order to decrease externalizing problems in school. Instead, behavior problems in school need to be solved within school settings. Finally, even a brief program can be effective in order to decrease externalizing behaviors.
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| 5. |
- Nylen, Kata, et al.
(författare)
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Knowledge and Will : An Explorative Study on the Implementation of School-Wide Positive Behavior Support in Sweden
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- School-wide positive behavior support (SWPBIS) is a well-evaluated school approach to promoting a positive school climate and decreasing problem behaviors. Initial implementation is one of the most critical stages of program implementation. In this qualitative study, the initial implementation of SWPBIS in Swedish schools was studied using an implementation model of behavior change as guidance for interviews and analyses. The study makes significant contributions to previous research as little is known of the implementation of SWPBIS in Swedish context. Focus-group interviews were conducted with 59 professionals on implementation teams from nine schools. Themes were extracted according to implementation team members' perceptions and descriptions of how the initial implementation was carried out. The results of this study revealed relevant themes within the three domains of Capability, Opportunity, and Motivation. Core features were found under the themes of knowledge and experience of similar evidence-based programs, process or result orientation, time, manual content, organizational prerequisites, team functioning, implementation leadership, program as a unifying factor, program aligning with staff beliefs, plausible expectations, and emotional reinforcement. Results are discussed in terms of how they can be used in continuing to develop the Swedish model of SWPBIS. Implications regarding implementation in Swedish schools are discussed, as is the applicability of the model of behavior change for studying implementation in schools.
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| 6. |
- Olofsson, Viveca, 1963-
(författare)
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Child prevention and group based parenting programs : effectiveness and implementation
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Approximately 10–25% of children and youth suffer from mental health problems, such as depression, emotional difficulties, and disruptive behaviors. The evidence base of the effectiveness of preventive interventions targeting youth mental health currently delivered in regular care is weak. Also, little is known about what is needed for continued delivery of preventive programs in regular care. Hence, there is an evident need of effectiveness evaluations of preventive interventions and their implementation in regular care. In childhood, parenting is an important risk or protective factor for child development, and many programs to improve parents’ parenting has been developed used as preventive interventions. Using an ecological approach to prevention and the prevention research cycle as the theoretical framework this dissertation aim to investigate: 1) the long-term effectiveness of four parenting programs (Cope, Comet, Connect, and the Incredible Years); 2) whether the programs work better for some compared to others; 3) if it matters where parents attend the programs; 4) the field of implementation research regarding group based parenting programs ; and 5) implementation challenges specifically related to such parenting programs. Overall, the long-term results reveal that there are no significant difference in effectiveness across the programs over time. Also, the programs does not seem work better for some compared to others, and neither does it seem as if program effectiveness is much influenced by the sectors delivering the programs (child and adolescent psychiatry, social care, or school). Concerning the implementation of preventive interventions the research base is small, and conclusive evidence concerning implementation aspects of group based parenting programs are non-existing. Thus, it was not possible to draw firm conclusions about their implementation. Nonetheless, existing research clearly suggest that program specific challenges can influence the implementation of group based parenting programs. Implications for practice and research are discussed, for instance, adaptations to the prevention research cycle.
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| 7. |
- Olsson, Tina
(författare)
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Crossing the Quality Chasm? : The short-term effectiveness and efficiency of MST in Sweden: An example of evidence-based practice applied to social work
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this dissertation is to evaluate the effectiveness and cost-effectiveness of Multisystemic Therapy (MST) in Sweden. This evaluation is set against the background of evidence-based social work practice and is organized around four separate but interrelated studies. The first of these studies used program theory reconstruction to investigate three conceptualizations of evidence-based practice (EBP). Here it is argued that evidence-based practice is not a homogeneous concept, and that interested parties within research, practice and policy may not have a shared vision of EBP, even though they may use the same terminology. The second study, a randomized trial, assessed the effectiveness of MST within the normally operating social services system for 156 youths who met the diagnostic criteria for conduct disorder. Youth were randomly allocated between MST and treatment-as-usual (TAU) groups. Assessments were conducted at intake and seven months after referral. Results from mulitagent and multimethod assessment batteries showed a general decrease in psychiatric problems and antisocial behaviors among participants across treatments. There were no significant differences in treatment effects between the two groups. The third study assessed the costs of treating conduct disorder with MST and TAU. From the perspective of the municipal social welfare system, all intervention costs were collected for the six-month period starting at randomization to treatment group. MST was not found to reduce the extent to which youth were placed outside of their homes. In addition, the costs of out-of-home placement were the same for both MST and TAU group youth. MST was, however, associated with a reduction in the use and costs associated with other non-placement services. This reduction was not found to offset the additional cost of MST. The fourth and final study investigated the treatment outcomes and costs associated with MST versus TAU for intervention with substance abusing and non-substance abusing conduct disordered youth. This study found no differences in treatment outcome between these two groups. This dissertation found MST to be equally effective but less cost-effective than TAU.
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