The Role of Paraprofessionals in Providing Treatment for Posttraumatic Stress Disorder in Low-Resource Communities

National Center for PTSD, VA Palo Alto Health Care System, Menlo Park Division, 795 Willow Rd, Menlo Park, CA 94025, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 08/2010; 304(5):571-2. DOI: 10.1001/jama.2010.1096
Source: PubMed
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    • "Reasonable concerns can be raised about the selection and training that would be required to ensure that these individuals—who often do not have formal mental health training— could appropriately manage the difficulties presented by children with conduct problems. Despite promising findings regarding the effectiveness of mental health services delivered to historically underserved populations by carefully selected and trained community members (e.g., Jain, 2010), the challenges of delivering services in this manner are substantial. Many of the challenges are eliminated or assuaged, however, if the focus of an intervention is on the prevention of disruptive behavior disorders rather than their treatment (Acevedo- Polakovich et al., 2013). "
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    ABSTRACT: Left untreated, conduct problems can have significant and long-lasting negative effects on children's development. Despite the existence of many effective interventions, U.S. Latina/o children are less likely to access or receive evidence-based services. Seeking to build the foundation to address these service disparities, the current study used a Community-Based Participatory Research approach to examine U.S. Latina/o parents' perceptions of the need for interventions to prevent childhood disruptive behaviors in their community in general, and of an existing evidence-based intervention-parent-child interaction therapy (PCIT)-in particular. Results suggest that parents recognize a need for prevention resources in their community and value most of the core features of PCIT. Nevertheless, important directions for potential adaptation and expansion of PCIT into a prevention approach were identified. Results point to several goals for future study with the potential to ameliorate the unmet mental health needs experienced by U.S. Latina/o families with young children at risk for developing conduct problems. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychological Services 11/2014; 11(4):410-20. DOI:10.1037/a0036200 · 1.08 Impact Factor
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    • "In addition to technical skills related to parent training and mental health triage, natural helpers might also need to be provided with guidance regarding the multiple ethical issues that can arise when working with underserved families (Jain, 2010). The work done to develop ethical principles and practices for other natural helper groups, including adults who mentor youth (e.g., Rhodes, Liang, & Spencer, 2009), can serve as a model. "
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    ABSTRACT: In response to the high levels of unmet need among historically underserved young children with conduct problems, this paper outlines some of the key issues involved in incorporating natural helpers into the delivery of parenting interventions for the treatment of conduct problems among historically underserved children. Strategies for the selection and training of natural helpers are discussed along with challenges that might be encountered in these processes. Directions for future research are also highlighted. With appropriate selection and training procedures in place, natural helpers may increase the accessibility of services for children and families and foster the reduction of service disparities.
    Children and Youth Services Review 09/2013; 35(9):1463–1467. DOI:10.1016/j.childyouth.2013.06.003 · 1.27 Impact Factor
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    ABSTRACT: We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine's typology, prevention programs were categorized as universal, selective, or indicated; programs containing more than one prevention level were characterized as multi-level. Family support types included those led by a mental health professional, led by a peer, or team-led. Among the 37 prevention programs reviewed, 27% (n=10) were universal, 41% (n=15) were selective, 16% (n=6) were indicated, and 16% (n=6) were multi-level. The predominant model of family support was professionally led (95%, n=35). Two (n=5%) provided team-led services. None were purely peer-led. In terms of content of family support services, all (100%, n=37) provided instruction/skill build. Information and education was provided by 70% (n=26), followed by emotional support (n=11, 30%) and instrumental or concrete assistance (n=11, 30%). Only 14% (n=5) provided assistance with advocacy. The distribution of models and content of services in prevention studies differ from family support within treatment studies. As family support is likely to be an enduring component of the child and family mental health service continuum, comparative effectiveness studies are needed to inform future development.
    Clinical Child and Family Psychology Review 11/2011; 14(4):399-412. DOI:10.1007/s10567-011-0100-9 · 4.75 Impact Factor
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