Faculty Bibliography

OBJECTIVE:This pilot study compared a novel communication strategy, the positive approach to the psychiatric interview, with the traditional approach to see if the positive approach can be taught to psychiatric residents; reproduced with standardized patients; measured with a structured scale, the "Positive Approach Outcome Measure," by blinded raters; and used to improve rapport (assessed with the Bond score), a key driver of engagement. METHODS:Thirty psychiatric residents were randomly assigned to conduct two psychiatric interviews with standardized patients. The standardized patients completed the Working Alliance Inventory-Short Revised, an assessment of the therapeutic alliance. T tests and linear regression examined the effect of the training on the outcome of interest, the Bond score. RESULTS:The Bond scores for the positive approach group (M = 19.27, SD = 2.87) and the traditional approach group (M = 16.90, SD = 3.44) were statistically significantly different (p = 0.05). All residents trained in the positive approach received a positive score on the Positive Approach Outcome Measure while none of the traditional approach-trained residents attained the threshold. The inter-rater reliability for the blinded raters was high (0.857), as was the intra-rater reliability (1.0). CONCLUSIONS:The positive approach can be taught to residents and reproduced consistently and was associated with improvement in a key driver of treatment engagement: rapport. The positive approach may be an important, inexpensive intervention to improve treatment engagement and ultimately treatment outcomes.

OBJECTIVES/UNASSIGNED:Courses on well-being are increasingly evaluated to see how they may promote mental health in college. We examined the impact of a course on students' well-being, anxiety, and depression. METHODS/UNASSIGNED: = 114). Well-being measures included the PERMA Profiler and Satisfaction with Life Scale (SWLS) at the beginning and conclusion of the semester. The Depression Anxiety and Stress Scale - 21 items (DASS-21) measured psychopathology. RESULTS/UNASSIGNED: = .264) in SOH. There was no improvement for the PERMA Profiler in either group, and no differences between groups. There was no significant change on the DASS-21 for SOH subjects. CONCLUSIONS/UNASSIGNED:Undergraduate courses that deliver positive psychology psychoeducation have a small effect size even in non-randomized studies. Future curriculum innovation is needed and better research to validate positive psychology psychoeducation.

This paper describes the implementation of Behavioral Activation (BA) as the core psychotherapy treatment within a broader clinician-led effort to establish a care pathway for adolescent depression in an academic medical center that served public and private hospital systems. This quality improvement effort required a standardized yet flexible approach to psychotherapy to be used by clinicians with a range of experience and training backgrounds while serving diverse clinical populations in child psychiatry and pediatric clinics. This paper highlights implementation of BA in treating adolescent depression across these varying systems. In particular, the paper emphasizes the application of BA as a principle-driven, treatment that enables flexibility across settings while remaining rooted in scientific evidence. The paper also reviews lessons learned from this effort that may support efforts to implement BA in other clinical settings and systems.

Objectives: Undergraduate college courses on well-being have proliferated in the United States, but there are few data examining whether they have an impact on student well-being or mental health. This study examined the impact of such a course on students' well-being and grade point average (GPA) compared to students who completed a psychology course on psychopathology.
Method(s): Participants were 152 undergraduates enrolled in the "Science of Happiness" (SOH), which focuses on well-being and mental health challenges (n = 64), and "Child and Adolescent Psychopathology" (CAP), a psychology course (n = 88). Well-being measures were collected using validated questionnaires (PERMA Profiler [PP], Satisfaction with Life Scale [SWLS]) at the beginning of the semester and at the completion of the semester. Both t tests and linear regression examined the effect of the courses on the outcomes.
Result(s): At baseline, there were no statistically significant differences in well-being or grades between the 2 groups. Examining the pre/post-SOH changes, we found statistically significant improvements on the SWLS (M = 1.28; SD = 4.85; t63 = 2.11; p < 0.04) and in GPA (M = 0.07; SD = 0.17; t72 = 3.47; p < 0.001). The improvement in the PP Well-being was not significant for either SOH or CAP but trended positive for SOH (M = 0.05) and negative for CAP (M = -0.05). In CAP, there was no statistically significant improvement in SWLS, but GPA change was statistically significant (M = 0.04; SD = 0.14; t96 = 2.99; p < 0.004). When we examined the pre-/postdifferences between the 2 groups, we found no statistical significance for SWLS or GPA.
Conclusion(s): Given the prevalence of mental health challenges in college students and the need for effective, large-scale prevention interventions for this population, courses on well-being are a strategy that warrant further exploration. PRE, COLST, SC
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In traditional medical practice, the diagnostic interview is focused on symptom collection, diagnosis, and treatment. The psychiatric interview is based on the medical model, but mental health clinicians lack the tests found in general medicine. Rapport is the most essential tool for the psychiatrist to uncover symptoms and develop a diagnosis and treatment plan. This article brings a scientific lens to the psychiatric interview. Under this microscope the value of eliciting the patient's well-being at the outset of the interview becomes clear. Using positive psychology, an evidenced-based rationale for the positive assessment is outlined and methodology and practice of the assessment reviewed.

Objectives: The application of mindfulness-based practices in psychiatry is indeed real and patient-level outcomes include symptom reduction and enhanced sense of well-being. Perhaps as importantly, the provider also experiences gains such as enhanced attention, empathy, compassion, and resilience. Methods: This hands-on workshop led by experienced mindfulness-based researchers, practitioners, and authors will consider the evidence for mindfulness in clinical psychiatry and teach the audience several simple mindfulness exercises for themselves and their patients. Results: Upon workshop completion, participants will have considered the application of mindfulness in several common practice-based cases in child psychiatry. Conclusions: The clinician will be able to define mindfulness, understand its applications, refine mindfulness techniques as part of their toolkit, and access mindfulness resources for themselves and their child and adolescent patients