Try a new search

Format these results:

Searched for:



Total Results:


The impact of operational partnership on telemental health before, during, and after COVID-19

Carper, Teresa L; Hunley, Holly A; Myers, Ursula S; Chen, Cory K; Birks, Anna H; Williams, Kathryn E; Lindsay, Jan A; Weaver, Kendra
The coronavirus disease (COVID-19) pandemic significantly accelerated the growth of telehealth services within the Veterans Health Administration (VHA), as the use of video conferencing to meet with Veterans in their homes increased tenfold in a 3-month period. A substantial portion of telehealth in VHA has traditionally comprised mental health services, and both the scope and volume of such services were significantly broadened in response to COVID-19 to allow for social distancing. The current article is a review of this mobilization from the framework of the People, Process, Technology, and Information model, with a particular highlight on the critical operational partnership between individual facilities providing care and the governing VHA program offices. Lessons learned and future goals for the sustainment and integration of telemental health services are also discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMID: 35201810
ISSN: 1939-148x
CID: 5322362

Implementation of Telemental Health (TMH) psychological services for rural veterans at the VA New York Harbor Healthcare System

Chen, Cory K; Palfrey, Amy; Shreck, Erica; Silvestri, Brittney; Wash, Lauren; Nehrig, Nicole; Baer, Alyssa L; Schneider, Jennifer A; Ashkenazi, Sagiv; Sherman, Scott E; Chodosh, Joshua
Meeting the mental health needs of our current veteran population is one of the primary challenges facing the Veteran's Health Administration (VHA). Particularly for veterans residing in rural areas, the lack of providers, high provider turnover, and the burden of traveling long distances to VHA facilities may contribute to difficulties accessing mental health care. Telemental Health (TMH) services help bridge the geographic gap between mental health providers and veterans who need mental health services. The VHA TMH Hub initiative has attempted to leverage changes in technology-facilitated care by developing a model in which a facility "hub" could expand mental health resources to remote "spoke" clinics and veterans' residences. This paper describes the implementation of the VA New York Harbor Health care System (VA NYH) TMH Hub, which was one of 6 programs funded by the VHA Office of Rural Health (ORH) in September 2016. We will describe the structure of the program, services provided, veterans served, and our efforts to integrate quality improvement, research, and clinical training into the operations of the program. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
PMID: 30742470
ISSN: 1939-148x
CID: 3684642

Trauma focused psychodynamic psychotherapy: A step-by-step treatment manual

Busch, Fredric N; Milrod, Barbara L; Chen, Cory K; Singer, Meriamne B
New York, NY, US: Oxford University Press, 2021
Extent: xi, 137 p.
ISBN: 9780197574355
CID: 5212752

The impact of brief dynamic interpersonal therapy (DIT) on veteran depression and anxiety

Chen, Cory K; Nehrig, Nicole; Wash, Lauren; Wang, Binhuan
A significant proportion of veterans continue to experience depression or anxiety following treatment with the empirically supported psychotherapies offered by the Veterans Health Administration. Continued development and testing of new treatments may be useful. Brief dynamic interpersonal therapy (DIT) is a short-term psychodynamic therapy developed for depression in the United Kingdom and is being disseminated as an alternative to cognitive behavioral therapy within the National Health Service. This study represents the first evaluation of DIT in the United States, implemented at a veterans affairs medical center for veterans with depression and/or anxiety. Electronic medical records of veterans receiving DIT from 2012 to 2018 at a New York-based veterans affairs medical center were reviewed. Linear mixed-effects models were used to analyze depression and anxiety scores collected at each session from the Patient Health Questionnaire and the Generalized Anxiety Disorder seven-item scale. Following DIT, patients presenting with clinically significant depression and/or anxiety reported a 46% reduction in Patient Health Questionnaire-9 scores (N = 60) and a 43% reduction in Generalized Anxiety Disorder seven-item scale scores (N = 46). Large effect sizes on both measures were found (d = 1.17, 95% CI [0.88, 1.47], p < .0001; d = 1.24, 95% CI [0.90, 1.58], p < .0001, respectively). DIT is a promising alternative to currently offered psychotherapies for veterans with depression and anxiety. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
PMID: 31999192
ISSN: 1939-1536
CID: 4344432

Barriers and facilitators to implementing a U.S. Department of Veterans Affairs Telemental Health (TMH) program for rural veterans

Shreck, Erica; Nehrig, Nicole; Schneider, Jennifer A; Palfrey, Amy; Buckley, Julia; Jordan, Brittney; Ashkenazi, Sagiv; Wash, Lauren; Baer, Alyssa L; Chen, Cory K
Telemental health refers to the use of information and technology to provide mental health services when providers and patients are separated geographically. The U.S. Department of Veterans Affairs' (VA) Telemental Health Hub (TMH) initiative started in 2002 to address the mental health needs of rural Veterans and has been increasingly used since that time. Services are typically provided from a VA medical center (VAMC) to a VA community-based outpatient clinic, as well as to Veterans' homes. The VA NY Harbor Health Care System TMH Hub (VA NYH TMH Hub) was established in 2016 through funding from VA's Office of Rural Health. Since March 2017, the VA NYH TMH Hub has provided individual, couples, and group therapy, as well as neuropsychological and psychodiagnostic testing to Veterans in rural New York and Iowa. As the TMH initiative continues to grow, it is increasingly important to understand program development, particularly barriers and facilitators to support ongoing growth. The present article examines factors that enhance and challenge the provision of psychotherapy via TMH, as experienced by TMH psychologists. Reflections are based on discussions among nine TMH psychologists regarding their experiences providing TMH treatment, generated and categorized during weekly staff and peer supervision meetings. Administrative, technical, and clinical barriers and facilitators are discussed. Unique considerations are also discussed, related to the structure of the VA NYH TMH Hub and the ways in which the therapeutic relationship may be impacted by TMH. Current considerations highlight strategies to improve telehealth processes and provide practical guidance to support TMH growth.
ISSN: 2163-8969
CID: 4331212

When distance brings us closer: leveraging tele-psychotherapy to build deeper connection

Chen, Cory K.; Nehrig, Nicole; Wash, Lauren; Schneider, Jennifer A.; Ashkenazi, Sagiv; Cairo, Elana; Guyton, Angel F.; Palfrey, Amy
ISSN: 0951-5070
CID: 4567852

The secret sorrows of men: Impact of Dynamic Interpersonal Therapy on 'masculine depression'

Chapter by: Dognin, Joanna S; Chen, Cory K
in: The social and interpersonal origins of depression today by Clarke, Jeremy [Ed]; Cundy, Paul [Ed]; Yakeley, Jessica [Ed]
New York, NY, US: Routledge/Taylor & Francis Group, 2020
pp. 87-102
ISBN: 9780367458980
CID: 5093592

Patient Extratherapeutic Interpersonal Problems and Response to Psychotherapy for Depression

Chen, Cory K; Nehrig, Nicole; Chou, Leetyng Jennifer; McGowan, Richard; Guyton, Angel F; Mustafiz, Fayel; Bailey, Robert W
OBJECTIVES/UNASSIGNED:This paper aimed to synthesize empirical findings of patient extratherapeutic interpersonal variables associated with individual psychotherapy treatment outcomes in adult outpatients with depression. METHODS/UNASSIGNED:A systematic search strategy was used to identify relevant studies. Thematic analysis was used to identify recurring themes in the findings. RESULTS/UNASSIGNED:Forty studies met search criteria. Three themes of patient extratherapeutic interpersonal variables were identified: capacity to engage with others, capacity to navigate relationships, and capacity to achieve intimacy, progressing from basic to advanced levels of interpersonal interaction. Interpersonal variables such as interpersonal distress and style, attachment orientation, and quality of object relations were particularly useful in predicting treatment outcomes, whereas access to social support and marital status provided mixed results, likely because they do not account for relationship quality. CONCLUSIONS/UNASSIGNED:Recognizing variables associated with treatment response can help clinicians identify patients at risk for nonresponse and guide efforts for adapting existing therapies and developing new ones.
PMID: 31813229
ISSN: 0002-9564
CID: 4238632

Predictors of Symptoms Remission Among Family Caregivers of Individuals With Dementia Receiving REACH VA

Chen, Cory K; Nehrig, Nicole; Abraham, Karen S; Wang, Binhuan; Palfrey, Amy P; Baer, Alyssa L
Resources for Enhancing All Caregivers Health (REACH VA) is a behavioral intervention for caregivers of individuals with dementia disseminated in the VA. Although shown to improve caregiver and care recipient outcomes, some caregivers continue to experience depression or caregiver burden following the intervention. Factors that predict symptom remission following REACH VA are unknown. The present study investigated attachment, social support, and psychopathology as predictors of symptom remission for family caregivers who completed REACH VA. Caregivers who do not remit perceive lower levels of social support from loved ones, endorse poorer attachment quality, and have more personality disorder characteristics, particularly affective instability. These factors that impair caregivers' abilities to be effectively attuned to the needs of their care recipients and to reap benefits from a brief and focused behavioral intervention such as REACH VA. Interventions that target caregiver interpersonal functioning and emotion regulation skills may be helpful to those who do not respond to REACH VA.
PMID: 30722668
ISSN: 1938-2731
CID: 3632132

The Benefits and Limitations of a Behavioral Intervention for Caregivers of Dementia Patients: A Qualitative Study

Nehrig, Nicole; Shifrin, Maria; Abraham, Karen; Chen, Cory K.
ISSN: 1077-7229
CID: 4069962