Strategic Treatment and Assessment for Youth (STAY): A Theoretically-Driven, Culturally-Tailored MBC Approach.

Prerna G Arora, Michael Awad, Kayla Parr, Elizabeth H Connors
Author Information
  1. Prerna G Arora: Department of Health Studies and Applied Educational Psychology, Teachers College, Columbia University, New York City, NY, USA. pa2542@tc.columbia.edu. ORCID
  2. Michael Awad: Department of Psychiatry, Yale University, New Haven, CT, USA.
  3. Kayla Parr: Department of Health Studies and Applied Educational Psychology, Teachers College, Columbia University, New York City, NY, USA.
  4. Elizabeth H Connors: Department of Psychiatry, Yale University, New Haven, CT, USA.

Abstract

Racial and ethnic minoritized (REM) youth are at greater risk for depression and suicide than their White peers. Despite this, REM youth are much more likely than their White peers to prematurely dropout of treatment. Culturally tailored and scalable engagement models to improve mental health treatment retention among REM youth with depressive symptoms and suicidal thoughts and behaviors (STB) are urgently needed. Strategic Treatment Assessment for Youth (STAY) is a theoretically-driven, culturally tailored measurement-based care (MBC) approach to treatment engagement for REM youth with depressive symptoms and suicide risk. Specifically, STAY uses MBC feedback processes to reduce perceptual barriers to treatment, thus improving treatment retention and ultimately, client outcomes among REM youth. In addition to standard MBC components, STAY includes a greater emphasis on providing a client-centered rationale for MBC which includes assessing and discussing treatment expectations, the use of individualized progress measures and alliance measures, and cultural competence training. The goal of this manuscript is to describe the STAY model based on initial theoretical development and preliminary clinician-informed refinements. Further, a case example of STAY is presented with a particular focus on the use of feedback processes. Finally, the current and future directions to empirically examine STAY as a treatment retention strategy with REM populations are provided.

Keywords

References

  1. Suicide Life Threat Behav. 2007 Feb;37(1):22-34 [PMID: 17397277]
  2. J Consult Clin Psychol. 1997 Jun;65(3):453-63 [PMID: 9170769]
  3. J Couns Psychol. 2015 Jul;62(3):337-50 [PMID: 26167650]
  4. Community Ment Health J. 1996 Aug;32(4):353-61 [PMID: 8840078]
  5. School Ment Health. 2013 Aug 1;5(3): [PMID: 24223677]
  6. Clin Psychol Rev. 2010 Apr;30(3):338-48 [PMID: 20071063]
  7. Annu Rev Clin Psychol. 2007;3:29-51 [PMID: 17716047]
  8. J Fam Psychol. 2008 Feb;22(1):167-70 [PMID: 18266544]
  9. Adm Policy Ment Health. 2018 Jan;45(1):48-61 [PMID: 27631610]
  10. Child Dev. 2007 May-Jun;78(3):746-56 [PMID: 17517002]
  11. J Clin Child Adolesc Psychol. 2017 Jul-Aug;46(4):600-610 [PMID: 26042461]
  12. JAMA Pediatr. 2021 Apr 1;175(4):345-346 [PMID: 33284346]
  13. J Couns Psychol. 2011 Oct;58(4):537-54 [PMID: 21875181]
  14. J Affect Disord. 2020 Apr 1;266:766-771 [PMID: 29954612]
  15. Public Health Rep. 2003 Jul-Aug;118(4):293-302 [PMID: 12815076]
  16. Health Soc Work. 1998 Feb;23(1):9-15 [PMID: 9522199]
  17. Psychol Serv. 2020 Aug;17(3):238-246 [PMID: 31058519]
  18. J Am Acad Child Adolesc Psychiatry. 2011 Feb;50(2):160-70 [PMID: 21241953]
  19. J Am Acad Child Adolesc Psychiatry. 2019 Apr;58(4):459-461 [PMID: 30926072]
  20. J Consult Clin Psychol. 2010 Jun;78(3):298-311 [PMID: 20515206]
  21. Psychiatr Serv. 2000 Mar;51(3):349-53 [PMID: 10686242]
  22. Pediatrics. 2019 Nov;144(5): [PMID: 31611338]
  23. Front Psychol. 2020 Nov 27;11:533903 [PMID: 33329172]
  24. Focus (Am Psychiatr Publ). 2018 Jul;16(3):341-350 [PMID: 32015714]
  25. Psychol Serv. 2022 Feb 07;: [PMID: 35130008]
  26. Psychotherapy (Chic). 2018 Dec;55(4):520-537 [PMID: 30335463]
  27. J Couns Psychol. 2019 Mar;66(2):234-246 [PMID: 30702322]
  28. J Am Acad Child Adolesc Psychiatry. 2013 Oct;52(10):1101-15 [PMID: 24074479]
  29. Transcult Psychiatry. 2018 Feb;55(1):3-30 [PMID: 29035137]
  30. BMJ. 2009 Mar 19;338:b663 [PMID: 19299474]
  31. J Consult Clin Psychol. 2005 Oct;73(5):872-879 [PMID: 16287387]
  32. Lancet. 2012 Mar 17;379(9820):1056-67 [PMID: 22305766]
  33. Child Youth Care Forum. 2008 Aug 1;37(4):153-170 [PMID: 19774098]
  34. J Consult Clin Psychol. 2002 Apr;70(2):439-43 [PMID: 11952203]
  35. Br J Psychiatry. 2007 Oct;191:335-42 [PMID: 17906244]
  36. J Cult Divers. 2007 Summer;14(2):56-60 [PMID: 19175244]
  37. J Child Fam Stud. 2010 Oct 1;19(5):629-645 [PMID: 20823946]
  38. J Health Care Poor Underserved. 2011 May;22(2):562-75 [PMID: 21551934]
  39. J Can Acad Child Adolesc Psychiatry. 2010 Aug;19(3):182-96 [PMID: 20842273]
  40. Psychiatr Serv. 2011 Dec;62(12):1423-9 [PMID: 22193788]
  41. Adm Policy Ment Health. 2016 May;43(3):271-6 [PMID: 26887937]
  42. Clin Psychol Rev. 2021 Apr;85:102002 [PMID: 33721605]
  43. Community Ment Health J. 2005 Oct;41(5):539-55 [PMID: 16142537]
  44. J Health Care Finance. 2010 Spring;36(3):57-72 [PMID: 22329331]
  45. J Clin Psychol. 2018 Nov;74(11):1907-1923 [PMID: 30091201]
  46. J Fam Psychol. 2006 Mar;20(1):108-16 [PMID: 16569095]
  47. Neuropsychiatr Dis Treat. 2019 Feb 22;15:603-609 [PMID: 30863081]
  48. J Am Med Inform Assoc. 2021 Sep 18;28(10):2265-2268 [PMID: 34244760]
  49. BMC Res Notes. 2018 Jan 27;11(1):76 [PMID: 29374497]
  50. Psychother Res. 2017 Jan;27(1):102-111 [PMID: 26390171]
  51. Cogn Behav Pract. 2015 Feb;22(1):49-59 [PMID: 27330267]
  52. Adm Policy Ment Health. 2018 May;45(3):392-403 [PMID: 29143173]
  53. J Med Internet Res. 2018 Jan 03;20(1):e2 [PMID: 29298748]
  54. J Clin Child Adolesc Psychol. 2018 Sep-Oct;47(5):821-831 [PMID: 27911081]
  55. Psychotherapy (Chic). 2013 Dec;50(4):496-502 [PMID: 24295457]
  56. Ment Health Serv Res. 2000 Mar;2(1):27-40 [PMID: 11254067]
  57. J Couns Psychol. 2013 Jul;60(3):353-366 [PMID: 23647387]
  58. Am J Psychiatry. 2006 Jan;163(1):28-40 [PMID: 16390886]
  59. J Clin Psychol. 2022 Oct;78(10):1963-1972 [PMID: 36107419]
  60. Int J Health Serv. 2011;41(2):231-8 [PMID: 21563622]
  61. Clin Psychol (New York). 2016 Jun;23(2):180-200 [PMID: 29456295]
  62. J Behav Health Serv Res. 2003 Oct-Dec;30(4):393-405 [PMID: 14593663]
  63. Health Aff (Millwood). 2003 Sep-Oct;22(5):39-50 [PMID: 14515880]
  64. J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):22-31 [PMID: 21156267]
  65. J Adolesc Health. 2021 Jan;68(1):43-52 [PMID: 33143986]
  66. Acad Med. 2003 Jun;78(6):560-9 [PMID: 12805034]
  67. Clin Child Fam Psychol Rev. 2005 Jun;8(2):149-66 [PMID: 15984084]
  68. Psychol Serv. 2023;20(Suppl 2):150-157 [PMID: 35201811]
  69. Behav Modif. 2013 May;37(3):356-77 [PMID: 23188886]
  70. Am J Psychiatry. 2015 Oct;172(10):1004-13 [PMID: 26315978]
  71. Curr Psychiatry Rep. 2013 Jan;15(1):332 [PMID: 23250813]
  72. Psychol Serv. 2020 Aug;17(3):247-261 [PMID: 31318240]
  73. Scand J Caring Sci. 2017 Sep;31(3):505-513 [PMID: 27486028]
  74. Psychotherapy (Chic). 2006 Fall;43(3):271-9 [PMID: 22122096]
  75. Psychotherapy (Chic). 2018 Mar;55(1):89-100 [PMID: 29565626]
  76. Psychiatr Serv. 2012 Feb 1;63(2):122-9 [PMID: 22302328]
  77. Cultur Divers Ethnic Minor Psychol. 2020 Oct;26(4):532-543 [PMID: 32105106]
  78. Adm Policy Ment Health. 2012 Mar;39(1-2):90-103 [PMID: 22407557]
  79. Psychother Res. 2023 Jun;33(5):669-682 [PMID: 36449985]
  80. Community Ment Health J. 2006 Oct;42(5):449-58 [PMID: 16964565]
  81. Psychother Res. 2001 Mar;11(1):49-68 [PMID: 25849877]
  82. Psychiatr Serv. 2017 Feb 1;68(2):179-188 [PMID: 27582237]

Grants

  1. T32 DA019426/NIDA NIH HHS
  2. UL1 TR001863/NCATS NIH HHS
  3. K08 MH116119/NIMH NIH HHS
  4. K08MH116119/NIMH NIH HHS
  5. R34 MH134915/NIMH NIH HHS
  6. T32DA019426/NIAAA NIH HHS

MeSH Term

Humans
Adolescent
Suicidal Ideation
Male
Depression
Female
Culturally Competent Care
Cultural Competency

Word Cloud

Created with Highcharts 10.0.0treatmentSTAYREMyouthMBCretentionRacialethnicminoritizedgreaterrisksuicideWhitepeerstailoredengagementamongdepressivesymptomsStrategicTreatmentAssessmentYouthcarefeedbackprocessesincludesusemeasuresdepressionDespitemuchlikelyprematurelydropoutCulturallyscalablemodelsimprovementalhealthsuicidalthoughtsbehaviorsSTBurgentlyneededtheoretically-drivenculturallymeasurement-basedapproachSpecificallyusesreduceperceptualbarriersthusimprovingultimatelyclientoutcomesadditionstandardcomponentsemphasisprovidingclient-centeredrationaleassessingdiscussingexpectationsindividualizedprogressallianceculturalcompetencetraininggoalmanuscriptdescribemodelbasedinitialtheoreticaldevelopmentpreliminaryclinician-informedrefinementscaseexamplepresentedparticularfocusFinallycurrentfuturedirectionsempiricallyexaminestrategypopulationsprovided:Theoretically-DrivenCulturally-TailoredApproachCulturalAdaptationsDepressionMeasurement-basedSuicide

Similar Articles

Cited By (1)