Browsing by Author "Rodriguez, Gabriela M."

Now showing 1 - 5 of 5
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    Characterizing Intervention Strategies Used in Community-Based Mental Health Care for Infants and Their Families
    (Springer, 2018-09) Rodriguez, Gabriela M.; Garcia, Dainelys; Blizzard, Angela; Barroso, Nicole E.; Bagner, Daniel M.; Psychiatry, School of Medicine
    Mental health interventions for infants typically target high-risk groups and can prevent long-term negative outcomes. Despite federal initiatives promoting early intervention, minimal research has examined usual care services for infants, which is important to improve routine care. The current study characterized usual care practices in infant mental health through the adaptation and administration of a provider survey. Providers (n = 126) reported using a wide range of intervention strategies and few intervention programs with varied evidence. Findings can inform future research to identify quality improvement targets of usual mental health care for high-risk infants and their families.
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    Chronic Illness and Internalizing Symptomatology in a Transdiagnostic Clinical Sample of Youth
    (Oxford, 2020-07) Wolock, Elizabeth; Queen, Alexander; Rodriguez, Gabriela M.; Weisz, John R.; Psychiatry, School of Medicine
    Objective In research with community samples, children with chronic physical illnesses have shown elevated anxiety and depressive symptoms, compared to healthy peers. Less is known about whether physical illnesses are associated with elevated internalizing symptoms even among children referred for mental health treatment—a pattern that would indicate distinctive treatment needs among physically ill children receiving mental health care. We investigated the relationship between chronic physical illness and internalizing symptomatology among children enrolling in outpatient mental health treatment. Method A total of 262 treatment-seeking children ages 7–15 and their caregivers completed a demographic questionnaire, Child Behavior Checklist, and Youth Self-Report during a pre-treatment assessment. Physical illnesses were identified through caregiver report. Results There was no overall association between the presence/absence of chronic physical illness and parent- or child-reported symptoms. However, number of chronic physical illnesses was related to parent- and child-reported affective symptoms. Children with two or more chronic physical illnesses had more severe depressive symptoms than those with fewer physical illnesses. Conclusion Having multiple chronic illnesses may elevate children’s risk of depression symptomatology, even in comparison to other children seeking mental health care. This suggests a need to identify factors that may exacerbate depression symptoms in physically ill children who are initiating therapy and to determine whether different or more intensive services may be helpful for this group. The findings suggest the potential utility of screening for depression in youth with chronic physical illnesses, as well as addressing mental and physical health concerns during treatment.
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    Clinician Training, Then What? Randomized Clinical Trial of Child STEPs Psychotherapy Using Lower-Cost Implementation Supports with versus without Expert Consultation
    (APA, 2020-12) Weisz, John R.; Thomassin, Kristel; Hersh, Jacqueline; Santucci, Lauren C.; MacPherson, Heather A.; Rodriguez, Gabriela M.; Bearman, Sarah Kate; Lang, Jason M.; Vanderploeg, Jeffrey J.; Marshall, Timothy M.; Lu, Jack J.; Jensen-Doss, Amanda; Evans, Spencer C.; Psychiatry, School of Medicine
    Objective: Implementation of evidence-based treatments in funded trials is often supported by expert case consultation for clinicians; this may be financially and logistically difficult in clinical practice. Might less costly implementation support produce acceptable treatment fidelity and clinical outcomes? Method: To find out, we trained 42 community clinicians from four community clinics in Modular Approach to Therapy for Children (MATCH), then randomly assigned them to receive multiple lower-cost implementation supports (LC) or expert MATCH consultation plus lower-cost supports (CLC). Clinically referred youths (N = 200; ages 7–15 years, M = 10.73; 53.5% male; 32.5% White, 27.5% Black, 24.0% Latinx, 1.0% Asian, 13.5% multiracial, 1.5% other) were randomly assigned to LC (n = 101) or CLC (n = 99) clinicians, and groups were compared on MATCH adherence and competence, as well as on multiple clinical outcomes using standardized measures (e.g., Child Behavior Checklist, Youth Self-Report) and idiographic problem ratings (Top Problems Assessment). Results: Coding of therapy sessions revealed substantial therapist adherence to MATCH in both conditions, with significantly stronger adherence in CLC; however, LC and CLC did not differ significantly in MATCH competence. Trajectories of change on all outcome measures were steep, positive, and highly similar for LC and CLC youths, with no significant differences; a supplemental analysis of posttreatment outcomes also showed similar LC and CLC posttreatment scores, with most LC–CLC differences nonsignificant. Conclusions: The findings suggest that effective implementation of a complex intervention in clinical practice may be supported by procedures that are less costly and logistically challenging than expert consultation.
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    Correction to: Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications
    (Springer, 2021) Garcia, Dainelys; Blizzard, Angela M.; Peskin, Abigail; Rothenberg, W. Andrew; Schmidt, Ellyn; Piscitello, Jennifer; Espinosa, Natalie; Salem, Hanan; Rodriguez, Gabriela M.; Sherman, Jamie A.; Parlade, Meaghan V.; Landa, Alexis L.; Davis, Eileen M.; Weinstein, Allison; Garcia, Angela; Perez, Camille; Rivera, Jessica M.; Martinez, Chary; Jent, Jason F.; Psychiatry, School of Medicine
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    Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications
    (Springer, 2021-04) Garcia, Dainelys; Blizzard, Angela M.; Peskin, Abigail; Rothenberg, W. Andrew; Schmidt, Ellyn; Piscitello, Jennifer; Espinosa, Natalie; Salem, Hanan; Rodriguez, Gabriela M.; Sherman, Jamie A.; Parlade, Meaghan V.; Landa, Alexis L.; Davis, Eileen M.; Weinstein, Allison; Garcia, Angela; Perez, Camille; Rivera, Jessica M.; Martinez, Chary; Jent, Jason F.; Psychiatry, School of Medicine
    Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent–Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.