IU Indianapolis ScholarWorks :: Browsing by Author "White, Dominique A."

Browsing by Author "White, Dominique A."

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Consumer factors predicting level of treatment response to illness management and recovery
(American Psychological Association, 2017-12) White, Dominique A.; McGuire, Alan B.; Roudebush, Richard L.; Luther, Lauren; Anderson, Adrienne; Phalen, Peter; McGrew, John H.; Psychology, School of Science
OBJECTIVE: This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations. METHOD: Secondary analyses from a multisite study of IMR were conducted. Self-report data from consumer participants of the parent study (n = 236) were analyzed for the current study. Consumers completed prepost surveys assessing illness management, coping, goal-related hope, social support, medication adherence, and working alliance. Correlations and multiple regression analyses were run to identify self-report variables that predicted level of treatment response to IMR. RESULTS: Analyses revealed that goal-related hope significantly predicted level of improved illness self-management, F(1, 164) = 10.93, p < .001, R2 = .248, R2 change = .05. Additionally, we found that higher levels of maladaptive coping at baseline were predictive of higher levels of adaptive coping at follow-up, F(2, 180) = 5.29, p < .02, R2 = .38, R2 change = .02. Evidence did not support additional predictors. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Previously, consumer-level predictors of level of treatment response have not been explored for IMR. Although 2 significant predictors were identified, study findings suggest more work is needed. Future research is needed to identify additional consumer-level factors predictive of IMR treatment response in order to identify who would benefit most from this treatment program. (PsycINFO Database Record
Essential Components of Early Intervention Programs for Psychosis: Available Intervention Services in the United States
(Elsevier, 2015-10) White, Dominique A.; Luther, Lauren; Bonfils, Kelsey A.; Salyers, Michelle P.; Department of Psychology, School of Science
Programs providing interventions for early psychosis are becoming commonplace in the United States (U.S.); however, the characteristics of existing services remain undocumented. We examined program characteristics, clinical services, and program eligibility criteria for outpatient early intervention programs across the U.S. using a semi-structured telephone interview. Content analysis was used to identify the presence or absence of program components, based in part on a recent list of essential evidence-based components recommended for early intervention programs (Addington, MacKenzie, Norman, Wang and Bond, 2013) as well as program characteristics, including eligibility criteria. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the examined components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The populations served by US programs were most frequently defined by restrictions on the duration of psychosis and age. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for future improvement.
Essential components of early intevention programs for psychosis: a qualitative study of available services in the United States
(2014-12) White, Dominique A.; Salyers, Michelle P.; McGuire, Alan B.; McGrew, John H., 1953-; Minor, Kyle S.
Programs providing interventions for early psychosis are becoming commonplace in the United States (US); however the terrain of existing services within programs remains undocumented. Unlike other countries, the US does not have a systematic approach to defining and treating this population. We examined program characteristics, clinical services, and treatment population parameters for early intervention programs across the US. A semi-structured telephone interview was conducted with program directors between July 2013 and April 2014. Content analysis was used to identify the presence or absence of 32 evidenced based practices recently recommended for early intervention programs (Addington, et al., 2013). Frequent client requests were identified and functional definitions of the population served were assessed. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the 32 essential components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The population was most frequently defined by age restrictions, and restrictions on the duration of psychosis. Emergent themes of client requests included functional and social recovery as well as help meeting practical needs. Findings have the ability to assist researchers and policy-makers in determining best practice models and creating measures of fidelity. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for improvement moving forward.
Expectations of Success as a Predictor of Negative Symptom Reduction over 18 months in Individuals with Schizophrenia
(Elsevier, 2015-09) Luther, Lauren; Fukui, Sadaaki; Firmin, Ruth L.; McGuire, Alan B.; White, Dominique A.; Minor, Kyle S.; Salyers, Michelle P.; Department of Psychology, School of Science
Negative symptoms are often enduring and lead to poor functional outcomes in individuals with schizophrenia. The cognitive model of negative symptoms proposes that low expectancies of success contribute to the development and maintenance of negative symptoms; however, longitudinal investigations assessing these beliefs and negative symptoms are needed. The current study examined whether an individual’s baseline expectancies of success – one’s beliefs about future success and goal attainment – predicted negative symptoms reduction over 18 months in individuals with schizophrenia-spectrum disorders (n=118). Data were collected at baseline, 9 months, and 18 months as part of a randomized controlled trial of Illness Management and Recovery. A mixed effects regression analysis revealed a significant reduction in negative symptoms over time, with a significant interaction effect between time and baseline expectancies of success. After controlling for baseline negative symptoms, demographic variables, and treatment conditions, those with high and moderate baseline expectancies of success evidenced a significant reduction in negative symptoms at 18 months, while those with low baseline expectancies of success did not evidence reduced negative symptoms. Findings support the cognitive model of negative symptoms and suggest that expectancies of success may be a useful treatment target for interventions aimed at reducing negative symptoms.
Facilitators and Barriers to Illness Management and Recovery Implementation
(Office of the Vice Chancellor for Research, 2013-04-05) White, Dominique A.; McGuire, Alan B.; Salyers, Michelle P.
Illness Management and Recovery (IMR) is an evidence-based program designed to help people with severe mental illness better manage their illness and achieve personally meaningful goals. IMR has shown improved outcomes including better coping and reduced psychiatric symptoms. There have been some difficulties implementing IMR, even within programs that have received IMR training. The purpose of the current study was to examine the differences between facilitators and barriers for implementing IMR as perceived by providers of IMR and non-providers of IMR in order to identify potential targets for implementation strategies. A national online survey was conducted with VA Medical Centers (VAMCs), resulting in 151 responses representing 107 VAMCs nationwide. Survey respondents included local recovery coordinators (LRCs) and staff referred by the LRC for being knowledgeable regarding IMR. The current analyses focused on two open-ended questions pertaining to facilitators and barriers to implementation. The authors independently developed codes through an iterative process to categorize responses. We then established overall consensus on codes and applied those codes to each open-ended response. Chi-square tests were performed on each category to determine differences between provider and non-provider perceived facilitators and barriers. Differences in identified facilitators and barriers were discovered between the providers and non-providers respondents. Overall barriers and facilitators to implementation are described. Identifying facilitators and barriers that differ between providers and non-providers can provide insight into areas that may impact implementation. By understanding these differences we can provide carefully targeted interventions to increase implementation, for example, gaining support from individuals who do not directly provide IMR, could reinforce the experiences of direct service providers.
Factors Affecting Implementation of an Evidence-Based Practice in the VA: Illness Management and Recovery
(APA, 2015-12) McGuire, Alan B.; Salyers, Michelle P.; White, Dominique A.; Gilbride, Daniel J.; White, Laura M.; Kean, Jacob; Kukla, Marina; Department of Psychology, School of Science
Objective: Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Methods: Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Results: Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. Conclusions and Implications for Practice: IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Illness management and recovery in community practice
(American Psychological Association, 2016-12) McGuire, Alan B.; Roudebush, Richard L.; Bartholomew, Tom; University, Rutgers; Anderson, Adrienne I.; Bauer, Sarah M.; McGrew, John H.; White, Dominique A.; Luther, Lauren; Rollins, Angela; Roudebush, Richard L.; Pereira, Angela; Salyers, Michelle P.; Psychology, School of Science
Objective To examine provider competence in providing Illness Management and Recovery (IMR), an evidence-based self-management program for people with severe mental illness, and the association between implementation supports and IMR competence. Methods IMR session recordings, provided by 43 providers/provider pairs, were analyzed for IMR competence using the IMR treatment integrity scale. Providers also reported on receipt of commonly available implementation supports (e.g., training, consultation). Results Average IMR competence scores were in the “Needs Improvement” range. Clinicians demonstrated low competence in several IMR elements: significant other involvement, weekly action planning, action plan follow-up, cognitive-behavioral techniques, and behavioral tailoring for medication management. These elements were commonly absent from IMR sessions. Competence in motivational enhancement strategies and cognitive-behavioral techniques differed based on the module topic covered in a session. Generally, receipt of implementation supports was not associated with increased competence; however, motivational interviewing training was associated with increased competence in action planning and review. Conclusions and Implications for Practice IMR, as implemented in the community, may lack adequate competence and commonly available implementation supports do not appear to be adequate. Additional implementation supports that target clinician growth areas are needed.
Illness management and recovery in community practice
(American Psychological Association, 2016-12) McGuire, Alan B.; Roudebush, Richard L.; Bartholomew, Tom; University, Rutgers; Anderson, Adrienne I.; Bauer, Sarah M.; McGrew, John H.; White, Dominique A.; Luther, Lauren; Rollins, Angela; Roudebush, Richard L.; Pereira, Angela; Salyers, Michelle P.; Psychology, School of Science
Objective To examine provider competence in providing Illness Management and Recovery (IMR), an evidence-based self-management program for people with severe mental illness, and the association between implementation supports and IMR competence. Methods IMR session recordings, provided by 43 providers/provider pairs, were analyzed for IMR competence using the IMR treatment integrity scale. Providers also reported on receipt of commonly available implementation supports (e.g., training, consultation). Results Average IMR competence scores were in the “Needs Improvement” range. Clinicians demonstrated low competence in several IMR elements: significant other involvement, weekly action planning, action plan follow-up, cognitive-behavioral techniques, and behavioral tailoring for medication management. These elements were commonly absent from IMR sessions. Competence in motivational enhancement strategies and cognitive-behavioral techniques differed based on the module topic covered in a session. Generally, receipt of implementation supports was not associated with increased competence; however, motivational interviewing training was associated with increased competence in action planning and review. Conclusions and Implications for Practice IMR, as implemented in the community, may lack adequate competence and commonly available implementation supports do not appear to be adequate. Additional implementation supports that target clinician growth areas are needed.
Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout
(Springer, 2016) Dreison, Kimberly C.; White, Dominique A.; Bauer, Sarah M.; Salyers, Michelle P.; McGuire, Alan B.; Department of Psychology, School of Science
Limited progress has been made in reducing burnout in mental health professionals. Accordingly, we identified factors that might protect against burnout and could be productive focal areas for future interventions. Guided by self-determination theory, we examined whether supervisor autonomy support, self-efficacy, and staff cohesion predict provider burnout. 358 staff from 13 agencies completed surveys. Higher levels of supervisor autonomy support, self-efficacy, and staff cohesion were predictive of lower burnout, even after accounting for job demands. Although administrators may be limited in their ability to reduce job demands, our findings suggest that increasing core job resources may be a viable alternative.
Perceptions of Treatment Plan Goals of People in Psychiatric Rehabilitation
(Springer, 2015-06) McGuire, Alan B.; Oles, Sylwia K.; White, Dominique A.; Salyers, Michelle P.; Department of Psychology, IU School of Science
Collaborative treatment planning is a process by which providers and consumers work together to set goals for treatment, choose between alternative services, and establish a plan. Research has not examined consumers’ views of their treatment plan goals. The present study examined ways in which consumers react to their treatment plan goals. Twenty-one interviews with Veterans engaged in psychiatric rehabilitation regarding goals listed in their treatment plan were analyzed using inductive content analysis. Reactions to treatment plan goals are reported. Analyses indicate people do not vary in a linear degree regarding agreement with treatment plan goals. Clinicians and researchers should examine the extent to which treatment plan goals are consistent with the consumer’s personal goals and self-concept.

Browsing by Author "White, Dominique A."

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