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Social work students typically use role play with student colleagues to practice clinical intervention skills. Practice with simulated clients (SCs) rather than classmates changes the dynamics of the role play and may improve learning. This is the first known study to employ the SC model in substance use assessment in social work education. Social work students completed a questionnaire assessing attitudes, knowledge, and perceived skills (AKS) regarding substance misuse prior to completing an online screening, brief intervention, and referral to treatment training, and then following role plays with SCs. Paired t-tests indicate increased confidence in substance use assessment and intervention ability, and stronger feelings that routine screening is critical to practice. Incorporating SCs with didactic learning increases students' self-perceived ability to assess and change client behaviors and reduce substance misuse.

Victoria Osborne Freelance writer Melbourne Victoria This article is about teen services at Eltham library, a branch of Yarra Plenty Regional Libraries in northeastern Melbourne. Eltham staff used the playing [...]

Reliable and valid assessment of abnormal speech patterns may enable earlier recognition of nonpsychotic disorders through characteristic speech patterns. This study sought to establish interrater reliability using a standardized guide for scoring. A scoring guide defining 27 elements (e.g., inappropriate self-reference, simple loss of goal, circumstantiality) of disordered thought was developed. The seminal work of Andreasen's and Holzman's groups provided 12 elements, and 15 new elements were suggested by clinical literature. Audiotaped interviews with 12 psychiatric inpatients, adults of both sexes and various ages hospitalized for acute management of nonpsychotic psychiatric disorders, provided speech samples for observation of disordered thought by two independent raters. Using the guide's definitions and accompanying examples of elements of disordered thought, reliability in scoring was high (kappa of .85 for agreement on the presence of any abnormal speech element and kappa values from .66 to 1.00 for agreement on the presence of individual elements).

Virtual reality (VR) in an immersive platform has been used in healthcare education to teach medical procedures; its use has not been studied much for the 'softer' skills of healthcare education. This pilot study had MSW students interacting with a standardized patient in a VR provider office. The purpose was to assess experiences of utilizing VR, for potential integration into the curriculum. 8 MSW students who were trainees in a grant-supported program were given a brief orientation on how to wear headsets, customize avatars, and were given a case scenario of an adolescent at risk for suicide. After a 20 minute interaction, students debriefed with faculty. A post-test assessed experiences. Most agreed (88%) the experience was helpful for skills practice. 95% strongly agreed that including VR in the curriculum would improve skills. Qualitative responses revealed students found the simulations to be valuable to training, having benefits for patient care; however they noted limitations like lack of ability to read non-verbal communication, and felt these would be more helpful at the beginning of their learning. VR simulations can be a helpful way for students to practice skills, particularly for students who attend programs online. [ABSTRACT FROM AUTHOR]

The article discusses some of the health and behavioral health issues associated with deployment, the impact that the large numbers of returning veterans will have on the training needs for social workers. Military-related traumatic brain injuries (TBIs) have dramatically increased over the past decade. TBI, which can result in physical, cognilive, social, emotional, and behavioral challenges. Closed head injuries comprise 80% of TBIs and symptoms can range in severity.

Practice-based research networks (PBRNs)—collaborations of practice settings that work together to generate research knowledge—are underused in mental health services research. This article proposes an agenda for mental health services research that uses a variety of PBRN structures and that focuses on what really happens in practice, the effectiveness of practice innovations in real world care, the challenges of implementing evidence supported interventions, modification of clinician behavior, and assessment of the effect of mental health policy changes on practice. The challenges of conducting research within PBRNs are substantial, including difficulties in maintaining positive member relations, securing ongoing funding, sustaining productivity, overcoming IRB entanglements and achieving both scientific excellence in recruitment and measurement validity and utility for practitioner members. However, the awareness of these challenges allows researchers and practitioners to build networks that creatively overcome them and that infuse mental health services research with heavy doses of the realities of everyday clinical practice. [ABSTRACT FROM AUTHOR]

BACKGROUND: Optimal stimulus parameters for electroconvulsive therapy (ECT) are unclear. Pulse duration and frequency related to convulsive threshold and seizure duration in the first ECT treatment in a series were evaluated. METHODS: Convulsive threshold was estimated for all patients (N = 550) receiving ECT over 27 months. Thresholds were estimated using different brief pulse stimulators, starting with a dose of approximately 25 mC per pulse train for right unilateral (RUL) stimulation (50 mC for bilateral [BL] stimulation). The charge was applied in 25-mC serial increments (approximately doubling for BL stimulation) up to approximately 100 mC (>200 mC for BL stimulation) to a generalized motor seizure endpoint. Patients lacking seizure response at 100 mC (200 mC for BL stimulation) received >500 mC. RESULTS: Convulsive threshold increased with age, African American identity, diagnosis other than depression, and female sex, and decreased with RUL electrode placement, low frequency (30 Hz), and brief pulse width (0.5 msec). RUL stimulation and lower anesthetic medication doses promoted longer seizures. Younger patients had longer seizures than older patients. Pulse width and frequency did not affect seizure duration. Lower charge yielded longer seizures. CONCLUSIONS: ECT efficiency appears to be achieved by lower frequency and briefer pulse duration stimulation. Randomized trials are needed for corroboration of these findings. [ABSTRACT FROM AUTHOR]

Background: Optimal stimulus parameters for electroconvulsive therapy (ECT) are unclear. Pulse duration and frequency related to convulsive threshold and seizure duration in the first ECT treatment in a series were evaluated., Methods: Convulsive threshold was estimated for all patients (N = 550) receiving ECT over 27 months. Thresholds were estimated using different brief pulse stimulators, starting with a dose of approximately 25 mC per pulse train for right unilateral (RUL) stimulation (50 mC for bilateral [BL] stimulation). The charge was applied in 25-mC serial increments (approximately doubling for BL stimulation) up to approximately 100 mC (>200 mC for BL stimulation) to a generalized motor seizure endpoint. Patients lacking seizure response at 100 mC (200 mC for BL stimulation) received >500 mC., Results: Convulsive threshold increased with age, African American identity, diagnosis other than depression, and female sex, and decreased with RUL electrode placement, low frequency (30 Hz), and brief pulse width (0.5 msec). RUL stimulation and lower anesthetic medication doses promoted longer seizures. Younger patients had longer seizures than older patients. Pulse width and frequency did not affect seizure duration. Lower charge yielded longer seizures., Conclusions: ECT efficiency appears to be achieved by lower frequency and briefer pulse duration stimulation. Randomized trials are needed for corroboration of these findings.