With the rapid progress of technology and the Internet, the popularity of social media among youth as a preferred form of communication has grown exponentially. In addition to many of the challenges youth face in real life, much of their identity and development now occurs in online spaces as well. Traditional bullying has evolved into cyberbullying, which has been labeled a public health issue. Though both forms of bullying share similar characteristics, risk factors, and potential consequences, research on cyberbullying has revealed the need for new and novel interventions aimed at mitigating its negative impact on youth mental health.
This review examines the role of advanced practice providers (APPs), such as nurse practitioners and physician assistants, in psychiatric practice and related supervision considerations. The number of psychiatric APPs has increased significantly in recent years, with data indicating substantial workforce expansion. APPs receive substantially fewer supervised clinical hours in training than psychiatrists. Current literature suggests that APPs report perceived feelings of inadequacy in their initial practice years, reinforcing the need for structured supervision and post-graduate training programs. Standardized best practices for APP supervision remain largely undefined. The authors critically examined recent literature related to APP practice in psychiatry and provide recommendations for a multi-tiered supervision model, ongoing competency assessments and quality monitoring, and organizational oversight to support successful integration of APPs into psychiatric practice. Future research and evaluation should focus on assessing the efficacy of supervision strategies and their impact on APP clinical outcomes.
ObjectiveThe American Association of Psychiatric Pharmacists (AAPP) sought to develop a consensus-based set of outcomes and measures to standardize psychiatric pharmacy practice and research. The measures in this Core Outcome Set for Psychiatric Pharmacists (COS-PP) are designed to study the impact of psychiatric pharmacists caring for individuals living with psychiatric disorders.MethodsThe COS-PP was developed using guidelines from the Core Outcome Measures in Effectiveness Trials (COMET) initiative. A committee systematically reviewed a catalog of 194 articles and 40 posters that referenced psychiatric disorders, patient-level outcomes, and pharmacist interventions. From these initial 234 resources, 554 combinations of outcomes and measures were identified. Additional papers, guidelines, and feedback from experts increased the number to 592 combined outcomes and measures. The principal investigator consolidated the list to 46 potential outcomes. AAPP members were invited to complete a survey rating the 46 potential outcomes on five key factors: comprehensive, attributable to pharmacy, feasible, scientifically sound, and usable. These survey results were provided to the 18 Board-Certified Psychiatric Pharmacists participating in a summit examining the potential outcomes and measures gleaned from literature review. Through discussion and refinement, consensus was achieved on the final COS-PP.ResultsThe final COS-PP included 21 outcomes, 14 of which included at least 1 measure (84 total measures). The outcomes were grouped according to the quadruple health care aims: better care, reduced healthcare costs, improved patient experience, and improved clinician well-being.ConclusionsCOS-PP will help define psychiatric pharmacists' support of the interdisciplinary team in addressing the quadruple health care aims. Using standardized outcomes across practice sites will allow aggregation of data on the impact of psychiatric pharmacists on patient care.
Abnormal patterns of feeding behavior are seen in children with and without developmental disabilities; if not treated early, these patterns may lead to a diagnosis of avoidant/restrictive food intake disorder (ARFID). A multitude of treatments for ARFID varying in theoretical orientation, intensity, and modality exist in the literature. Given the potential for complexity in the clinical presentation of ARFID, intensive interdisciplinary treatment programs are often the preferred intervention choice. However, due to the limited availability of these highly controlled settings, underserved populations are often limited to any outpatient feeding therapy that is available locally. This study focused on examining the outcomes of a behavioral outpatient feeding program in a community behavioral health center. Results show that there were statistically significant treatment outcomes when comparing observable feeding behaviors and caregiver satisfaction measures from admission to discharge. Moreover, these gains were maintained at follow-up supporting the treatment efficacy of such programs.
