Psychological First Aid Online Interactive Presentation June 10, 2008
Posted by Matt Conn in Child Safety, trauma.add a comment
Psychological First Aid (PFA) developed by the National Center for PTSD and the National Child Traumatic Stress Network is an evidence informed module used to assist children, adolescents, adults, and families in the immediate aftermath of disasters, crises, and terrorism. Aimed to reduce initial distress and foster short and long term adaptation and functioning, PFA can be implemented by a wide variety of service providers including, but not limited to first responders, crisis teams, school personnel, faith based organizations, emergency health care providers and other community based teams. This web-based presentation is facilitated by Linda Ligenza, LCSW, and Linda Watson, PhD and offers an overview of PFA Approaches, Factors Related to Recovery, Core Principles and Actions in PFA, Clinical Applications and Demonstrations, a web link to the PFA Training Manual and additional resources for service providers.
The Psychological First Aid online interactive presentation can be found at the following website: http://mentalhealth.samhsa.gov/samhsadr/presentation3.htm#
School of Social Work Associate Professor Kathryn Collins is building a database of web based training curricula related to social work micro, mezzo, macro, and policy practice (including promising, best, evidence based practices for each area). Please send any information or web addresses to kcollins@ssw.umaryland.edu.
Treatment for Adolescents with Depression: Cost-Effectiveness June 7, 2008
Posted by rickbarth in Uncategorized.add a comment
We previously provided information about the treatment effectiveness for depression of adolescents. in this report the sample is followed longer and a cost benefit analysis conducted. Treating depressed teenagers with either the antidepressant fluoxetine (Prozac) or a combination of fluoxetine and psychotherapy can be cost effective, according to a recent economic analysis of the NIMH-funded Treatment for Adolescents with Depression Study (TADS), and CBT, alone, may ultimately prove cost-effective. The study was published online ahead of print April 15, 2008, in the American Journal of Psychiatry.
Marisa Elena Domino, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues compared costs associated with each of the trial’s three active treatment groups—fluoxetine only, cognitive behavioral therapy (CBT) only, and a combination of fluoxetine and CBT—to costs associated with a placebo (sugar pill) group during the first 12 weeks of the trial. The researchers studied direct costs of medication and CBT sessions, and other costs outside the trial, such as visits to primary care providers, school-based services, and lost wages associated with caregivers transporting the adolescent to and from services.
Overall, cost was highest for participants in the combination group—a median of $2,832 per participant. Median cost per participant was $2,287 in the CBT-only group, $942 in the fluoxetine-only group, and $841 in the placebo group. Combination therapy was associated with the highest time and travel costs at $762, but medication costs were lower than those associated with the fluoxetine-only group because those in combination treatment tended to take lower doses of the medication. CBT costs for participants in the CBT-only group and participants receiving it as part of combination treatment did not differ.
Combination treatment cost more, but it also was shown to be more effective than the fluoxetine-only treatment in the first 12 weeks, as reported in August 2004. By assigning a monetary value to clinical improvement, the researchers deduced that both the fluoxetine-only treatment and combination treatment were cost-effective choices.
Finally, CBT was not found to be as effective or as cost effective as the other treatment groups in the first 12 weeks of the trial. However, by the end of the 36-week study, response rates in the CBT-only group had essentially caught up with the other two groups. Therefore, the researchers predicted that if long-term costs remain stable, CBT-only may become a cost-effective treatment choice as well.
Reference
Domino ME, Burns BJ, Silva SG, Kratochvil CJ, Vitiello B, Reinecke MA, Mario J, March JS. Cost-effectiveness of treatments for adolescent depression: results from TADS. American Journal of Psychiatry. Published online ahead of print April 15, 2008.
