The Resilient Youth Program: a promising skills-based online program for resiliency and stress management

BACKGROUND

Prevention programs that target resilience may help youth address mental health difficulties and promote well-being during public health crises.

AIMS

To examine the preliminary efficacy of the Resilient Youth Program (RYP).

METHOD

The RYP was delivered remotely from a US academic medical centre to youth in the community via a naturalistic pilot study. Data from 66 youth (ages 6-18, Mage = 11.65, SD = 3.02) and their parents were collected via quality assurance procedures (May 2020 to March 2021). Pre/post-intervention child/parent-reported psychological and stress symptoms as well as well-being measures were compared via Wilcoxon signed rank tests. Child/parent-reported skills use data were collected.

RESULTS

Among child-reported outcomes, there were significant decreases in physical stress (p = .03), anxiety (p = .004), depressive symptoms (p < .001) and anger (p = .002), as well as increased life satisfaction (p = .02). There were no significant differences in child-reported psychological stress (p = .06) or positive affect (p = .09). Among parent-reported child outcomes, there were significant decreases in psychological (p < .001) and physical stress (p = .03), anxiety (p < .001), depressive symptoms (p < .001), and anger (p < .002) as well as increased positive affect (p < .001) and life satisfaction (p < .001). Effect sizes ranged from small to medium; 77% of youth (73% of parents) reported using RYP skills. Age and gender were not associated with outcome change.

CONCLUSIONS

The RYP may help reduce psychological/stress symptoms and increase well-being among youth; further research is needed.

Incorporating Administrative Staff in Trans-Affirmative Care Training: A Cognitive-Behavioral Learning Approach

Administrative staff play an integral role in providing trans-affirmative health care. However, few trans-affirmative education and training interventions have been developed for non-medical health care staff. In this short report, we describe the development and piloting of a trans-affirmative care training intervention designed expressly for administrative staff. Based on our piloting, we put forth recommendations for the inclusion of administrative staff in trans-affirming education and training in health care systems. We hope to stimulate further development and evaluation of our approach, as well as changes in policies, so as to create more inclusive, trans-affirming health care systems.

Chronic non-malignant pain (CNMP) and substance use disorders

Introduction

Chronic non-malignant pain (CNMP) is defined as pain lasting a minimum of three months. In general, chronic pain affects 20% adult worldwide population. Moreover, pain is more common in patients with depression, anxiety, and substance-use disorders and with low socioeconomic status. We aimed to better understand the influence of pain on substance use and treatment use patterns of individuals who experienced clinically recognized pain and have substance use disorder.

Methods

Patients with pain disturbances were identified in Electronic Health Records (EHR) through ICD-9 code 338*, medical written diagnoses, or diagnoses of fibromyalgia. A patient was considered to have a substance use disorder if he received treatment for illicit drug or alcohol abuse or dependence. We combined 2010–2012 (EHR) data from primary care and specialty mental health setting in a Boston healthcare system (n = 131,966 person-years) and a specialty mental health care setting in Madrid, Spain (n = 43,309 person-years).

Results

We identified that 35.3% of individuals with clinically recognized pain also report substance use disorder, compared to only 10.6% of individuals without clinically recognized pain (P < 0.01). Those with co-morbid pain and substance use disorder were significantly more likely than their specialty care counterparts without co-morbid pain and substance disorders to be seen in the emergency room (56.5% vs. 36.6%, respectively, P < 0.01).

Conclusion

The findings suggest that CNMP is associated with an increase risk of substance abuse disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Sleep disturbances and substance use disorders: An international study of primary care and mental health specialty care patients

Introduction

There is no comprehensive evidence on the influence of sleep disturbances (SD) on substance use disorders (SUD) or treatment use patterns of individuals with comorbid disturbances.

Objective/aim

To better understand comorbidities and treatment use patterns of individuals with SD and SUD.

Methods

We combine 2010–2012 electronic health record (EHR) data from healthcare system in Boston (n = 131,966 person-years) and Madrid, Spain (n = 43,309 person-years). Patients with sleep disturbances (SD) were identified in the EHR through ICD-9 codes and medical records and substance use disorders (SUD) identified by documented treatment for drug or alcohol abuse or dependence. Rates of SUD are compared between individuals with and without SD. Among those with both, adequacy of mental health treatment (defined as eight or more outpatient visits or four or more outpatient visits with a psychotropic prescription) and ER use is compared.

Results

Among the individuals, 21.1% with SD also report SUD, compared to only 10.6% of individuals without SD (P < .01). Those with comorbidities were more likely than their specialty care counterparts without comorbidities to be seen in the ER (57.1% vs. 36.6%, respectively, P < .05). Limiting the sample to only those with both SD and SUD in specialty mental health care (n = 268 in Boston and n = 28 in Madrid), 49.2% of Boston patients received adequate care compared to 38.5% of Madrid patients, and 57.8% of Boston patients had any ER use in the last year vs. 50% of Madrid patients.

Conclusions

SD is correlated with SUD and comorbid patients are more likely to use emergency services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.