Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

Oluwoye, Oladunni; Fraser, Elizabeth

doi:10.1177/1049732321993443

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…At the provider-level, the challenges and need for training to address high rates of substance use among individuals with FEP was also a point of concern, which is consistent with prior research (Oluwoye & Fraser, 2021 ; Oluwoye et al, 2019 ). The CSC model used in the five programs that participated in the present study includes a substance use module focused on harm reduction in the individual therapy component of the program.…”

Section: Discussionsupporting

confidence: 79%

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study

Stokes

Fraser

Kriegel

et al. 2022

Community Ment Health J

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This study aimed to explore clinician roles and experiences related to the implementation and sustainability of coordinated specialty care (CSC) programs for first episode psychosis. Qualitative interviews were conducted with 20 CSC providers and team members, recruited from five CSC programs. Using a semi-structured guide, interviews explored experiences with the delivery of CSC in the context of community-based outpatient mental health agencies and the challenges with implementation. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. Themes were parsed into two overarching categories, provider, and organizational-level factors, and further distilled into subthemes which interacted with one another to form an interacting web of barriers to successful programmatic implementation for CSC programs. Study findings have important implications for development of future policy for financing mental health agencies, the creation of additional materials, supports for the model, and hiring and retention of staff for future implemented CSC programs.

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Section: Discussionsupporting

confidence: 79%

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study

Stokes

Fraser

Kriegel

et al. 2022

Community Ment Health J

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“…Substance use has consistently been associated with disengagement from services (Kreyenbuhl et al, 2009; Mascayano et al, 2021). For instance, a recent quantitative study found that cannabis and alcohol use reduced the likelihood of graduating from CSC (Oluwoye & Fraser, 2021). The findings presented in the present study extend previous research by illustrating how substance use impacts engagement in individual psychotherapy by increasing symptoms and decreasing motivation to meaningfully engage in sessions.…”

Section: Discussionmentioning

confidence: 99%

Exploring service provider perspectives on service user engagement across service components in coordinated specialty care programs for psychosis.

Stokes,

Fraser,

Stokes

et al. 2024

Psychological Services

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Engagement in services is a core element to successful outcomes for service users and programs. In coordinated specialty care (CSC) programs, designed for individuals experiencing first-episode psychosis, engagement has only been measured programmatically and not by service component. This qualitative study sought to explore provider perspectives on service user engagement in service components of CSC. Semistructured interviews were conducted with 20 service providers from five community-based early intervention programs for psychosis in the United States. Interviews were recorded and transcribed verbatim, and thematic analysis was used to analyze the data collected. Provider participants described barriers and facilitators that contribute to disengagement or engagement in four service components within early intervention programs: individual psychotherapy, family education and support, medication management, and vocational services. Barriers identified included substance use, stigma, trauma, and external pressures. Identified barriers to engagement in CSC were both unique to individual components and cut across them. By better understanding the complexity of barriers and their intersections within and across CSC components, there can be more effective policy and program development to reduce disengagement and hopefully increase positive outcomes for service users. Impact StatementThis article utilizes the perspectives of providers to identify barriers and facilitators to engagement in coordinated specialty care programs for those experiencing first-episode psychosis. The information presented provides value to the field and future policy decisions by identifying how barriers to engagement intersect and differ between coordinated specialty care components and allows for future engagement strategies to be targeted rather than universal to the multitherapeutic model.

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“…All participants emphasized their desire to know more about SU and effective treatment approaches. One study suggested that professionals trained in SU treatment, for example, certified SU and addiction specialists, could be incorporated into CSC teams (Oluwoye & Fraser, 2021). To date, research of teams with a recovery/SU specialist role has not been published, although qualitative work reveals that providers feel this would be a useful additional role (Stokes et al, 2022), and CSC teams in several states have SU specialist roles (Bello & Dixon, 2022).…”

Section: Conclusion and Implications For Practicementioning

confidence: 99%

Substance use approaches among peer support specialists in community mental health early psychosis programs.

Klodnick,

LaPelusa,

Reznik

et al. 2024

Psychiatric Rehabilitation Journal

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Objective: Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice. Method: Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts. Results: A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction. Conclusions and Implications for Practice: CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. Impact and ImplicationsThis study finds that peer support specialists on early psychosis Coordinated Specialty Care teams vary in their experiences with substance use (SU) recovery as well as their perceptions of and responses to client SU. Training in nonjudgmental SU exploration, harm reduction strategies, and SU recovery story matching with client SU perceptions may increase peer specialist effectiveness in validating and supporting clients with their SU goals.

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Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

Cited by 8 publications

References 40 publications

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study

Exploring service provider perspectives on service user engagement across service components in coordinated specialty care programs for psychosis.

Substance use approaches among peer support specialists in community mental health early psychosis programs.

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