Research supports the use of an abbreviated MBCT protocol for the effective treatment of depressive symptoms, possibly Social Interventions The concept of multi-level intervention follows an ecological theoretical framework (Salmon et al., 2020). The ecological model emphasizes three important elements: (1) an individual is nested in multiple social levels (micro, meso, exo, and macro), (2) a change or impact in any social level may affect other levels as well, and (3) the interactions of social levels can have indirect and direct implications on the individual (Salmon et al., 2020). The details of the ecological model are beyond the scope of this course; however, the main emphasis is that individuals are affected by multiple influences on various levels of the system and do not exist in a vacuum (Salmon et al., 2020). Thus, an intervention at a specific level, such as with family and friends (meso), social service agencies (exo), or policies and legislation (macro), can affect the overall social system of the individual and stimulate transformation down to the basic individual level (micro). These ecological systems are not static; they are dynamic processes that necessitate a holistic perspective from the clinician (Salmon et al., 2020). The change process involves interventions in multiple sectors of the community. When multi-system interventions cut across macro-level or social systems, the results of these interventions can be seen at the individual level (Salmon et al., 2020). In fact, some studies suggest that multi-level interventions are necessary in order to ensure sustainability for individual support (Salmon et al., 2020). Continuation of program activities, development of new programs, and coalition support are important components of mental health services at the social level. Without continued community support, individuals face even greater barriers that prevent them from resolving mental health issues. Research studies suggest a strong relationship between mental health problems (i.e., depression) and social influences (Remes et al., 2021). The first step toward developing a multi-level intervention is to first identify the components of a particular community that can help bring about change (Chilenski et al., 2015). Community readiness describes whether a community and organizations within that community are open and capable of providing support for individuals (Chilenski et al., 2015). Assets mapping is another tool that can identify potential resources that can be helpful in planning for community change efforts. Assets mapping can identify community leaders, community organizations, businesses, institutions, and the components of political structure that can facilitate change (Chilenski et al., 2015). Ecomapping is a tool that can help to evaluate supportive and stressful components of the environment (Bell et al., 2015). Community-level assessments and the interventions that arise from those assessments vary because each community is unique. Community-based interventions can increase participation, which can enhance individual well-being (Hegerl et al., 2013). For example, depression and other mental health issues can affect multiple sectors of a community, including Outcome Evaluation Clients, practitioners, funders, and agency directors now expect increased accountability and effectiveness in mental health interventions. Evidence-based practice is the current trend, and there are increasing demands on clinicians to select interventions that are rooted in empirical studies (Silverman et al., 2015). Various factors, including the relative advantage of new practices, a lack of adaptability, and an inability to remain current on rapidly changing guidelines, prohibit clinicians from adopting evidence-
as an effective population-level, cost-effective strategy (Burgess et al., 2021).
healthcare agencies, housing organizations, and psychiatric services. A community-based intervention can integrate community services for individuals, create task-oriented community groups, and lead to collaboration among different community sectors. At its fundamental level, in order for a community intervention to be effective, the community must have the capacity to implement interventions and involve its residents in proactive and productive ways (Chilenski et al., 2015). For example, a community that does not have an identified physical space to run a resident support group cannot offer its residents a place to brainstorm and develop crime reduction strategies that can help reduce stress and burden. Malekoff (2010) provides another example of community proaction. When the state and local governments threatened to cut the budget of a children’s mental health agency, the agency staff members organized groups to educate staff, community members, board members, and consumer groups about the need for mental health services. Their approach built a culture of advocacy that helped members at multiple community levels join together toward a common goal. With community capacity, support, and strength, transformative interventions can arise not only to enhance individual well- being but also to create and sustain a positive environment for the community as a whole (Chilenski et al., 2015; Hegerl et al., 2013). For example, an agency director may host an open house community event, perhaps to celebrate the opening of a new program. Members of the community attend the open house and interact with the agency’s clients. This, in turn, helps the clients engage with those who do not have a mental health issue, or clients may find that a local business owner has decided to hire someone for a job based on this community interaction. In these examples, the social interventions help create an environment that can be a powerful support system to help clients feel connected to their community. Self-Assessment Question 6 The American Psychological Association’s Clinical Practice Guidelines for the Treatment of Depression in Adults (2019) recommend evidence-based psychotherapy interventions, including: (Select all that apply.) a. Behavioral Therapy b. Cognitive Therapy c. Cognitive-Behavioral Therapy (CBT) d. Reparative Therapy (RT) e. Interpersonal Psychotherapy (IPT) f. Eye Movement Desensitization & Reprogramming (EMDR) g. Mindfulness-Based Cognitive Therapy (MBCT)
h. Psychodynamic Therapy i. Rebirthing Therapy (RT) j. Supportive Therapy
based practices (Gallo & Barlow, 2012). Additionally, many clinicians do not know how to effectively evaluate the quality of research studies, nor do they have the opportunity to become trained in a particular method. Clinicians frequently need support via software or online systems for conducting and communicating outcome evaluations with clients (Bickman et al., 2016). Measurement feedback systems provide a means of reporting and measuring client progress toward their goals so that both
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