Bachelor of Arts, University of North Carolina, Chapel Hill (2011)
Doctor of Philosophy, Indiana University (2018)
Concerned others' help utilization and patients' alcohol treatment outcomes.
Drug and alcohol dependence
2021; 228: 108983
BACKGROUND: This study of dyads composed of patients in treatment for alcohol use disorders (AUDs) and their Concerned Others (COs) examined (1) COs' attendance at three types of help (educational sessions, treatment sessions with the patient, and treatment sessions without the patient) during a 3-month period after patients' admission, and (2) whether COs' use of help was associated with better treatment outcomes reported by COs about patients, and patients about themselves.METHODS: Dyads (n=277) were assessed when patients entered AUD treatment and 3 months later (80 %). COs rated their patient's AUD, and patients rated their own AUD, on the Brief Addiction Monitor. At 3-month follow-up, COs answered three items about help (education, treatment with patient, treatment without patient) from their patient's treatment program. Main analyses were analyses of covariance to examine associations between COs' help use and patients' outcomes.RESULTS: At 3-month follow-up, COs who had obtained one type of help were significantly more likely to have also obtained the other two types of help. However, relatively few COs (39 %) obtained any type of help. COs who obtained help rated their patient as having more protection against future substance use. And, when COs had obtained help, patients rated themselves as having less risk of future substance use, and had attended a greater number of AA meetings, than when COs had not obtained help.CONCLUSIONS: Findings suggest that COs' use of help can benefit patients in AUD treatment. Clinicians and researchers should increase the availability and use of help among COs.
View details for DOI 10.1016/j.drugalcdep.2021.108983
View details for PubMedID 34507007
Screening for Intimate Partner Violence in Family Mediation: An Examination of Multiple Methodological Approaches Using Item Response Theory.
Many divorcing/separating parties seeking mediation to resolve family-related issues report intimate partner violence (IPV) victimization from the other party in the case. It is imperative that mediation staff screen parties for IPV so they can make informed decisions regarding how to proceed with mediation. Existing IPV screens for mediation have significant limitations. We examined three methodological approaches using item response theory that address these limitations by increasing the efficiency and clinical utility of an existing standardized IPV screen for mediation, the Mediator's Assessment of Safety Issues and Concerns (N = 904 mediating parties). We identified three subsets of items, with initial evidence for their validity, focused on helping mediation staff identify high levels of IPV or parties at risk for potentially negative mediation outcomes or needing specialized safety accommodations in mediation. Clinical recommendations are provided indicating which approach is most promising to be used in mediation settings. Overall, findings help advance understanding of how item response theory methodology can enhance the precision of IPV screening in mediation.
View details for DOI 10.1177/10731911211022843
View details for PubMedID 34151599
Patients With Alcohol Use Disorders and Their Concerned Others: Concordance of Lived Experience as a Moderator of Treatment Outcomes
JOURNAL OF STUDIES ON ALCOHOL AND DRUGS
2021; 82 (3): 395-400
View details for Web of Science ID 000660332900010
ASSOCIATION BETWEEN SUBSTANCE USE DISORDER AND HEALTHCARE FRAGMENTATION PATTERNS IN VETERANS AT HIGH RISK FOR HOSPITALIZATION
OXFORD UNIV PRESS INC. 2021: S61
View details for Web of Science ID 000648922700123
ASSOCIATION BETWEEN MENTAL HEALTH CONDITIONS AND CARE FRAGMENTATION AMONG A NATIONAL SAMPLE OF VETERANS 65 YEARS AND OLDER
OXFORD UNIV PRESS INC. 2021: S60
View details for Web of Science ID 000648922700120
- Intimate Partner Violence (IPV) and Family Dispute Resolution: A Randomized Controlled Trial Comparing Shuttle Mediation, Videoconferencing Mediation, and Litigation PSYCHOLOGY PUBLIC POLICY AND LAW 2021; 27 (1): 45–64
Patients With Alcohol Use Disorders and Their Concerned Others: Concordance of Lived Experience as a Moderator of Treatment Outcomes.
Journal of studies on alcohol and drugs
2021; 82 (3): 395-400
Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD.The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small.Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.
View details for PubMedID 34100708
"Relationship between substance use disorder (SUD) and healthcare fragmentation patterns in veterans at high-risk for hospitalization" (SW19)
View details for Web of Science ID 000603567100107
Psychotherapy Utilization, Preferences, and Retention among Women Veterans with Post-traumatic Stress Disorder.
Women's health issues : official publication of the Jacobs Institute of Women's Health
BACKGROUND: Psychotherapy is the gold standard treatment for post-traumatic stress disorder (PTSD), yet psychotherapy use and retention among veterans is low. Little is known about the barriers to care and factors associated with women veterans' PTSD psychotherapy use and retention. Using a nationally representative sample of 986 women Veteran's Health Administration primary care users with PTSD and a perceived need for mental health care, we examined 1) the proportion of women who used psychotherapy, 2) retention in psychotherapy among women who used any psychotherapy, and 3) individual factors related to psychotherapy use and retention.METHODS: Women completed a survey on their mental health care experiences. Outpatient mental health care use in the year before the survey was obtained from Veteran's Health Administration administrative data.RESULTS: Most women (79.1%) used psychotherapy, and 41.7% of those women had a minimal therapeutic dose of psychotherapy (≥8 visits). Mental health diagnostic comorbidity and being African American/Black or identifying as neither African American/Black nor White were significantly associated with higher psychotherapy use. Mental health diagnostic comorbidity, exposure to military sexual trauma, and receiving treatment aligned with gender-related and group-related preferences were associated with higher psychotherapy retention. Being a parent was associated with lower retention.CONCLUSIONS: Although a significant proportion of women veterans with PTSD are using psychotherapy, retention is enhanced when women are able to obtain treatment aligned with their preferences. Thus, efforts to promote patient-centered, shared decisions regarding mental health treatment options could increase the efficacy and efficiency of treatment for PTSD among women.
View details for DOI 10.1016/j.whi.2020.06.003
View details for PubMedID 32680627
- Subtypes of Violent Separating or Divorcing Couples Seeking Family Mediation and Their Association With Personality and Criminality Characteristics PSYCHOLOGY OF VIOLENCE 2020; 10 (4): 390–99
Trying Times and Trying Out Solutions: Intimate Partner Violence Screening and Support for Women Veterans During COVID-19.
Journal of general internal medicine
Initial reports indicate widespread increases in intimate partner violence (IPV) rates during the coronavirus disease 2019 (COVID-19) pandemic. Women veterans are at particular risk for experiencing IPV, and the COVID-19 pandemic and resulting stay-at-home orders may be exacerbating this risk. IPV screening and intervention are an integral part of the care provided to women veterans in the Veteran's Health Administration (VHA). Current changes in healthcare delivery during COVID-19 may present challenges to the VHA's standard methods of initiating IPV screening and intervention with women veterans. We discuss the potential challenges VHA healthcare providers may be encountering when conducting routine IPV screening during the COVID-19 pandemic and when providing resources and support to women veterans experiencing IPV. We describe solutions to these challenges, including existing efforts led by the VHA IPV Assistance Program (IPVAP) as well as additional potential solutions. New ideas and partnerships will be critical for helping the VHA continue to assist women veterans experiencing IPV as the COVID-19 pandemic evolves. Though our focus is on women veterans and the VHA, the challenges and solutions we discuss are likely applicable to other populations experiencing IPV and other health care systems screening for IPV.
View details for DOI 10.1007/s11606-020-05990-0
View details for PubMedID 32607932
An Examination of the Association Between Patient Experience and Quality of Mental Health Care Among Women Veterans.
Administration and policy in mental health
Improving patient experience is one strategy that may increase the quality of mental health care if better experience is linked to the likelihood of a potentially therapeutic dose (PTD) of treatment. This study sought to examine: (1) the proportion of women veterans who obtained a PTD of mental health treatment; and (2) the association between women's experiences with Veterans Health Administration (VHA) mental health services and obtaining a PTD of mental health treatment. We assessed patient experience via a survey that measured experiences with gender-sensitive care, ease of getting care, perceived quality of care, and extent to which care met needs. We used VHA administrative data to determine mental health utilization across a national sample of 2109 women veterans with episodes of mental health care that included psychotherapy or pharmacotherapy. Results indicated that 71% of women received a PTD. Positive ratings regarding perceived quality of care and whether care met needs were associated with higher odds of receiving a PTD of treatment. Findings provide supporting evidence for the continued necessity of offering patient-centered mental health care to women veterans. Careful consideration of women veterans' mental health care experiences may be crucial in promoting high value mental health care for this population in VHA.
View details for DOI 10.1007/s10488-020-01046-x
View details for PubMedID 32415345