Psychological Services

Role of psychologists in enhancing care quality for individuals with serious mental illnesses: Introduction to a special section.
This special section underscores the importance of psychologists in improving and enhancing care for individuals with serious mental illnesses (SMIs). People with diagnoses typically included in the category of SMIs—schizophrenia, schizoaffective disorder, bipolar disorder, and other diagnoses with symptoms severely impacting functioning—typically have layered marginalities and experience significant social stigma in addition to mental health symptoms. The complexity of challenges commonly experienced by individuals with SMI requires that treatment providers have specialized knowledge, training, and skills to provide specialty care needed to support mental health recovery. The included articles illustrate the breadth of the impact of psychologists on care for this population to date as well as the need to address growing care gaps for people with SMI through specialized training support to increase the provision of evidence-based practices and high-quality care. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Training guidelines and competencies for serious mental illness (SMI) psychology.
Individuals with serious mental illness (SMI) face unique and significant challenges that require evidence-based practices and clinicians who have advanced, comprehensive training to provide them. SMI affects about 5.5% of the U.S. population and results in serious health, social, and economic burdens. Despite advancements in treatment over the past 50 years, training programs for psychologists and other mental health providers have failed to keep up with these advances, underutilizing evidence-based assessments and interventions developed specifically for this population and found to be efficacious. To address this, the SMI Psychology Specialty has developed Training Guidelines to establish consistent, high-quality, and evidence-based training for postdoctoral psychologists. This article highlights selected features of the Training Guidelines for SMI Psychology. Although these were developed for postdoctoral training programs in SMI Psychology, they are applicable to training programs at all levels, and we hope that training programs in psychology and other mental health disciplines will incorporate these advances into their curricula. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Exploring trainee perspectives on barriers and facilitators in serious mental illness doctoral training.
Although there have been momentous and critical advancements in serious mental illness (SMI) psychology doctoral training models and competencies, there is still much systemic change needed to increase access to evidence-based SMI training for psychologists. In the last decade, there has been little to no growth or expansion of SMI training opportunities in clinical psychology doctoral programs in the United States, and psychologists are underrepresented in serving clients with SMI. As trainees and trainers committed to careers in SMI, the contributors aimed to identify barriers and facilitators throughout each stage of the SMI doctoral training pathway, including pregraduate school, graduate school, and internship to reflect critically on systemic issues that have impeded trainees from accessing the appropriate tools for SMI training. This conceptual article reviews the existing literature on barriers and facilitators to accessing SMI training. In centering trainee perspectives, the contributors also reflect on their own experiences through brief narratives illustrating the barriers and facilitators they have faced across training stages with existing empirical research. Recommendations made by the contributors include increasing access to financial support and mechanisms, diversifying departments and practicum sites to include SMI-focused training, and people in positions of power advocating for and centering trainee voices in departmental training decisions and development. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Confronting the dialectic between quality and access in early psychosis care in the United States: Finding the synthesis by leveraging psychological expertise.
Coordinated specialty care (CSC) is the dominant model for early psychosis care in the United States, representing a proactive recovery-oriented approach to serious mental illness in its early stages. CSC involves broad multidisciplinary support for participants, including from psychologists in some CSC teams, encompassing educational and vocational support, medication management, psychotherapy, case management, peer support, and family interventions. CSC programs have proliferated in the last 20 years, leading to a quality-access dialectic, where increasing access to treatment simultaneously prompts concerns about care quality, particularly in the context of staffing shortages and funding limits. Evidence-based psychosocial treatment, including psychotherapy, is an integral part of CSC, yet workforce training deficits, workforce turnover, and CSC financing pose threats to intervention fidelity and thus CSC participants’ ability to access high-quality care. We propose an enhanced role for psychologists as a way of resolving the quality-access dialectic in the area of psychosocial treatment, specifically evidence-based therapy. We describe the potential of psychologists’ skills in clinical supervision, formulation, evidence-based interventions and measurement-based care, drawing on practice examples. After considering possible limitations, we outline implementation models, for example, drawing on Early Psychosis Intervention Network and Project Extension for Community Healthcare Outcomes. We conclude with four recommendations: Psychologists should be placed in CSC team or network-leadership roles; psychological expertise should be made available to CSC teams for training, consultation, and technical assistance; psychological expertise should be used to address CSC implementation challenges; and research is needed to demonstrate psychologists’ value to stakeholders. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Serious mental illness—Psychology’s call to action: If not us, who? If not now, when?
While psychology has much to contribute to the care of individuals living with a serious mental illness (SMI), psychologists have been and continue to be underrepresented as their treatment providers. However, serving those living with an SMI presents an urgent public health need. In this article, we provide an overview of the historical role of psychology in the care of individuals with SMIs, and we argue that a confluence of factors renders this a propitious time for psychologists to increase their commitment to the care of those living with an SMI. These factors include (a) the availability of strengths-based and/or functional assessment tools and effective psychosocial interventions, often created or empirically tested and enhanced by psychologists, (b) the continuing evolution of a recovery movement which brings more optimism to the field, and (c) the establishment, over the past 15 years, of an APA recognized and approved infrastructure to provide and recognize formal SMI Psychology training and expertise. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Responsivity research: Informing psychological services for justice systems that work.
Public service psychologists engage their research competencies to explore the psychological health needs of underserved populations and the justice systems that deliver them psychological services. In late June 2023. the Criminal Justice Section of Division 18 of the American Psychological Association cosponsored the Fifth North American Correctional and Criminal Justice Psychology Conference: Towards a Justice System That Works, Toronto, Canada. This is the fourth time our journal, Psychological Services, has engaged to develop a section of peer-reviewed articles from the original empirical research presented at the North American Correctional and Criminal Justice Psychology Conference. Supplemented with additional justice-related articles featuring a theme of responsivity, this brief introduction outlines the importance of responsivity research—knowledge that informs unique aspects of a subpopulation so clinicians might better inform the services they deliver. Articles span a range of justice settings domestically and internationally and examine issues of gender, ethnicity, and the workforce to increase the empirically informed responsivity factors that deepen provider understandings of treatment needs. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
An exploratory two-part study of behavioral health service needs of women in jails.
Research shows that jailed women have disproportionately elevated rates of behavioral health conditions, including serious mental illness and substance use disorders; however, jails have not been able to effectively address these needs. There is a research gap in our understanding of mental health screening tools, linkages to care, and behavioral health service utilization for jailed women, specifically across multiple jails situated in urban and rural contexts. This two-part study compares the behavioral health needs and service utilization of women and men in eight Michigan jails. Results show significant differences in women’s and men’s behavioral health needs, including proportions of severe mental illness, alcohol and drug misuse, opioid preference, concerns for withdrawal, and length of jail stays. Mental health outcomes show significant gendered differences in advocacy for early release and jail- and post-jail treatment engagement. These findings highlight the need for jails to better assess behavioral health needs among women and may inform interventions aimed at improving women’s (and men’s) experiences while jailed. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Interpersonal process features of collaboration between probation and behavioral health practitioners.
This study sought to identify and conceptualize the central interpersonal process features that comprise good collaboration between behavioral health practitioners (BHPs) and probation officers (POs). Eighteen POs and 21 BHPs from geographically adjacent jurisdictions in a Midwestern state each participated in one of six focus groups. Researchers systematically coded focus group transcripts for interpersonal collaborative themes using both inductive and deductive strategies. Seven core themes—shared values and beliefs, communication and information sharing, knowledge of the other, trust, respect, team-based decision making, and equitable contribution—were identified and coded for importance, as indexed by frequency, latent tone, and group consensus. An initial working operational definition of these constructs, based on practitioners’ dialogue, is also provided. This study is one of the first to provide BHPs and POs who work with justice-involved people with prescriptive guidance about interpersonal actions and approaches that will best serve their professional collaborative efforts. Future research should examine whether these constructs hold across other samples and contexts and work to fully operationalize and measure these constructs and their importance for affecting various outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
To SHARE or not to SHARE: Exploring incarcerated women’s decisions about enrolling in exposure-based group therapy.
Exposure therapies effectively treat traumatic stress sequelae, including that which follows sexual violence victimization (SVV). Carceral facilities house women with significantly higher rates of SVV than community samples, yet they rarely implement this form of treatment. In this study, women with histories of SVV (n = 63) completed semistructured qualitative interviews about their decision to enroll or not enroll in an exposure-based group therapy called Survivors Healing from Abuse: Recovery through Exposure while incarcerated. All study participants were previously incarcerated in a prison, where they were offered the opportunity to enroll in Survivors Healing from Abuse: Recovery through Exposure. We used the theory of planned behavior to analyze factors that affected enrollment decisions. Results revealed that enrollment decisions among incarcerated women can be categorized within the theory of planned behavior framework. Interview responses indicated that recognizing current problems as related to experiences of SVV, holding positive attitudes about mental health treatment, observing peers engaging in help-seeking behaviors, and perceiving treatment as accessible were linked with enrollment. Negative perceptions of treatment, fear of judgment, and negative peer influence (e.g., distrust of peers) were linked to decisions not to enroll. While certain beliefs were influenced by contextual features of incarceration (e.g., peer interactions outside of group therapy), many overlapped with factors found to influence help-seeking among nonincarcerated populations. Findings have implications for how to engage members of underserved populations in resource-deprived contexts who have a great need for treatment of traumatic symptoms secondary to sexual violence. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Coercive control in a national U.S. self-report survey: Prediction of repeated intimate partner violence.
Coercive, controlling behavior toward intimate partners correlates with physical intimate partner violence (IPV). We examined whether it also predicts subsequent IPV or other aggression. We conducted a secondary analysis of self-reports by 1,039 women and 509 men who participated in the first two waves of the Interpersonal Conflict and Resolution Study (Mumford et al., 2019). We defined coercive control as any reported perpetration at Wave 1 of threat to physically harm, threat to use information to control, or put down or disrespect their partner. The participants also reported perpetration of verbal abuse and physical or sexual aggression against intimate partners. We tested correlations of these behaviors with similar acts toward nonintimates (friends or unfamiliar persons) in Wave 1 and the prediction of physical violence in Wave 2, approximately 5 months later. Coercive control (14% of men, 26% of women) was correlated with physical or sexual IPV (8% of men, 15% of women) in both women and men and with physical violence and coercive control to nonintimates. In logistic regressions entering Wave 1 physical IPV on the first step, Wave 1 coercive control was a significant independent predictor of Wave 2 physical IPV overall, and for men but not women. Coercive control did not independently predict nonintimate physical violence. Coercive control toward an intimate partner is a unique predictor of physical IPV among men. Future research should use improved measures of coercive control and further examine coercive control as an indicator of general antisociality. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Predictive validity of the Psychopathy Checklist: Screening Version (PCL:SV) in a sample of New Zealand Māori and European male prisoners.
Numerous studies have investigated the predictive validity of the Hare Psychopathy Checklist (PCL), but the majority have used samples from North America. The PCL may inform important decisions about people’s futures; recognition has been growing of the importance of ensuring that its psychometric properties are established in each jurisdiction where it is used, especially for Indigenous and non-European populations. The present study examined the predictive properties of the Hare Psychopathy Checklist: Screening Version (PCL:SV; Hart et al., 1995) in 371 New Zealand (NZ) male prisoners, including NZ European and NZ Māori subsamples. Discrimination analyses showed that PCL:SV total scores had moderate predictive accuracy for any new conviction within 5 years of release; no significant differences were detected for Māori versus NZ European on this outcome. PCL:SV Factor 2 (Lifestyle/Antisocial) scores were moderately predictive of violent recidivism within 5 years of release. In a second, independent sample of male prisoners (n = 102), both PCL:SV total and Factor 2 scores showed moderate predictive accuracy for serious institutional violence. Additionally, PCL:SV Facets 1 (Interpersonal) and 2 (Affective) scores were uniquely associated with time to sexual and violent recidivism, respectively. Understanding the predictive performance of clinical risk measures across diverse ethnic groups is an important step toward identifying and addressing ethnic disparities in criminal justice outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Implementing patient-reported outcome measures on an adolescent inpatient psychiatry unit: A feasibility study.
This article examines the feasibility of implementing patient-reported outcome (PRO) measures with adolescents on an inpatient psychiatry service. During the study period (March 8, 2021, to June 7, 2022), a total of 154 patient encounters were recorded for adolescents between 12 and 17 years of age. PROs were piloted during the first 3 months of the study period, with a focus on technical implementation. In the 12 months from June 8, 2021, through June 7, 2022, the PRO project moved to full implementation across all patient encounters. Fisher’s exact test and independent t tests were conducted to examine the differences between patients who completed the PROs and patients who did not complete them to determine the representativeness of the sample receiving them. During the 3-month pilot period, 31.8% of patients completed the PROs at admission and discharge, while during the 12-month full implementation, 74.5% of patients completed them at both time points. Statistical tests showed no significant diagnostic, sex, or race/ethnicity differences between patients who received and did not receive the outcome measures. Even without funding, small inpatient psychiatry services for adolescents can feasibly implement PROs with completion rates similar to other published studies and capture the majority of the patients served. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
A systematic review of mental health stigma reduction trainings for law enforcement officers.
The aim of the present systematic review was to evaluate the outcome of law enforcement officer (LEO) trainings on mental health (MH) stigma and other outcomes. A systematic search of Pubmed, APA PsycInfo, and Cochrane Central Register of Controlled Trials was conducted to identify studies examining MH stigma trainings implemented within the LEO profession. Both randomized and nonrandomized studies were considered. Risk of bias was assessed via the Cochrane Risk-of-Bias tool for randomized trials and the Risk of Bias in Non-Randomized Study of Intervention (Version 2). The present review identified 18 studies comprised of 2,399 participants (Mage = 37.37, SD = 4.76). Samples were predominantly composed of police officers (k = 16), followed by correctional officers (k = 2) and both (k = 1). Although the review aimed to investigate trainings targeting institutional, public, and self-stigma, all studies implemented trainings intended to decrease public stigma. Outcomes evaluated across studies included attitudes toward MH, knowledge about MH, self-efficacy/confidence, behavioral responses/de-escalation skills, social distance, and awareness, support, and utilization of MH resources. Although the outcomes evaluated were somewhat consistent across studies, there was variability in how variables were defined and measured. Due to this, data could not be compared across studies, and thus, conclusions could not be drawn regarding which trainings demonstrated the most effectiveness in reducing MH. Despite the increased research investigating the outcomes of trainings on stigma within the LEO population, the variability in methodology and the high rate of bias exhibited across studies suggest that more rigorous and better quality evaluations are warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Professional firefighters: Findings from the National Wellness Survey for Public Safety Personnel.
Professional firefighters are routinely exposed to occupational stressors that place them at a higher risk of developing mental health symptoms, including anxiety, depression, and posttraumatic stress. This article discusses findings of the National Wellness Survey for Public Safety Personnel, specifically the stressors that professional firefighters are exposed to on the job and their impact. Results indicated high levels of both occupational and individual stressors in this group. Common occupational and personal stressors and mental health symptomology endorsed by professional firefighters are discussed. Findings also revealed that about 40% of professional firefighters are facing clinically substantial levels of anxiety and depression, and more than 10% are experiencing clinically significant levels of posttraumatic stress disorder in numbers surpassing the general population. Most professional firefighters indicated being adversely impacted by their duties but did not want to utilize services, which is in line with prior research. Suggestions for assisting professional firefighters in mitigating occupational and personal stress are presented, and proposals for future research are provided. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Practice experiences for school reintegration: Endorsement for virtual reality with adolescents hospitalized for suicide-related crises.
This study applied qualitative methods and a user design approach to develop and iteratively refine a model for a virtual reality intervention designed to supplement standard inpatient treatment for adolescents hospitalized for suicide-related crises: the practice experiences for school reintegration (PrESR). The PrESR model allows patients to practice therapeutic skills within an immersive school environment to increase skill knowledge and skill use and to improve school reintegration. Adolescents previously hospitalized for suicide-related thoughts and behaviors (n = 13), hospital professionals with experience providing supports to hospitalized adolescents (n = 7), and school professionals with experience supporting adolescents with suicide-related risks (n = 12) completed focus group and/or one-on-one interviews to inform the development of the PrESR model. Transcribed interviews were analyzed using content analysis, and structured feedback was analyzed by calculating frequencies. Participating adolescents were between the ages of 13 and 18, identifying their race as White (61%), Asian (7.7%), American Indian and Black (7.7%), or Black (7.7%; note that 15.4% preferred not to answer) and their ethnicity as Hispanic (23%) or non-Hispanic (77%). Adolescents identified their gender as girl or woman (46%), boy or man (38%), or “some other way” (15%). A majority of adolescent and professional participants endorsed the PrESR as holding the potential to promote skill learning. Feedback addressed improvements to scenarios and skills; safety concerns, constraints to consider, and barriers to implementation; and information to include in the treatment manual. Findings also informed the types of difficulties adolescents face in schools and the potential feasibility of a virtual reality intervention to enhance standard inpatient care of adolescents hospitalized for suicide-related crises. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Examining veterans’ preferences for how to deliver couples-based treatments for posttraumatic stress disorder: Home-based telehealth or in-person?
Understanding the modality by which veterans prefer to receive couples-based posttraumatic stress disorder (PTSD) treatment (i.e., home-based telehealth, in-person) may increase engagement in PTSD psychotherapy. This study aimed to understand veterans’ preferred modality for couples-based PTSD treatments, individual factors associated with preference, and reasons for their preference. One hundred sixty-six veterans completed a baseline assessment as part of a clinical trial. Measures included a closed- and open-ended treatment preference questionnaire, as well as demographics, clinical symptoms, functioning, and relational measures, such as relationship satisfaction. Descriptive statistics and correlations examined factors associated with preference. An open-ended question querying veterans’ reasons for their preferred modality was coded to identify themes. Though veterans as a group had no clear modality preference (51% preferring home-based telehealth and 49% preferring in-person treatment), veterans consistently expressed high levels of preference strength in the modality they chose. The presence of children in the home was associated with stronger preference for home-based telehealth. Veterans who preferred in-person care found it to be more credible and had more positive treatment expectancies. Veterans who preferred home-based telehealth believed it was flexible and increased access to care. For both preference groups, veterans’ preferred modality was viewed as facilitating interpersonal relations and being more comfortable than the alternative modality. Veterans expressed strong preference for receiving their desired treatment modality for couples-based PTSD treatment. Results suggest that it is important to offer multiple treatment delivery options in couples-based PTSD treatment and matching couples to their preferred modality supports individualized, patient-centered care. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Is adequate dose adequate? An examination of the impact of psychotherapy on posttraumatic stress disorder symptoms utilizing Veterans Health Administration medical records.
Prior studies on individuals with posttraumatic stress disorder (PTSD) defined an adequate dose of psychotherapy as receiving at least nine sessions within a 15-week period. Yet, few studies have examined whether this definition of adequate dose is associated with meaningful change in PTSD symptoms over an extended period. To examine whether an adequate dose of individual or group psychotherapy was associated with PTSD symptom improvement, we identified mental health outpatient visits in the electronic medical record for a cohort of veterans enrolled in Veterans Health Administration (VHA) services (N = 1,649) across 5 years. Using latent growth curve modeling, we estimated the effect of receiving an adequate dose of psychotherapy on the PTSD symptom course. Among the sample, 992 participants (60.16%) received at least one individual therapy session and 506 participants (30.7%) received at least one group therapy session; of those, 226 (22.78%) received an adequate dose of individual therapy and 212 (41.9%) received an adequate dose of group therapy, respectively. An adequate individual therapy dose, but not group therapy dose, was associated with a decrease in PTSD Checklist for DSM-5 (PCL-5) scores over time. This improvement was extremely gradual (average of 1.57 PCL-5 point decrease per year). Adequate dose of psychotherapy, defined as nine sessions of routine psychotherapy over 15 weeks, is associated with minimal symptom change. This suggests that commonly used definitions of adequate dose have minimal clinical utility. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Examining mental health engagement among veterans diagnosed with serious mental illness.
Engagement in psychosocial mental health services has been found to support and facilitate the process of recovery in individuals with serious mental illness. However, many individuals eligible for these services are not receiving them. Presently, little is known about the factors that contribute to treatment engagement. This study aimed to identify attitudes related to treatment engagement among veterans with serious mental illness enrolled at a large VA medical center. Thirty-six veterans participated in individual qualitative interviews about their beliefs about the efficacy and purpose of mental health care; their perceptions of societal attitudes regarding mental health; and their experiences accessing mental health care. Based on their level of treatment engagement in the last year, veterans were classified as either engaged in psychosocial mental health services (n = 15), engaged in psychiatric medication management only (n = 14), or not engaged in VA mental health services (n = 7). Attitudes associated with level of service usage were examined to identify factors that might improve engagement in treatment and quality of mental health services. Results suggest that provider expertise and rapport were critical to engagement. Our findings also suggest that barriers to accessing care included beliefs about when it was appropriate to request services, stigmatizing attitudes within one’s social network, the complexity of the mental health system, and failures of providers and the treatment system to address the needs of a diverse patient population. Implications for clinical training and practice are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
A feasibility and pilot trial of the Brief Educational Guide for Individuals in Need (BEGIN): Psychoeducation for individuals at risk for psychosis.
Individuals at clinical high risk for psychosis (CHR) report a strong desire for psychoeducation, and clinical guidelines recommend psychoeducation in early psychosis care. Although several CHR psychoeducation models have been developed, additional research is needed to establish the effectiveness of these models. The goal of this study was to conduct a pilot trial of the Brief Educational Guide for Individuals in Need (BEGIN). BEGIN is a brief structured psychoeducation intervention designed to educate CHR individuals on symptoms and treatment options. We conducted a feasibility and pilot study of 25 CHR individuals (60% female, Mage = 20.6, 64% non-White, 52% Hispanic/Latino) identified via the Structured Interview for Psychosis Risk Syndromes. Qualitative interviews were administered to learn about their experience and analyzed using iterative thematic analysis. Participants (n = 12) completed pre- and post-BEGIN self-report measures to assess factors that influence treatment engagement, including CHR knowledge and motivation for therapy. Data were analyzed using Hedges’ g effect sizes and paired samples t tests. The intervention completion rate (83%) and therapeutic alliance were high. Qualitative themes and quantitative measures converged on similar results showing how CHR individuals were impacted by receiving psychoeducation via BEGIN, including increased CHR knowledge (g = 1.37), competence to monitor symptoms (g = 0.53), hope (g = 0.87), and motivation for therapy (g = 0.46). This study demonstrated the feasibility, acceptability, and potential benefits of the BEGIN CHR psychoeducation model, including enhancing motivation for treatment. The flexible but standardized format can facilitate BEGIN’s implementation and dissemination.This pilot study found that the Brief Educational Guide for Individuals in Need (BEGIN), a standardized five-session psychoeducation intervention for individuals at clinical high risk for psychosis (CHR), was feasible, acceptable, and enhanced mental health literacy and motivation for subsequent treatment. Clinicians can utilize the BEGIN intervention to ensure the empathic provision of psychoeducation when disclosing patients’ CHR status. Future research with a larger sample will establish efficacy and the development of a clinician training to facilitate implementation (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Psychological Services - Vol 22, Iss 1