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	<title>intervention development &#8211; Science</title>
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	<title>intervention development &#8211; Science</title>
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		<title>Review Finds No Existing Therapy Breaks the Trauma-Substance Cycle for Homeless Young Adults</title>
		<link>https://scienmag.com/review-finds-no-existing-therapy-breaks-the-trauma-substance-cycle-for-homeless-young-adults/</link>
		
		<dc:creator><![CDATA[Glenn Wilkins]]></dc:creator>
		<pubDate>Tue, 13 Oct 2026 11:44:51 +0000</pubDate>
				<category><![CDATA[Psychology & Psychiatry]]></category>
		<category><![CDATA[adolescent and young adult mental health]]></category>
		<category><![CDATA[behavioral health interventions]]></category>
		<category><![CDATA[community-based services]]></category>
		<category><![CDATA[evidence-based treatments for trauma and addiction]]></category>
		<category><![CDATA[harm reduction]]></category>
		<category><![CDATA[Homeless young adults]]></category>
		<category><![CDATA[homelessness]]></category>
		<category><![CDATA[homelessness and mental health]]></category>
		<category><![CDATA[implementation science]]></category>
		<category><![CDATA[integrated psychological therapies]]></category>
		<category><![CDATA[intervention development]]></category>
		<category><![CDATA[Mental health]]></category>
		<category><![CDATA[mental health treatment for homeless youth]]></category>
		<category><![CDATA[motivational interviewing]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[street-involved youth mental health]]></category>
		<category><![CDATA[substance use]]></category>
		<category><![CDATA[substance use disorder in young adults]]></category>
		<category><![CDATA[systematized review]]></category>
		<category><![CDATA[trauma and substance use intervention]]></category>
		<category><![CDATA[trauma-focused therapy]]></category>
		<category><![CDATA[trauma-substance cycle]]></category>
		<category><![CDATA[traumatic stress]]></category>
		<category><![CDATA[young adults]]></category>
		<guid isPermaLink="false">https://scienmag.com/?p=267647</guid>

					<description><![CDATA[A systematized review of 39 studies finds that no existing intervention simultaneously targets traumatic stress and substance use in young adults experiencing homelessness, but identifies brief delivery, harm reduction, and community-based feasibility as key components for building one.]]></description>
										<content:encoded><![CDATA[<p>Young adults experiencing homelessness face a brutal convergence of risks that few interventions have ever been designed to address. A new systematized review published in Community Mental Health Journal by researchers at DePaul University and the University of Illinois at Chicago has systematically mapped the landscape of psychological interventions targeting traumatic stress and substance use in people aged 18 to 25, and the central finding is stark: despite clear evidence that trauma, homelessness, and substance use feed into one another in a self-reinforcing cycle, not a single intervention in the existing literature was designed specifically for young adults experiencing homelessness, and very few concurrently targeted traumatic stress and substance use at all. The review, led by Jesse Gamoran and Nyssa L. Snow-Hill, screened 2,100 titles drawn from the PsycINFO and PubMed databases and, after duplicate removal and multi-stage screening, identified 39 peer-reviewed studies that met inclusion criteria. The work represents a deliberate pre-implementation step: rather than testing yet another intervention from scratch, the team mined the broader young adult intervention literature for components, delivery strategies, and structural features that could be adapted into a novel, integrated treatment tailored to the realities of life on the street or in unstable housing.</p>
<p>The methodological architecture of the review is worth examining because it shapes what the conclusions can and cannot tell us. A systematized review, as the authors define it following the typology of Grant and Booth, applies systematic review principles—structured searches, explicit inclusion criteria, and standardized data extraction—without necessarily the full protocol registration and dual independent review apparatus of a gold-standard systematic review. The team searched across four conceptual domains: young adulthood, interventions, substance use, and traumatic stress, with homelessness terms added and removed to capture both directly relevant studies and the wider evidence base from which adaptable elements might be borrowed. Data were extracted using a structured coding framework organized around three domains: effectiveness, real-world implementation, and intervention characteristics. This tripartite structure reflects a growing recognition in implementation science that an intervention&#8217;s clinical efficacy in a controlled trial tells only part of the story; whether it can actually be delivered, sustained, and funded in a community drop-in center or shelter is a separate and equally consequential question.</p>
<p>On the effectiveness front, the headline numbers are encouraging. Over half of the 39 included studies used randomized controlled designs, the most rigorous method for establishing causal effects, and roughly three-quarters reported significant improvements across multiple outcomes, including reductions in substance use, decreases in traumatic stress symptoms, and broader gains in mental health. That such a large proportion of interventions produced measurable benefits suggests the field is not starting from zero. Yet the review&#8217;s finer-grained analysis reveals why these findings cannot simply be transplanted to young adults experiencing homelessness. The interventions were most commonly delivered in academic, clinical, or service settings—university counseling centers, primary care clinics, structured research programs—with enormous variation in duration, treatment modality, and theoretical orientation. A web-based alcohol prevention program for college students, a telephone-based intervention for heavy drinking in primary care, a family-based group intervention for HIV and drug risk among homeless families, and home-based telehealth skills training for women veterans all appeared in the evidence base, each built around assumptions about stability, scheduling, and access that homeless young adults often cannot meet.</p>
<p>The co-occurrence problem sits at the heart of the review&#8217;s rationale. Epidemiological research has long documented that trauma and substance use are deeply intertwined in this population. Studies cited by the authors, including work by Bender and colleagues on homeless youth in three U.S. cities and by Gwadz and colleagues on gender differences in traumatic events among homeless youth, show elevated rates of posttraumatic stress disorder and multiple victimization both before and after young people leave home. The self-medication hypothesis, articulated by Khantzian, offers one explanatory framework: substances are used to blunt the intrusive memories, hyperarousal, and emotional dysregulation that follow traumatic exposure. Trauma itself is increasingly understood as a transdiagnostic risk factor, elevating risk across a range of mental disorders, and homelessness compounds the problem by exposing young adults to ongoing victimization and instability that perpetuate both the traumatic stress and the substance use. The result is a cycle in which each element exacerbates the others, prolonging homelessness and degrading health outcomes. Yet the review found that interventions addressing both traumatic stress and substance use simultaneously were rare, and none had been built from the ground up for young adults experiencing homelessness.</p>
<p>The implementation findings are particularly revealing about the gap between what works in trials and what survives contact with real-world service systems. The review found strong participant retention across many studies, which is notable given that retention is often the Achilles heel of interventions with mobile, crisis-exposed populations. However, reporting on treatment fidelity—whether the intervention was actually delivered as designed—and on cost was strikingly limited. Fidelity monitoring matters because an intervention that shows effects in a tightly supervised trial may drift or degrade when handed to frontline staff with competing demands; without fidelity data, implementers cannot know which results are reproducible. Cost reporting matters because service agencies operating on thin budgets must make allocation decisions, and an intervention whose resource requirements are unknown cannot be planned for. These reporting gaps, the authors suggest, represent a critical blind spot for anyone hoping to move from the literature to practice.</p>
<p>Among the 39 studies, 16 included samples in which at least half of the participants experienced homelessness or housing instability, and these studies offer the closest available approximations to the target population. They include trials of strength-based outreach interventions linked to shelters or drop-in centers that reduced hard drug use among homeless youth, a randomized controlled trial of a smartphone application plus brief motivational intervention that reduced substance use and sexual risk behaviors among homeless young adults, a brief motivational interviewing-based group intervention showing 24-month effects on alcohol use among emerging adults experiencing homelessness, and a feasibility study of the HOME program combining housing with opioid use disorder prevention. Other work examined housing and supportive services for young mothers experiencing homelessness and intensive addiction and housing case management for homeless veterans. Collectively, these studies demonstrate that young adults experiencing homelessness can be recruited, retained, and helped—but each addressed only part of the problem, typically substance use alone, without an integrated traumatic stress component.</p>
<p>From this mosaic, the review distills a set of design principles for a future integrated intervention. First, delivery should be brief and flexible: long, multi-session protocols that assume reliable attendance are poorly matched to a population whose daily lives are governed by shelter curfews, survival needs, and sudden displacement. Second, harm-reduction approaches should anchor the substance use component. Rather than demanding immediate abstinence as a condition of care, harm reduction meets young people where they are, reducing the risks of use while building trust and engagement—a stance with particular resonance for a population that has often experienced rejection and coercion from institutions. Third, the intervention must be feasible within community-based service settings such as drop-in centers and shelters, which are where homeless young adults already present, rather than requiring referral into academic clinics that many will never reach. The authors frame these components as hypotheses to be tested, not a finished blueprint, and they are explicit that the review is a critical pre-implementation step in a longer development process.</p>
<p>The review also surfaces structural features of the existing literature that constrain its usefulness. The theoretical orientations of included interventions ranged widely, from motivational interviewing and cognitive behavioral approaches to transdiagnostic protocols such as the Unified Protocol, which targets emotional disorders broadly rather than any single diagnosis. Duration varied from single-session brief interventions to multi-month programs. Delivery modalities spanned in-person individual and group formats, family-based sessions, telephone contact, web-based programs, and smartphone applications. This heterogeneity, while a barrier to simple meta-analytic conclusions, is arguably an asset for intervention development: it provides a menu of tested mechanisms and delivery channels from which adaptable elements can be selected and recombined. The authors&#8217; structured coding framework makes that menu explicit, which is precisely what a design team needs when assembling a new intervention rather than evaluating an old one.</p>
<p>What comes next, according to the authors, is direct testing within the population itself. Future research should prioritize intervention trials conducted with young adults experiencing homelessness, to determine which components retain their effectiveness and feasibility when the assumptions of stability and access no longer hold. The stakes are considerable. Homelessness among young adults is associated with elevated rates of mental health and substance use disorders, disrupted education, and long-term trajectories of instability, and the window of emerging adulthood is a developmental period in which effective intervention may alter lifelong outcomes. By systematically cataloguing what has been tried, what worked, how it was delivered, and where the evidence runs out, this review converts a scattered literature into a usable map. It does not offer a cure, and it is candid that none exists yet for this population. What it offers instead is something the field has lacked: a rigorous, transparent account of the raw materials available for building the first integrated traumatic stress and substance use intervention designed specifically for young adults experiencing homelessness, and a clear-eyed statement of the implementation conditions any such intervention must survive.</p>
<p><strong>Subject of Research:</strong> Traumatic stress and substance use interventions for young adults experiencing homelessness</p>
<p><strong>Article Title:</strong> A Systematized Review of Traumatic Stress and Substance Use Interventions in Young Adults: Implications for Intervention Development with Young Adults Experiencing Homelessness</p>
<p><strong>Article References:</strong> Gamoran, J., Bushnell, A., Fragkos, E., Darbro, R., Gueye, A., &amp; Snow-Hill, N. L. (2026). A Systematized Review of Traumatic Stress and Substance Use Interventions in Young Adults: Implications for Intervention Development with Young Adults Experiencing Homelessness. <em>Community Mental Health Journal</em>. <a href="https://doi.org/10.1007/s10597-026-01734-2" rel="noopener noreferrer">https://doi.org/10.1007/s10597-026-01734-2</a></p>
<p><strong>Image Credits:</strong> AI Generated</p>
<p><strong>DOI:</strong> <a href="https://doi.org/10.1007/s10597-026-01734-2" rel="noopener noreferrer">10.1007/s10597-026-01734-2</a></p>
<p><strong>Keywords:</strong> homelessness, young adults, traumatic stress, substance use, systematized review, intervention development, harm reduction, mental health, implementation science, PTSD, motivational interviewing, community-based services</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">267647</post-id>	</item>
		<item>
		<title>Teachers and Teenagers Build a Mental Health Program That Lives Inside Ordinary Lessons</title>
		<link>https://scienmag.com/teachers-and-teenagers-build-a-mental-health-program-that-lives-inside-ordinary-lessons/</link>
		
		<dc:creator><![CDATA[Glenn Wilkins]]></dc:creator>
		<pubDate>Mon, 12 Oct 2026 21:34:52 +0000</pubDate>
				<category><![CDATA[Science News]]></category>
		<category><![CDATA[addressing adolescent anxiety and depression through education]]></category>
		<category><![CDATA[adolescent emotional well-being in classrooms]]></category>
		<category><![CDATA[Adolescent Mental Health]]></category>
		<category><![CDATA[Classroom]]></category>
		<category><![CDATA[co-designed mental health interventions for teens]]></category>
		<category><![CDATA[co-production]]></category>
		<category><![CDATA[collaborative development of mental health curricula]]></category>
		<category><![CDATA[embedding mental health strategies in education]]></category>
		<category><![CDATA[feasibility]]></category>
		<category><![CDATA[impact of school environment on youth mental health]]></category>
		<category><![CDATA[integrating mental health into school lessons]]></category>
		<category><![CDATA[intervention development]]></category>
		<category><![CDATA[long-term sustainability of school mental health programs]]></category>
		<category><![CDATA[overcoming implementation barriers in school mental health initiatives]]></category>
		<category><![CDATA[PLOS One]]></category>
		<category><![CDATA[practical approaches to mental health in schools]]></category>
		<category><![CDATA[prevention]]></category>
		<category><![CDATA[school-based intervention]]></category>
		<category><![CDATA[school-based mental health programs]]></category>
		<category><![CDATA[secondary schools]]></category>
		<category><![CDATA[teacher-led psychological support]]></category>
		<category><![CDATA[teachers]]></category>
		<category><![CDATA[transdiagnostic]]></category>
		<category><![CDATA[wellbeing]]></category>
		<guid isPermaLink="false">https://scienmag.com/?p=266099</guid>

					<description><![CDATA[Researchers co-developed a transdiagnostic mental health intervention with teachers and teenagers that embeds wellbeing support directly into routine secondary school lessons.]]></description>
										<content:encoded><![CDATA[<p>Every classroom holds an invisible workload. Alongside the curriculum, teachers absorb the emotional weather of thirty young people at a time, and the rising tide of anxiety, low mood, and distress among adolescents has turned that weather increasingly stormy. A new study published in PLOS One describes a deliberately practical response: rather than bolting a mental health program onto an already crowded school day, researchers worked with teachers and teenagers to build psychological support directly into the lessons that happen anyway. The intervention, called the Child and Adolescent Mentally Healthy Classroom intervention, or CAMH Class, was co-developed from the ground up by the people who would actually have to live with it, and the early evidence suggests that this approach may solve one of the most stubborn problems in school-based mental health research, namely what happens after the researchers leave.</p>
<p>The rationale behind the project rests on a well-documented gap. Schools are widely recognized as one of the best settings for promoting young people&#8217;s mental health, because they reach nearly every child regardless of family circumstances, and because the classroom is where much of adolescent life is actually lived. Yet most evidence-based interventions fail to survive the transition from clinical trial to routine practice. Programs designed by specialists often demand resources schools do not have, clash with teacher preferences, or simply feel alien to the students they are meant to help. The team behind CAMH Class, led by Tracy M. Stewart of the University of Edinburgh with colleagues including Gillean McCluskey, Debi Fry, Lesley McAra, and Josie N. Booth, set out to reverse that engineering order: start with the constraints of real classrooms and design the intervention to fit them, rather than expecting classrooms to bend around an intervention.</p>
<p>The design philosophy is explicitly transdiagnostic. Instead of targeting a single diagnosis such as depression or anxiety, transdiagnostic interventions address the shared underlying processes that cut across multiple forms of distress, such as emotional regulation, coping strategies, and social connection. This matters for schools because young people rarely present with neat diagnostic categories, and because a program that requires referral pathways or specialist screening creates bottlenecks that many institutions cannot sustain. A transdiagnostic, universal approach delivered to whole classes can promote wellbeing and prevent the onset or escalation of symptoms simultaneously, without singling anyone out, which also reduces the stigma that keeps many adolescents from engaging with mental health provision at all.</p>
<p>The development process itself was structured and sequential. In total, 32 participants aged between 15 and 63 took part, with a mean age of 32.72 years, organized into three distinct groups. The first group consisted of teachers, with a mean age of 36.80, who participated in four sequential development workshops. These workshops were the engine room of the project, where teachers identified the mental health priority areas most relevant to their classrooms and began shaping activities that could be woven into ordinary teaching. A second group, young people with a mean age of 15.85, attended a dedicated development workshop, ensuring that the student voice was not filtered entirely through the perspectives of adults. Finally, a fresh group of teachers who had played no part in the initial design took part in a refinement workshop, with a mean age of 37.38, providing an independent check on whether the emerging intervention made sense to people encountering it for the first time.</p>
<p>This layered structure reflects a core principle of co-production research: the people who deliver and receive an intervention hold knowledge that outside experts cannot replicate. Teachers know the rhythm of a school week, the practical limits of a fifty-minute lesson, the topics that will land with a particular year group, and the difference between an activity that sounds good on paper and one that works with a restless class on a Friday afternoon. Young people know what feels patronizing, what feels authentic, and what they would actually be willing to engage with in front of their peers. By bringing both groups together, the researchers aimed to produce something that neither could have designed alone, and to build a sense of ownership that increases the chances the intervention will be used long after any formal evaluation ends.</p>
<p>The workshops yielded a set of classroom activities mapped onto the priority areas that teachers and young people identified together. The key innovation is not any single exercise but the delivery mechanism: every activity is designed to be integrated directly into routine teaching, so that supporting mental health becomes part of how a lesson is taught rather than an additional subject competing for timetable space. This embedded approach addresses the single most common reason school interventions collapse, which is that they require dedicated time, trained external facilitators, or funding streams that evaporate. If the intervention lives inside ordinary pedagogy, its marginal cost approaches zero, and its sustainability no longer depends on grant cycles or the enthusiasm of a single champion within a school.</p>
<p>The feasibility findings are encouraging, though appropriately qualified. Both teachers and young people judged the intervention feasible and acceptable, but subject to contextual considerations, a phrase that carries real weight in implementation science. What works in one school may falter in another depending on leadership support, staff workload, class composition, and the wider culture of the institution. The researchers did not treat this context-dependence as a flaw to be engineered away; rather, the co-development process was explicitly designed to surface these contextual factors early, so that schools adopting the intervention can adapt it intelligently rather than discarding it when the first obstacle appears. That flexibility is characteristic of interventions built for the messy reality of public education rather than the controlled conditions of a trial.</p>
<p>Teachers who engaged with the activities reported observations that go beyond mental health narrowly defined. They perceived a positive impact on young people&#8217;s engagement, learning, energy, and overall enjoyment in class, alongside the intended benefits for wellbeing. This is a significant detail, because teachers are asked to invest their own effort in any classroom-based program, and an intervention that improves the experience of teaching, not just the outcomes for students, is far more likely to be sustained. It also hints at a virtuous cycle familiar from the broader literature on social and emotional learning: classrooms where students feel emotionally supported tend to be calmer and more productive, which in turn reduces stress for teachers, which further improves the emotional climate. CAMH Class appears positioned to exploit that feedback loop deliberately.</p>
<p>The study, published in December 2026, represents the development phase of a longer research program, and the authors are careful about what it does and does not establish. What it demonstrates is that co-production can produce a school-based mental health intervention that teachers and young people genuinely accept, that fits within routine teaching, and that targets transdiagnostic processes relevant to a wide range of outcomes. What remains to be tested, in future evaluation phases, is whether the intervention produces measurable and lasting improvements in mental health symptoms at scale. Even so, the translation problem it addresses is arguably the field&#8217;s most urgent challenge. Reviews of school-based mental health research repeatedly find effective programs that never reach the classrooms that need them, because the programs were never designed for routine conditions in the first place.</p>
<p>The broader significance of the work lies in its method as much as its product. If CAMH Class succeeds in subsequent trials, the template it offers, sequential workshops with teachers, a dedicated youth workshop, and independent refinement by fresh stakeholders, could be applied to interventions across education, public health, and beyond. The study&#8217;s authors describe their co-production approach as having the potential to bridge the gap in intervention translation to the classroom and ultimately benefit young people&#8217;s mental health. At a moment when adolescent mental health services are stretched thin across much of the world, the idea that prevention might be built into the ordinary fabric of the school day, at minimal cost and with the endorsement of the people in the room, is a proposition worth taking seriously. The classroom, this research suggests, may be the most underused mental health resource in the country, and the people best placed to unlock it were there all along.</p>
<p><strong>Subject of Research:</strong> Co-development of a transdiagnostic, classroom-embedded mental health intervention for secondary schools</p>
<p><strong>Article Title:</strong> Co-developing the Child and Adolescent Mentally Healthy Classroom (CAMH Class) intervention for use in routine teaching in secondary schools</p>
<p><strong>Article References:</strong> Stewart, T. M., McCluskey, G., Johnson, H., Fry, D., McAra, L., &amp; Booth, J. N. (2026). Co-developing the Child and Adolescent Mentally Healthy Classroom (CAMH Class) intervention for use in routine teaching in secondary schools. <em>PLOS One, 21</em>(10), e0359563. <a href="https://doi.org/10.1371/journal.pone.0359563" rel="noopener noreferrer">https://doi.org/10.1371/journal.pone.0359563</a></p>
<p><strong>Image Credits:</strong> AI Generated</p>
<p><strong>DOI:</strong> <a href="https://doi.org/10.1371/journal.pone.0359563" rel="noopener noreferrer">10.1371/journal.pone.0359563</a></p>
<p><strong>Keywords:</strong> adolescent mental health, school-based intervention, co-production, transdiagnostic, classroom, teachers, PLOS One, feasibility, prevention, wellbeing, secondary schools, intervention development</p>
]]></content:encoded>
					
		
		
		<post-id xmlns="com-wordpress:feed-additions:1">266099</post-id>	</item>
		<item>
		<title>Building Mental Health Care With Communities: How Theory of Change Shaped a New Psychosis Intervention in Africa</title>
		<link>https://scienmag.com/building-mental-health-care-with-communities-how-theory-of-change-shaped-a-new-psychosis-intervention-in-africa/</link>
		
		<dc:creator><![CDATA[Glenn Wilkins]]></dc:creator>
		<pubDate>Thu, 08 Oct 2026 14:46:38 +0000</pubDate>
				<category><![CDATA[Psychology & Psychiatry]]></category>
		<category><![CDATA[aiming to improve quality of life and community participation for people]]></category>
		<category><![CDATA[and personal dimensions into mental health care in resource-limited settings]]></category>
		<category><![CDATA[and social inclusion. Utilizing Theory of Change]]></category>
		<category><![CDATA[co-production]]></category>
		<category><![CDATA[community reintegration largely unaddressed]]></category>
		<category><![CDATA[community-based rehabilitation]]></category>
		<category><![CDATA[economic]]></category>
		<category><![CDATA[emphasizing holistic care]]></category>
		<category><![CDATA[empowerment]]></category>
		<category><![CDATA[global mental health]]></category>
		<category><![CDATA[GUIDED framework]]></category>
		<category><![CDATA[intervention development]]></category>
		<category><![CDATA[low-and-middle-income countries]]></category>
		<category><![CDATA[perpetuating stigma and exclusion for individuals with psychosis. The SUCCEED intervention exemplifies a community-centered approach]]></category>
		<category><![CDATA[psychosis]]></category>
		<category><![CDATA[severe mental illness]]></category>
		<category><![CDATA[sub-Saharan Africa]]></category>
		<category><![CDATA[SUCCEED programme]]></category>
		<category><![CDATA[the program was co-designed with local stakeholders across four African countries to ensure cultural relevance and sustainability. This approach highlights the importance of integrating social]]></category>
		<category><![CDATA[theory of change]]></category>
		<category><![CDATA[TIDieR framework]]></category>
		<guid isPermaLink="false">https://scienmag.com/?p=248226</guid>

					<description><![CDATA[Researchers co-produced a community-based rehabilitation intervention for people living with psychosis in four African countries through iterative Theory of Change workshops, situation analysis, formative research and piloting.]]></description>
										<content:encoded><![CDATA[<p>In much of sub-Saharan Africa, a diagnosis of psychosis can be a life sentence of exclusion. Services are scarce, often limited to urban hospitals, and frequently focused narrowly on medication rather than the broader dimensions of a person&#8217;s life: their relationships, their work, their standing in the community, and their basic economic security. Against this backdrop, an international research collaboration has spent years developing and refining a community-based rehabilitation intervention designed with, rather than for, people living with psychosis in West and Southeast Africa. The results of that effort, published in PLOS Mental Health, offer a detailed account of how the intervention known as SUCCEED — Support, Comprehensive Care and Empowerment for People with Psychosocial Disabilities — was co-produced across four countries using an iterative application of Theory of Change methodology.</p>
<p>The scale of the problem the programme addresses is difficult to overstate. Psychosis and other severe mental health conditions cause substantial disability and reduced functioning across multiple domains of life, from self-care and mobility to social participation and productive work. In low- and middle-income settings, the services that exist to meet this need are often weak and predominantly biomedical, meaning they concentrate on clinical treatment while leaving the social and economic consequences of illness unaddressed. Community-Based Rehabilitation, or CBR, has emerged as a promising alternative because it takes a comprehensive and person-centred approach, aligning closely with effective case management models that have proven their worth in other areas of global health.</p>
<p>SUCCEED set out to harness that potential. The programme&#8217;s stated ambition was to improve quality of life, mental health outcomes, and community participation for people living with psychosis in four sub-Saharan countries. But rather than importing a model designed elsewhere and testing whether it survived transplantation, the research team — led by Julian Eaton and Olubukola Omobowale, with collaborators including Rita Tamambang, Rachel Greenley, and Grace K. Ryan — began with an open question: what would a rehabilitation intervention look like if the people who would use it, and the communities who would deliver it, helped design it from the ground up?</p>
<p>The methodological backbone of the answer is Theory of Change, a framework widely used in international development but less commonly applied with such rigour in mental health intervention design. A Theory of Change process asks stakeholders to articulate the long-term outcome they want to achieve and then work backwards, mapping the preconditions that must be in place for that outcome to occur, the assumptions underlying each causal link, and the interventions required to make each precondition a reality. In SUCCEED&#8217;s case, this was not a one-off workshop exercise. The team conducted multiple iterations of Theory of Change, revisiting and revising the causal map as new evidence accumulated from situation analysis, formative research, and piloting.</p>
<p>That iterative structure is what distinguishes the work. The first Theory of Change iterations drew on a situation analysis that documented the realities on the ground: the state of formal services, the role of traditional and faith-based healers, the economic pressures on households affected by psychosis, and the stigma that isolates individuals from the communities that might otherwise support them. Formative research then probed these findings in greater depth, generating the contextual understanding needed to specify what a feasible, acceptable intervention might look like in each setting. Early versions of the intervention were piloted, and the lessons from those pilots fed back into revised Theories of Change, which in turn reshaped the intervention itself.</p>
<p>To make this process transparent and reproducible, the researchers structured their reporting using two established frameworks. The GUIDED framework for intervention development provided the scaffolding for presenting the multiple Theory of Change iterations as results in their own right, rather than as background context. The TIDieR framework — Template for Intervention Description and Replication — was used to describe the final intervention in sufficient detail that other teams could understand exactly what it involves, a critical step if the programme is ever to be evaluated in a trial or adapted elsewhere. This dual framing is a deliberate answer to a common criticism of complex interventions: that their development is described so loosely that outsiders cannot tell what was done, why, or whether it could be done again.</p>
<p>The content of the intervention reflects the priorities that emerged from the co-production process. Consistent with CBR principles, SUCCEED is built around comprehensive, person-centred support delivered close to where people live, aiming to strengthen functioning and community participation rather than treating symptoms in isolation. The co-production approach meant that people with lived experience of psychosis, along with family members, community workers, and local service providers, were not merely consulted but were active participants in deciding what the intervention should contain, how it should be delivered, and what success would look like. The Theory of Change workshops gave these diverse stakeholders a shared language and a shared map, allowing disagreements and assumptions to surface early and be examined openly.</p>
<p>The authors draw two conclusions from the process that carry weight well beyond this specific programme. First, they find that Theory of Change can promote participatory processes of intervention co-development: the framework&#8217;s demand for explicit causal reasoning creates a natural structure for genuine dialogue, in which stakeholders must negotiate not just what should be done but why they believe it will work. Second, they observe that the same process generates research questions. Because every arrow in a Theory of Change diagram represents an assumption that can be tested, the completed maps double as an agenda for evaluation, pointing evaluators toward the mechanisms that matter most and the links that remain most uncertain.</p>
<p>Perhaps the most important message, however, concerns flexibility. The team concludes that interventions must remain flexible and open to revision, even when they possess core active ingredients. In mental health research, there is a persistent tension between the standardisation needed for rigorous evaluation and the adaptation needed for real-world contexts. SUCCEED&#8217;s development model suggests a way through that tension: hold firm to the essential components that the Theory of Change identifies as causally necessary, while allowing the surrounding details of delivery to evolve as communities, evidence, and circumstances change. The multiple iterations documented in the paper are, in effect, a record of that controlled evolution.</p>
<p>For the wider field of global mental health, the study arrives at a moment when funders and governments are increasingly demanding evidence that interventions in low-resource settings are not only effective but also locally legitimate and sustainable. Co-production has become a watchword, yet it is often invoked without a clear account of how participation actually shaped the result. By presenting its Theory of Change iterations as findings, the SUCCEED team has provided one of the more concrete demonstrations available of what co-produced intervention development looks like in practice — from the first situation analysis through formative research and piloting to a fully specified, replicable community-based rehabilitation package for people living with psychosis in West and Southeast Africa.</p>
<p><strong>Subject of Research:</strong> Co-production of a community-based rehabilitation intervention for people living with psychosis in West and Southeast Africa using Theory of Change methodology</p>
<p><strong>Article Title:</strong> Co-production using Theory of Change in the development of the SUCCEED Africa community-based rehabilitation intervention for people living with psychosis in West and Southeast Africa</p>
<p><strong>Article References:</strong> Eaton, J., Omobowale, O., Tamambang, R., Greenley, R., Dzapasi, L., Buyanga, M., Nkhata, M., Bamidele, O., Sefasi, A., Omigbodun, O., Esliker, R., Aturu, O., Oduguwa, A., Ogunmola, O., Koroma, A., Munetsi, E., Shakespeare, T., &amp; Ryan, G. K. (2026). Co-production using Theory of Change in the development of the SUCCEED Africa community-based rehabilitation intervention for people living with psychosis in West and Southeast Africa. <em>PLOS Mental Health, 3</em>(9), e0000668. <a href="https://doi.org/10.1371/journal.pmen.0000668" rel="noopener noreferrer">https://doi.org/10.1371/journal.pmen.0000668</a></p>
<p><strong>Image Credits:</strong> AI Generated</p>
<p><strong>DOI:</strong> <a href="https://doi.org/10.1371/journal.pmen.0000668" rel="noopener noreferrer">10.1371/journal.pmen.0000668</a></p>
<p><strong>Keywords:</strong> psychosis, community-based rehabilitation, Theory of Change, co-production, global mental health, sub-Saharan Africa, intervention development, GUIDED framework, TIDieR framework, severe mental illness, low- and middle-income countries, SUCCEED programme</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">248226</post-id>	</item>
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		<title>New Training Program Aims to Help Psychiatrists Talk About Sexual Health With Teens</title>
		<link>https://scienmag.com/new-training-program-aims-to-help-psychiatrists-talk-about-sexual-health-with-teens/</link>
		
		<dc:creator><![CDATA[Glenn Wilkins]]></dc:creator>
		<pubDate>Mon, 05 Oct 2026 00:12:11 +0000</pubDate>
				<category><![CDATA[Science Education]]></category>
		<category><![CDATA[addressing sexual difficulties in teens with psychiatric disorders]]></category>
		<category><![CDATA[adolescent psychiatric care]]></category>
		<category><![CDATA[adolescent psychiatry]]></category>
		<category><![CDATA[behavior change theory]]></category>
		<category><![CDATA[clinical communication]]></category>
		<category><![CDATA[clinical intervention for adolescent sexual health]]></category>
		<category><![CDATA[evidence-based training for mental health professionals]]></category>
		<category><![CDATA[health education in adolescent psychiatry]]></category>
		<category><![CDATA[health professionals]]></category>
		<category><![CDATA[improving clinician confidence in sexual health discussions]]></category>
		<category><![CDATA[intervention development]]></category>
		<category><![CDATA[Medical Education]]></category>
		<category><![CDATA[Medical Research Council framework]]></category>
		<category><![CDATA[Mental health]]></category>
		<category><![CDATA[mental health and sexuality education]]></category>
		<category><![CDATA[mental health treatment and sexual satisfaction]]></category>
		<category><![CDATA[psychotropic medications]]></category>
		<category><![CDATA[sexual health]]></category>
		<category><![CDATA[sexual health communication training]]></category>
		<category><![CDATA[systematic development of psychiatric training programs]]></category>
		<category><![CDATA[training for psychiatrists on adolescent sexual health]]></category>
		<category><![CDATA[training intervention]]></category>
		<category><![CDATA[youth mental health]]></category>
		<category><![CDATA[youth mental health and sexual wellbeing]]></category>
		<guid isPermaLink="false">https://scienmag.com/?p=236214</guid>

					<description><![CDATA[Researchers have developed a theory-driven training program to help adolescent psychiatry professionals address the sexual health impacts of mental disorders and psychotropic medications.]]></description>
										<content:encoded><![CDATA[<p>Sexual health is one of the most quietly neglected corners of adolescent psychiatry. Young people aged 12 to 24 who live with psychiatric disorders face a heightened risk of sexual difficulties compared with their peers, ranging from sexual dysfunction linked to their illness and its treatment to diminished sexual and relational satisfaction. Yet in clinical practice across youth psychiatric wards, the topic is rarely raised, and clinicians often lack the training, confidence, or institutional permission to open the conversation. A new study published in BMC Medical Education describes the systematic development of a training intervention designed to change that, giving psychiatry professionals the tools to address sexual health with their adolescent patients in an informed, structured, and compassionate way.</p>
<p>The research team, led by Michelle Veilleux of the Fondation Santé des Étudiants de France and Université Paris Cité, together with colleagues from INSERM research units and Paris hospitals, set out to build the program on firm methodological ground rather than on intuition. They followed the Medical Research Council framework for developing and evaluating complex interventions, a widely respected roadmap in health services research that insists on understanding the problem, identifying the underlying mechanisms of change, and tailoring the intervention to its implementation context before any evaluation takes place. This stepwise approach matters because training programs that skip the development phase frequently fail to change real-world behavior, no matter how well intentioned they are.</p>
<p>The first stage involved a rigorous assessment of learning needs. The team combined an analysis of the existing scientific literature with an examination of the patient context and semistructured interviews with professionals working in adolescent psychiatry. These interviews revealed a landscape of uncertainty: clinicians recognized that sexual health was relevant to their patients&#8217; wellbeing but reported feeling ill equipped to discuss it, unsure of their role legitimacy, and concerned about the boundaries of professional practice. The needs assessment made clear that the barrier was not indifference but a genuine gap in knowledge, skills, and confidence, compounded by the sensitive and sometimes taboo nature of the subject.</p>
<p>From this groundwork, the researchers identified sixteen pedagogical objectives, which they organized into three coherent domains. The first domain covers sexual knowledge, including the physiological and pharmacological facts that clinicians need in order to understand how psychiatric disorders and psychotropic medications can affect desire, arousal, and sexual function in young patients. The second domain addresses professional attitudes and role legitimacy, tackling the internal and cultural barriers that make clinicians hesitant to see sexual health as part of their job. The third domain focuses on applied communication and intervention skills, translating knowledge and attitude into the practical ability to raise the topic, respond to disclosure, and intervene appropriately.</p>
<p>What distinguishes this intervention from many ad hoc training efforts is its explicit grounding in behavioral theory. The team constructed a theory of change model by combining social cognitive theory, the theory of reasoned action, and the World Health Organization&#8217;s guidelines for brief sexuality-related communication. Social cognitive theory emphasizes that behavior change depends on self-efficacy, the belief that one can successfully perform the behaviors in question, which can be built through modeling, guided practice, and mastery experiences. The theory of reasoned action adds that intentions to act are shaped by attitudes toward the behavior and by perceived social norms, meaning the training must also shift what clinicians believe is expected of them in their professional environment.</p>
<p>The WHO framework for brief sexuality-related communication supplies the clinical technique. It provides a structured, nonjudgmental way for health professionals to introduce sexual health into routine consultations, using open questions and permission-giving language that normalizes the topic without forcing disclosure. By weaving these three theoretical strands together, the intervention targets multiple determinants of behavior simultaneously: the capability to act, the confidence to act, and the motivation to act. This theory-driven architecture is the pedagogical core of the program and is intended to make the resulting behavior change durable rather than superficial.</p>
<p>The intervention itself takes the form of three training modules. The first is a short introductory session designed to open the subject, establish shared vocabulary, and signal institutional endorsement of the effort. The remaining two modules are skill-focused, using the theoretical models to build concrete competencies in recognizing the sexual health impacts of psychiatric disorders and psychotropic treatments, and in communicating about these issues with adolescents in a clinical setting. The modular structure allows the training to be adapted to different ward schedules and professional groups, from nurses and psychologists to psychiatrists, reflecting the multidisciplinary reality of adolescent psychiatric care.</p>
<p>Crucially, the developers did not design the program in a vacuum. They explored the specificities and needs of the implementation context, the actual adolescent psychiatry wards where the training would be deployed, and incorporated these findings into the design. This attention to context is a hallmark of the MRC framework and reflects a growing consensus in implementation science that an intervention&#8217;s success depends as much on fit with local workflows, hierarchies, and cultures as on the quality of its content. A training program that ignores the realities of a busy inpatient unit, for example, risks being perceived as an added burden rather than a valued resource.</p>
<p>The study was conducted as part of the SEX-T-ADO research project, registered as NCT05316948, and received a favorable opinion from a French Committee for the Protection of Persons, with data collection compliant with national regulations and the Declaration of Helsinki. The work was funded by a grant from the French program for research in nursing and paramedical sciences, known as PHRIP, and by the French National Association for Research and Technology, ANRT, underscoring the institutional commitment in France to strengthening the paramedical and nursing dimensions of this kind of care.</p>
<p>The authors are careful to frame this publication as a development study rather than a proof of effectiveness. A future evaluation is planned to assess whether the training actually changes professional behavior, knowledge, and attitudes, and to examine how the program is implemented across different clinical contexts. That evaluation will be the true test of the theory of change model. Still, the significance of the work lies in its demonstration that a sensitive, long-overlooked aspect of adolescent mental health care can be approached with the same scientific rigor as any other clinical intervention. For the many young psychiatric patients whose sexual wellbeing has been silently affected by their disorders and medications, and for the clinicians who have wanted to help but did not know how, this research offers a credible, evidence-based path forward.</p>
<p><strong>Subject of Research:</strong> Development of a theory-based training intervention for psychiatry professionals on adolescent sexual health</p>
<p><strong>Article Title:</strong> Development of a training intervention to support psychiatry professionnals in adressing sexual health with adolescents</p>
<p><strong>Article References:</strong> Veilleux, M., Martin, P., Ghosn, J., Foussier, A., Thoison, C., Huas, C., Godart, N., &amp; Bourmaud, A. (2026). Development of a training intervention to support psychiatry professionnals in adressing sexual health with adolescents. <em>BMC Medical Education</em>. <a href="https://doi.org/10.1186/s12909-026-10351-2" rel="noopener noreferrer">https://doi.org/10.1186/s12909-026-10351-2</a></p>
<p><strong>Image Credits:</strong> AI Generated</p>
<p><strong>DOI:</strong> <a href="https://doi.org/10.1186/s12909-026-10351-2" rel="noopener noreferrer">10.1186/s12909-026-10351-2</a></p>
<p><strong>Keywords:</strong> adolescent psychiatry, sexual health, medical education, training intervention, psychotropic medications, behavior change theory, Medical Research Council framework, clinical communication, mental health, intervention development, youth mental health, health professionals</p>
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