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Posttraumatic stress disorder (PTSD) clinics in the Department of Veterans Affairs (VA) often provide psychoeducational or skill-building groups to prepare veterans for trauma-focused PTSD treatments. However, there has been limited evaluation of the effectiveness of this phase-based approach for treatment engagement and symptom reduction. Participants included 575 veterans seeking treatment for PTSD whose treatment outcomes were assessed in a VA outpatient PTSD clinic staffed by mental health professionals and trainees. Participants completed self-report measures of baseline characteristics and psychiatric symptoms as part of routine PTSD clinic treatment. We tested the association of preparatory group treatment with engagement in and treatment response to subsequent trauma-focused psychotherapies, cognitive processing therapy (CPT) and prolonged exposure therapy (PE), which are designated by VA as evidence-based psychotherapies (EBP). Following participation in preparatory treatments, 94/391 (24%) of veterans engaged in a subsequent trauma-focused EBP (CPT or PE). Relative to patients who had previously completed a preparatory group, patients initiating a trauma-focused EBP without having first attended preparatory PTSD treatment had similar rates of trauma-focused EBP completion and better treatment response, as measured by decreases on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; PCL-5), F(1, 3009) = 10.89, p = .001, and Patient Health Questionnaire 9 measure of depressive symptoms F(1, 3688) = 6.74, p = .010. MG101 Overall, veterans reported greater symptom reduction when engaging in trauma-focused EBP directly, without having previously attended a preparatory group. These data support veteran engagement in trauma-focused EBPs for PTSD without first being encouraged to complete psychoeducational or skill-building groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Mr. Everett Alvarez is a prior Navy pilot and officer who served during the Vietnam War as a Lieutenant Junior Grade (LTJG, O-2). Mr. Alvarez was the first pilot shot down, captured, and held as a prisoner of war (POW) at the Hỏa Lò Prison, also known as the "Hanoi Hilton." He was held as a POW for 8.5 years, the second longest period of time a United States service member has been held captive. After his release and return to the United States, Mr. Alvarez continued his Naval service with a successful career. He went on to receive his Master of Science degree in Operations Research and Systems Analysis and retired at the rank of Commander (CDR, O-5). Retired CDR Alvarez has continued his service to the United States by holding positions such as the Deputy Director of the Peace Corps, Deputy Administrator of the Department of Veterans Affairs (VA), and Chairman and board member of the Board of Regents for the Uniformed Services University of the Health Sciences (USU). Interviewers were doctoral candidates in the USU Department of Medical and Clinical Psychology and Graduate School of Nursing. (PsycInfo Database Record (c) 2020 APA, all rights reserved).How does it feel to be a doctor and a patient? What impact does my lived experience have on my work as a psychiatrist? In the present narrative, I describe my personal experiences with bipolar disorder and my difficulties in accepting the diagnosis of a mental health disorder due to mental health stigma. I outline the possible benefits resulting from a deeper insight into a psychological crisis (e.g., more empathy and patience). I describe the establishment of a support and interest group for prosumers diagnosed with bipolar disorder in Germany and its activities of offering support to colleagues and providing public information and education aimed at reducing the stigma of mental health disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).A substantial proportion of U.S. military veterans experience mental health and/or substance use disorders. As public awareness of these difficulties rises, so too does interest in the relation between veteran behavioral health and high-risk events, namely suicide attempts, incarceration, and homelessness. Using latent class analysis and a large, nationally representative sample of community veterans, the current study examined common patterns of veteran behavioral health disorders and the associations between these patterns and high-risk events. Results suggest four classes of veterans, including a "healthy" class (comprising 69% of the total sample), a "substance use disorder" class (16%), a "personality disorder-substance use disorder" class (8%), and a "depressive disorder" class (7%). Veterans in the healthy class had the lowest rates of suicide attempt (2%), incarceration (14%), and homelessness (3%), whereas veterans in the personality disorder-substance use disorder class had the highest rates of these events (27%, 45%, and 22%, respectively). Results attest to the importance of investing clinical resources into addressing the needs of veterans experiencing complex behavioral health patterns, particularly personality and substance use disorders. Implications for the health care of veterans are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).A majority of mental health care providers seek personal therapy (i.e., are prosumers), and many providers experience suicidal ideation. Although mental health care providers may have more awareness of mental health than undergraduates, stigma is prevalent across both mental health care professionals and within universities. link2 Furthermore, suicidality is a particularly stigmatized aspect of mental health. Stigma may affect a client's willingness to work with therapists who are prosumers. Although client preferences have implications for treatment engagement, retention, and outcomes (Swift & Callahan, 2009, 2010; Swift, Callahan, & Vollmer, 2011), we are unaware of any research that considers clients' preferences regarding a prosumer therapist. The current study used a delay discounting paradigm to compare undergraduates' and mental health care providers' preferences of a prosumer therapist (i.e., with or without prior treatment history or prior suicidal ideation). We hypothesized that mental health care providers would be more accepting of a prosumer therapist, compared to undergraduates. Across both samples we expected a therapist with prior personal therapy to be more preferred than a therapist who has experienced prior suicidal ideation. Results were as expected, which may indicate a greater degree of mental health stigma among undergraduates compared to the mental health profession and greater stigma toward suicide in comparison to therapy experience in general. (PsycInfo Database Record (c) 2020 APA, all rights reserved).The debilitating stigma of mental illness is present in psychologists, psychology departments, and in the larger higher education environment. link3 My reflections on my experience as an African American psychology professor living with bipolar disorder can shed light on how stigma can prevent colleagues from intervening and providing much-needed support to a colleague in crisis. I summarize the history of my struggle with mental illness and with the decision to write about it. I emphasize the importance of vigilance with respect to the fact that changes in medication can rapidly and radically impact one's mood and behavior. My insights as a prosumer can inform administrators, staff, and faculty as they develop policies and practices to assist employees with mental health concerns, which should include providing trusted colleagues with permission to contact a spouse, friend, therapist, and/or family member in the event of a change in behavior. The aim is reduced stigma, greater authenticity on the part of the person living with mental illness, and early intervention, similar to the response one would expect to a heart attack, to interrupt or prevent a prolonged episode of psychological distress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).This study examined the effectiveness of the after-action review (AAR)-also commonly termed debrief-and 4 training characteristics within the context of Villado and Arthur's (2013) conceptual framework. Based on a bare-bones meta-analysis of the results from 61 studies (107 ds [915 teams and 3,499 individuals]), the AAR leads to an overall d of 0.79 improvement in multiple training evaluation criteria. This effect is larger than some of the largest training method effects reported in Arthur, Bennett, Edens, and Bell (2003), and it is also larger than Tannenbaum and Cerasoli's (2013) estimate of the effect of the AAR on task performance (d = 0.67). Two training characteristics consistently contributed to the effectiveness of the AAR (a) alignment to the individual or the team, and (b) objective performance review media. The effects of the other training characteristics were often interactive. Most notably, the facilitation approach contributes to the effectiveness of the AAR in combination with the individual versus the team and the type of review media, with the most effective combinations being the self-led facilitation approach coupled with a team-aligned AAR, and the self-led approach coupled with objective media. Additionally, the AAR that is highly structured is more effective than a less structured AAR in the military, but high and low structured AARs display comparable effectiveness in healthcare. Overall, this study suggests that the effectiveness of the AAR should be understood as a function of the combined influence among multiple interacting characteristics. Future theoretical development and research should be directed at better understanding these interactions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).How can employees of multinational corporations (MNCs) who are dispersed in various locations around the globe feel included? Integrating social capital theory and the MNC literature regarding resource and status differences between employees located in headquarter (HQ) versus non-HQ (i.e., subsidiary) country locations, we examined the role of the focal employee's professional advice ties and specifically their centrality as a source of advice to HQ contacts in enhancing inclusion. Moreover, we assessed the efficacy of two agentic strategies (i.e., cross-border work and access to well-connected site leaders) in facilitating the formation of inclusion-enhancing professional advice ties and whether their impact depends additionally on the focal employee's location inside or outside HQ country locations. Testing our predictions in a sample of 362 MNC employees dispersed across 33 sites, our findings showed that being central as a source of professional advice to HQ contacts enhanced employees' perceived inclusion. We also found that although employees in non-HQ countries suffered a "geographic disadvantage" in building professional advice ties to HQ contacts, these employees gained centrality as a source of professional advice to HQ contacts when they engaged in work that required cross-border interactions, especially when they also had site leaders who were well-connected. For employees located inside HQ countries, their professional advice ties to other HQ contacts were facilitated by having well-connected site leaders. We discuss the theoretical implications of our findings and provide practical recommendations for enhancing the inclusion of MNC employees based on whether they are located inside or outside of HQ countries. (PsycInfo Database Record (c) 2020 APA, all rights reserved).