John M. Keesler

Background: Rural communities continue to experience behavioral health disparities associated with workforce shortages, digital exclusion, and fragmented coordination between trusted community-based supports and formal behavioral health systems. Although telehealth has expanded opportunities for care, less is known about how key implementation factors interact within hybrid behavioral health systems—coordinated systems that integrate trusted community-based support with formal digital behavioral health services—or how these interactions influence implementation and engagement across community and formal care settings. Objective: This exploratory pilot study examined implementation domains relevant to hybrid behavioral health systems in rural communities using the hybrid community care model (HCCM) as the conceptual framework for survey development and interpretation of the findings. Methods: A cross-sectional survey was administered to professionals and community stakeholders attending a rural community workshop in the Midwestern United States, with a 46.3% (38/82) response rate. Survey items operationalized 4 theoretically informed implementation domains: relational trust, digital system capacity, coordination, and perceived feasibility of hybrid care models. Descriptive statistics and Spearman rank-order analyses were conducted to examine preliminary associations among individual survey items. Results: Spearman rank-order correlations indicated that coordination-related items demonstrated the strongest and most consistent associations, particularly among referral knowledge, collaboration between the community and behavioral health providers (BHPs), and continuity of care (ρ=0.383-0.633; P ≤.02). Perceived hybrid care feasibility demonstrated more variable associations, with respondents perceiving more limited BHP and appointment availability reporting stronger support for community-BHP partnerships (ρ=−0.471 and −0.648, respectively; P =.004 and P <.001). Conclusions: Preliminary findings suggest that coordination warrants further investigation as an implementation process within hybrid behavioral health systems. The HCCM served as a conceptual framework for interpreting the observed perception patterns and provides a foundation for future hypothesis-driven implementation research. Additional studies using validated measures are needed to further evaluate the implementation domains represented within the HCCM and examine their applicability across diverse rural settings.

Social inclusion is integral to the quality of life for people with disabilities (PWD). Using a social work lens, this article examines how policy, culture, and religion intersect to shape societal responses to disability in three nations: the United States, Egypt, and Ethiopia. Despite the existence of legal frameworks promoting disability rights, implementation gaps persist due to limited funding, lack of accountability, and cultural barriers. Social workers are positioned to bridge the gap between policy and practice by advocating for equitable resource distribution and culturally relevant applications of disability rights. Community inclusion for PWD demands systemic change, beyond legislation, to challenge dominant cultural narratives and transform structural norms. A culturally responsive, rights-based approach is essential to creating truly inclusive communities for PWD worldwide.

Objectives: As momentum for trauma-informed care (TIC) in intellectual and developmental disability (IDD) services increases, guidance for staff training in TIC is needed. Methods: Through a synthesis of clinical knowledge, applied experience, and research-based evidence, integral considerations and training components to advance TIC within IDD services are identified and discussed. Results: Careful planning regarding organizational context, staff development, and measurement is necessary to ensure the success of TIC staff training. Training components include the stress continuum, defining trauma, the prevalence and indicators of trauma, the principles of TIC, relational work and compassion-focused leadership, the impact of caregiving, and self-care and staff care. Conclusions: TIC staff training requires an investment and a shift in approach, from behavioral to relational approaches. Despite a lag, the future is promising for enhancing the overall wellbeing of people with IDD and those that support them.

Organizations supporting people with intellectual and developmental disabilities (IDD) are increasingly becoming aware of the impact of trauma, yet have often fallen short in their efforts to respond through trauma‐informed care (TIC). This study describes and evaluates the first‐of‐its‐kind learning collaborative (LC) to advance system‐wide TIC among four IDD organizations, occurring during the COVID‐19 pandemic. A multi‐method approach, including a pre‐ and post‐survey for staff, process notes, and a liaison survey, was used to monitor and assess organizational change and experience with the LC. Quantitative analyses demonstrated mixed results associated with staff‐level change. The process notes revealed the complexity of organizational change and a positive learning experience that was further supported by the liaison survey. Limitations, implications, and future directions are discussed.

COVID-19 had a profound impact on teaching and learning at academic institutions across the globe. This study examined the experiences of social work students (n = 884) during the pandemic and their associated level of burnout. Using a mixed methods approach, data from an online survey within a school of social work at a large Midwestern university were examined using stepwise regression and thematic analysis. Student demographics, academic characteristics, and experiences with COVID-19 were examined as predictors of burnout. Resilience was tested as a moderator of the association between COVID-19 experiences and burnout. Regression models accounted for 34.3% to 45.5% of variance across three domains of burnout (i.e., exhaustion, cynicism, and professional/academic efficacy), with COVID-related experiences accounting for most of the variance. Although resilience had a significant main effect, the interactions of resilience and COVID-19 experiences were not significant. Quantitative results were illuminated by thematic analysis of the qualitative data from which emerged four major themes: online teaching pedagogy, impact of COVID-19, transition of teaching and learning, and affective domains of learning. Engaging in humanistic education is discussed as a possible approach to circumvent burnout, bolster student resilience, and encourage academic success.

Background: As trauma‐informed care advances in the service delivery system for people with intellectual and developmental disabilities, additional resources are needed to foster staff development. This article describes the development and pilot evaluation of a digital training on trauma‐informed care among direct service providers (DSPs) in the disability service industry.Method: Following an AB design, a mixed methods approach was used to analyse the responses of 24 DSPs to an online survey at baseline and at follow‐up.Results: The training was associated with increased staff knowledge in some domains and greater alignment with trauma‐informed care. Staff expressed a strong likelihood of using trauma‐informed care in practice and identified organisational assets and barriers to implementation.Conclusions: Digital trainings can facilitate staff development and the advancement of trauma‐informed care. Although additional efforts are warranted, this study fills a gap in the literature regarding staff training and trauma‐informed care.

Background: Taking a trauma informed care approach has demonstrated positive outcomes for services for people in the general population. Given the increased vulnerability to psychological trauma for adults with an intellectual disability, this study explores what residential staff know about trauma and trauma informed care.Methods: Thirty‐two staffs representing three staff groups: direct care staff; managers; and specialist practitioners, were interviewed using semi‐structured interviews, which were analysed following a structured framework.Findings: Each staff group held different perspectives in their knowledge of trauma and trauma informed care. Limitations were noted in staffs' knowledge of trauma, implementation of evidence‐based supports, and access to specialist services for adults with an intellectual disability. All participants highlighted their training needs regarding trauma.Conclusion: Increased training on recognising and responding to trauma is needed among community staff supporting those with a trauma history if organisations are to move towards trauma informed care.

Background: Individuals with intellectual/developmental disabilities are vulnerable to potentially traumatic events and trauma sequelae. Despite ongoing advances surrounding trauma and intellectual/developmental disabilities, trauma‐specific treatments are needed for people with intellectual/developmental disabilities. This study explores the first implementation of Progressive Counting (PC), a novel trauma treatment, with people with intellectual/developmental disabilities.Methods: A case series with descriptive analyses was used to explore the implementation and effectiveness of PC among four adults with intellectual/developmental disabilities and trauma histories.Findings: PC was associated with reductions in symptoms and increased quality of life. Although individual experiences required modest adaptations to the intervention, PC was generally well‐tolerated and required a limited number of treatment sessions.Conclusions: PC demonstrates promise as a trauma‐specific treatment. Additional research with increased methodological rigor is warranted to further establish its efficacy. Recommendations for future research and practice are provided.