Transitioning from military to civilian life can be challenging, but with the right mindset and preparation, it can also be a fulfilling experience. With May being Military Appreciation Month, we spoke to three veterans, Amber Rodgers (Maj.), Angela Burd (MSG), and Jerome Simmons (SGM), about their experiences transitioning to civilian life and how their military background has helped them in their current roles at Magellan Federal.

They each offer valuable insights on overcoming challenges and making the most of the transition, including setting attainable goals, building new habits, and staying connected with the military community. Whether you’re a veteran, caregiver, or spouse, their advice can help you navigate this exciting but daunting time in your life.

Q: Are you a veteran, caregiver, or spouse?

Amber Rodgers: Veteran and spouse
Angela Burd: Veteran
Jerome Simmons: Veteran

Q: What’s your branch of service?

Amber Rodgers: Air Force
Angela Burd: U.S. Army
Jerome Simmons: U.S. Army

Q: How many years of service do you have?

Amber Rodgers: 10
Angela Burd: 27
Jerome Simmons: 30

Q: What was your experience transitioning from military to civilian life leading up to your role at Magellan Federal?

Amber Rodgers: It was a quick 3-week transition from active duty to civilian life and my Magellan role!

Angela Burd: I retired in 2021, and the transition was smooth. I had a lot of time to prepare. The military sets you up for success through the transition assistance program. I researched employment in the civilian sector because I believed I wanted a drastic change from the military in my second career. But after a few months as a civilian, I realized I greatly missed the military community. I knew I still had a desire to “serve” in some capacity. Then I came across the job posting for MFLC recruiting, and it felt like an amazing opportunity to put my military experience to great use!

Jerome Simmons: My transition has been tough to the point that I’m still up at 04:00 a.m. every day. I took a break for the first 90 days, which did not last because I ran out of things to do. I started working a contract job at Fort Bliss, TX, to stay active and still give back to the Soldiers. The job that I currently have is a true blessing allowing me to give back once again.

Q: What challenges did you face during your transition, and how did you overcome them?

Amber Rodgers: I initially struggled with not feeling busy enough, I was overwhelmed during active duty and trying to be present for my family, and then it all stopped when I got out. I couldn’t remember when I’d only worked an 8hr day. I focused on spending that “extra” time with my family, being outside, and finding hobbies.

Angela Burd: My greatest challenge was transitioning from being a leader and expert in my field to starting over and learning civilian aspects of the workforce. I needed to recognize that I would not initially come into the workforce at the “rank” I previously held; that I needed to establish myself as a valuable employee and learn, grow, and challenge myself to work toward new goals.

Jerome Simmons: The first challenge I faced was not being in charge anymore. I did a lot of cycling and CrossFit to take my mind off the pressure of not leading Soldiers!

Q: How do you think your military experience has prepared you for your role at Magellan Federal?

Amber Rodgers: The military prepared me to lead people, problem-solve, and think strategically.

Angela Burd: I can appreciate the mission and recognize the value of Magellan Federal from the angle of the service member. Additionally, I recruit Military and Family Life Counselors. I feel that my prior service lends to the credibility of who we are and what we do. I appreciate the counselors because so many times throughout my years of service, I now recognize that I could have used an MFLC!

Jerome Simmons: My experience with the Army has made it easy for me to network with Green Suiters (Army) and other organizations on the installation.

Q: What skills did you learn in the military that you feel are particularly valuable in your current position?

Amber Rodgers: Time management, setting goals, communicating expectations, giving and receiving feedback, and accountability.

Angela Burd: Adaptability. I have learned to make the best of plans but be ready at any time for a change in mission. All candidates are different and the ability to adapt can assist in keeping great candidates interested in our roles and ultimately filling our ranks with the right employees to serve our service members and their families.

Jerome Simmons: Leading and patience are two great skills that I’ve learned.

Q7: How do you stay connected with the military community while working in a civilian role?

Amber Rodgers: I serve in the Air National Guard.

Angela Burd: I had a great bond with my team of Soldiers, my leadership, and their families. Many have become lifelong friends who still come to me for advice from when I was in their positions. It is a great feeling to know that my work remains valued and worthy of recognition even after being gone for two years.

Jerome Simmons: I have a ton of old Soldiers, civilians, and leaders that stay in touch with me monthly for mentorship and mentee.

Q8: What advice would you give to someone who is currently transitioning from military to civilian life?

Amber Rodgers: Acknowledge that “it’s different,” normalize the transition of old habits, and explore how to build new habits. Find the similarities and find excitement in the differences. Take time for yourself and recognize that this is a transition for your family, too, don’t forget them!

Angela Burd: Start planning early. Set attainable goals for yourself with realistic timelines. Include your family in your plans. Ask questions, build connections, and network! Be realistic about what you want in a role. You may fail a time or two and need to reassess your goals, but that’s OK! The military community is always there to pick you up, and your training taught you to be resilient so you will eventually succeed!

Jerome Simmons: Please, please establish some type of support channel, whether it be military or civilian, that would push and motivate you!

Military Caregiver Month is a time to recognize and honor more than 5.5 million spouses, parents, children, relatives, friends, coworkers, and neighbors who provide care and assistance while warriors heal from their injuries. The caregiver’s dedication can lead to swifter recovery times for their loved one, a better quality of life, and saves the United States billions of dollars in health care costs.

The month of May is when the nation formally recognizes a caregiver’s dedication. It’s an understanding and appreciation that caregiving can sometimes come at a cost to their emotional, physical, and financial well-being. One of the goals of Military Caregiver Month is to get the word out regarding the life-changing work that caregivers are doing every day to support our nation’s wounded warriors, but also to take the time to spotlight resources that are available for Military Caregivers and advocate for additional resources to fill any gaps that have been identified.

Available Resources for Military Caregivers

Veterans’ Affairs

These caregiver support programs within Veterans’ Affairs (VA) are open to all caregivers regardless of the warrior’s years of service.

• VA Caregiver Support Program—based out of local VA Medical Centers, this program supports military caregivers with one-on-one and group coaching, mobile/telephone support, skills training, information regarding online programs, and referrals to available VA and community resources.
• Caregiver Support Line (1-855-260-3274)—Military caregivers can call to learn more about navigating barriers to accessing care and community resources available to help the veteran and receive supportive counseling for themselves from licensed social workers. Caregivers can also use the Support Line to network and obtain advice by participating in monthly telephone education groups where they can ask questions and learn additional skills regarding their own self-care.
• VA Peer Support Mentoring Program—New military caregivers are matched with more experienced caregivers to obtain ongoing monthly support and consultation with the National Peer Mentoring Support Program Managers. Through this supportive program, the military caregiver can socialize and create supportive friendships with individuals who understand the issues faced by caregivers and can provide support and advice.
• VA Comprehensive Assistance for Family Caregivers—This program is specifically geared towards those providing care for veterans with serious injuries who have served on or after 9/11. It provides approved caregivers support options, including a monthly stipend, respite care, payment of approved travel expenses, health insurance, and mental health services.

The Department of Defense

The Department of Defense (DoD) provides resources and information exclusively for military caregivers who assist wounded, ill, or injured Service members with activities of daily living.

• Military Caregiver PEER (Personalized Experiences, Engagement, and Resources) Forum Initiative—This initiative utilizes Military Family Life Counselors to organize and conduct forums that provide non-medical counseling opportunities for military caregivers. At these forums, attendees discuss topics they would like to focus on, such as managing stress, nutrition, financial wellness, and employment, among other issues. The Military Caregiver PEER Forums aim to reduce stress, provide emotional support, and be a resource for valuable information through guided discussion among military caregivers, allowing them to share practical, accurate, and thorough information based on their personal experiences.
  
• Caregiver Resource Directory (CRD)—The CRD is designed to help empower military caregivers with information about national and local resources and programs specifically for them. Topics include helplines, advocacy and benefits information, career transitions and employment, military caregiver support, children’s needs, education and training, financial support, rest and relaxation, and more.

You can access the 2022 CRD online or request a CRD at OSD.Caregiver@mail.mil.

• National Resource Directory – The NRD is an online database containing thousands of validated Federal, State, and local level resources that support recovery, rehabilitation, and reintegration for service members, veterans, family members, and caregivers.
• Virtual PEER Forums—Military caregivers may join their peers through virtual teleconference lines during forums scheduled on the first Thursday of every month at 11 a.m. ET and the fourth Thursday at 2 p.m. ET. Virtual Peer Forums allow caregivers to share their expertise and network with others who are experiencing similar challenges. Click here to RSVP.
• Warrior Care Recovery Coordination Program – A Defense Health Agency program where caregivers can learn more about navigating the various DoD programs developed for Wounded Warriors.
• Military Caregiver webinars, events, and specialized resources.

While caregiving is rewarding, it can also be challenging and overwhelming. That’s why spending awareness about the resources available to military caregivers is essential.

On May 17^th, we celebrate National Employee Health and Fitness Day! By sharing tips on how to stay active even during busy workdays, National Employee Health and Fitness Day is a day to raise awareness of the health benefits of physical activity and remind employees about the necessity and advantages of regular physical activity. Physical activity provides a much-needed break from the stress of everyday tasks and duties and gives us energy, boosts mental ability, and prevents fatigue throughout the rest of the day. Magellan Health’s Evergrace Davis, associate information security compliance analysist, is also an AFAA Certified Group Fitness Instructor. In 2020, Davis launched “KeepItMovin with Grace,” a workout program that provides individuals of all ages and fitness levels with fitness classes and step challenges. Davis began her fitness journey over 12 years ago as a workout class instructor and lives by the motto, “keep it moving” with the goal of living life to the fullest. Continue reading to learn Davis’ tips on how employees can find ways to include physical fitness throughout even the busiest workdays.

How can employees who work from home find ways to prioritize health and fitness throughout their workday?

I know that working from home can be challenging but we must find ways to prioritize fitness by keeping our bodies moving. Fitness is so beneficial to your health and can improve your work mood and overall health.  I suggest trying the STOP method which means “Stop Typing on PC.” Practice this by blocking off time on your calendar for fitness breaks. Scheduling time is making fitness a priority because we sit for hours in one place and many only get up for coffee, lunch, and bathroom breaks. Here are some suggestions below:

• Put on your gym shoes and go for a walk around the block.
• Step away from your computer for five minutes of stretching.
• Getting some direct sunlight improves your health making you feel recharged and refreshed to continue with the workday.

How can employees who work in an office find ways to prioritize health and fitness throughout their workday?

There are ways for employees to prioritize their health and fitness while working in the office throughout the workday both indoors and outdoors. The STOP method still applies while in the office!  Block off time and schedule your fitness breaks. Always be prepared for working out by having a change of clothes, towel, water bottle, and gym shoes in the car. Here are some more suggestions employees can do while working in an office:

• Indoors: Walk up and down the hallways, up and down stairs, go the fitness center if your company provides one and get on the treadmill, stretch, or lift some weights.
• Outdoors: Go outside to stretch or take a walk around the building, or a quick jog.

By doing this, employees can improve their mood and health by making sure they keep moving even during the workday!

What are the benefits of regular physical activity? What are some easy ways for employees to add physical activity into a busy workday?

There are so many benefits to maintaining regular physical activity. By prioritizing physical activity consistently, your body learns to look forward to daily movement and exercise. Another benefit are the results that you will see from consistently staying active. You may find yourself feeling better, less stressed, and possibly experiencing more energy, and better sleep.

For National Nurses Week, we are honoring the contributions and sacrifices made by all nurses in the medical community who are instrumental in enhancing the health of their patients. Nurses are the healthcare professionals who perform some of the most challenging and essential healthcare tasks and serve as the first and last point of contact for most patients as well as being a crucial link between patients and doctors. Nurses have a versatile career with dozens of specialties that require extreme focus and dedication. We’re spotlighting two of Magellan Health’s nurses who each explain why they chose to become nurses, and who describe what are some of the most rewarding and challenging aspects of working in this field:

• Tracy McClain, RN, BSN, Care Coordinator, Employer Center of Excellence
• Jacqueline Rigby Siomos, RN, senior care manager, Cambria County Clinical

Continue reading to learn more from Jacqueline and Tracy on their experience as nurses:

Why did you become a nurse and what are the most rewarding aspects of working in this field?

Jacqueline: I really wanted to help people and becoming a nurse was the best fit for me. I knew nursing had a lot of different opportunities available and I would always be guaranteed to have a fulfilling career. I enjoy that I learn something new each day, whether it’s a new medication, a new treatment modality, or a new data system.

Tracy: I always knew since a very young age that I wanted to work in a career that allows me to help people. Helping and supporting people in their time of need by bringing them care, comfort, and compassion does as much for me as it does the people I help.

What are some challenges you face being a nurse? How do you overcome those challenges?

Jacqueline: One of the biggest challenges is stress and burnout. It is very important to have healthy self-care rituals to be refreshed and rejuvenated for the next workday. You must commit to be a lifelong learner if you want to be a nurse since healthcare is an ever-changing field. 

Tracy: Not being able to help or make a positive difference in someone’s life, but I just always remind myself that I can’t save the whole world, so I stay focused on the people I can impact and never give up on anyone.

Is there anything you’d like to highlight about working in this field and National Nurses Week?

Jacqueline: Nursing is a challenging field, but the rewards of helping others outweigh all the challenges. I have always been blessed to work with a wonderful group of nurses and other professionals who always make the workday go smoothly. The nursing profession offers tremendous amounts of flexibility in scheduling, clinical specialties, and employment locations. Celebrating National Nurses Week is a great way to recognize the hard work and dedication of all my colleagues in the field. We are all in this together.

Tracy: Working in this field and with my team at Magellan has helped me gain knowledge and grow as a person. I have worked here for 25 years and can honestly say I am a more patient, compassionate, and educated nurse. It’s nice to know that nurses are being recognized for what they do and made to feel proud of being a nurse, especially when burn out tends to be high in this field.

Hard work, dedication, love, and resilience weave together an extraordinary tapestry that is the military spouse. We are strong, independent women and men fiercely supportive of each other. We care wholeheartedly about all associated with the military and work tirelessly to support those who support us through serving our country.

Military Spouse Appreciation Month recognizes the spouse’s contributions to the military and the community. Those in the military took an oath to serve our country and receive medals, salutes, and commendations for their commitment. The sacrifices of the families, while not as evident, should also be applauded and recognized for their commitment to the service of our country through their support of the service member. Often these sacrifices go unnoticed and can create challenges, such as maintaining a job or career.

The Struggle of Finding Employment as a Military Spouse

On many military installations, spouses volunteer thousands of hours for the cause of the community and the military services. One can find a spouse volunteering at thrift stores, schools, Community Action Centers, Military Spouse Clubs, and the American Red Cross, to name a few. The spouse’s work is visible and needed. When the service member knows that the family is stable and receiving the required support within the community, they can focus on serving their mission without hesitation.

Along with the usual marital stresses, most non-military spouses are near support systems of family, lifelong friends, and resources known to them. We learn to make friends quickly, and those people become our family. The resentment and loneliness this lifestyle brings can be hard to understand. The sacrifice, commitment, and the stress of many domestic roles can be lonely and isolating at times. We can sometimes lose our identity – known only as someone’s spouse or someone’s parent. Many opportunities present themselves, such as worldwide travel, educational benefits, and excellent schools, but with these opportunities there can be just as many, if not more, sacrifices.

So much of our military lifestyle is beyond our control. Affordable childcare options are a major concern for military spouses. It is a primary family expense and the main reason many spouses choose not to work outside the home. At one point in my career, I worked 40 hours a week and cleared less than $600 monthly after childcare expenses, transportation, lunch, hair, nails, etc. I was exhausted and felt enormous guilt for allowing my children to be cared for by strangers while I earned a mere pittance.

Military spouses sometimes “Suffer in Silence,” fearing that speaking up may impact our service member’s career.

Qualities of a Military Spouse

We cover family milestones, holidays, and events alone, often finding ways to make up for the missing service member. In many cases, giving birth is a prime example. Thanks to my husband’s battalion chaplain (and his wife who made him do it), Gary was able to sneak away for a couple of hours (in full camouflage paint and an odor to match!) from field exercises to visit our newborn son and me in the neonatal intensive care unit in Fayetteville, NC.

Charlene Austin, the wife of Secretary of Defense General Lloyd Austin, has always been a working military spouse. She gave me this advice years ago when I became despondent during my job search. “This [military] experience is guaranteed to be like no other. Remain open to options and alternatives. Grow to be happy with yourself and work to realize your needs and goals.” That is good advice, but so much easier said than done.

Military spouses often sacrifice a stable career with their active-duty partner. The constant moving makes it hard to have career progression since you are not in any position long enough to have forward momentum. For example, my dear friend, Ivy, has multiple graduate degrees. Yet, she decided not to work for nearly twenty years because it was difficult to secure positions with growth and one that would work with her schedule of raising children and supporting her military service member.

Military spouses are adaptable, flexible, punctual finance managers, organizational managers, schedule managers, and residential physician assistants. They serve as Girl Scout leaders, Boy Scout leaders, piano teachers, sports coaches, and tutors. We are located in an area for 12-36 months. Within the first two weeks of arrival, the spouse has unpacked and arranged the house, registered students in new schools (who is my emergency contact when I don’t know anyone?!), obtained new doctors and a dentist, scheduled sporting activities and other extra-curriculum activities, and planned the summer vacation with fun activities.

Why Companies Should Hire Military Spouses

Securing positions and establishing a career have changed within the last 10 years for military spouses; however, it can sometimes still be difficult for a spouse to secure a position if they are not a teacher or working within the medical field. Many employers hesitate to hire a military spouse because they focused on the spouse leaving and not the skills the person was contributing to the overall mission.

An organization would benefit from having a military spouse who can work independently and collaboratively to complete tasks without supervision. A military spouse has likely managed a household and children and settled conflicts—from submitting damage claims to advocating for the best classes for their child. Military spouses are often highly educated and experienced; therefore, they meet the requirements for many positions. They should not be discounted simply because they may be at a temporary station. There are a lot of remote work options these days that may result in continuity beyond service location.

Carolyn Shelton, the spouse of General Hugh Shelton, former Chairman of the Joint Chiefs of Staff, shared an interesting story concerning her job search in the Washington, DC, area. She was submitting applications but had very little previous employment. She added her volunteer experience as a military spouse instead. A hiring manager reviewed her application and said, “Anyone who would volunteer this much at no pay has to be reliable. You’re hired!” Never discount the strength of your volunteer experience. You gain marketable skills needed in the business community.

When I met Carolyn, she had moved 24 times in 29 years. She humorously described her first experience as a military spouse (although I am sure humorously was not how she would have described it then).  They arrived at Ft. Benning, Georgia, where her husband was to attend Ranger School. He told her, “I’m going to sign in with the unit, then I’ll be back.” He didn’t make it back for two days! This happens more often than we care to admit.

It is past time that companies provide childcare assistance or subsidies. A flexible spending account should be one of many benefits companies offer employees. I hope the future holds affordable options for all companies that will foster a healthier work-life balance.

Companies like Magellan Federal have already taken giant steps in supporting military spouses in the workplace. Our Talent Acquisition team is superb at keeping the company recognized as a Military Friendly Top 10 Spouse Employer. Our President and CEO, Anna Sever, is the spouse of an active-duty military service member. I do not doubt that under her leadership, we will continue to build on the foundation the company was founded on – care for surviving spouses of the fallen. I applaud Magellan Federal for the emphasis placed on mental health and access to resources.

I encourage other corporations to provide more opportunities for military spouses. Hire them because they get the job done and allow them to manage at the highest positions!

On May 3, the U.S. Surgeon General issued an advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection, calling it an “Epidemic of Loneliness and Isolation.”

Loneliness is the feeling of being isolated, or alone. It isn’t always tied to the amount of time you spend with other people but can come from a gap between the relationships you have and the ones you need or want.

There may not be a magic cure for loneliness, but there are healthy ways to cope and reconnect socially and regain a sense of belonging. Here are five steps to reduce loneliness:

1. Try helping someone else – Helping just one person at one time is a way to connect that improves the life of another, makes you feel better about yourself, and can be a great way to help people and meet others who share your interests. You can smile and be friendly, stop to help a neighbor, volunteer your time or donate food.
2. Think about getting a pet or finding a way to interact with animals – A pet can be a great companion, and source of comfort and may also lower stress and blood pressure. If you can’t have a pet, there are many volunteer opportunities to help animals in every community.
3. Take care of the relationships you already have – Reaching out to friends and family can help strengthen your sense of belonging. Set aside a few hours a week to connect. There doesn’t have to be a specific reason to call, and the call doesn’t have to be that long. A familiar look or a loving smile can change our experience instantly, even if we are far away or unable to see each other. You never know how reaching out to just one person may connect you to others.
4. Find new connections through activities you enjoy – Start or restart a hobby. Take a class to learn something new. Check out programs at the library or community center. You can invite friends or acquaintances you want to get to know better. Alternatively, you can go alone and meet people who share at least one interest of yours.
5. Talk with a counselor – It can be hard to make changes on your own and scary to think about being in social situations. If loneliness makes it hard for you to go about your day, a counselor can help.

As you think about taking small steps, remember the importance of self-care to help you feel better from the inside out. Exercise, healthy eating, proper sleep, sunshine and meditation are good ways to improve your emotional health.

Sources:

• Healthwise
• Surgeon General’s Advisory on Our Epidemic of Loneliness and Isolation – PDF

Applied behavior analysis

Applied behavior analysis (ABA) is a science-based therapy that can help individuals with behavioral, developmental and social challenges. It is rooted in the principles of behaviorism and focuses on reinforcing positive behaviors while reducing negative ones. In this article, we will explore who can benefit from ABA, who can provide ABA therapy, how to access ABA therapy and more.

Who can benefit from ABA?

ABA therapy can be beneficial for a variety of individuals, including those with autism spectrum disorder (ASD), developmental disabilities and learning disorders. ABA therapy can help with communication skills, social skills and behavior management. It can also improve adaptive living skills.

Who is qualified to deliver ABA?

ABA therapy is delivered by what is generally known as a Board-Certified Behavior Analyst (BCBA). These professionals have a master’s or doctoral degree and have passed a certification exam. BCBA’s also have extensive training and experience in the principles of ABA therapy. There are also professionals who can provide ABA therapy under the supervision of a BCBA and are commonly referred to as:

• Board Certified Assistant Behavior Analysts (BCaBAs)—Have completed a bachelor’s degree and have passed a certification exam.
• Registered Behavior Technicians (RBTs)—Have completed a minimum of 40 hours of training and have passed a competency assessment.

In addition to these professionals, ABA therapy teams may also include speech-language pathologists, occupational therapists and physical therapists. These professionals work together to provide a comprehensive approach to ABA therapy, addressing your child’s unique needs and goals.

How are ABA services accessed?

Accessing ABA services is a multi-step process:

1. A diagnosis and recommendation for ABA therapy is made by a medical doctor (MD) or a healthcare-related PhD.
2. Parents contact their health plan or an ABA provider to begin the process of securing insurance authorization to conduct an assessment.
3. An ABA provider works with parents to ensure insurance approval is granted before the assessment begins.
4. A BCBA conducts the assessment. If the child is deemed a suitable candidate for ABA therapy, the BCBA submits treatment recommendations to the health plan.
5. Once the health plan approves the recommendations, ABA therapy can begin.

Insurance coverage for ABA therapy may vary depending on the specific diagnosis. It is always prudent to check with your health plan to determine which diagnoses are covered. This process ensures your child receives the proper care and the health plan covers the cost of ABA therapy consistent with the terms of your coverage.

What are other pathways to ABA?

In addition to accessing ABA therapy through health insurance authorization, you can explore:

• State-funded programs which provide services and support to individuals with developmental disabilities. They can also help you identify ABA providers and may cover the cost of therapy for eligible children.
• Local school districts that offer Individualized Education Plans (IEP). Schools may have in-house ABA providers or work with outside agencies to provide services to children in need.
• Out of pocket, or private pay, allows you to choose your own ABA provider and have more control over the type and frequency of therapy sessions.

It is important for you to explore all options and choose the pathway that best meets your needs and the needs of your child.

How are goals developed and how is progress measured?

Goals for ABA therapy are developed based on your child’s unique needs and abilities. A BCBA will conduct an assessment to identify areas of strength and areas for improvement. Once goals are established, progress is measured through data collection and analysis. This information is used to adjust treatment plans as needed. Progress reports are shared with you and other professionals involved in your child’s care.

 What does ABA look like?

ABA sessions are typically conducted one-on-one with a BCBA, RBT or BCaBA. ABA sessions are highly structured and tailored to meet your child’s specific needs. A typical ABA session is comprised of three main components.

1. Goal implementation—During sessions, the therapist works with your child to help them achieve their goals which are developed based on their unique needs and abilities.
2. Behavior plan implementation—Behavior plans are developed to address specific behaviors your child is struggling with. Therapists use positive reinforcement strategies to increase positive behaviors and decrease negative ones.
3. Family/caregiver training and support—Family and caregivers play a key role in the success of ABA therapy. During ABA sessions, therapists work with family and caregivers to provide training and support. Family and caregivers learn the core principles of ABA, along with strategies to help reinforce positive behaviors at home and manage challenging behaviors. By working together, the therapist, your child and you can achieve positive outcomes and promote meaningful change.

Where can ABA take place?

ABA therapy can be delivered in your child’s natural settings, including home, school and the community. Therapy can also take place in clinics. The therapist will collaborate with you and other professionals to determine the most appropriate setting for your child.

Interested in learning more about ABA?                              

• Find and watch the recording of our webinar, “What is Applied Behavior Analysis (ABA) and how can it help my family?” here.
• Visit the following websites:
  • Centers for Disease Control and Prevention (CDC)—Learn about early signs of ASD, severity levels and how they are defined, types of testing available and more.
  • Autism Speaks—Learn the signs of autism and become familiar with the typical developmental milestones that your child should be reaching at all ages.

Evidence-based or evidence-informed treatment? Confused? You are not alone. Often used interchangeably, the terms “evidence-based” and “evidence-informed” in healthcare are two very different things. So, what do they really mean?

What is evidence-based treatment?

Evidence-based care is considered the gold standard in treating behavioral health conditions. Typically, “evidence-based” refers to an individual intervention that is based on quantitative research studies conducted in controlled, blinded settings and proven to be effective across a wide range of environments and people. Medications and other treatments that receive U.S. Food and Drug Administration (FDA) approval for a certain indication are also considered evidence-based.

What is evidence-informed treatment?  

 Evidence-informed care is an approach that shows promise but lacks enough proof of success to be viewed as a gold standard. Practitioners take bits and pieces from a variety of research, including evidence-based interventions and apply them to a condition. This produces something uniquely tailored to a certain need. Unlike evidence-based treatments, evidence-informed treatments don’t have results from research in controlled settings that demonstrate their effectiveness across a wide range of settings and people. When considering medication and other drug-like treatments, evidence-informed interventions have not received FDA approval for the condition they are treating. This is called “off-label” use.

Examples of evidence-based treatments

• Cognitive behavioral therapy (CBT) is a type of talk therapy that has proved effective in the treatment of anxiety, depression, addictions, phobias and certain physical health conditions. CBT focuses on changing automatic negative thoughts that can contribute to and worsen mental health and substance use symptoms. CBT has more evidence supporting it than any other psychological therapy.
• Acceptance and commitment therapy (ACT) is a type of mindful talk therapy that helps individuals stay focused on the present moment and accept thoughts and feelings without judgment. Over 200 randomized controlled trials have proven ACT is an effective treatment for depression, psychosis, chronic pain, substance use disorder, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder and social phobia.
• Dialectical behavior therapy (DBT) is a type of talk therapy based on CBT and specially adapted for people who experience emotions very intensely. Nine published randomized controlled trials and five controlled trials of DBT have proven its effectiveness for treating borderline personality disorder, including in highly suicidal women.
• Exposure and response prevention (ERP) therapy is a form of CBT that encourages individuals to engage with their obsessive thoughts without carrying out their associated compulsions. Treatment begins with placing individuals in situations which cause a tolerable level of anxiety and gradually build up to settings they find more difficult. ERP has been proven effective for treating obsessive-compulsive disorder in numerous clinical trials.
• Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique that involves moving your eyes a specific way while you process traumatic memories. The goal of EMDR is to help individuals heal from trauma or other distressing life experiences. Since the first EMDR clinical trial in 1989, dozens of other clinical trials have proven this technique is effective and faster for the treatment of post-traumatic stress disorder.
• Transcranial magnetic stimulation (TMS) is a noninvasive treatment that was first used to treat depression in individuals who were nonresponsive to other treatments. TMS involves using a magnetic coil to influence the brain’s natural electrical activity and has full FDA approval for the treatment of major depressive disorder, obsessive-compulsive disorder, migraines and smoking cessation.
• Esketamine is an FDA-approved nasal spray used to treat severe treatment-resistant depression. Esketamine was found effective in a phase 3, double-blind, active-controlled study conducted at 39 outpatient centers from August 2015 to June 2017. The study involved nearly 200 adults with moderate to severe depression and a history of not responding to at least two antidepressants.
• Fluoextine is an antidepressant medication that is approved by the FDA to treat depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. It belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs) and works by increasing the activity of serotonin in the brain. Data based on a group of 9,087 patients who were included in 87 different randomized clinical trials confirms that fluoxetine is safe and effective in the treatment of depression from the first week of therapy.

 Examples of evidence-informed treatments   

Response Disequilibrium Therapy (RDx)—Based on the response disequilibrium model, RDx puts patients in charge of implementing their own treatment procedure outside of therapy sessions in the same environments that trigger their symptoms so they can learn new behaviors to replace and control their previous responses to distressing situations.

While preliminary findings from case studies involving 19 participants with OCD suggest RDx may be a promising alternative to traditional OCD treatments, future research is needed to determine its effectiveness across a wide range of settings, people and problems to classify it as an evidence-based intervention.

• Pregabalin (an FDA-approved anticonvulsant medication and fibromyalgia treatment) has been used off-label to treat generalized anxiety disorder, social anxiety disorder, bipolar disorder, insomnia and chronic pain conditions other than fibromyalgia. For pregabalin to be used for these conditions in an evidence-based manner, the FDA would have to approve their use for each specific condition.
• Risperidone (an atypical antipsychotic medication approved by the FDA for the treatment of schizophrenia, bipolar disorder and autism-associated irritability) has been used in a variety of off-label ways, including to treat borderline personality disorder, post-traumatic stress disorder (PTSD) and bipolar disorder. To date, the FDA has not approved risperidone to treat these three conditions.

Are mental health and wellness apps evidence-based or evidence-informed?

These days, you can’t browse the web or use most apps on your phone without seeing an ad for a wellbeing or therapy program or app. Used alone or to supplement traditional treatment and promote wellbeing, not all mental health, substance use and wellbeing apps use evidence-based practices, nor have they been extensively researched in treating specific conditions. Wellbeing and therapy apps are typically considered:

• Evidence-based when evidence-based interventions are fully implemented on the platform and followed by users in the same manner they would be if they were being delivered during face-to-face treatment. For example, the original evidence-based model below is used in a wellbeing app that delivers CBT digitally and all steps are followed as listed.
  1. Identify troubling situations or conditions in your life.
  2. Become aware of your thoughts, emotions and beliefs about these problems.
  3. Identify negative or inaccurate thinking.
  4. Reshape negative or inaccurate thinking.
• Evidence-informed when only certain components of evidence-based interventions are implemented on the platform, and/or the app only fully implements or uses components of evidence-informed interventions. For instance, if a wellbeing app provides CBT and only asks users to identify troubling thoughts and become aware of their thoughts, emotions and beliefs about these problems, it is evidence-informed because it does not ask users to identify and reshape negative or inaccurate thinking.

When considering using an app for yourself, your patients, your employees or your members, ask yourself these questions:

• Are the treatments used in the app based on quantitative research?
  • Were the studies conducted in controlled, blinded settings?
  • Are the treatments proven to be effective across a wide range of environments and people?
• Are all treatment steps included in the process, or has the process been watered down?
• Have the treatments used in the app received FDA approval for a certain indication, if FDA approval is possible?

Magellan’s approach to evidence-based versus evidence-informed treatments and mental health, wellbeing and substance use apps

The American Psychiatric Association and the American Psychological Association both consider evidence-based interventions preferred approaches for the treatment of psychological conditions.

At Magellan, we are leading the way in providing innovative, impactful behavioral healthcare solutions. When developing new and enhancing existing offerings , like our digital cognitive behavioral therapy (DCBT) programs, we always start with evidence-based treatments and adhere fully to all tenets. Magellan Healthcare’s DCBTs have been heavily researched in the studies below:

• FearFighter® for anxiety, panic and phobia (now available online in Spanish)
  • Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directions. L. Gega, I. Marks, D. Mataix-Cols. Journal of Clinical Psychology: In Session (2004), Vol. 60 (2), 147-157.
  • Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: Randomized controlled trial with pre-registration nursing students. L. Gega, I.J. Norman and I.M. Marks. International Journal of Nursing Studies 44 (2007) 397-405.
  • The feasibility and effectiveness of computer-guided (CBT) (FearFighter) in a rural area. L. Hayward, A.D. MacGregor, D.F. Peck, P. Wilkes. Behavioural and Cognitive Psychotherapy (2007) 35, 409-419.
• MoodCalmer for depression (now available online in Spanish)
  • Saving clinician’s time by delegating routine aspects of therapy to a computer: A randomized controlled trial in phobia/panic. I.M. Marks, M. Kenwright, M. McDonough, M. Whitaker and D. Mataix-Cols (2004).
  • Technology-based advances in the management of depression: Focus on the COPE program. Disease Management and Health Outcomes. J.H. Greist, D.J. Osgood-Hynes, L. Baer and I.M. Marks (2000) 7, 4.
• RESTORE® for insomnia and other sleep difficulties (now available online in Spanish)
  • Implementing computer-based psychotherapy among veterans in outpatient treatment for substance use disorders. E.D.A. Hermes and R.A. Rosenheck. Psychiatric Services 67:2, February 2016, 176-183.
  • Cognitive behavioral therapy for insomnia enhances depression outcomes in patients with comorbid major depressive disorder and insomnia. R. Manber, J.D. Edinger, J.L. Gress, M.G. San Pedro-Salcedo, T.F. Kuo, T. Kalista. SLEEP, Vol. 31, No. 4, 2008, 489-495.
  • Logging on for better sleep: RCT of the effectiveness of online treatment for insomnia. N. Vincent and S. Lewycky. SLEEP, Vol. 32, No. 6, 2009, 807-815.
  • Sleep locus of control and computerized cognitive-behavioral therapy (cCBT). N. Vincent, K. Walsh, and S. Lewycky. Behaviour Research and Therapy, 48 (2010), 779-783.
• SHADE for substance use disorder
  • Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: Short-term outcome. A.L. Baker, D.J. Kavanagh, F.J. Kay-Lambkin, S.A. Hunt, T.J. Lewin, V.J. Carr and J. Connolly. Addiction, 105, (2009) 87-99.
  • Clinician-assisted computerised versus therapist-delivered treatment for depressive and addictive disorders: A randomised controlled trial. F.J. Kay-Lambkin, A.L. Baker, B. Kelly and T.J. Lewin. Medical Journal Australia, 195, 3, 1 August 2011.
  • Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: A randomized controlled trial of clinical efficacy. F.J. Kay-Lambkin, A.L. Baker, T.J. Lewin and V.J. Carr. Addiction, 104, 278-388 (2009).
• ComfortAble® for chronic pain
  • Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. D.M. Ehde, T.M. Dillworth and J.A. Turner. American Psychologist (2014), Vol. 69, No. 2, 153-166.

We further validate this research with outcomes from practical application of our solutions. By doing this, we ensure our clients and members receive only high-quality products and services that work in the real world—where it really matters.

SOURCES:

• ACT is an Empirically-Supported Therapy: Background and Clinical Evidence
• Act Theory: Acceptance and Commitment Therapy Explained
• CBT Explained: An Overview & Summary of CBT
• Dialectical Behavior Therapy
• EDMR Therapy
• Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives – PMC
• The Evidence for Cognitive Behavioural Therapy in any Condition, Population or Context: A Meta-review of Systematic Reviews and Panoramic Meta-analysis
• Fluoxetine: a review on evidence-based medicine
• National Library of Medicine: Pregabalin
• National Library of Medicine: Risperidone
• New Therapy Shows Promise for Swift Treatment of Obsessive Compulsive Disorder – Association for Psychological Science – APS
• Psychiatry.org – Study Supports Effectiveness of New Fast-Acting Antidepressant, Esketamine Nasal Spray
• Transcranial Magnetic Stimulation
• VR therapy for OCD Can Enhance the Delivery of Exposure Response Prevention
• What is Evidence-Based Therapy: 3 EBT Interventions