Our goals for this project include (1) designing a competency framework and learning objectives that define the role and scope of practice for a BHSS; (2) scaling the role for Washington state by creating processes for integrating the BHSS Clinical Training Program into existing four-year degree programs in the behavioral healthcare field; (3) partnering with Washington State higher education institutions to adopt the BHSS Clinical Training Program; (4) developing curricular resources to share with Washington State colleges and universities including an Educator’s Guide; (5) collaborating with government agencies, policy groups, and practicum partners to implement the BHSS role in employment settings. Department of Health approved programs deliver BHSS curriculum. For more information about approved education programs, visit the Department of Health (DOH) webpage, the Behavioral Health Support Specialist Workforce Development Project webpage, or contact:
The vast majority of young adults with early psychosis own mobile phones, identify texting as their preferred communication modality, and report an interest in messaging-based treatments. We developed a texting intervention for people with psychosis called the Mobile Interventionist. Treatment is conducted via daily recovery-oriented text conversations between patients and a trained messaging practitioner. This novel form of engagement produces an asynchronous but continuous form of treatment and combines the advantages of digital health (i.e., accessibility, reach beyond the brick-and-mortar clinic, low intensity), with the flexibility, personal tone and sensitivity of a clinician. Several studies have demonstrated that our texting intervention approach is feasible, acceptable, engaging and effective. This initiative will help translate this promising research into real-world clinical practice by implementing the Mobile Interventionist texting model at the University of Washington’s Specialized Treatment Program for Early Psychosis (STEP).
Clinically, the intervention may improve the illness management of young adults with early psychosis participating in the pilot, improving their long-term trajectories. Programmatically, the pilot bridges the research/practice gap by providing training and guided clinical experience to a real-world clinical team.
The World Health Organization ranks psychotic disorders as the third most disabling health condition worldwide. Eleven million Americans will experience psychosis during their lifetime, and roughly 60 million Americans have a loved one affected by psychosis. Research affirms that psychotherapeutic interventions can help family caregivers develop skills to better connect and communicate with their loved one, which corresponds to better treatment engagement, symptom improvement, fewer hospitalizations, improved functioning, reduced substance use, reduced mortality and overall improvement in quality of life for the individual with psychosis. Family interventions are therefore critical to a holistic and effective clinical response to a psychotic disorder. Nevertheless, a recent federal investigation found that fewer than 2% of US families caring for someone with psychosis had received a family intervention for psychosis.
Psychosis REACH (Recovery by Enabling Adult Carers at Home) is a family intervention for psychosis co-developed by faculty in the UW Department of Psychiatry and Behavioral Sciences that delivers psychoeducation and illness management skills training to family caregivers in the community. To enhance broad and equitable access to tens of millions of families and caregivers, this project will develop “Psychosis iREACH,” a digital platform that uses Artificial Intelligence (AI) technology to deliver Psychosis REACH to diverse families navigating psychosis. A virtual coach will assist families to access self-management skills practice, automated self-assessment, tailored training goals and individualized learning trajectories whenever and wherever families need the support. Psychosis iREACH represents a multidisciplinary collaboration among faculty in the School of Medicine, School of Nursing and School of Science, Technology, Engineering & Mathematics.
Traumatic brain injury (TBI) is a major cause of disability in Washington state and throughout the US. TBI increases the risk and complexity of multiple behavioral health conditions including post traumatic stress disorder, depression, anxiety, irritability, anger/aggression, substance misuse and cognitive impairment. In addition, TBI impairs a person’s ability to manage their health care and increases the risk of unemployment, long-term functional impairment, and caregiver burnout. Successful TBI recovery can depend in large part on access to and engagement in behavioral health treatment. Unfortunately, TBI-focused community resources are scarce and fragmented. Treatment of post-TBI symptoms often falls to community providers who have little support and are under-prepared to manage these complexities. This burden disproportionally affects rural providers who have little access to specialist care at academic centers.
The purpose of this project is to create and assess the use of the ECHO (Extension for Community Healthcare Outcomes) model to provide education and support by experienced TBI experts to community providers who treat persons with TBI. The ECHO model uses both a virtual educational lecture series and patient case discussion to improve provider preparedness to treat patients and improve patient outcomes. We will launch a monthly to bi-monthly program that will train providers from a variety of disciplines and settings in identification and evidence-based behavioral health treatments, web technologies and mobile technologies, and provide detailed case consultation. We will assess the success, reach and impact of our TBI ECHO by collecting and comparing attendee experiences, clinical information and patient outcomes.
This project received two years of additional funding from the Washington State Department of Social and Health Services.
On top of climate change, political divisiveness and cultural turbulence, we have faced the most devastating pandemic since global influenza 100 years ago. The resulting social and economic stresses have manifested as widespread anxiety, a worsening opioid epidemic and the highest suicide rates in decades.
Proven behavioral health strategies like Caring Contacts offer hope. Caring Contacts is a program where suicidal individuals receive periodic letters or text messages from a behavioral health practitioner, creating a connection and showing someone cares. Caring Contacts have reduced suicide deaths, attempts and thoughts of suicide and offer an easy re-connection to healthcare, but behavioral health practitioners are in high demand and short supply and often struggle with prioritizing messages and sending timely replies. By analyzing a patient’s text messages, computerized algorithms can identify indicators of risk and other important information to help behavioral health practitioners with the nature and timing of their responses, allowing one behavioral health practitioner to reach hundreds of suicidal patients.
This project brings together behavioral health care, mobile technologies that people now expect and innovative informatics methods to identify critical signs of suicide risk that busy practitioners may miss. Our team consists of experts in behavioral health, usability and design, artificial intelligence/natural language processing, software engineering, health care information systems and emergency medicine. Our goal is simple: to use technology to provide critical support for those in crisis, and to save lives.
Perinatal mood and anxiety disorders affect one in seven pregnant and postpartum women nationwide, making them the most common complication of pregnancy. Unfortunately, only one in 20 women who need treatment for these conditions actually receives it. This translates to a multigenerational issue, which can negatively affect the mother and child’s long-term physical, emotional and developmental health. It also means an estimated $14.2 billion annually in societal costs in the U.S. alone. While not every perinatal individual with mental health concerns has access to a mental health provider, cell phones and text messaging are ubiquitous. Nonjudgmental support delivered through text messaging may be a low cost approach to reaching women who need emotional support in the perinatal period.
Our project aims to evaluate a text-based mentoring program, the Nurture Program, and assess whether it is possible to support mothers through their third trimester of pregnancy and nine months postpartum and enhance their emotional well-being. The Nurture Program combines the convenience of secure text messaging with the personalization of having a trained peer mentor with whom the mother can develop a trusting relationship. This program also provides resources on child development, connections to local support agencies and suggestions for parent-child bonding and parental wellness activities. Surveyed participants of the Nurture Program consistently report their mentor helped them feel less stressed and more confident in their role as a parent. This study will allow us to measure the impact of this cost-effective approach to promoting perinatal emotional well-being.
After COVID infection, 10-50% of people experience persistent symptoms such as fatigue, palpitations, insomnia, cognitive problems, and headache – often with significant associated distress and functional impairment. The exact combination of symptoms varies from person to person, and it is expected that the specific causes vary from person to person as well.
Because of this variability, the current recommendation is for an evaluation by a multidisciplinary team. This creates a demand on our medical system that far outstrips current resources, and risks exposing patients to long, complex medical evaluations whose results are hard to interpret. In addition, clinical treatment trials that mix patients with similar symptoms but different underlying causes have high failure rates.
To address these challenges, a team of investigators including Rebecca Hendrickson, MD, PhD (Department of Psychiatry and Behavioral Sciences), John Oakley, MD, PhD (Department of Neurology), and Aaron Bunnell, MD (Department of Rehabilitation Medicine) are testing an online platform to identify patients whose pattern of symptoms suggest a particular underlying cause that is common after certain physiologic (i.e. illness or injury) and psychological stressors: increased adrenergic (adrenaline/noradrenaline) signaling in the brain and peripheral nervous system. We will pair this with a smaller number of detailed in-person assessments to validate our symptom-based measures and characterize associated biomarkers.
Our results will provide a detailed assessment of the patterns of symptoms caused by high amounts of adrenergic signaling that are seen in persistent post-COVID syndrome, how they change over time, and their association with objective measures of cognition and physiology. The project will provide the information needed to begin clinical treatment trials using existing, well-tolerated treatments that modulate adrenergic signaling. We hope the results will also have strong relevance to other potentially related disorders such as Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia.
Deaths related to the opioid overdose epidemic remain at an all-time high
across the country despite significant efforts to reduce them. There is a
pressing need to support medication treatment for opioid use disorder (OUD) to
help people stay in treatment and reduce the risk of overdose death and other
serious health consequences of untreated addiction. Smartphone-based apps can
facilitate the delivery of an evidence-based approach called contingency
management that incentivizes use of medications for OUD, reduces use of
non-prescribed opioids and improves retention in OUD treatment.
This study will leverage a commercially available smartphone app that can
bring this much-needed behavioral support to patients receiving OUD treatment
in a primary care clinic and in a specialty OUD treatment clinic. The approach
offers a potentially non-labor intensive, cost-effective and highly scalable
means of delivering OUD care.
Although suicide is one of the leading causes of death for people with
substance use disorders (SUDs), no widespread suicide prevention intervention
exists for delivery in community addiction treatment settings. The
effectiveness and feasibility of delivering Preventing Addiction Related
Suicide (PARS), a group-based psychoeducational program that provides
evidence-based suicide prevention and safety strategies, was recently
demonstrated by the UW Center for Suicide Prevention and Recovery.
To enhance widespread implementation and dissemination of PARS, this project
will develop online training and implementation tools. PARS-Web will be created
in collaboration with key state agencies and suicide prevention professionals
to meet the new training requirements for Washington State Chemical Dependency
Professionals. The goal is to integrate PARS as a part of standard care in
addiction treatment agencies nationwide.
Most adults in the US experience a traumatic event at some point in their
lives. Trauma is linked to the development of mental health disorders, increased
suicidality, work and relationship impairment and increased physical health
conditions. Effective treatments exist, but many people don’t receive these
treatments because of a lack of providers who are trained in evidence-based,
trauma-focused treatment, especially those in rural or underserved areas.
This project aims to build, implement and test an ECHO (Extension for
Community Healthcare Outcomes) model for disseminating evidence-based,
trauma-focused care, both psychotherapy and pharmacotherapy approaches, to
providers working with underserved communities in Washington state. The team
will evaluate the impact and reach of the training model, with the goal of
expanding the ECHO approach to improve trauma-informed mental health care
throughout Washington.
