Redesigning Dialectical Behavior Therapy (DBT) for Autistic Young Adults in Community Clinics

This project will 1) identify the unique barriers autistic young adults experience in accessing full-model Dialectical Behavior Therapy (DBT) for suicidal thoughts and behaviors and non-suicidal self-injury in community settings, 2) determine needed adaptations to DBT from the perspectives of service providers and recipients, and 3) user-test elements of a redesigned DBT protocol. 

A pilot trial on EMA habit formation behavioral strategies for improving engagement of digital mindfulness interventions among non-suicidal self-injury engagers

Non-suicidal self-injury (NSSI), the purposeful, direct damage of one’s body without the intent to die, is a pervasive public health concern with clinically significant long-term consequences. Mindfulness – a core skill in DBT, an evidence-based treatment for NSSI, is designed to target emotion dysregulation and rumination and may be particularly relevant due to the proliferation of digital mindfulness interventions in recent years. To this end, the goal of this study is to expand the use of ecological momentary assessment (EMA) and to develop and evaluate a program of habit-formation strategies (e.g., SMART-goal setting, reinforcement scheduling) to boost user engagement and treatment effects of DMI. Following a 1-week EMA baseline period, participants (N=40) will be randomized to either TAU (Mindfulness only) or Experimental (Mindfulness + Behavioral Prompts) conditions for a 4-week intervention EMA period.

Immune changes with neuropsychiatric symptoms in dementia

Though the focus of most research on dementia is the pathogenesis of cognitive deficits, neuropsychiatric symptoms (NPS) are identified in >90% of those afflicted, resulting in hastened cognitive decline, worsened general health, reduced patient and caregiver quality of life, sooner institutionalization, and increased mortality. Affective symptoms, including depression, are the most common NPS in Alzheimer’s Disease (AD), and are present in over half of patients. Using the in-depth clinical phenotyping of participants in the National Alzheimer’s Coordinating Center (NACC) with matched plasma samples, we propose to determine the correlation between select cytokines/chemokines and T-cell differentiation with depression in dementia.

THRIVE Study

This is a study of an app intended to support recent sexual assault survivors, called THRIVE. In a prior grant, we pilot tested THRIVE and found that it reduced risk for alcohol misuse and posttraumatic stress. In the first year of this grant, we aim to revise the app to increase usability and inclusivity. In the second through fifth years of the grant, we will conduct a larger randomized controlled trial of multiple versions of the app among college students who have experienced sexual assault in the past 12 weeks. This will allow us to identify the most effective and low-burden version of THRIVE. If we are successful in identifying a highly effective and efficient version of THRIVE, this intervention would represent a highly-scalable strategy to reduce the substantial burden of posttraumatic stress and alcohol misuse on student survivors and campus service systems.

Health Outcomes of Betting on Sports (Project HOBS)

Project HOBS is examining associations between sports betting, mental health, and substance use among young adults. Surveys are collected bi-weekly for one calendar year (25 follow-ups) and at a distal 15-month follow-up.

State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center

The State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center is a national technical assistance center funded by the U.S. Department of Education’s Office of Special Education Programs. Through this subcontract, the UW SMART Center has a subcontract to develop a micro-credentialing program on implementation science (IS) for educators, and to develop and convene a national community of practice of educators focused on application of IS.

Machine learning methods for identifying person-level mechanisms of alcohol use among sexual and gender minority intersections

The goals of the proposed research are to 1) distinguish sexual and gender minoritized (SGM) subgroups and intersections at heightened risk for alcohol use (AU; e.g., bisexuals and trans persons, SGM young women of color), 2) assess the role of state policies in moderating AU risk, and 3) delineate moderators and mechanisms of heightened AU across SGM populations within and beyond the coronavirus pandemic. Aim 1 will identify heterogeneity in substance use behaviors among SGM communities. It will then test race/ethnicity and age as intersectional moderators of SGM inequities and state-level policies impacting SGM communities that further differentiate AU risk among SGM groups. Findings will then be extended to address mediators and moderators of AU in the monthly AURP COVID-19 Participant Experience Survey (Aim 2) as well as the longitudinal, biennial data that extends beyond the pandemic into 2027 (Aim 3).

Parent-Child Assistance Program – Oklahoma

This project seeks to compare the effectiveness of the Parent-Child Assistance Program (PCAP) to services as usual in the state of Oklahoma using a randomized, controlled design.

Guiding opioid therapy University of Southern California (USC) / National Institute on Aging (NIA)

Patients on long-term opioid therapy are aging and now face magnified risk of harm with continued high-dose opioid use. These increased risks are due to age-related changes in drug metabolism, multi-morbidity, and polypharmacy. The dominant approach to mitigate these risks is to screen for aberrant patient opioid behaviors, with assessments like the Current Opioid Misuse Measure (COMM), so that clinicians can pre-empt misuse early through review of contractual opioid agreements or by lowering patient dosages. By focusing on opioid misuse alone, this strategy encourages forced opioid tapering that is associated with opioid overdose and mental health crisis. Many persons have mental health, trauma-related or polysubstance use disorders that need to be addressed. Directing clinician attention to the comorbid conditions associated with opioid misuse may promote safer and more effective care. Such an approach provides a broader understanding of the pain experience and may help address the reasons why patients use or misuse opioids.

The specific aims are: (1) to develop a simple experimental approach for the collection of clinical pain data and for assessing, preventing, and managing pain in later life through the electronic health record; and (2) to assess the comparative effectiveness of PainTracker, a set of questions that targets a broad range of problems associated with pain, in a randomized controlled trial.

Treating Parents and Children with ADHD (TPAC)

ADHD often runs in families. The TPAC study focuses on parents with ADHD who also have a child with the disorder, aiming to open the door to new ADHD treatments for adults and children. All parents in the study receive training that uses behavior modification techniques and reward-based interventions to improve communication, increase compliance and reduce negative interactions between parents and children. This training is offered in nine sessions via telehealth. Some parents in the study will also receive medication for ADHD.

This ADHD study aims to understand if treating the parent with medicine and/or parent training could reduce the need for medicine in young children, especially because children under six generally don’t respond well to medication. The theory with this approach is that parents with ADHD are more prone to being distracted and disorganized, and they are much less likely to receive treatment than children. If we can first help parents with ADHD, they may be more successful in implementing behavioral training to help their child.

Because a lot of ADHD research is conducted in white, middle-class families, our lab has added an additional piece to this study, focused on better serving under-resourced families. These families cover a broader range of ethnic groups and a larger geographic area. This research aims to reduce barriers to diagnosis and treatment, and include a wider range of participants in clinical trials. The goal of this work is to collect more data about how to best serve these groups and ultimately improve treatment and care in more diverse communities.

TPAC is a hybrid implementation study, meaning that it evaluates how well the treatment works and the impact on the region and providers. Twice a year, we have a focus group with pediatricians, social workers and parents that have been through this study to evaluate results. This collaborative approach aims to build a model for more multidisciplinary care and ultimately improve ADHD care across our state and beyond.

Interested in hearing more about this study? Please contact us at tpac@seattlechildrens.org.