Cognitive Behavioral Therapy for psychosis (CBTp) is a time-limited, structured form of talk therapy that is indicated for individuals who experience distress related to psychotic symptoms. Although evidence demonstrates effectiveness in enhancing care and outcomes for clients with psychosis, CBTp is not widely available in the United States. The UW SPIRIT Lab in the Department of Psychiatry & Behavioral Sciences (PI: Sarah Kopelovich, PhD) applies evidence-based implementation and dissemination strategies such as blended learning, train and trainer, Project ECHO, longitudinal consultation to agencies, supervisors, and practitioners, fidelity assessment and monitoring, and sustaining the first CBTp Provider Network in the United States. The CBTp workforce development project aims to sustain and expand access to CBTp across publicly-funded behavioral health settings in Washington State.
Geographic Area: Washington
Developing a digital training resource for clinicians learning CBT for psychosis (CBTpro)
The Cognitive Behavioral Therapy Training Study will rigorously test CBTpro — a novel tool that uses spoken language technologies and conversational Artificial Intelligence to train behavioral health practitioners in Cognitive Behavioral Therapy. We conducted a 2-week field trial, followed by a Randomized Clinical Trail in community mental health agencies to evaluate both learner and client outcomes. The study aims to expand global access to CBT training to students and practitioners, support quality psychological treatments for clients with a range of behavioral health disorders (including Serious Mental Illness), and support ongoing clinical quality assurance in routine care settings.
Implementation Toolkit to Enhance EBP Among Marginalized Families (I-TEAM)
Although the efficacy of early intervention (EI) for autistic children and their families has been established, many marginalized families with diverse cultural and linguistic backgrounds still report inequitable access to evidence-based practices (EBP). The proposed research addresses three aims including: AIM 1. Identify facilitators and barriers of EBP implementation among marginalized families of young autistic children in EI; AIM 2. Develop an implementation toolkit with a focus on capacity building of EI providers to implement EBP with cultural responsiveness; and AIM 3. Examine the feasibility, acceptability, and appropriateness of this toolkit through a pilot trial using RUBI behavioral parent training program.
Training and technical assistance for jails implementing medication for Opioid Use Disorder programs
Our team provides training and technical assistance to 19 jails across Washington State who received legislative funding to implement and expand a medication for opioid use disorder program at their facility.
Policy codesign with law enforcement to improve crisis response for people who use drugs
This project examines the acceptability and feasibility of policy codesign process to help three regions in Washington develop their own local strategy to improve crisis response for people who use drugs, focusing on calls with law enforcement. Policy codesign is an evidence-based approach that aims to develop policies from “the ground up” that are tailored to community needs and promote region ownership. Design team members include local law enforcement, people with lived experience of substance use and legal involvement, and service providers.
A study to verify the clinical benefit of aducanumab in participants with early Alzheimer’s disease (ENVISION)
The primary objective of this study is to verify the clinical benefit of monthly doses of aducanumab in slowing cognitive and functional impairment as measured by changes in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score as compared with placebo in participants with early Alzheimer’s disease.
A Study of Donanemab in participants with early Alzheimer’s disease (TRAILBLAZER-ALZ 2)
The reason for this study is to see how safe and effective the study drug donanemab is in participants with early Alzheimer’s disease.
Developing a cannabis intervention for young adults with psychosis
Up to one-third of young people experiencing early psychosis use cannabis, and one in four meet criteria for a cannabis use disorder. Cannabis use is associated with multiple negative outcomes, including relapse, rehospitalization, increased psychotic symptoms and reduced treatment engagement and medication adherence. Psychosis relapse is a particularly devastating and costly outcome, leading to greater disability and accounting for $37 billion in healthcare costs per year. Cannabis is considered the most preventable cause of psychosis relapse. Despite this, no effective cannabis-reduction intervention has been developed for this population.
This study will address the urgent need for an effective cannabis-reduction intervention for this high-risk population by adapting a gold-standard treatment, Motivational Enhancement Therapy (MET), for youth and young adults living with psychosis. A tailored cannabis intervention and provider manual will be developed and evaluated for feasibility and acceptability. This novel intervention has the potential to mitigate the costly impact of psychosis on public health systems and ultimately improve psychosis outcomes among young people living in Washington State.
Developing a pediatric telebehavioral health consultation model for emergency departments
As rates of pediatric mental health emergencies have skyrocketed over the last decade – and even more so since the Covid-19 pandemic – the number of youth staying in emergency departments (EDs) and medical units while awaiting inpatient psychiatric care or stabilization (i.e., “boarding”) has reached unprecedented levels. The massive surges in patient volume, coupled with widespread staff shortages and lack of staff expertise in treating mental health, are overwhelming ED and hospital resources. This causes dangerous or even life-threatening delays in care for youth populations in greatest need of medical and psychiatric treatment. Prolonged ED stays not only delay necessary mental health care, but they can cause additional trauma and distress for youth already in crisis. While the boarding crisis affects all hospitals and EDs, it poses an even greater challenge to community EDs that lack on-site mental health specialists and/or pediatric providers.
To address the boarding crisis, this project will pilot a model in which a multidisciplinary team of mental health clinicians at Seattle Children’s Hospital provides telebehavioral health consultation to community EDs in Western Washington to guide care for youth who are boarding. The primary goals of this model are (1) to improve timeliness of mental health care and reduce length of stay for youth boarding in community EDs, and (2) to support ED staff in providing more developmentally appropriate and evidence-informed mental healthcare. The Seattle Children’s team will provide case consultation to ED providers and staff, including support with decisions about hospitalization, medication treatment, behavioral interventions and case management services. The team will also deliver practical trainings to community ED staff to build their internal capacity to care for boarding youth. If this initiative is successful, additional funding could expand ED telebehavioral health consultation services statewide, with a focus on rural communities.
Using teen Mental Health First Aid to address mental health inequity among school youth
Over 2.5 million US adolescents struggle with mental health challenges, and multiracial adolescents are at greatest risk due to limited access to mental health programs. As roughly half of lifetime mental disorders have their first onset by mid-adolescence, it is vital to promote help-seeking for prevention and early intervention during this important developmental stage.
This project will test the implementation of an evidence-based mental illness prevention program — teen Mental Health First Aid (tMHFA) — in a diverse and underserved school district to facilitate help seeking among teens aged 16-18. While tMHFA has a proven track record of effectively enhancing knowledge of mental health problems, reducing stigma and promoting help-seeking behaviors, its efficacy across dimensions of race and ethnicity is underexamined in the US.
Academic (UW & SMART Center), education (Tacoma Public Schools) and behavioral health organization (MultiCare) stakeholders will address this gap by conducting a mixed-methods study with 1) focus groups to obtain diverse teens aged 15-18 opinions about facilitators and barriers in help-seeking; and 2) longitudinal data collection to examine the impact of the innovative tMHFA’s potential to address help-seeking barriers across dimensions of race and ethnicity. The findings of this project will guide both the revisions to the program to improve its efficacy and the scaling of this program to support government legislation to expand service delivery to other schools and to rural areas across the state.
