Evaluation and dissemination of the TRANSforming Families: Embracing Change with Teens Therapy Group

Transgender and gender diverse (TGD) adolescents experience 4-18 times higher rates of anxiety, 4-23 times higher rates of depression, 11-54 times higher rates of suicidal ideation, and 2-5 times higher rates of suicide attempts compared to their cisgender peers. Importantly, parents/guardians (i.e., caregivers) can have a significant impact on TGD adolescent mental health, with recent research suggesting that caregiver support and acceptance are associated with a 30-40% reduction in these mental health concerns.

Community-based support groups are common practice with TGD adolescents and families. However, group intervention programs that work specifically with caregivers are rare, and existing programs have not been formally evaluated. Therefore, the goal of this project is to evaluate TRANSforming Families: Embracing Change with Teens, a virtual, multi-family program that was developed by mental health providers in the Seattle Children’s Gender Clinic (SCGC), to understand its impact on caregiver support and acceptance and adolescent mental health. This partnership between SCGC mental health providers and researchers will represent one of the first formal evaluations of a group intervention program for caregivers of TGD adolescents, the results of which can inform future implementation and evaluation of this program in pediatric gender clinics across the United States.

PHSKC School Based Health Services

Project includes the design and development of survey instruments for the provider-level skills and agency-level readiness needs assessment and analyzing the data.

PHSKC Planning and Evaluation

Project includes activities surrounding the provision of evaluation, training, and consultation services to PHSKC. These include developing, conducting and analyzing a needs assessment for mental health providers and agency leads to further refine a tier 2/3 model of care. Training and consultation supports will be provided.

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.

Systematic redesign of an autism community implementation toolkit for schools

The aims of the current project are to: 1) Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers who serve autistic adolescents; 2) Conduct prototyping and usability field testing of the redesigned ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools.

Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments- Educational Redesign (ACT SMARTER)

The aims of the current project are to: 1) Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers who serve autistic adolescents; 2) Conduct prototyping and usability field testing of the redesigned ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools.

Evidence Based Practice Institute (EBPI)

The Evidence-Based Practice Institute (EBPI) is a partnership between the University of Washington and the Washington State Healthcare Authority (HCA), housed at CoLab. We promote the use of evidence-based practices in Washington State through training, research, workforce development, and data sharing. EBPI was initially established as an independent institute in 2007 by the Washington State Legislature House Bill 1088, with the goal of strengthening the quality of public children’s behavioral healthcare. Now, EBPI is housed under the broader umbrella organization of CoLab and continues to serve as a statewide resource to promote high quality mental health services for children and youth in Washington State.

Evaluation of an asynchronous remote communities approach to behavioral activation for depressed adolescents

In an effort to address the significant challenges in access to and engagement with evidence-based psychosocial interventions for adolescent depression, the proposed research is piloting the use of Asynchronous Remote Communities (ARC) supported behavioral activation (BA) to treat adolescent depression. We aim to 1) build and conduct usability testing on a functional and robust ActivaTeen platform that will satisfy the needs of mental health clinicians and adolescent patients and 2) test the feasibility, usability, and change in proposed target mechanisms (therapist alliance, timeliness of intervention, social belongingness, and engagement) and outcomes of BA+ActivaTeen compared to BA treatment only within a moderately-sized randomized control trial conducted within Seattle Children’s Hospital outpatient psychiatry clinic.

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.

Expanding access to adolescent depression care by non-specialists with a digital intervention

Adolescent depression is one of the most common mental health concerns during adolescence and can be a cause of significant impairment across the lifespan, particularly if untreated. Access to evidence-based psychotherapy is poor and pandemic-related increased demand for services has greatly worsened access issues, leaving many adolescents without effective and critically needed treatment. Adolescent depression is often first identified in primary care, making it the ideal setting for improving early access to treatment. While treatment by mental health specialists within primary care is effective, the workforce is not adequate to meet the high demand for services. Online depression treatment has been shown to be effective and has the added potential to expand access, particularly given adolescent’s comfort with digital technology. Importantly, the addition of human coaching alongside online treatments has been shown to boost engagement and treatment outcomes.

The goal of this project is to increase early access to evidence-based depression treatment in primary care settings. The project team will work with adolescents, caregivers and providers to develop an accessible and engaging online treatment for delivery in primary care. To support integration and enhance engagement, the project will also develop a coaching toolkit that can be utilized by a range of non-mental health specialists, including nurses, medical providers, social workers and bachelor’s level staff.