Training psychiatry residents in complex communication skills for working with clients and their supports

Individuals with serious persistent mental illness (SPMI) and their families and communities face significant challenges during psychiatric hospitalization. Persons with SPMI and their supporters express a need for enhanced communication from their behavioral healthcare teams during these pivotal periods of time where symptoms are new or intense. Yet, a substantial number of mental health providers have limited training in communicating complex topics such as diagnosis and prognosis. This can lead to providers avoiding essential conversations; individuals with SPMI can be unheard or excluded from participating in treatment planning.

This educational initiative seeks to craft an innovative curriculum for psychiatry residents focused on person-centered communication skills. Drawing from proven communication training frameworks within palliative care, the training will equip residents with strategies such as: utilizing person-centered language; conducting family meetings; delivering diagnostic and prognostic information. The curriculum will be developed with guidance from individuals with lived experienced of SPMI and their supporters. Moreover, the project will deliver a dedicated online portal featuring educational materials, recorded presentations, role-play scripts, and communication guides. Tools, such as self-assessment and evaluation rubrics, will be created to evaluate efficacy.  

Improving the implementation of smartphone-based contingency management in medical settings for the treatment of methamphetamine use disorder: a qualitative analysis of patient and clinician experiences

The proposed research is a qualitative analysis of patient and clinician experiences during a pilot study of mHealth-delivered contingency management for the treatment of methamphetamine use disorder and will address perceived facilitators and reinforcing factors, barriers and limitations, and proposals for future improvements including specific recommendations regarding the intervention and its mode of delivery.

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.

Acceptability and feasibility of a single-session + digital mental health intervention for people with psychosis on an acute psychiatric inpatient unit

People with psychosis are admitted more frequently to inpatient psychiatric units and have a longer length of stay once admitted compared to those with other psychiatric conditions. Cognitive Behavioral Therapy for psychosis (CBTp) reduces hospital admissions when delivered in outpatient settings and facilitates quicker symptom improvement when delivered in inpatient settings. Despite this, implementation of CBTp is exceedingly rare in practice. The purpose of this study is to test the feasibility and acceptability of a conjoint single-session CBTp intervention + FOCUS digital mental health intervention for people with psychosis admitted to inpatient psychiatry units.

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.

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).