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.
Early intervention can significantly improve the trajectory of a young adult at risk for psychosis. Specialized treatment programs for youth at risk are associated with reduced symptoms and relapse risk and increased functioning. Family caregivers play a critical role in facilitating treatment engagement and recovery, but too often they lack the support they need. Specialty psychosis services providing psychoeducation for family members are expanding but still difficult to access. Caregivers face many barriers to care: limited providers and session time availability, long travel times, or patient ambivalence about treatment. As a result, a minority of youth with early psychosis have caregivers that have accessed standard-of-care family interventions.
To address these gaps, our team developed Bolster, a mobile health (mHealth) app designed to provide psychoeducation, communication coaching, and self-care support to caregivers to youth at risk for psychosis. In preliminary work, Bolster was feasible to deliver, acceptable to caregivers, and showed promising efficacy. However, mHealth interventions that are supplemented by a human clinical support have higher engagement and effectiveness than those that are purely self-guided. To optimally implement mHealth for early psychosis caregivers, there is a need for development of this clinical workforce.
We propose to develop and pilot an emerging clinical role – the
mHealth support specialist (mHSS) – equipped specifically to support caregivers
to youth with early psychosis. Specifically, we will (1) develop a training and
supervision framework supporting the mHSS for caregivers, (2) test this
framework through training and supervising one mHSS, and (3) evaluate this
approach as the mHSS provides support to caregivers to young adults with early
psychosis throughout Washington State. Delivering this intervention has the
potential to greatly expand population access to evidence-based strategies for
psychosis. Developing the mHealth support specialist model would make
Washington a national leader in scalable digital interventions for caregivers.
This study takes a critical step toward realizing that vision.
This project will evaluate the effect of a debriefing workshop on the knowledge, attitudes, and practice of giving debriefs after adverse events among physicians and their trainees.
The purpose of this project is to enhance the usefulness and cultural relevance of the Spanish version of the PMQ-9, a questionnaire that assesses manic symptoms in individuals with bipolar disorder.
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.
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.
