Practice Type: Community Mental Health/Health Center/Faith Health Center

Embedded clinical coaching

Using an embedded clinical coaching framework, the Evidence Based Practice Institute (EBPI)/CoLab is promoting the development of quality care expertise within behavioral health agencies to reduce the cost and improve the speed of clinical workforce training. The goal of this project is to move principles of effective behavioral health care more quickly into practice, and to foster agency resilience to workforce turnover. This project is part of a broader Leadership Initiative for Quality.

To develop and eventually implement an embedded clinical coaching model, EBPI/CoLab partnered with multiple organizations in Washington to determine priorities and gather feedback. Through these partnerships, EBPI/CoLab identified key characteristics of an effective clinical coaching model, and incorporated stakeholder feedback to ensure scalability and adaptability. This coaching model includes the development of an asynchronous training for new clinicians, an embedded peer consultation structure, and competency checks through clinician-submitted videos. Through this novel embedded coaching structure, organizations can retain internal expertise and better support a shifting workforce.

Supervisor tools for quality

The Supervisory Tools for Quality initiative recognizes the integral role that clinical supervisors play in supporting behavioral health clinicians’ use of effective practices in community mental health agencies, and aims to leverage this role to improve the scale up and sustained use of quality behavioral health services. Specifically, this project is focused on the development of cost effective, easy to use, and practical strategies to elevate supervision practices. This project is part of a broader Leadership Initiative for Quality.

This initiative involved partnering with supervisors to form a Supervisor Advisory Team. This team worked to provide practical and tangible supports to supervisors in order to improve delivery of quality and effective behavioral health services, and ultimately strengthen outcomes for economically and racially marginalized children and adolescents. This advisory group included experienced supervisors in behavioral health organizations across the state. Geographic regions represented included Bellingham, Bellevue, Lakewood, Spokane, Walla Walla, and Yakima. To date, we have completed three Supervisor Advisory Team meetings.

Expanding culturally responsive care for children and families in Washington State

The Expanding Culturally Responsive Care initiative, a new project funded through a 2022 Washington State legislative proviso, aims to strengthen the lived experience behavioral health workforce and create a culturally responsive care curriculum for statewide implementation in Medicaid-serving organizations. This initiative was developed in response to Washington State’s urgent need for more culturally responsive, effective public behavioral health services–services that many families do not currently have access to. Ideally, this initiative will allow for more families to receive care that promotes true healing, mental health wellness and health equity. Curriculum and strategy development will be done through a participatory, collaborative co-design process with broad ranging input from across the state, and will center community voice, transparency, and accountability throughout all stages of the process. This project is part of a broader Leadership Initiative for Quality.

Impact of the Preventing Addiction-Related Suicide (PARS) Intervention on patients who receive community-based addiction treatment

Persons with substance use disorders are 5-10 times more likely to die by suicide than the general public. Recognizing this, Rick Ries, MD, Katherine (Kate) Comtois, PhD, MPH, and the UW Center for Suicide Prevention and Recovery (CSPAR) staff developed the first and only suicide prevention intervention successfully developed with and tested in community addiction treatment centers. The primary outcomes of the multisite PARS clinical published in JAMA Network Open in April 2022. Led by Dr. Ries, Kevin Hallgren, PhD, Amanda Kerbrat, LICSW, and Yanni Chang, MD, this project will fund a more detailed secondary analyses to better characterize which patients respond best to the PARS intervention, which in turn will help inform intervention improvements.

Establishing the Current State of Assertive Community Treatment (ACT) Implementation in the U.S.

This study aims to fill a significant knowledge gap that has impeded empirically-informed implementation and sustainability of high-fidelity Assertive Community Treatment (ACT). Investigators are conducting a survey of ACT stakeholders, including specialty adaptations (e.g., Forensic ACT [FACT]) across all U.S. states and territories, examining the relationship between ACT fidelity and outcomes, and examining contextual factors (e.g., financing and policy) that impact high-fidelity ACT implementation and sustainability.

Development and testing of a research-based Tier 3 Wraparound model for schools

This project will adapt the defined, research-based, Wraparound care coordination model for youth with complex behavioral health needs to the education environment, including training curricula, installation protocols, fidelity measures, and other components. The project will initially convene national experts and local stakeholders who will review and aid in iterative refinement of materials, followed by a small-scale pre-post pilot, and culminating in a small-scale randomized pilot study comparing proximal and distal outcomes for 60 students in 6 elementary schools assigned to the “Tier 3 Wraparound” protocol versus services as usual.

Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment

Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.

mHealth in West Africa: developing an evidence-based psychosocial intervention toolkit

There is a shortage of skilled mental health providers in Ghana. Due to the prevalence of traditional faith healers, coupled with the established infrastructure that faith healers in Ghana have, global mental health leaders have argued that these paraprofessionals may be leveraged as conduits of basic illness management strategies.

This study aims to: 1) Employ user-centered mixed-method rapid ethnographic data collection strategies to conduct a targeted needs assessment, and 2) Distill and integrate findings from all data sources to identify content and usability requirements for a human-centered, culturally/contextually-informed multi-media mHealth toolkit for healers.