I am a clinical psychologist with research interests in the treatment of alcohol and substance use disorders and co-occurring mental health conditions.
My research focuses on understanding how to improve access to evidence-based treatments and understanding why and how patients benefit from treatment. I am particularly interested in research measurement-based care — i.e., the use of standardized measures to monitor treatment progress and inform clinical decision-making.
Broad areas of interest include:
Alcohol and drug use disorder treatment, including the effectiveness of digital and behavioral interventions, mechanisms of behavioral change, and social and environmental determinants of change.
Technology to support behavioral change, including patient- and clinician-facing tools that support clinical decision-making, treatment adherence, and treatment progress monitoring.
Applied statistical analysis, including methods for analyzing longitudinal data, clinical trials data, multilevel data, missing data, psychometric analysis, and data visualization.
I am a Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, and the Director of the Division of Population Health. I am also a Core Investigator at the HSR&D Center for Innovation for Veteran-Centered and Value-Driven Care at the VA Puget Sound Health Care System, and the Director of the VA Virtual Care QUERI Program.
For the last 35 years, my research has focused on access to care. I have published a framework for conceptualizing access to care in the digital age that incorporates virtual care technologies. I have conducted clinical trials to test the effectiveness of virtual care technologies to facilitate the delivery of evidence-based mental health services in rural primary care clinics. I have also conducted implementation trials to test the effectiveness of strategies to promote the uptake of virtual care technologies by primary care patients and providers. My research has been supported by NIMH, NIAAA, PCORI, and VA HSR/QUERI.
As a board-certified clinical health psychologist, I have primarily focused my clinical work on preventive medicine with special expertise in diabetes, weight management, and tobacco use cessation. I train clinicians in motivational interviewing and health coaching, and am currently a co-investigator on a research study examining an intervention with peer health coaches in the Veterans Health Administration (VHA). After nearly two decades of working in complex healthcare settings, like the VHA and serving in several leadership roles within and external to the VHA, I have grown a passion for supporting those who serve others and improving workplace well-being. I am an Associate Certified Coach and am enrolled in a Masters program in Leadership and Organizational Development. I coach leaders and individual contributors on their professional and personal goals, help teams work better together, engage clinics in identifying and implementing meaningful changes to improve workplace satisfaction.
I have pursued a career at the intersection of mental health and primary care, training in both family medicine and addiction psychiatry. I currently practice in various integrated care settings as a consulting psychiatrist and in the outpatient adult psychiatry clinic. I am the co-medical director for the University of Washington Psychiatry and Addiction Case Conference (UW PACC), a weekly online learning collaborative to help community providers across the state improve their psychiatric and addiction clinical skills. My area of interest is focused on improving addiction and psychiatric treatment to primary care settings. I also spend a significant amount of time training both family medicine and psychiatry trainees and fellows on integrated treatments for substance use disorders.
My clinical service and research focuses on the interaction of mental and physical illness, especially in patients with chronic pain. Much of my research in recent decades has focused on the risks of treating chronic pain with opioids. I have developed educational programs and outcome tracking tools to assist with opioid treatment of chronic pain. I have published a book about patient empowerment in chronic disease care, The Patient as Agent of Health and Health Care (Oxford, 2017). I have another book written with Jane Ballantyne forthcoming, The Right to Pain Relief and other deep roots of the opioid epidemic (Oxford, 2022).
I am a Seattle native who has spent my entire academic career at the University of Washington School of Medicine. I joined the faculty of the UW Department of Psychiatry and Behavioral Sciences in 1977 and was based at the Seattle VA Puget Sound Health Care System. I joined the Seattle-American Lake Geriatric Research, Education and Clinical Center (GRECC) in 1977 as a clinical investigator and later served as GRECC Director from 1987-1998. In 1998, I was appointed Chair of the Department of Psychiatry and Behavioral Sciences and held this position until February, 2014.
I am certified by the American Board of Psychiatry and Neurology with Added Qualifications in Geriatric Psychiatry and am listed in America’s Top Doctors and Best Doctors in America. I am recipient of the 2005 American Academy of Child & Adolescent Psychiatry, Robert Cancro Academic Leadership Award: Best Chair.
I have conducted extensive research on the treatment of depression in patients with heart disease and stroke and has published more than 140 scientific publications. I am active in community efforts to improve the quality of care for the seriously mentally ill and with my faculty colleagues am implementing regionally, nationally, and internationally innovative and highly effective models of care that integrate mental health care into primary care settings. I am working with medical schools and the health ministries in Vietnam and Cambodia to strengthen psychiatric education, expand the mental health workforce, and develop delivery systems for psychiatric care in those countries.
I am clinical psychologist and a Professor of Psychiatry and Pediatrics, and a clinical researcher specializing in ADHD throughout the lifespan. I direct the PEARL Clinic (Program to enhance attention, regulation, and learning) at Seattle Children’s. The PEARL Clinic is based on a multidisciplinary and collaborative care model which works closely with PCP’s who refer families to PEARL for evaluation and access to our behavioral group treatment programs and treatment recommendations. The PEARL clinic also provided multidisciplinary training for psychologists, psychiatrists, pediatricians, family medicine physicians, and medical students. The majority of my clinical work involves diagnostic evaluations and consultations for the parents, referring physician, and schools.
My research emphasis is on personalizing ADHD treatment, and determining how best to combine and sequence interventions throughout the lifespan for individuals with ADHD. I have assisted in the development of several stimulant and non stimulant medications, and participated in many clinical trials. Currently, we are conducting a study for parents with ADHD who have young children with ADHD symptoms where we are treating the parent with medication and behavioral parent training or behavior parent training. I am also investigating the relationship between genetic factors and ADHD treatment response.
Other areas of interest include sleep problems and overlap with ADHD, and novel treatments such as Trigeminal Nerve Stimulation (TNS) and augmentation strategies such as mindfulness and physical exercise or activity level.
I am a licensed clinical psychologist in Washington State. I am the Director of the University of Washington School of Medicine’s Psychology Internship Program which is accredited by the American Psychological Association’s Office of Program Consultation and Accreditation. And, I conduct research on health and risk behaviors across the lifespan. Specifically, I have conducted research in the areas of college student alcohol use, young adult gambling behavior, and co-morbidity of substance use and mental health/risk behaviors (i.e. risky sexual behaviors). I have extensive experience working with college students/young adults, military/veteran, and minority/diverse populations. I am also interested in mental health issues including depression, anxiety, and PTSD. I maintain an active clinical practice in the areas of mental health issues with patients diagnosed with hematological and oncological illness and have clinical responsibilities at the Fred Hutchinson Cancer Center. I also provide clinical supervision for psychology residents and psychology practicum students at Fred Hutchinson Cancer Center as well. Overall, my professional aspirations are to improve the public health through empirically-supported psychological interventions and providing mentorship to diverse trainees to expand the reach of psychology.
I am a national expert on collaborative care and specifically, on training teams to implement and deliver mental health treatment in primary care settings. My passion for translating complex research ideas into practical real-world applications began when I received my MD and PhD in Anatomy and Neurobiology as part of the Medical Scientist Training Program at the University of California at Irvine.
I am currently a Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington where I have developed additional expertise in suicide prevention training, mental health workforce development, adult learning best practices, and mentorship. I am the Co-Director of the AIMS Center (Advancing Integrated Mental Health Solutions) and Director of the UW Integrated Care Training Program for residents and fellows.
My work focuses on the integration of mental health services and general medical care and on translating research on evidence-based mental health interventions into effective clinical and public health practice. I have published over 300 scientific papers and I am the recipient of numerous federal and foundation grants and awards for my research on integrated behavioral health care. I work with national and international organizations dedicated to improving behavioral health care for diverse populations. I have served as Senior Scientific Advisor to the World Health Organization and as an advisor to the President’s New Freedom Commission on Mental Health.
