Personal Statement
My career goal is to give suicidal clients and their clinicians the best chance to succeed. I have been working in the area of health services, treatment development, and clinical trials research to prevent suicide for over 30 years. My graduate training was in community/clinical psychology and focused on achieving clinical ends through prevention and other systemic interventions in socio-culturally diverse populations. I have brought these perspectives into health services research. I have developed or adapted interventions to improve care and clinician willingness to work with suicidal patients including Caring Contacts, Dialectical Behavior Therapy (DBT), Collaborative Assessment and Management of Suicidality (CAMS), and Preventing Addiction Related Suicide (PARS). I have developed an adaptation of DBT Next Steps, a program to assist psychiatrically disabled individuals find and maintain living wage employment. My research has been funded by NIMH, NIDA, the Department of Defense, American Foundation for Suicide Prevention, and the State of Washington.
I am the director of the Center for Suicide Prevention and Recovery (CSPAR) whose mission is to promote the recovery of suicidal individuals and the effectiveness and well-being the clinicians and families who care for them by conducting rigorous and ecologically valid research, developing innovative interventions, improving policies, systems and environments of care, and providing expert training and consultation. CSPAR faculty and staff seek a deep understanding of the cultures and settings in which we work that leads to meaningful and effective interventions ready for implementation.
I also direct the Suicide Care Research Center, an NIMH P50 funded research center focused on using Human Centered Design and MOST optimization methodology to improve the care of adolescents and young adults (age 13-30 years) in outpatient medical settings. We are conducting one fully powered trial, three R34s, and 4 pilot studies within UW Medicine and Seattle Children’s hospital to develop innovative interventions to support primary care, Collaborative Care, and specialty medical clinics care for patients experiencing suicidal thoughts and behavior. The center supports effort of over 20 faculty and 16 staff as well as 11 emerging and advanced collaborating scholars and funds 2 annual pilot grants (each $100,000 over two years).
In addition to clinical research, I founded the Society for Implementation Research Collaboration (SIRC) focused on disseminating and implementing innovative, evidence-based interventions in the systems that need them. Beyond my research, I directed the Harborview Dialectical Behavior Therapy program at Harborview Medical Center 1996-2019, co-lead the UWAnnual Comprehensive DBT Training Program and Suicide Care in Healthcare Systems: We Can Do Better Serving our Patients and Caring for our Clinicians, both of which meet the Washington State requirement for suicide prevention training. I have a long history of training and mentoring junior faculty, post-doctoral scholars, psychiatry residents, pre-doctoral psychology interns, undergraduate students, and post-baccalaureate trainees. I provide psychotherapy and consultation at the UWMC Outpatient Psychiatry Clinic.
Personal Statement
I am a Child and Adolescent Psychiatrist who has served for over 20 years as the attending psychiatrist on the middle-schooler unit at Child Study and Treatment Center. I also serve, 25% time , as “College Mentor” in the UW School of Medicine Introduction to Clinical Medicine Curriculum where I mentor six students in each UW SoM class through their four year curriculum. I serve as preceptor/supervisor for one CAP fellow during their rotation at CSTC. I also run the elective clerkship for fourth year medical students (approximately 10 students/year) during 2 and 4 week rotations at CSTC.
Personal Statement
As a clinical and forensic psychiatrist, my professional roles include being the Director of the UW Center for Mental Health, Policy, and the Law; Associate Professor in the Department of Psychiatry; and a Staff Psychiatrist at the VA Puget Sound. I hold multiple board certifications: Psychiatry, Forensic Psychiatry, Brain Injury Medicine, and Sports and Performance Psychiatry. In addition to my medical training, I earned my law degree from the University of Washington.
As a member of the American Academy of Psychiatry and the Law (AAPL), I serve on the Ethics, Research, and Resident Education Committees and I twice earned AAPL’s Young Investigator Award. I am the Legal Digest Editor for the Journal of the American Academy of Psychiatry and the Law.
I have served as an expert witness or consultant in legal cases involving criminal and civil competencies; criminal responsibility; malpractice; personal injury; sexual and gender harassment; and fitness for duty, among others. I teach courses in forensic mental health at the University of Washington and speak locally and nationally on topics related to psychiatry and the law.
Personal Statement
My lab’s focus is reward processing, how it differs under behavior phenotypes that are more vulnerable or resilient to mental illness and how it is changed by psychiatric pathology. Our primary focus is dopamine transmission and the circuits in which is participates.
We developed tools that allow us to track dopamine with sub-second resolution in animals over the course of months (Clark et al, Nat Methods, 2010). This approach allows us to study trajectories of precise neurochemical encoding of behaviors over the course of the development of symptomology and subsequent treatment in animal models of disease. We also have adapted this technology for intraoperative recording in humans (Kishida et al, PLoS One, 2011).
Our research highlights include contributions in the area of dopamine’s role in learning (Flagel et al, Nature, 2012), decision making (Gan et al, Nat Neurosci, 2010) and goal navigation (Howe et al, Nature, 2013). We have gleaned information on how stress impacts appetitive motivation (Wanat et al, Nat Neurosci, 2013), how adolescent alcohol use produces enhanced risk taking later in life (Clark et al, PLoS One, 2012), and identified biological mechanisms for the motivational shift in stress-induced depressive disorders (Lemos et al, Nature, 2012) and the switch to excessive drug intake in substance abuse (Willuhn et al, Nat Neurosci, 2014).
These approaches have attracted a large number of collaborations, including National Academy members Akil, Palmiter, Graybiel and Kandel.
Personal Statement
I completed my Residency in Psychiatry with the UW in 1982 and since then have worked at Harborview Medical Center in the Psychiatry Department. I am a Clinical Associate Professor and provide weekend and on-call coverage for 5MB on the Intensive Psychiatric Unit.
Personal Statement
I am a board-certified Psychiatrist at Harborview and UW Medicine and a UW Associate Professor of Psychiatry and Behavioral Sciences.
I enjoy acting as a consultant to my patients in helping them achieve their healthcare and life goals.
My clinical interests include medical student and resident education, medical co-morbidities of psychiatric patients and evidenced-based medicine. I practice, teach, and supervise in Harborview’s acute inpatient psychiatric units as an Attending Physician and Medical Director of Inpatient Psychiatry.
Personal Statement
I am Co-Director of the VA VISN 20 (Northwest Network) Mental Illness Research, Education, and Clinical Center (MIRECC). I am also the Friends of Alzheimer’s Research Professor of Psychiatry and Behavioral Sciences at the University of Washington (UW) School of Medicine and am Associate Director of the UW Alzheimer’s Disease Research Center. My research over the past 30 years has addressed cognitive and behavioral problems and cerebrospinal fluid (CSF) biomarkers in neurodegenerative dementing disorders such as Alzheimer’s disease. More recently, my research has focused on combat trauma posttraumatic stress disorder and the clinical phenomenology as well as neuroimaging and CSF biomarkers of neurodegeneration in combat blast concussion mild traumatic brain injury and in Gulf War Veterans Illness. I continue to conduct single site as well as multi-site large scale studies of CSF biomarkers and pharmacological treatment trials for behavioral disorders and traumatic brain injury.
Summary of my research program:
Blast Concussion Mild Traumatic Brain Injury (mTBI)
Strategies: multimodal neuroimaging: structural and functional magnetic resonance imaging (diffusion tensor imaging [DTI], DTI tractography, macromolecular proton fraction mapping, resting state and task-based functional MRI; susceptibility-weighted imaging, FDG-positron emission tomography [PET]; cerebrospinal fluid and plasma biomarkers; genetic risk factors; clinical, neurocognitive and behavioral assessments,
Gulf War Veterans Illness (GWVI)
Strategies: multimodal neuroimaging and CSF and plasma biomarkers as described above, epigenetics, pain sensitivity testing and ability to activate endogenous opioid systems, and functional activity of paraoxonase I, the enzyme that metabolizes organophosphate insecticides.
Cerebrospinal Fluid and Plasma Biomarkers of Neurodegeneration Strategies: Bead-based multiplex assays using Luminex and Meso-Scale platforms, Quanterix ultra-sensitive platform, and broad-scale mass spectrometry for measurement of proteins, circulating RNAs, microRNAs in collaboration with VA/UW and Institute for Systems Biology investigators.
Pharmacologic Treatment of Disruptive Agitation in Alzheimer’s Disease (AD)
Strategies: Alzheimer’s Disease Cooperative Study multi-center randomized placebo-controlled trial of the alpha-1 adrenoreceptor antagonist, prazosin, for treatment of disruptive agitation in AD.
