The objective of this project is to leverage Artificial Intelligence (AI) to create COACH: an on-device AI-driven digital navigator system that will support patients’ effective use of Digital Mental Health Technologies. We aim to: 1. Develop a prototype chatbot-based digital navigator; 2. Conduct preliminary evaluation of the system including lab-based usability testing with healthy participants and “red-team” stress testing with project confederates.
Targeted Condition: Depression
Optimizing telemental health with live artificial intelligence clinical scaffolding and feedback
This project aims to develop a clinical scaffolding system to enhance telemental health care by providing real-time coaching and actionable suggestions during video-based sessions. Modeled after live supervision methodologies, it supports clinicians by identifying intervention targets and offering text-based coaching prompts to guide care. Unlike automated chatbots, this approach enables clinicians to adapt suggestions to patient needs, balancing automation with oversight for safer AI-supported mental healthcare. The proposed in-session support will facilitate efficient implementation of strategies and clinician skill development. This project seeks to enhance data privacy by processing all data on-device and avoiding external data transfers.
Canoe Journey: Land, water, language and culture for youth wellbeing
The Canoe Journey study is an exploratory study aimed at examining the acceptability and fit of motivational interviewing (MI) and dialectical behavioral therapy (DBT) among American Indian and Alaska Native youth and young adult Canoe Journey participants. The team will develop a list of MI and DBT approaches in collaboration with Canoe Journey partners, and exploring the acceptability and fit of the approaches during Canoe Journey events in 2025, along with a list of tribally specific approaches to healing mental health in collaboration with Canoe Journey partners and confirm knowledge of these approaches among participants in 2026. The team will examine the relationship between measures of wellness with knowledge and use of MI, DBT, and tribally specific approaches to healing mental health in 2027, along with the acceptability and fit of a relational mental health intervention among Canoe Journey participants.
Deciphering Mechanisms of ECT Outcomes and Adverse Effects (DECODE)
Electroconvulsive therapy (ECT) is one of the most effective antidepressant non-invasive brain stimulation therapies for adults with major depression. However, a number of patients fail to respond despite adequate trials, and while clinically beneficial, ECT can produce adverse cognitive effects including amnesia, executive dysfunction, and verbal dysfluency.
In this prospective study, we propose the first investigation integrating multiple units of analysis including clinical and cognitive phenotyping, whole-brain neuroimaging, EEG, and E-field modeling to establish the mechanisms underlying ECT-induced antidepressant response (response biomarkers) and cognitive adverse effects (safety biomarkers), as well as to find the “sweet spot” of ECT dosing for optimal antidepressant benefit and cognitive safety. This proposal will result in a paradigm shift from “trial and error” approaches of ECT parameter selection to individualized, precision dosing to improve patient outcomes.
Exploring the implementation determinants of paraprofessional task-shared mental roles in integrated behavioral care settings in Washington State
The gap between the number of people needing and accessing mental health care has led to the development of new types of mental health providers to help expand access to care. These providers, referred to as paraprofessionals, have typically at most a bachelor’s degree and treat mild and moderate depression and anxiety. However, because the novelty of these roles in the Unites States, little is known about organizational and employee barriers to uptake and implementation. Further, little is known about US patient perspectives on having a paraprofessional mental health provider. The proposed research explores behavioral health employer, behavioral health employee, and patient perspectives on two new paraprofessional roles being deployed in Washington State – the mental health Community Health Worker and the Behavioral Health Support Specialist – to help identify key barriers and facilitators to implementation of these roles.
Self-directed mindfulness in medically hospitalized patients: a pragmatic trial
Consultation-liaison psychiatrists are often asked to manage mood and anxiety symptoms experienced by patients admitted to medical and surgical floors of the hospital. This study aims to determine the feasibility and effectiveness of a self-directed mindfulness intervention as an adjunctive treatment for improving mood, anxiety, and perceived stress in medically hospitalized patients. Participants, consisting of patients evaluated by the consultation-liaison psychiatry service, will be randomized to an adjunctive mindfulness intervention group or a treatment-as-usual control group. Feasibility and acceptability of implementing a mindfulness intervention will be assessed. Group differences in the changes in symptom severity and psychotropic medication administration will be investigated.
Willow Study
The goal of this study is to understand the impact of stigma on mental health and recovery from trauma in different parts of the country.
Community resilience to late life depression among first generation Asian Indian immigrants in the greater Seattle area (The CREED Seattle Study)
Asian Indians, are one of the fastest growing ethnic groups in the country, growing from 1.9 million (2000) to 4.6 million (2020). With a median household income of $119,000, Asian Indians are highly educated (43% have a postgraduate degree), are proficient English speakers (82%) and are often touted as a “model minority”. While these data create an impression of general well-being and success, there is limited information on the mental health of this community, as most research tends to aggregate results of the Asian population. Aging and age related mental health issues, especially late life depression in the community, in particular, has been under-studied. As culture exerts a significant influence on psychiatric morbidity, it is likely that this population has unique drivers to late life syndromic and subsyndromal depression beyond what is known from typical studies. Additionally, migration related, as well as acculturative stress, may provide unique influences. However, immigrant Indian communities are known for community engagement, providing large social networks and support which may reduce risk for depression. As a result, it is possible that higher risk resulting from immigration related stress might be mitigated by social engagement. This project will study older first-generation Asian Indians in the Greater Seattle Area to study the association between community engagement and depression symptoms.
Coach up the coaches: extending the reach of mental health professionals in sport settings
More than half of school-aged youth in the US play at least one organized sport, are similarly at-risk for mental health disorders as compared to their non-athlete peers, and face heightened barriers to seeking and sustaining mental health care. While coaches are not licensed mental healthcare providers, there is a robust evidence-base about laypeople (e.g., parents, teachers) effectively delivering brief interventions across population settings to help reduce psychological distress and increase the adoption of health behaviors. However, such brief interventions have not as-yet been adapted for the sport setting, or delivered by coaches.
The overarching goal of this project is to identify sport setting appropriate (very) brief interventions and adapt them for coach delivery in the sport setting. This will be accomplished by working in partnership with coaches, athletes, and licensed mental health care providers. We will use University of Washington’s First Approach Skills Training (FAST) training model (originally designed to train primary care clinicians in mental healthcare skills) to train a pilot cohort of coaches to deliver these interventions. This project is the starting point for a potentially transformative opportunity to extend the reach of mental healthcare professionals into the large and often underserved population of youth sport participants.
Evaluation and dissemination of the TRANSforming Families: Embracing Change with Teens Therapy Group
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.
