Breakout M – October 14, 2011 (MC: Sara J. Landes)


Bringing the Scientist-Practitioner Model to Life: The Evidence Based Treatment Centers of Seattle
Presentation Slides       Video of Presentation

Presenter:    Stacy Shaw Welch, PhD
Authors:    Stacy Shaw Welch, Jennifer Sayrs, Travis Osborne, Jennifer Tininenko, and Sally Moore, Evidence Based Treatment Centers of Seattle, University of Washington

Abstract:    This talk will describe the processes developed over the past six years to implement and study evidence based practices in a large private practice setting. The Evidence-Based Treatment Centers of Seattle (EBTCS) comprises a group of over twenty clinicians serving over 600 active clients. EBTCS was founded with a mission of providing evidence-based treatments delivered with fidelity to a broad group of clients. It includes specialty centers for Dialectical Behavior Therapy (DBT), anxiety disorders, eating disorders and general child and adolescent issues. The processes EBTCS has developed over time for promoting a culture of science, preventing burnout, maintaining adherence to evidence-based practice, and preventing drift will be described. EBTCS has also invested heavily in developing sustainable systems to conduct research in the clinic, outside of any formal research mechanism or funding. The challenges and solutions we have come to for collecting data, providing feedback, and finding access to resources such as Institutional Review Board (IRB) reviews outside of an academic setting will be described. Initial data will be presented as examples of what can be accomplished using this model among private practitioners.


Enhancing Dissemination of Empirically Supported Therapies: A Novel Use of Telephone-Based Learning Communities
Presentation Slides       Video of Presentation

Presenter:    Timothy Kelly, BS
Authors:    Linda A. Dimeff, Timothy S. Kelly, Eric A. Woodcock, BTECH Research, Inc., David H. Barlow, Boston University, and Jill Ehrenreich-May, University of Miami

Abstract:    For more than two decades, the chasm between therapies grounded in research data and what is utilized in frontline clinical practice has received considerable attention (US Surgeon General, 1999).  The underutilization of the latest empirically supported treatments (EST) amongst practicing mental health professionals, often referred to as the “dissemination problem,??? has been the focus of many randomized controlled trials.  Many such trials compared the effectiveness of commonly used training modes (e.g. workshops, text manuals, online training (OLT) or some combination of those) for imparting knowledge and clinical competence of a particular EST (Sholomskas & Carroll, 2006; Sholomskas et al., 2005).  Results indicate these approaches are moderately successful (Dimeff, Paves, Skutch, & Woodcock, 2010).  Recently, a number of trials suggest the unique medium of OLT may impart knowledge more efficiently than text manuals or workshops (Dimeff et al., 2009). Despite these encouraging results, we believe there is still room for improvement. 

The OLT medium may provide unique advantages for transferring knowledge (e.g. interactive multimedia environments) but it may also have specific pitfalls: no human interaction, ability to role play, and no adherence feedback.  We sought to develop a simple adjunct to OLT specifically targeting those deficits; learning community conference telephone calls (LC).  The structure and format of the LC was informed by combining two, well-established models for learning: facilitated discussions often found in distance education and clinical consultation groups. Participants in these LCs met weekly with 3-7 peers, for one hour, and were led through discussions on, and practice of, the material by a non-expert facilitator. Each meeting was structured around specific content topics and scheduled at a time convenient for the group.  Utilizing peer-to-peer interaction and role playing, we hypothesized the LC meetings would enhance mastery of course content.

This research evaluated three different, additive training modes (self-guided reading of a treatment manual

[TXT], online training plus manual [OLT], online training plus manual plus participation in a LC [OLT+LC]) of training naïve treatment providers in Mastery of Anxiety and Panic for Adolescents.  All three training modes consisted of equivalent content and learning objectives.  Using a hybrid efficacy-effectiveness design, treatment providers (N=140) were randomly assigned to one of the three conditions.  Outcome variables included content knowledge and application, course completion, LC attendance, LC satisfaction, and a simulated clinical role play (performance).  Outcome variables were assessed at baseline, post-training, and 90-days following training.

Analyses will focus on descriptive data from the OLT+LC condition as well as compare the two OLT conditions in terms of knowledge gain, course completion, and performance.


Implementation of Evidence-Based Mental Health Practices in Seattle’s School-Based Health Centers
Presentation Slides       Video of Presentation

Presenter:    Aaron Lyon, PhD
Authors:    Aaron Lyon, Elizabeth McCauley, Kristy Ludwig, Ann Vander Stoep, University of Washington, TJ Cosgrove, and Jessica Knaster Wasse, Public Health of Seattle-King County

Abstract:    Multiple community studies have documented that the education sector has become the most common location for youth to receive mental health services (Burns et al., 1995; Farmer et al., 2003) and that school-based services can effectively reduce access disparities for ethnic minority and low-socioeconomic status youth (Kataoka et al., 2007). Unfortunately, as with many other service settings, utilization of evidence-based practices (EBP) by therapists working in the education sector has been low (Evans & Weist, 2004), indicating a critical need and opportunity to increase training initiatives and implementation research with school-based providers. This presentation will provide an overview of an ongoing quality improvement program, beginning in 2006 and focused on the implementation of EBP among mental health counselors in Seattle’s network of school-based health centers (SBHCs). SBHCs represent an integrated care delivery model, currently operating in nearly 2,000 schools across the United States (Strozer et al., 2010). Specific SBHC EBP implementation efforts have included training and support in cognitive-behavioral therapy techniques, modularized interventions for anxiety and depression, and the use of standardized assessments for the purposes of treatment planning and progress monitoring. These initiatives have been driven by ongoing evaluation of the school context, including qualitative and quantitative identification of the characteristics of the setting that influence implementation processes. Future directions for implementation research in SBHCs will be discussed including efforts to maximize intervention-setting fit through brief treatment/stepped care models and integration of academic data into routine progress monitoring.