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INVITED SPEAKERS
Invited Addresses
Invited Address #1: Wednesday, November 18 | 5:00 PM - 6:00 PM EST
Leveraging Implementation Science and Community-Based Partnerships to Bridge the Science-Practice Gap Among Diverse Populations Dr. Luana Marques, Ph.D., Massachusetts General Hospital Primary Category: Dissemination & Implementation Science Keywords: Implementation, cognitive behavioral therapy, underserved populations Moderate level of familiarity with the material Earn 1 Continuing Education Credit
At the end of this session, the learner will be able to:
Invited address #2: Friday, November 20 | 10:30 AM – 11:30 AM EST The Thrilling Path From Treatment Development to Implementation: Can Transdiagnostic Treatment Approaches and Implementation Science Close Critical Gaps for Adolescents and Adults With Mental Health Problems? Allison G. Harvey, Ph.D., DBSM, University of California, Berkeley, CA Allison G. Harvey, Ph.D., DBSM, is a Professor, Clinical Psychologist, and Director of the Golden Bear Sleep and Mood Research Clinic in the Department of Psychology, University of California, Berkeley. Her clinical training and Ph.D. were completed in Sydney, Australia. Dr. Harvey moved to the University of Oxford as a postdoctoral fellow in the Department of Psychiatry and then joined the Department of Experimental Psychology as faculty with a Fellowship at St. Anne's College. In 2004 she moved to UC Berkeley. Dr. Harvey has practiced as a cognitive-behavior therapist for more than 20 years. She is a treatment development researcher who conducts experimental and intervention studies focused on understanding and treating sleep and circadian problems, severe mental illness, and behavior change processes. More recently, she has expanded her focus to the science of dissemination and implementation. Dr. Harvey has had the honor of participating in the Training Institute for Dissemination and Implementation Research in Health (TIDIRH) hosted by the National Cancer Institute. She has published over 250 peer reviewed papers and chapters and authored three books. Her team's research is funded by the National Institute of Mental Health and National Institute of Child Health and Human Development. Dr. Harvey is a recipient of numerous awards, including from the American Association for Behavior Therapy and from NARSAD. Dr. Harvey has also been awarded an Honorary Doctorate from the University of Orebro, Sweden and is a Fellow of the Association for Psychological Science. She has served on the Executive Committee of the Academy of Psychological Clinical Science and the Review Committee for the Psychological Clinical Science Accreditation System (PCSAS). Primary Category: Transdiagnostic, Treatment CBT, Dissemination Key Words: Cognitive processes, Dissemination, Sleep Participants Earn 1 Continuing Education Credit
The first transdiagnostic intervention target to be discussed is sleep and circadian dysfunction. An observation that underpins this approach is that prior research has tended to treat specific sleep problems (e.g., insomnia) in specific diagnostic groups (e.g., depression). Yet real-life sleep and circadian problems are often not so neatly categorized, particularly in mental illness, where features of insomnia often overlap with delayed sleep phase, irregular sleep-wake schedules, and even hypersomnia. In the hope of addressing this complexity, the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) was developed. TranS-C is transdiagnostic in two ways: It addresses a range of sleep and circadian problems across a range of mental and physical health problems. The results from two RCTs that tested TranS-C for high-risk youth and adults diagnosed with a mental illness will be described. The second intervention target to be described is patient memory for the content of treatment. This transdiagnostic target is important as poor memory for treatment is common and is associated with worse treatment outcome. Data will be presented on the development and outcome from an approach to improving memory for treatment: the adjunctive Memory Support Intervention. The final part of the lecture will highlight the importance of implementation science for the future of our field. At this point in history, relatively few innovative, scientifically derived treatment development efforts ever get implemented and sustained in routine practice settings. There are many reasons for this, yet this gap is truly a disservice to the ever evolving and complex needs of the public. At the end of this session, the learner will be able to:
Recommended Readings: Harvey, A.G., & Buysse, D. J. (2017). Treating sleep problems: A transdiagnostic approach. Guilford Press. Harvey, A.G., Hein, K., Dolsen, M.R., Dong, L., Rabe-Hesketh, S., Gumport, N.B., Kanady, J., Wyatt, J.K., Hinshaw, S.P., Silk, J.S., Smith, R.L., Thompson, M.A., Zannone, N., & Blum, D.J. (2018). Modifying the impact of eveningness chronotype ("night-owls") in youth: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 57, 742-754. Harvey, A. G., Lee, J., Smith, R., Gumport, N., Hollon, S. D., Rabe-Hesketh, S., Hein, K., Dolsen., M.R., Hamen, K., Kanady, J., Thompson, M. A., & Abrons, D. (2016). Improving outcome for mental disorders by enhancing memory for treatment. Behavior Research and Therapy, 81, 35-46. Invited address #3: Saturday, November 21 | 10:30 AM – 11:30 AM EST Helping Give Away Psychological Science: Bringing the Best of Our Work to the People Who Would Benefit Eric Youngstrom, Ph.D., Professor of Psychology and Neuroscience and Psychiatry, UNC Chapel Hill Eric Youngstrom, Ph.D., is a professor of Psychology and Neuroscience and Psychiatry at the University of North Carolina at Chapel Hill, where he is also the Acting Director of the Center for Excellence in Research and Treatment of Bipolar Disorder. He earned his Ph.D. in clinical psychology at the University of Delaware, and he completed his predoctoral internship training at Western Psychiatric Institute and Clinic before joining the faculty at Case Western Reserve University. Dr. Youngstrom is a licensed psychologist, a teacher, President and Past-President of Divisions 5 & 53 of APA, and a parent of two daughters who are now thinking about "adulting" and careers. He married another psychologist (a romance from freshman year!) who has been his foil and "Reality Fairy" throughout his professional journey. He is passionate about bringing the best information to the people who would benefit. This focus has transformed his teaching and research. He is the Co-Founder and President of Helping Give Away Psychological Science (HGAPS), a nonprofit that he will describe in detail. Primary Categories: Dissemination and Implementation Science, Assessment Key words: Dissemination, Implementation, Assessment Participants earn 1 continuing education credit
At the end of this session, the learner will be able to:
Recommended Readings: Becker-Haimes, E. M., Tabachnick, A. R., Last, B. S., Stewart, R. E., Hasan-Granier, A., & Beidas, R. S. (2020). Evidence base update for brief, free, and accessible youth mental health measures. Journal of Clinical Child & Adolescent Psychology, 49, 1-17. https://doi.org/10.1080/15374416.2019.1689824 Friedberg, R. D., Nakamura, B. J., Winkelspect, C., Tebben, E., Miller, A., & Beidas, R. S. (2018). Disruptive innovations to facilitate better dissemination and delivery of evidence-based practices: Leaping over the tar pit. Evidence-Based Practice in Child and Adolescent Mental Health, 3, 57-69. https://doi.org/10.1080/23794925.2018.1427009 Lessig, L. (2008). Remix. Penguin. Available for free download at: https://archive.org/details/LawrenceLessigRemix IInvited address #4: Sunday, November 22 | 10:30 AM – 11:30 AM EST Strange Bedfellows Share Mutual Dreams: Increasing Access to Mindfulness Based Interventions for Mood and Anxiety Disorders Zindel V. Segal, Ph.D., C.Psych., Distinguished Professor of Psychology in Mood Disorders, Graduate Department of Psychological Clinical Science, University of Toronto- Scarborough Zindel Segal, Ph.D., is Distinguished Professor of Psychology in Mood Disorders at the University of Toronto-Scarborough. Dr. Segal has pioneered the use of mindfulness meditation for promoting resilience in the area of mood disorders. He is the recipient of several awards, including the Douglas Utting Research Prize and the Mood Disorder Association of Ontario's Hope Award and has been continuously funded by the National Institute of Mental Health and the Canadian Institutes of Health Research for the past 20 years. His program of research has helped to characterize psychological markers of relapse vulnerability in depression and affective disorder, especially the link between affective and self-devaluative components of dysphoria. This work has in turn provided an empirical rationale for offering training in mindfulness meditation to recurrently depressed patients in recovery. An author of over 10 books and 180 scientific publications, including The Mindful Way Through Depression - a patient guide for achieving mood balance in everyday life- Dr. Segal continues to advocate for the relevance of mindfulness-based clinical care in psychiatry and mental health. Primary Categories: Dissemination & Implementation Science, Adult Depression, Treatment: Mindfulness and Acceptance Key words: Depression, Mindfulness, Dissemination Basic to moderate familiarity with the material Participants earn 1 continuing education credit
At the end of this session, the learner will be able to:
Recommended Readings: Graham, A. K., Greene, C. J., Kwasny, M. J., Kaiser, S. M., Lieponis, P., Powell, T., & Mohr, D. (2020). Coached mobile app platform for the treatment of depression and anxiety among primary care patients: A randomized clinical trial. JAMA Psychiatry. PMID: 32432695 Muñoz, R., Bunge, E., Chen, K., Schueller, S., Bravin, J., Shaughnessy, E., & Pérez-Stable, E. (2015). Massive open online interventions: A novel model for delivering behavioral-health services worldwide. Clinical Psychological Science. https://doi.org/10.1177/2167702615583840 Segal, Z. , Dimidjian, S., Beck, A., Boggs, J. M., Vanderkruik, R., Metcalf, C. A., Gallop, Felder, J. N., & Levy, J. (2020). Outcomes of online mindfulness-based cognitive therapy for patients with residual depressive symptoms: A randomized clinical trial. JAMA Psychiatry. PMID: 31995132
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It takes 17-20 years for evidence-based practice (EBP) to reach routine practice, and this science-practice gap is 10 years larger in mental health and for underserved populations (Boren & Balas, 2000; Institute of Medicine, 2006). Narrowly focused strategies such as solely establishing the effectiveness of an EBP or training providers to deliver EBPs without addressing multilevel factors contributing to the science-practice gap are not sufficient to increase EBP uptake among diverse populations. Implementation science (IS) and community based participatory research (CBPR) provide a systematic method of implementation and evaluation to further address the science-practice gap (Bauer et al., 2015; Minkler & Wallerstein, 2011) and to reduce dispartites. This presentation describes three projects that leverage IS and CBPR to address barriers to facilitate the adoption of EBPs for diverse populations: clients seeking Posttraumatic Stress Disorder (PTSD) treatment from a diverse community health center in Chelsea Massachusetts, high-risk young men served by a community organization, and inner-city youth. Results from a NIMH-funded implementation-effectiveness hybrid study of Cognitive Processing Therapy (CPT) for PTSD underscore significant client-level predictors of treatment engagement (e.g., language) and effect of provider-level modification on client outcomes (Youn et al., 2019; Marques et al., 2019). The second research project, exemplifies the feasibility, acceptability and effectiveness of a modular Cognitive Behavioral Theory (CBT) iteratively developed and delivered by paraprofessionals for high-risk young men involved in the justice system (Valentine et al., 2019; Marques et al., 2020). Last, the development and scalability of a cognitive behavioral skills focused summer internship to improve emotion regulation among urban youth facing adversity is discussed. Cross cutting implications of these studies will be presented, including barriers encountered by diverse populations and strategies for increasing access within underserved communities.
Mental health problems remain common, chronic and difficult to treat. Progress toward improving outcomes must include the identification of novel intervention targets that are safe, powerful, inexpensive and scalable. This lecture will describe two transdiagnostic intervention targets and discuss the use of the experimental therapeutics approach to develop and disseminate treatments.
Psychologists create a huge amount of research and clinical materials every year. Only a fraction of it directly helps patients. Problems of awareness, access, and applicability are among the obstacles. Open-source approaches to dissemination show great promise in fixing the leaky pipeline due to easy accessibility and low cost. For example, Wikipedia is the largest encyclopedia in the world and the 5th most visited internet site. Wikiversity, whose audience is practitioners and graduate students, is a sister site geared towards teaching and practice. Imagine if we could use these to share resources and improve implementation of psychological science. Well, we can! The proof-of-concept projects have included editing more than 300 pages on Wikipedia and also on Wikiversity. An Evidence Based Assessment site has more than 200 pages that have been accessed more than 275,000 times. The pages include links to more than 250 PDFs of measures (stored on OSF.io so the links will not rot), along with details about scoring and interpretation. An assessment center with free, automated scoring for more than 70 scales has been built with grants from the APS, SSCP, SCCAP/Division53, SCP/Division 12, and the APA/CODAPAR. It provides free scoring reports, and it has been used more than 35,000 times. Creative Commons licensing, widely used in the arts, offers an easy way for us to share the science and practice. Free, simple strategies will let us crowdsource the expertise of ABCT and bring the best information to the people who would benefit.
Digital delivery of therapy content represents one avenue for increasing access to evidence-based treatments (Muñoz et al., 2015), with this format's virtues being especially highlighted during the COVID-19 pandemic.
Indeed, the strong evidence base for Mindfulness-Based Cognitive Therapy tied to its, paradoxically, limited availability in the community spurred the development of Mindful Mood Balance (MMB), a digital version of in-person MBCT. Using MMB as a case study,
I will present findings from a recent RCT (N=460) evaluating MMB against Usual Depression Care in a large HMO, to highlight the professional challenges that must be navigated in order to successfully migrate an in-person intervention to the web (Segal et al., 2020).
The nub of the problem has to do with the nature of partnerships and commercialization, two topics that require stepping outside of our comfort zones as treatment developers (Mohr et al., 2020). Partnerships enable you to stay true to the guiding principle in digitizing your work, namely ensuring treatment fidelity.
To achieve this, you will need to form partnerships with programmers, eLearning experts, web developers and stakeholders. While your work may not have been motivated by commercial incentives, you will need a strategy for positioning your work in a crowded mental health digital marketplace.
In this marketplace, the results of a satisfaction survey are considered as credible as outcomes from a well-powered RCT and clarifying what distinguishes your approach from the rest of the field is paramount. Finally, distribution channels already exist that deliver mental health content to millions of subscribers and present a
choice point about whether to have your work featured as one of their offerings or to mount a public facing website to reach the public more directly.
It is likely that just as evidence-based treatments differ, so will their respective routes to digital delivery. Broader dissemination of evidence-based care for mental disorders is one of ABCT's core misions and digital mental health offers one concrete approach to supporting this ideal.