The applicant is proposing funding through the Pathway to Independence Career Development Award (K99) to conduct a program of training and research that will to develop skills in mixed-methods research strategies and knowledge of theories of dissemination and organizational change. The applicant will interface clinical intervention research and organizational research to determine barriers to the sustained use of empirically supported psychotherapies after training occurs within community mental health agencies. The proposed research projects will complement the training program by providing opportunities to implement the mixedmethods strategies to assess barriers to sustained implementation of empirically supported treatments within community based-settings. Mentors at two NIMH-funded research centers at Penn, both of which have developed collaborative relationships with mental health agencies in Philadelphia, will support the applicant in the proposed research and training. The first study will employ surveys to examine some hypothesized barriers to the sustainability of new interventions in community mental health settings, as well as microethnographic methods to generate more specific hypotheses regarding barriers specific to these settings. The second study will examine the natural trajectory of the use of cognitive therapy after training in community mental health settings over two years. The relationship between clinician attitudes towards CT, specific organizational factors, and the sustained adoption of CT will be examined using a mixed-methods strategy. A secondary goal of this research will be to conduct the first examination the "real world" modifications that the treatment protocol undergoes as a result of the needs of the client and the realities of clinical practice. These results will inform the development of an RO1 to test a model of the individual and organizational factors that predict the sustainability of adoption within community mental health settings. This research program will yield some of the first data regarding the organizational and individual factors that impact the long-term sustainability of evidence-based psychotherapies. The knowledge gained can lead to the implementation of interventions that appropriately address barriers to the use of evidence-based therapies in community settings, which will in turn promote increased access to interventions that, despite extensive empirical support, currently are not widely available to community mental health consumers

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Transition Award (R00)
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Application #
Study Section
Special Emphasis Panel (ZMH1-ERB-H (09))
Program Officer
Hill, Lauren D
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Boston University
Internal Medicine/Medicine
Schools of Medicine
United States
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Gibbons, Carly R; Stirman, Shannon Wiltsey; Derubeis, Robert J et al. (2013) Research setting versus clinic setting: Which produces better outcomes in cognitive therapy for depression? Cognit Ther Res 37:605-612
Stirman, Shannon Wiltsey; Gutierrez-Colina, Ana; Toder, Katherine et al. (2013) Clinicians' perspectives on cognitive therapy in community mental health settings: implications for training and implementation. Adm Policy Ment Health 40:274-85
Wiltsey Stirman, Shannon; Calloway, Amber; Toder, Katherine et al. (2013) Community mental health provider modifications to cognitive therapy: implications for sustainability. Psychiatr Serv 64:1056-9
Stamatakis, Katherine A; Norton, Wynne E; Stirman, Shannon W et al. (2013) Developing the next generation of dissemination and implementation researchers: insights from initial trainees. Implement Sci 8:29
Wiltsey Stirman, Shannon; Kimberly, John; Cook, Natasha et al. (2012) The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implement Sci 7:17
Lyon, Aaron R; Stirman, Shannon Wiltsey; Kerns, Suzanne E U et al. (2011) Developing the mental health workforce: review and application of training approaches from multiple disciplines. Adm Policy Ment Health 38:238-53
Stirman, Shannon Wiltsey; Brown, Gregory K; Ghahramanlou-Holloway, Marjan et al. (2011) Participation bias among suicidal adults in a randomized controlled trial. Suicide Life Threat Behav 41:203-9
Becker, Kimberly D; Stirman, Shannon Wiltsey (2011) The science of training in evidence-based treatments in the context of implementation programs: current status and prospects for the future. Adm Policy Ment Health 38:217-22
Gibbons, Carly J; Stirman, Shannon Wiltsey; Brown, Gregory K et al. (2010) Engagement and retention of suicide attempters in clinical research: challenges and solutions. Crisis 31:62-8
Gibbons, Carly J; Fournier, Jay C; Stirman, Shannon Wiltsey et al. (2010) The clinical effectiveness of cognitive therapy for depression in an outpatient clinic. J Affect Disord 125:169-76