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

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Transition Award (R00)
Project #
5R00MH080100-05
Application #
8204729
Study Section
Special Emphasis Panel (ZMH1-ERB-H (09))
Program Officer
Hill, Lauren D
Project Start
2010-03-05
Project End
2013-12-31
Budget Start
2012-01-01
Budget End
2013-12-31
Support Year
5
Fiscal Year
2012
Total Cost
$239,345
Indirect Cost
$38,931
Name
Boston University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Stirman, Shannon Wiltsey; Matza, Alexis; Gamarra, Jennifer et al. (2015) System-Level Influences on the Sustainability of a Cognitive Therapy Program in a Community Behavioral Health Network. Psychiatr Serv 66:734-42
Castro, Frank; AhnAllen, Christopher G; Wiltsey-Stirman, Shannon et al. (2015) African American and European American veterans' perspectives on receiving mental health treatment. Psychol Serv 12:330-8
Stirman, Shannon Wiltsey; Pontoski, Kristin; Creed, Torrey et al. (2015) A Non-randomized Comparison of Strategies for Consultation in a Community-Academic Training Program to Implement an Evidence-Based Psychotherapy. Adm Policy Ment Health :
Gamarra, Jennifer M; Luciano, Matthew T; Gradus, Jaimie L et al. (2015) Assessing Variability and Implementation Fidelity of Suicide Prevention Safety Planning in a Regional VA Healthcare System. Crisis 36:433-9
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
Stirman, Shannon Wiltsey; Miller, Christopher J; Toder, Katherine et al. (2013) Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implement Sci 8:65
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
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
Stewart, Rebecca E; Stirman, Shannon Wiltsey; Chambless, Dianne L (2012) A Qualitative Investigation of Practicing Psychologists' Attitudes Toward Research-Informed Practice: Implications for Dissemination Strategies. Prof Psychol Res Pr 43:100-109

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