Bipolar disorder is a devastating, chronically recurring condition with significant public health impact, characterized high rates of suicide and high levels of functional and occupational impairment. In the last 15 years, combined psychosocial intervention and medication has been found to speed remission of acute symptoms, delay recurrences, and reduce inter-episode symptoms in a number of controlled trials, yet these effective psychosocial interventions are seldom implemented in community mental health settings. The proposal seeks to address these challenges by developing and piloting a comprehensive approach to implementation that will support the implementation of an evidence-based psychotherapy (EBP) for bipolar disorder in community mental health settings. The proposal builds on approaches developed during a large multi-site bipolar effectiveness trial (STEP-BD). It enhances those approaches through developing a comprehensive approach to implementation that incorporates technology-supported implementation assistance that targets key organizational factors and individual clinician factors associated with effective implementation. The project will then compare this comprehensive approach to implementation designed to improve effective implementation to an implementation-as-usual strategy in terms of feasibility and acceptability. The results will be used to support the development of a larger grant proposal to examine the effectiveness of a comprehensive approach to implementation, as well as provide important information to the field more generally regarding factors associated with effective implementation of interventions in community mental health settings.

Public Health Relevance

Bipolar disorder is a devastating, chronically recurring condition with significant public health impact, characterized high rates of suicide, and high levels of functional and occupational impairment. In the last 15 years, combined psychosocial intervention and medication has been found to speed remission of acute symptoms, delay recurrences, and reduce inter-episode symptoms in a number of controlled trials, yet these effective psychosocial interventions are seldom implemented in community mental health settings. This project seeks to develop and examine the feasibility, acceptability, and preliminary impact of a comprehensive approach to supporting the implementation of an effective psychosocial intervention for bipolar disorder in community mental health settings. If successful, the resulting intervention could substantially lower the public health impact of bipolar disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
1R34MH091319-01A1
Application #
8119943
Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Chambers, David A
Project Start
2011-02-22
Project End
2012-02-29
Budget Start
2011-02-22
Budget End
2012-02-29
Support Year
1
Fiscal Year
2011
Total Cost
$276,351
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Hamm, Megan; Williams, Kelly; Nikolajski, Cara et al. (2015) Readiness to Implement an Evidence-Based Psychotherapy: Perspectives of Community Mental Health Clinicians and Administrators. Psychiatr Serv 66:1109-12
Stein, Bradley D; Celedonia, Karen L; Swartz, Holly A et al. (2015) Implementing a Web-Based Intervention to Train Community Clinicians in an Evidence-Based Psychotherapy: A Pilot Study. Psychiatr Serv 66:988-91
Stein, Bradley D; Celedonia, Karen L; Swartz, Holly A et al. (2015) Psychosocial Treatment of Bipolar Disorder: Clinician Knowledge, Common Approaches, and Barriers to Effective Treatment. Psychiatr Serv 66:1361-4
Stein, Bradley D; Celedonia, Karen L; Kogan, Jane N et al. (2013) Facilitators and barriers associated with implementation of evidence-based psychotherapy in community settings. Psychiatr Serv 64:1263-6