PRINCIPAL RESEARCH CORE a) Intervention Development Program- This Program will focus on developing innovative patientcentered interventions for mood disorders. To facilitate dissemination and implementation, we will emphasize the core values of efficiency, portability across a range of clinical settings and flexibility across diverse clinical and sociodemographic groups. During years 1-3, much of the intervention development program's work will focus on Developmental Project #1 described below. Work for this project, however, will emphasize generalizable methods, structures and procedures (e.g. common theoretical models for motivational enhancement and self-management support, common database structures for web-based programs, common logical structure for treatment algorithms, common procedures for training and supervision, common self-management content, common methods for selfmonitoring). Center scientists will contribute to the Intervention Development program as follows: ? Behavioral Science, Evette Ludman- This component of the Intervention Development Program will build on our expertise in theory-based behavioral intervention design and implementation, treatment material development, treatment fidelity, and quality assurance. During years 1-3, Dr. Ludman will adapt educational and self-management materials for the web-based intervention in Developmental Project 1. Long-term work will focus on generalizable intervention models for use across a range of mood disorders and treatment settings. Continuing previous work 55, she will also collaborate with the Methods Core to develop tools assessing the underlying mechanisms by which self-management interventions change behavior and clinical outcomes. Our self-management interventions are influenced by social cognitive and self-determination theories, and incorporate strategies of cognitive behavioral psychotherapy and motivational enhancement approaches to health behavior change. Key emphases are patient activation and patient-provider collaboration as core components of effective disease management. Goals include increasing motivation and confidence regarding self-management and developing specific self-management skills relevant to mood disorders (e.g., cognitive symptom management, goal setting and problem-solving). The guiding theories emphasize both intervention content and the counseling strategy or communication style. Self-determination theory posits that an """"""""autonomy supportive"""""""" (vs. """"""""controlling"""""""") style creates healthhcare partnerships that foster autonomous motivation for self-management. Autonomy support is demonstrated by the extent to which providers listen fully, take the patients'perspective, provide meaningful information, and offer choices for treatment and self-care. These specific strategies for supporting autonomy are built into each intervention. Each intervention includes an individually tailored balance on motivational enhancement, education/skills training, self-efficacy enhancement and goal setting/action planning. All work will be coordinated with the Information Technology and Applying Evidence to Practice components.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Exploratory Grants (P20)
Project #
5P20MH068572-05
Application #
7876997
Study Section
Special Emphasis Panel (ZMH1)
Project Start
Project End
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
5
Fiscal Year
2009
Total Cost
$218,042
Indirect Cost
Name
Group Health Cooperative
Department
Type
DUNS #
078198520
City
Seattle
State
WA
Country
United States
Zip Code
98101
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Imel, Zac E; Hubbard, Rebecca A; Rutter, Carolyn M et al. (2013) Patient-rated alliance as a measure of therapist performance in two clinical settings. J Consult Clin Psychol 81:154-65
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Simon, Gregory E; Ludman, Evette J (2010) Predictors of early dropout from psychotherapy for depression in community practice. Psychiatr Serv 61:684-9
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Simon, Gregory E; Arterburn, David E (2009) Does comorbid psychiatric disorder argue for or against surgical treatment of obesity? Gen Hosp Psychiatry 31:401-2
Simon, Gregory; Rutter, Carolyn; Crosier, Marlan et al. (2009) Are comparisons of consumer satisfaction with providers biased by nonresponse or case-mix differences? Psychiatr Serv 60:67-73

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