The goal of this award is to support the development of a research career in an academic setting with a focus on implementation science in the service of advancing effective mental health interventions for children and adolescents. The well-documented gap between mental health research and mental health practice has prompted the need for research collaborations between practice and research partners in order to increase the effectiveness of interventions delivered to youth in practice settings;this need is especially salient in the area of adolescent depression. Thus, the paramount goals of the current proposal are a) to use a partnership between researchers and school-based mental health professionals to develop an observational coding method to characterize school-based usual care group psychotherapy for adolescent depression, b) develop a databse of strategies used by usual care providers to increase implementability and engagement, and c) to use the resulting coding system to identify specific procedures and common factors used in group psychotherapy that predict clinical improvement in depression coding sessions from already collected data. A corollary aim, for the independent investigator phase, will be to incorporate the procedures associated with clinical improvement, as well as implementability and engagement, into an enhanced intervention for adolescent depression and to test the effectiveness and feasibility of this intervention in a small randomized trial. This sequence of studies will provide information regarding the effective elements of usual care, which will benefit the direction of future interventions to address adolescent depresison. As well, the research-practice partnership that is central to this proposal targets the oft-criticized unidirectionality of efforts to bridge the research-practice gap via transporting evidence-based treatments designed into real-world practice settings for which they may be ill-suited. These studies will grant me opportunities to consult with leading experts in the areas of services and effectiveness research (Drs. John Weisz and Ann Garland), treatment of adolescent depression (Drs. Laura Mufson, Kevin Stark, Paul Rohde), observational coding (Drs. Bryce McLeod and Stephen Shirk), common factors of effective therapies (Dr. John Norcross), psychodynamic therapies (Stuart Ablon) and multilevel modeling (Dr. Sharon-Lise Normand), as well as expanding my research skills in preparation for a career as an independent investigator.
The prevalence of youth depression constitutes a major public health concern;yet treatment effect sizes from randomized clinical trials are modest. Moreover, the majority of children and adolescents who receive mental health interventions receive them in school, where the interventions remain largely undocumented. Identifying the elements used in these treatments could inform interventions to treat adolescent depression.
