Symposium VII: Implementation & Training Speakers
Eric Granholm & Matthias Pilny
Sarah Kopelovich
Dan Shapiro
Paul Grant & Francesca Lewis-Hatheway
Title: Improving Daily-life Functioning in Schizophrenia with Cognitive Behavioral Social Skills Training Delivered on Assertive Community Treatment: A Pragmatic Randomized-controlled Trial Comparing ‘In-lab Measures’ to Ecological Momentary Assessment of Outcomes
Abstract: Psychosocial interventions can improve functioning in people with schizophrenia, but are not available to most patients. In this pragmatic randomized-controlled trial, Cognitive Behavioral Social Skills Training (CBSST) was modified and tested in Assertive Community Treatment teams (ACT). Intent-to-treat analyses at 18 months (N=178) showed no significant differences in interview-based measures of functioning between groups. However, ecological momentary assessment (EMA) revealed that ACT+CBSST led to greater functional improvement compared to ACT alone. The findings suggest that integrating CBSST into ACT leads to greater improvements on EMA measures of daily-life functioning than ACT alone. Implementation and assessment related issues will be discussed.
Title: From Care Chasms to Care Pathways: Creating Something from (Next-to-) Nothing.
Abstract: The CBTp Stepped Care model, implemented in Washington State in 2017, aims to enhance CBTp access and care continuity across inpatient and outpatient settings. Under this model, practitioners across care settings receive training in milieu-based, low-intensity, group, and formulation-based CBTp. Despite the increase in access to these specialized services, constraints in the care pathway remain. This presentation will describe the CBT Care Pathway Model and will report on implementation benchmarks and roadblocks observed in three demonstration sites.
Title: CBT-based Stepped Care for Youths at Clinical High-Risk for Psychosis in Community Mental Health Settings: The SCIP Step Implementation Trial
Abstract: Intervention during the clinical high risk for psychosis phase is associated with better outcomes in those who develop psychosis and those who develop other conditions. However, in most real-world community settings that wish to implement specialized early psychosis care, including CBT, resources and expertise are limited. Thus, research on targeted treatments that work and can be implemented in community-based settings is needed. This presentation describes development, implementation, and program evaluation of a stepped-care intervention that blends CBT with team-based care—Cognitive Behavioral Case Management—in six community mental health settings in California, with plans to expand across the county.
Title: Going Big: Implementing and Sustaining Recovery-Oriented Cognitive Therapy (CT-R) in 4 State Systems; Lessons Learned
Abstract: In the United States, many individuals given a serious mental health condition diagnosis find themselves within care that is managed by a state system. Disproportionately from socially and economically disadvantaged communities, these individuals experience care in a variety of settings, delivered by a diverse range of professionals or paraprofessionals. The CT-R center has developed unique expertise successfully helping large systems of care sustain CT-R implementation long-term. As each system of care is different, having different needs, priorities, and challenges, we will describe our experiences – successes, challenges, innovations – in four state systems: Georgia, Pennsylvania, New York, and New Jersey.