Overview/Global IP-RISP Effort
Principal Investigator: Paul Crits-Christoph, PhD (NIMH funded)
This purpose of this study funded by the National Institutes of Health (NIH) Interventions and Practice Research Infrastructure Program (IP-RISP) is to bridge the huge gap between academic based psychotherapy research and the practice of psychotherapy in community settings. In the past, research on various types of psychotherapy has been limited to academic settings, which do not always capture the unique challenges of serving clients in the community.
Evidence-based psychotherapies have not been tested in publicly funded community mental health settings with typical patients, and they are not commonly delivered in such settings. This research study will examine whether treatments proven efficacious in academic contexts are effective in the community when delivered by community-based providers and when adapted to meet the practical constraints of service delivery in the community.
Over the next five years, this project will seek to establish a clinic-wide outcome assessment and conduct pilot studies of evidence-based treatments for depressive disorders in order to see how well these treatments adapt to the community.
The National Institute of Mental Health (NIMH) is funding this five-year project to facilitate the development of infrastructure to carry out the planned community-based research. The study is being carried out in collaboration with a large non-profit, publicly funded Philadelphia community mental health agency, Northwestern Human Services of Philadelphia (NHSP). Paul Crits-Christoph, PhD, is the Principal Investigator from Penn.
Investigators from the Center for Psychotherapy Research and the administrators and providers from the NHSP serve as equal partners in the conceptualization of research questions, the modification of evidence-based treatments, the implementation of studies, and interpretation and dissemination of findings. Activities will focus on building a successful partnership among all relevant stakeholders, including the City of Philadelphia behavioral health administration, community administrators, therapists, staff, consumers, and researchers.
Research will be carried out at two NHSP facilities - the E. Mt. Airy Avenue (Northwest Philadelphia) and Knights Road (Northeast Philadelphia) locations.
Pilot studies that are a part of IP-RISP:
Engagement and Attrition Pilot Studies
Principal Investigator: Marna Barrett, Ph.D.
- The first pilot will focus on attrition during the engagement phase (i.e., no show after intake)
- The second pilot will focus on attrition from treatment itself.
Treatment Effectiveness Pilot Studies
Supportive Expressive Therapy versus Treatment as Usual for Depression in the Community
Principal Investigator: Mary Beth Connolly Gibbons, PhD
This pilot study addresses an issue of high public health significance, namely the lack of treatment response in many patients with major depression. This pilot investigation is an effectiveness trial designed to evaluate whether supportive-expressive psychotherapy (SE) is more successful in relieving depressive symptoms than the psychotherapy normally provided by the community agency.
What Sequence/Combination of Treatment for Depression is More Effective?
Principal Investigator: Jacques Barber, PhD, ABPP
This pilot investigation is an effectiveness trial designed to compare two strategies in terms of effectiveness and treatment retention in a community setting - pharmacotherapy followed by the addition of cognitive therapy (CT), or CT followed by the addition of pharmacotherapy.
Influences on the Sustainability of Evidence-Based Psychotherapies
Principal Investigator: Shannon Stirman, PhD (NIMH funded)
This program of training and research will facilitate the use of theory and methods of dissemination research to examine the sustainability of an implementation of cognitive therapy in community mental health agencies. A partnership formed between Philadelphia Department of Behavioral Health and the University of Pennsylvania to provide training in cognitive therapy to community mental health therapists provides the opportunity to examine a variety of factors that may be associated with the success of this effort.
The aims of the research are:
- To assess barriers to the sustained adoption of cognitive therapy for depression and suicidal behaviors in community mental health agencies
- To conduct preliminary research that will inform the development of an R01 to determine predictors of the sustained use of CT among newly-trained community-based therapists
- To conduct preliminary research to determine the nature and scale of the interventions that will be necessary to promote and assess the integration and sustained use of CT in community-based settings
- To examine ways in which CT is modified upon adoption in community mental health settings
Needs Assessment and Readiness Analysis of Community-Based Agencies in Philadelphia
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 micro- ethnographic methods to generate specific hypotheses regarding barriers specific to these settings.
The specific aims of this study are:
- To conduct a large-scale assessment of organizational climate, culture, readiness for change, and individual attitudes in community mental health settings
- To assess potential barriers and incentives for the sustained use of CT in urban mental health agencies
- To determine which centers to target for collaboration in future research
Organization and Individual-level factors and the sustained use of Cognitive Therapy
This study will examine the natural trajectory of the use of cognitive therapy after training in community mental health settings over two years.
The specific aims of this study are:
- To determine the extent to which CT is implemented in CMH settings after training, and to examine the relationship between organizational context and sustainability.
- To conduct a preliminary assessment of specific individual and organization-level barriers and facilitating conditions for the sustainability of CT after training in CMH settings, and develop a testable model upon which to base a future developmental R01
- To compare therapists' self-reports of their use of and attitudes towards CT to objective measures of adherence to CT
- An exploratory aim is to examine the ways that community-based therapists adapt CT in CMH settings
Development of a Tool to Measure Consumer Preferences in MDD Treatment
Principal Investigator: Paul Crits-Christoph, PhD (NIMH Funded)
The overall goal of this grant is to develop and pilot an instrument that helps guide clinical treatment decisions for people seeking treatment for major depressive disorder in a community mental health setting by incorporating evidence-based practice data that has been customized to the treatment preferences of individual consumers.
The specific aims of this study are:
- To investigate the best (i.e., valid and user-friendly) method of assessing consumer preferences for evidence-based mental health treatment.
- To utilize consumer ratings to evaluate three preferences instruments for their clarity, difficulty, reasonableness, and comfort level.
- To determine the ability of each measure to predict time spent in initial treatment in order to ascertain the relative validity and clinical usefulness of the instruments.
To learn more about our current treatment programs, research protocols, or to ask specific questions about the Center, please call us at 215-349-5222.