Project CALMER (Exploratory Project 2)

Clinician Anxiety Labeling and Management through Exposure Research (Project CALMER)

Suicide is inherently an affectively charged topic and clinicians often experience anxiety and low self-efficacy in detecting and intervening with those at risk. This anxiety leads to poor implementation of evidence-based suicide screening, assessment, and interventions (SSAIs). Clinician anxiety and low self-efficacy related to SSAI use are thus candidate targets for implementation strategy design to optimize SSAI uptake in diverse mental health settings. This exploratory project brings together an interdisciplinary team to leverage decades of research on behavior change from exposure theory to design and pilot-test an exposure-based implementation strategy (EBIS) to target clinician-level anxiety about SSAI use. We will test the effect of EBIS as an implementation strategy to augment Implementation as Usual (IAU) to enhance SSAI implementation in community mental health settings. Specifically, Aim 1 will use participatory design methods to develop and refine EBIS in collaboration with a stakeholder advisory board of clinicians, administrators, and content experts. In Aim 2, we will further iteratively refine EBIS with up to 15 clinicians in a pilot field test, using rapid cycle prototyping, in collaboration with the INSPIRE Methods Core. Clinicians in Aim 2 will also provide qualitative feedback on EBIS’ ability to mitigate anxiety and increase self-efficacy to deliver SSAIs to optimize our ability to engage target mechanisms of clinician anxiety. Aim 3 will test the refined EBIS in a pilot implementation trial with 40 community mental health clinicians.