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Research at Mass General
The goal of the Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-based Treatments (PRIDE) is to increase the access to and quality of mental health care in community-based agencies across Massachusetts.
Based out of Massachusetts General Hospital, Community Psychiatry PRIDE provides a framework for consultation, training and supervision of community-based providers in their delivery of evidence–based treatments for mental health disorders. We work to build strong community partnerships through community-based participatory research strategies to ensure that treatments are culturally-relevant and responsive to the unique challenges of the community, and that all positive change is sustainable.
Research projects focus on the implementation of evidence-based treatments (EBTs) for mental health problems across a variety of contexts. Community Psychiatry PRIDE places high priority on expanding access to and quality of care in settings with low human resources. Therefore, research projects typically enroll study therapists with limited or no prior experience delivering EBTs for mental health disorders.
Community Psychiatry PRIDE is currently running two studies:
Learn more about our research and clinical trials.
See publications by Luana Marques, PhD, the director of Community Psychiatry PRIDE.
Clinical Research Director
Luana Marques, PhD, is the director and founder of Community Psychiatry PRIDE at Massachusetts General Hospital and an associateprofessor in Psychology at Harvard Medical School. She completed her PhD in Clinical Psychology at The State University of New York (SUNY) Buffalo, and her clinical internship and postdoctoral fellowship in the cognitive behavioral therapy (CBT) track at Mass General/Harvard Medical School in 2007.
Dr. Marques’ major clinical and research interests include the implementation of evidence-based practices for individuals suffering from a variety of behavioral health disorders in diverse communities. Her goal is to decrease disparities in care for individuals experiencing behavioral health difficulties, especially among low-income and ethnic minorities. Upon beginning her work in community mental health clinics, Dr. Marques became increasingly aware of the substantial implementation gap in evidence-based psychotherapeutic treatments for anxiety and trauma-related disorders.
Dr. Marques founded Community Psychiatry PRIDE in 2013, and her research now centers primarily on reducing the disproportionate mental health burden among underserved populations in resource-constricted community clinics across Massachusetts
Kaylie Patrick earned her MPH in Epidemiology from Boston University School of Public Health and holds a Bachelor of Science in Public Health from the University at Albany.
She is an experienced program manager having managed multiple concurrent international research projects. Ms. Patrick has also worked extensively as a public health researcher, and has demonstrated commitment to ensuring the use of sound methodology and implementation. Her research interests include health disparities, human rights, adolescent mental health and well-being, and the impacts of food security on mental health outcomes.
Prior to joining PRIDE, Ms. Patrick worked at the FXB Center of Health and Human Rights at the Harvard T. H. Chan School of Public Health managing projects throughout Nepal, Hong Kong, China and Bangladesh. In addition, during graduate school she worked closely with one of her professors on a quasi-experimental study of the effectiveness of a digital nutrition curriculum in public middle schools around Boston. Ms. Patrick also has clinical research experience implementing a cross-sectional study of health literacy in adolescents during her undergraduate career in Albany.
Clinical Research Coordinator
Emily Ahles is the clinical research coordinator at Community Psychiatry PRIDE at Mass General. Ms. Ahles completed her Bachelor of Arts in Psychology at the University of Notre Dame in 2015, and plans to enter a doctoral program in clinical psychology in 2018.
Ms. Ahles’ major clinical and research interests include the dissemination and implementation of evidence-based practices for trauma, PTSD and eating disorders in low- income community settings and with vulnerable populations. During her undergraduate career, she worked as a research assistant in the Adolescent Socio-Emotional Development Lab, the Development and Psychopathology Lab, and the Psychological and Educational Measurement Lab at the University of Notre Dame. She also completed a senior thesis entitled “Is Fat Talk Just Something Women do to Bond?”, which she presented at the 87th annual meeting of the Midwestern Psychological Association in 2015.
During her time at Mass General, Ms. Ahles has been involved in a National Institutes of Health (NIH) funded study examining the implementation of cognitive processing therapy for PTSD at MGH Chelsea HealthCare Center. She has also been responsible for the management and organization of the education and mentorship program for undergraduate volunteer research assistants and co-ops at Community Psychiatry PRIDE.
Director of Public and Community Psychiatry
Dr. Derri Shtasel serves as the Michele and Howard J. Kessler Chair and director of the Mass General Division of Public and Community Psychiatry, is the executive director of the Kraft Family National Center for Leadership and Training in Community Health and is an associate professor of Psychiatry at Harvard Medical School. In her dual leadership roles, Dr. Shtasel focuses on strengthening relationships among community health centers, community mental health centers and academic medical centers, enhancing fellowship and residency education in community sites, increasing access to care for underserved and marginalized populations and narrowing the gap between community health and academic medicine. Her work is informed by a public health perspective and commitment to social justice. Her clinical work has centered on persons with severe mental illness and homelessness.
Dr. Shtasel is a recipient of an Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill (NAMI) and has been named a Distinguished Fellow of the American Psychiatric Association. She is the 2014 recipient of the Dr. Jim O’Connell award from Boston Healthcare for the Homeless as well as the 2014 Mass General Department of Psychiatry Clinical Mentorship Award. She is a graduate of Swarthmore College, Temple University School of Medicine, NYU/Bellevue Psychiatry Residency Training and the Harvard School of Public Health.
Community Psychiatry Program for Research in Implementation and Dissemination (PRIDE) conducts research exploring the disproportionate mental health burden in under-served and resource-constricted communities. Our current studies are described below.
Post-traumatic stress disorder (PTSD) may develop after an individual is exposed to one or more traumatic events, resulting in symptoms such as flashbacks, uncontrollable physical reactions and avoidance of memories relating to the trauma. An effective, evidence-based treatment for PTSD is cognitive processing therapy (CPT), a psychosocial intervention that focuses on how distorted or upsetting thoughts influence one’s behaviors. While it is known that this treatment is effective, it has yet to be tested in community health settings. Our goal is to close this gap between the science and practice.
This study takes place in community mental health centers (CMHC), namely Mass General's Chelsea HealthCare Center–located in one of the most impoverished zip codes in Massachusetts. Of the patients at Chelsea HealthCare Center, 66% are Latino and 30% only speak Spanish. Many of these patients experience a multitude of health issues, life stressors and varying degrees of trauma. These factors all contribute to the barriers preventing this population from receiving adequate healthcare services. Until recently, no providers at Chelsea HealthCare Center had been trained in any evidence-based treatments for PTSD.
The goals of this study are:
• To identify provider barriers related to the implementation of CPT in these diverse CMHCs • To identify stakeholders’ views of the barriers impacting the implementation of CPT and to further adapt intervention methods and materials with various providers and patients in both English and Spanish • To train community health workers in CPT • To conduct a pilot test of the modified CPT in order to begin to analyze patient outcome
This National Institutes of Health (NIH)-funded study is currently wrapping up the fifth and final year of the grant. We have gathered qualitative data, including provider and patient interviews, as well as quantitative data, such as self-report questionnaires. Ultimately, we aim to bridge the gap between research and practice by involving providers, patients, and stakeholders in modifying CPT to fit the community needs.
Learn more about using CPT for PTSD.
Boston, Chelsea and Springfield, MA
Federal and state governments grapple with the overwhelming costs of traditional corrections practices–currently at $50 billion a year and rising–and poor communities of color suffer from the reverberations of perpetual imprisonment, sustained violence and family instability. Each year, tens of thousands of inmates are either released from Massachusetts correctional facilities or are serving probation sentences and lack the resources necessary to keep themselves from re-offending and returning to jail.
At the center of this crisis are the 17- to 24-year-old young men that our community partner organization, Roca, works with in urban communities across the commonwealth. These predominantly black and Latino young men are disconnected, under-educated and unable to succeed in traditional programming and employment. They often struggle with criminal and/or aggressive behavior, substance use, skills deficits, poverty, lack of social supports, trauma and mental health problems.
Currently there is no behavioral health curriculum to deal with these problems in this population. The aim of this study is to develop and test an evidence-based treatment of cognitive behavioral therapy that is a good cultural fit for the organization and program participants. This intervention can be delivered by paraprofessionals, thus it has been designed with the intention to be easily replicated beyond Roca.
Despite the fact that empirically-supported interventions for common mental disorders have been identified in the context of research settings, reliable dissemination of these treatments to community settings have remained elusive. In order to provide evidence-based treatements, clinicians are tasked with learning a new intervention for each presenting condition, an undertaking with little practicality in busy community settings. This is particularly the case in safety net settings with limited resources and high numbers of patients with complex comorbidities. One promising solution is to focus on the dissemination of transdiagnostic interventions that can be applied across diagnostic boundaries.
The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is an intervention that can be applied to a range of disorders. The UP is a cognitive behavioral treatment explicitly designed to address anxiety, depressive and related disorders. The overarching goal of this project is to implement the UP, as the first-line treatment for patients presenting to the Behavioral Health Service of the Boston Healthcare for the Homeless Program (BHCHP).
BHCHP is a safety net setting with a mission of providing and assuring access to the highest quality health care for Boston’s homeless men, women and children. This study, supported by Boston University’s Center for Implementation and Improvement Sciences (CIIS), aims to:
1. Identify and address the organizational context and patient characteristics that may influence implementation of the UP in this setting 2. Assess the feasibility and acceptability of an adapted UP 3. Identify methods for scaling implementation of appropriate EBTs in safety-net settings.
Chelsea, MA and Lynn, MA
Little research focuses on how to ensure and assess long-term continued quality in the practice of cognitive behavioral therapy (CBT). Observation and expert fidelity ratings, often considered the “gold standard” for clinical trials, are not feasible in large systems in which thousands of providers have been trained, nor are they likely to be feasible in smaller, less well-resourced community settings.
Across most CBTs, clinicians introduce worksheets in session to guide clients through key cognitive and behavioral strategies, focusing on empirically established core elements of the treatment. The development of a feasible, scalable quality assessment tool to assess common elements of CBT worksheets that can be applied across protocols can facilitate the assessment of quality and support improvement across large systems that implement CBTs.
This project, conducted in partnership with the National Center for PTSD Dissemination and Training Division (VA Palo Alto Health Care System and Stanford University School of Medicine), the National Center for PTSD Behavioral Science Division (VA Boston Healthcare System and Boston University School of Medicine) and the Beck Community Initiative (Perelman School of Medicine, University of Pennsylvania), proposes to develop and test a general CBT quality assessment tool that facilitates brief ratings of clinicians’ ability to convey and apply core CBT skills to individual clients across several common presenting problems.
This National Institutes of Health (NIH)-funded study to do the following over the course of the four-year grant:
• Develop an efficient method of assessing worksheet quality that uses information from CBT worksheets • Examine this measure’s psychometric properties by collecting data from CBT sessions with diverse clients, in a variety of settings, delivered by clinicians with varying levels of CBT expertise and experience • Assess this method’s feasibility (e.g., perceived burden, barriers, associated time and costs), acceptability and relative advantage
Community Psychiatry PRIDE offers a position for one postdoctoral fellow each year. See the Community Psychiatry PRIDE Fellowship page to learn more about this position.
Learn more about the fellowship
Donations provide critical resources to the Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-based Treatments (PRIDE) team of clinicians and researchers as Mass General they seek to improve current treatments and reduce mental health disparities in ethnic and racially diverse communities. Gifts may be made for general unrestricted use by the team or directed to a particular physician’s research.For additional information on how to direct your gift, contact Lorraine Fanton in the Mass General Development Office at 617-724-6439 or by email. You may also contact the main Development Office at 617-726-2200 or toll-free at 877-644-7733.
Give online now
Donations by CheckChecks can be made out to the Massachusetts General Hospital with the word "Community Psychiatry PRIDE" or a particular research area in the memo field and sent directly to the Development Office:
Mass General Hospital Development Office, Attn: Lorraine Fanton125 Nashua Street, Suite 540Boston, MA 02114-1101
Online GiftsYou may make a gift using the online credit card donation form on the Mass General secure server. Be sure to click on “Other” and enter "Community Psychiatry PRIDE".
Tribute GiftsYou may make your gift in honor of or in memory of a friend or family member. If you enclose a note with the address, we will send a notification to the family.Tribute gifts can be sent to the address above or can be made online. The honoree's name and acknowledgement address can be entered at the bottom of the form.Matching GiftsMany companies match charitable gifts made by employees, retirees and directors. Please check with your company’s personnel department to learn if your business matches charitable gifts to hospitals.
70 Everett Avenue, Suite 516 Chelsea, MA 02150
Directions to Community Psychiatry PRIDE
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