Community Psychiatry Program for Research in Implementation and Dissemination of Evidence Based Treatments (PRIDE) was founded in 2013 and brings to bear the breadth of resources that exist within Massachusetts General Hospital to provide excellence in training, coaching and research for underserved and vulnerable populations. PRIDE was founded to further the mission of Mass General's Division of Public and Community Psychiatry by extending its clinical and training initiatives to resource restricted settings where best practices are not present.
We believe that every human being in the world deserves a chance to reduce their suffering, to maximize their potential and to live a fulfilling life.
We partner with community organizations to improve the lives of youth facing adversity by collaboratively developing, executing and testing innovative implementation models. These models are designed to maximize the uptake and sustainability of evidence-based mental health strategies.
- Why: Every individual in the world affected by poverty, trauma and other forms of adversity deserves to learn evidence-based skills that have the potential to change the trajectory of their lives
- How: Through an innovative implementation science model that matches local challenges with proven evidence-based psychological interventions, we co-create sustainable and fiscally responsible training and coaching programs
- What: We provide assessment, training, coaching, consultation and continuous evaluation of state-of the-art cognitive-behavioral strategies designed to be delivered by youth development professionals to youth facing adversity
PRIDE research projects focus on the implementation of evidence-based treatments (EBTs) for mental health problems across a variety of context. In particular, PRIDE has a robust research portfolio evaluating the implementation and effectiveness of community-based projects that aim to increase access to quality mental health care among underserved populations.
Publications by Luana Marques, PhD, the Director of Community Psychiatry PRIDE
Publications by Soo Jeong Youn, PhD, the Director of Evaluation
PRIDE 2020 Impact Report
Throughout this past year, PRIDE launched an online course to bring mental health to all, hosted 150 high school students for a summer internship, and brought cutting-edge science to the public through 90+ media appearances. View PRIDE’s 2020 Impact Report and read more about the teams collaborative accomplishments with community partners this past year.
Cognitive-Behavioral Strategies (CBS) for youth development organizations: Strengthening organizational capacity
In Connecticut, more than one in five youth are disengaged or disconnected from high school. Youth who are disengaged and disconnected often face significant challenges with emotion dysregulation because of stress and adverse events, which in turn increases their risk of destructive and impulsive actions and risky behaviors. In partnership with Dalio Philanthropies, this project seeks to strengthen the capacity of the three Connecticut Opportunity Project partners to deliver their services with excellence by providing the organizations’ staff evidence-based training and coaching on how to deliver emotion regulation strategies. Through this program staff will be equipped with strategies that have been shown to be effective, can be delivered by youth development professionals and sufficiently address the complex social-emotional needs of the youth they serve. To achieve excellence in CBS delivery within the three Connecticut Opportunity Project partners, the project has two primary aims:
- To create an open source evidence-based curriculum to target emotion dysregulation among youth who are disengaged and disconnected.
- To develop and refine a tailored evidence-based training and coaching program to build capacity for youth development professionals to deliver CBS with excellence.
Capitalizing on implementation science to bring Cognitive-Behavioral Strategies to Boston Public Schools
Charlestown High School (CHS) serves one of the highest need student populations within the Boston Public Schools system, with 88% of students classified as high needs. External challenges faced by students, including financial instability, trauma exposure, and fractured support networks, are linked to the development of social-emotional and behavioral problems that interfere with learning and academic success. The CHS and PRIDE partnership was established in January 2019, with the joint mission of addressing the significant social-emotional needs of the students at CHS. The partnership started with a comprehensive engagement period to gain an in-depth understanding of CHS’s existing academic programming, infrastructure, resources, and student and staff composition. Following the engagement period, PRIDE hosted an intensive summer internship for 8 high school students to learn cognitive-behavioral skills, apply them in their lives, and co-design a refined version of the curriculum to increase uptake at CHS.
Leveraging routine clinical materials & mobile technology to assess CBT quality
Massachusetts (Boston, East Boston, Chelsea & Lynn)
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 aims 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
(NIMH 1 R01 MH112628-01)
PRIDE has a robust portfolio of implementation science projects and community partnerships. Below are the details for projects that are currently in the data analysis phase.
Implementation of cognitive processing therapy for PTSD in diverse communities
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.
(NIMH K23 MH096029-01A1)
Implementing evidence-based life skills programming for reducing recidivism among high-risk youth
Massachusetts (Boston, Chelsea & Springfield)
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.
Transdiagnostic approaches to facilitate sustainable implementation of mental health treatment
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 treatments, 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:
- Identify and address the organizational context and patient characteristics that may influence implementation of the UP in this setting
- Assess the feasibility and acceptability of an adapted UP
- Identify methods for scaling implementation of appropriate EBTs in safety-net settings
Investigating the need for and barriers to implementing evidence-based mental health intervention
Approximately 90% of individuals in need of mental health care in Mexico do not receive it, and only 5% receive minimally adequate treatment. A limited mental health workforce and inadequate training contribute to the large mental health treatment gap. One way to address this gap is to build sustainable research capacity that can foster the development of both infrastructure and training opportunities.
This project, conducted in partnership with the Universidad de Monterrey, aims to investigate the need for evidence-based mental health interventions in Mexico, determine the training needs of local providers and examine the barriers and facilitators to implementing mental health interventions and training programs in Mexico. In addition, the goal of this study is to build research capacity at the Universidad de Monterrey (UDEM).
Education & Training
Community Psychiatry PRIDE is currently accepting applications for a postdoctoral fellow.