Community Psychiatry PRIDE
70 Everett Avenue, Suite 516
Chelsea, MA 02150
- Clinical Research Director, Luana Marques, PhD: firstname.lastname@example.org
- Clinical Fellow, Soo Jeong Youn, PhD: email@example.com
- Program Manager, Kaylie Patrick, MPH: firstname.lastname@example.org
- Clinical Research Coordinator, Anna Bartuska, email@example.com
- Clinical Research Coordinator, Yesenia Aguilar Silvan: firstname.lastname@example.org
Explore This Research Lab
What We Do
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 under the Division of Public and Community Psychiatry, 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.
Community Psychiatry PRIDE conducts research exploring the disproportionate mental health burden in under-served and resource-constricted communities. Research projects focus on the implementation of evidence-based treatments (EBTs) for mental health problems across a variety of contexts. We place 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.
See publications by Luana Marques, PhD, the director of Community Psychiatry PRIDE.
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
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.
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.
Leveraging routine clinical materials & mobile technology to assess CBT quality
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 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)
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
Postdoctoral Fellowship at Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments (PRIDE)
Community Psychiatry PRIDE offers a position for one postdoctoral fellow each year.
- Department of Psychiatry
Soo Jeong Youn, PhD - Postdoctoral Fellow
Kaylie Patrick, MPH - Program Manager
Yesenia Aguilar Silvan, BA - Clinical Research Coordinator
Anna Bartuska, BS/BA - Clinical Research Coordinator
Derri Shtasel, MD, MPH - Director of the Division of Public and Community Psychiatry
- Isis Almazan Garcia-Rodriguez, Suffolk University ’19
- Ayotola Onipede, Tufts University ’19
- Ga Tin Fifi Wong, Tufts University ‘19
- Noah Snyder, Tufts University ’19
Support Our Work
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.
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