Areas of Focus


The Northwest MHTTC provides specialized training in the area of Evidence-Based Practices (EBPs) for adults and transitional aged youth who experience or are at risk for serious mental illness (SMI). Our team partners with stakeholders in our region to train and support the behavioral health and allied workforce with empirically-supported and evidence-based behavioral health treatments for adults in HHS Region 10 (Alaska, Idaho, Oregon, and Washington).   

Nationally, more than ten million Americans were diagnosed with a serious mental illness in the past year. Living with a serious mental health condition can have a profound effect on self-esteem, identity, connections to others, health outcomes, and functioning. Despite established effectiveness of EBPs to improve recovery-oriented outcomes for adults experiencing a SMI, few programs deliver these services consistently or with high fidelity. Our faculty have provided training, consultation, technical assistance, and fidelity assessments to support sustainable implementation of EBPs that can substantially enhance the functional recovery of individuals living with mental illness. We aim to provide communities, clinicians, policy-makers and others in the field with the information and tools they need to incorporate evidence-based practices into their communities or clinical settings. 

What is a serious mental illness?

Serious mental illnesses primarily include schizophrenia-spectrum disorders, bipolar disorder, and major depression as well as other mental illnesses (e.g., post traumatic stress disorder) that cause significant difficulties with carrying out meaningful life roles and activities. SMI resources can be found here.

What is Evidence-Based Practice?

Evidence-based practice includes treatments or service programs that have demonstrated effectiveness in targeting a range of clinical and recovery outcome domains. In our work, we also ensure that EBPs are disseminated and implemented in a manner that is compatible with the cultural, environmental, and organizational context.  


What is Cognitive Behavioral Therapy for Psychosis? 

Despite an evidence base that spans more than 25 years, Cognitive Behavioral Therapy for psychosis (CBTp) is not widely available in community mental health settings in the United States. In fact, nationally, fewer than 1% of all licensed clinicians in the United States are trained in CBTp. In order to effectively address the science-to-practice gap, we must exponentially increase the number of trained  CBTp providers while maintaining high standards for competence and adherence.  

Since 2014, the SPIRIT (Supporting Psychosis Innovation through Research, Implementation and Training) Lab has been increasing the skills of the Washington State mental health workforce to offer CBTp as the standard of care for individuals with a schizophrenia spectrum disorder. On a biweekly basis, CBTp therapists and therapists-in-training come together to receive didactic instruction, engage in role plays, share successes, and troubleshoot challenges in our CBT ECHO Clinics.  


What is Assertive Community Treatment?

Assertive Community Treatment (ACT) is an effective, evidence-based, recovery-oriented mental health service delivery model that utilizes a trans-disciplinary team approach providing intensive outreach-oriented services to individuals with severe and persistent mental illnesses and co-occurring disorders.  Utilizing a client-centered approach, team members are responsible for addressing the needs of consumers and carry low caseloads to allow for individualized care and frequent contracts (1:10 staffing ratio).  Ideally, services are available 24/7 and are directed to consumer needs with most (75%) treatment services delivered in the community.  Assertive Community Treatment is ideally suited for people with schizophrenia-spectrum disorders or bipolar disorder, who have difficulty with role functioning and frequently access high intensity services (e.g., inpatient, jail). Although ACT has been widely disseminated, practical challenges related to enhancing staff competencies in the delivery of psychosocial interventions can severely hinder the effectiveness of this EBP. The SPIRIT Lab has provided implementation support of Washington State’s growing cadre of PACT teams, providing training, technical assistance, consultation, and fidelity reviews to each team for more than a dozen years. 


Northwest MHTTC Goals 

The Northwest MHTTC will focus on scaling up, disseminating, implementing, and sustaining CBT for psychosis and Assertive Community Treatment within Region 10. In addition, we will develop training resources for these two EBPs that can be used nationwide.