A session titled, "Systematic Implementation of Cognitive Behavioral Therapy for Psychosis with Early Intervention for Psychosis Coordinated Specialty Care Teams" was presented by the Northwest MHTTC and affiliates at the Association for Behavioral and Cognitive Therapies 54th Annual Convention, held virtually November 17-22, 2020.
Evidence supports the use of Cognitive Behavioral Therapy for psychosis (CBTp) in the tertiary prevention of psychosis among individuals at high risk and as a consistent component of treatment packages among individuals who have experienced a psychotic episode. However, even among early psychosis coordinated specialty care teams, CBTp competencies are rare. Oregon’s Early Assessment and Support Alliance (EASA) has been a frontrunner in providing team-based specialty care for individuals who have or are at risk for psychotic disorders. In 2018, the EASA Center for Excellence (EASA C4E) partnered with SAMHSA-funded Northwest Mental Health Technology Transfer Center (MHTTC) at the University of Washington to support the implementation of CBTp, using an evidence-based implementation framework and empirically supported and emerging implementation practices.
This presentation will review pre-, peri-, and post-implementation activities as well as implementation outcomes. Nine providers, six site supervisors, and the EASA C4E clinical training director were directly involved in the 18-month CBTp implementation (October 2018-April 2020) across seven community mental health agencies in Oregon. Post-implementation evaluation (time point 5) occurs April, 2020. Process data to-date suggest that CBTp trainings and follow-up consultations have been well-received and rated as high-quality. Preliminary outcome data indicate statistically significant improvements in CBTp-related knowledge between pretest and post-event (t = -4.39, p = .002), and small positive effects on self-reported practice changes. There were no significant changes in attitudes towards EBP or attitudes toward psychosis, although attitudes were generally positive at both time points. Additional findings on changes in organizational readiness and implementation outcomes will be included as long-term follow-up data become available. Together, these data provide preliminary evidence that intensive, multimodal implementation supported by an external facilitator can effectively promote knowledge gains and practice changes designed to support individuals at high risk for psychotic disorders.
Sarah L. Kopelovich, PhD
Faculty-Scientist
University of Washington School of Medicine
Seattle, Washington
Jennifer Blank, B.A.
Research Coordinator
University of Washington School of Medicine
Seattle, Washington
Jonathan Olson, PhD
Research Scientist
University of Washington
Seattle, Washington
Jeffery Roskelley, LICSW
Staff Trainer
University of Washington
Seattle, Washington
Ryan Melton, PhD
EASA Clinical Training Director
Early Assessment and Support Alliance
Portland, Oregon
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