Youth receiving mental health treatment have better outcomes when homework, or between-session practice, is assigned by providers and completed by youth and caregivers between treatment sessions. Many providers struggle with assigning homework during treatment, and many families struggle with completing homework assignments.
In this project we will develop a mobile application, "PRACTICE," to help providers and patients with homework exercises during mental health treatment. After developing the app we will be asking providers and youth patients and their caregivers to test the app and provide us with feedback during a one-time, remote interview. Next we will be recruiting mental health providers and families to participate in a treatment trial where we will preliminarily evaluate the effectiveness of the app. This will include a typical course of best-practice treatment where some providers and families will be randomly assigned to receive treatment enhanced with the PRACTICE app. As a last part of this study, we will be interviewing providers, supervisors, and senior leaders at local community-based clinics to get their ideas on how best to implement the use of the PRACTICE app in community settings.
This research is taking place at the Ralph H. Johnson VAMC and surrounding Community-Based Outpatient Clinics (CBOCs). This study is examining the effectiveness of PE-PC in VHA primary care mental health integration (PCMHI) clinics. We will randomize Veterans presenting in VA PC with chronic PTSD who meet minimal inclusion/exclusion criteria to receive PE-PC (four, 30-minute weekly sessions) or PCMHI treatment as usual.
Veterans who have prematurely dropped out of exposure therapy for PTSD will be contacted and offered the opportunity to return to treatment, this time with the assistance of a Veteran who has successfully completed this treatment in the past. Participants may receive a PE "Workout Buddy." This peer will meet them at the in vivo exposure therapy location and offer support an encouragement while the patient remains in that location. Participants may receive a PE general support peer. This peer will contact them once per week to check in about treatment progress and encourage session attendance, as well as discuss any life stresses. As the PTSD treatment standards in Charleston and other VA sites across the country increasingly include telemedicine delivered care, both in person and telemedicine based exposure therapy recipients will be included.
This Charleston Alcohol Research Center (ARC) pilot study seeks to provide the preliminary validation of a novel natural rewards fMRI paradigm which may be used in the development and/or evaluation of alcohol addiction medication treatments. Specifically, individuals with alcohol use disorder (AUD) and social drinkers will be recruited for a magnetic resonance imaging (MRI) study which will include magnetic resonance spectroscopy, an alcohol cue task, and this novel natural rewards paradigm which examines brain response to social reward and food. Invited participants will complete an initial screening diagnostic assessment visit at the Medical University of South Carolina, which will consist of clinical interviews with research staff, questionnaires, and labs. If still eligible, participants will be invited for a second appointment which will include additional clinical measures, questionnaires, and an MRI scan. This study is confidential and participants will be compensated for participating.
The purpose of the study is to examine whether 60-minute sessions of Prolonged Exposure (PE) is as effective as the standard 90-minute sessions in reducing the symptoms of posttraumatic stress disorder (PTSD). PE is a well-researched, very effective individual (one-to-one) therapy that is designed to help people to deal with traumatic events they have suffered in the past, including combat. This study is being conducted at the Charleston VA Medical Center, surrounding Community-Based Outpatient Clinics (CBOCs), and in the community. It will involve approximately 200 active duty participants. This research is funded by the Department of Defense.
This study examines the effects of the FDA-approved medication Gabapentin among individuals with Bipolar Disorder who smoke marijuana. Participants in the study will take Gabapentin and matched placebo (one at a time) for 5 days each. There are 5 study visits, including 2 MRI scans.
We recently completed an NIMH R34 in which we piloted a patient- and provider-informed tablet-based toolkit designed to facilitate delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) ? a treatment that was selected because it addresses a wide range of symptoms using techniques shared by other treatments for emotional and behavioral disorders. The tablet-based toolkit consists of numerous components (e.g., videos, interactive games, drawing applications) that are designed to facilitate provider-patient interactions in a way that enhances children's engagement and supports adherence to the treatment model. The tablet-based toolkit was very well received by children, caregivers, and providers in our pilot work. Moreover, all benchmarks for feasibility outlined in our NIMH R34 application were met or exceeded. We now propose to conduct a hybrid effectiveness-implementation trial to examine the extent to which the tablet intervention may improve fidelity, engagement, and children's mental health outcomes. We will conduct a randomized controlled trial with 120 mental health providers and 360 families in partnership with dozens of clinics in the Carolinas and Florida. Providers will be assigned randomly to tablet-facilitated vs. standard TF-CBT. Youth aged 8-16 years with clinically elevated symptoms of PTSD will be recruited. Baseline and 3-, 6-, 9-, and 12-month post-baseline assessments will be conducted by independent, blind evaluators. Sessions will be videorecorded for observational coding of engagement and fidelity by independent raters blind to study hypotheses. We will also examine costs and conduct semi-structured interviews with families, providers, supervisors, and agency leaders to inform future dissemination and implementation initiatives. Technology-based resources that are scalable, easy to use, and designed for efficient integration into everyday practice may have sustained national impact. The return on investment of these initiatives will ultimately rest on their potential to improve the spread of best-practice treatments and the quality with which they are delivered to the children who need them.
The this study will examine how fatigue level impacts symptoms of depression and anxiety among adolescents with SCD on a daily basis. It will further examine how cognitive appraisal of stress and self-concept moderate the relationship between fatigue and symptoms of depression and anxiety among adolescents with SCD on a daily basis to better understand mechanisms driving internalizing in this population.
This study examines the effects of the medication gabapentin and the supplement n-acetylcysteine among individuals with Bipolar Disorder who regularly drink alcohol. Participants in this study will take gabapentin, n-acetylcysteine, and matched placebo (one at a time) for 5 days each. There are 8 study visits, including 3 MRI scans.
Depression treatment is a core health disparity for Latinos in the U.S. as U.S. Latinos are more likely than non-Hispanic Whites to experience depression, but are less than half as likely as Whites to receive evidence-based care for depressive symptomatology. Mobile technologies offer an ideal strategy for meeting the widespread depression treatment needs of U.S. Latinos as recent U.S. population-level data suggests that Latinos adopt smartphones at a rate higher than any other demographic group. The purpose of the proposed project is to develop, test, and refine a Spanish-language mobile application version of brief Behavioral Activation, an idiographic, straightforward, empirically supported treatment for elevated depressive symptoms, for referral by primary care physicians in the service of increasing access to evidence-based treatment for depression for Latinos.