Browsing by Author "Bearman, Sarah Kate"

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    Clinician Training, Then What? Randomized Clinical Trial of Child STEPs Psychotherapy Using Lower-Cost Implementation Supports with versus without Expert Consultation
    (APA, 2020-12) Weisz, John R.; Thomassin, Kristel; Hersh, Jacqueline; Santucci, Lauren C.; MacPherson, Heather A.; Rodriguez, Gabriela M.; Bearman, Sarah Kate; Lang, Jason M.; Vanderploeg, Jeffrey J.; Marshall, Timothy M.; Lu, Jack J.; Jensen-Doss, Amanda; Evans, Spencer C.; Psychiatry, School of Medicine
    Objective: Implementation of evidence-based treatments in funded trials is often supported by expert case consultation for clinicians; this may be financially and logistically difficult in clinical practice. Might less costly implementation support produce acceptable treatment fidelity and clinical outcomes? Method: To find out, we trained 42 community clinicians from four community clinics in Modular Approach to Therapy for Children (MATCH), then randomly assigned them to receive multiple lower-cost implementation supports (LC) or expert MATCH consultation plus lower-cost supports (CLC). Clinically referred youths (N = 200; ages 7–15 years, M = 10.73; 53.5% male; 32.5% White, 27.5% Black, 24.0% Latinx, 1.0% Asian, 13.5% multiracial, 1.5% other) were randomly assigned to LC (n = 101) or CLC (n = 99) clinicians, and groups were compared on MATCH adherence and competence, as well as on multiple clinical outcomes using standardized measures (e.g., Child Behavior Checklist, Youth Self-Report) and idiographic problem ratings (Top Problems Assessment). Results: Coding of therapy sessions revealed substantial therapist adherence to MATCH in both conditions, with significantly stronger adherence in CLC; however, LC and CLC did not differ significantly in MATCH competence. Trajectories of change on all outcome measures were steep, positive, and highly similar for LC and CLC youths, with no significant differences; a supplemental analysis of posttreatment outcomes also showed similar LC and CLC posttreatment scores, with most LC–CLC differences nonsignificant. Conclusions: The findings suggest that effective implementation of a complex intervention in clinical practice may be supported by procedures that are less costly and logistically challenging than expert consultation.
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    Evaluating a Modular Approach to Therapy for Children With Anxiety, Depression, Trauma, or Conduct Problems (MATCH) in School-Based Mental Health Care: Study Protocol for a Randomized Controlled Trial
    (Frontiers Media, 2021-03-05) Harmon, Sherelle L.; Price, Maggi A.; Corteselli, Katherine A.; Lee, Erica H.; Metz, Kristina; Bonadio, F. Tony; Hersh, Jacqueline; Marchette, Lauren K.; Rodríguez, Gabriela M.; Raftery-Helmer, Jacquelyn; Thomassin, Kristel; Bearman, Sarah Kate; Jensen-Doss, Amanda; Evans, Spencer C.; Weisz, John R.; Psychiatry, School of Medicine
    Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH) on students' mental health and academic outcomes. Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five school districts. School clinicians are randomized to either MATCH or usual care (UC) treatment conditions. The target sample includes 168 youths (ages 7-14) referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health. Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board (IRB14-3365). We plan to publish the findings in peer-reviewed journals and present them at academic conferences. Clinical Trial Registration: ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016.