Category: Dissemination / Implementation

Symposium

Applying Recovery-Oriented Cognitive Therapy to Individuals With Serious Mental Illness Within Assertive Community Treatment

Friday, November 17
4:15 PM - 5:45 PM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Community-Based Assessment / Intervention | Severe Mental Illness
Presentation Type: Symposium

Background: Cognitive behavioral therapies are clinically indicated for all SPMI diagnoses, but are under-utilized in community-based care, including many ACT teams. Little research has been devoted to the delivery of CBT for psychosis (CBTp) by ACT clinicians and there is no published literature to-date evaluating implementation models unique to ACT teams. Previous experience in Washington State training ACT mental health professionals in CBTp revealed profound difficulties in uptake, adherence, and sustained practice. Accordingly, we piloted Recovery-Oriented Cognitive Therapy with 13 ACT teams.


Methods: The implementation model consisted of pre-workshop assigned readings, in-person training, a cross-training guide, four consultation calls focused solely on cross-training to the broader team, and eight consultation calls consisting of didactics plus case-based consultation. Teams were permitted to send four team members to the training, including the team leader, clinicians, and peer specialist. Adaptations to the consultation calls were designed to address the difficulties of coordinating among ACT team members.


Results: Thirteen of the 14 ACT teams attended the training and 11 of 13 participated in consultation. Pre- and post-workshop evaluations reflected an increase in acquired knowledge of the intervention (paired t(46) -10.19, p < .001). Team members left the training with a high degree of confidence in the intervention (scale range = 0—7, M(SD) = 6.26(.759)) and intention to implement (scale range = 0—7, M(SD) = 6.60(.495)). Most teams (63.6%) endorsed cross-training of some kind. Providers will be re-assessed on knowledge items following consultation. TMACT fidelity scores will inform both penetration and quality of the clinical process and service.


Discussion: ACT teams are a unique service delivery model that may require unique implementation methods to enhance the uptake, quality, and sustainment of EBPs. The implementation model presented here pays particular attention to cross-training and provides role-specific guidance to team members.

Sarah L. Kopelovich

Acting Assistant Professor
University of Washington School of Medicine

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