Research
Learn about our Current and Recent Research ActivitiesAssertive Community Treatment (ACT)
Project Title: Establishing the Current State of Assertive Community Treatment (ACT) Implementation in the U.S.
While ACT is an evidence-based practice for adults with serious mental illness (SMI), there is wide variability in ACT implementation and fidelity, resulting in similar variability in clinical outcomes. Absent has been a valid, reliable, and up-to-date evaluation of the availability of high-fidelity ACT teams in the U.S., resulting in over-reporting on ACT availability, misguided efforts around ACT implementation, and missed opportunities to optimize outcomes for individuals experiencing SMI within a program known to be effective when implemented well.
Led by Principal Investigator, Lorna Moser, Ph.D., from the University of North Carolina-Chapel Hill (UNC), and in collaboration with Gary Cuddeback, Ph.D. (UNC) and Lynette Studer, (University of Wisconsin-Madison), Dr. Monroe-DeVita is a Co-Investigator on the first comprehensive study of ACT across the U.S. This study aims to fill a significant knowledge gap that has impeded empirically-informed implementation and sustainability of high-fidelity ACT. Investigators are conducting a survey of ACT stakeholders, including specialty adaptations (e.g., Forensic ACT [FACT]) across all 50 U.S. states, examining the relationship between ACT fidelity and outcomes, and examining contextual factors (e.g., financing and policy) that impact high-fidelity ACT implementation and sustainability.
This project is supported by the Laura and John Arnold Foundation (LJAF) (12-02686 Prime Award No. 5116912). For more information about this project, please contact Principal Investigator, Lorna Moser (lorna_moser@med.unc.edu) or Co-Investigator, Maria Monroe-DeVita (mmdv@uw.edu).
News Release: https://www.med.unc.edu/psych/cecmh/education-and-training/unc-institute-for-best-practices/
Cognitive Behavioral Therapy for psychosis
The SPIRIT Lab is partnering with community behavioral health agencies across the country to pilot a web-based training tool that will make training in CBT for psychosis brief, inexpensive, and scalable. This trial aims to evaluate the effect that using CBTpro has on learners’ approaches to clinical encounters and their clinical outcomes. If you are interested in gaining access to the tool, please contact Project Director, Rachel Brian (rbrian@uw.edu)
Digital mental health interventions for psychosis
mHealth Washington is an initiative funded by the National Institute of Mental Health and is a collaboration between core faculty of SPIRIT and core faculty of the BRiTE Center, the University of Washington and Washington Health Care Authority.
The mHealth Washington team is partnering with 20 community agencies to implement FOCUS in multiple counties throughout Washington State. This implementation effectiveness trial aims to evaluate strategies to integrate mHealth into real-world clinical practice. The team is comprised of multi-discipline experts including academic researchers, policy makers, mental health advocates, Medicaid leaders and individuals with lived experience.
Early Psychosis
SPIRIT faculty work with faculty from Washington State University, and other external collaborators as part of the Center of Excellence in Early Psychosis to advance research on early psychosis, particularly as it relates to promoting evidence based practice, implementation science and clinical outcomes. A list of recent publications can be found here.
Our studies focus on a wide range of topics in Early Psychosis, ranging from family caregiver support and engagement, to supporting cardiovascular health and wellness in coordinated specialty care programs and more. Learn more about the current research projects underway with the Center of Excellence in Early Psychosis here.
Epidemiology and Impact
In the U.S., a person with schizophrenia has a life expectancy that is on average, more than 25 years shorter than that of the general population. Compared to their peers, people with schizophrenia are at substantially increased risk of unemployment, incarceration, homelessness, and social isolation. Our research has investigated the epidemiology and impact of psychosis and factors that drive quality of care and outcomes.
Family Interventions
Family interventions are critical to a holistic and effective clinical response to a psychotic disorder. Nevertheless, a recent federal investigation found that fewer than 2% of US families caring for someone with psychosis had received a family intervention for psychosis.
Dr. Sarah Kopelovich along with colleagues Dr. Sunny Chieh Cheng and Dr. Dong Si will develop and test Psychosis iREACH, a digital platform that uses Artificial Intelligence (AI) technology to deliver an evidence-based family intervention for psychosis (i.e., Psychosis REACH). Psychosis iREACH will include a virtual coach that will assist families in accessing self-management skills practice, automated self-assessment, tailored training goals and individualized learning trajectories whenever and wherever families need the support.
This work is supported by the Garvey Institute for Brain Health Solutions.
Integrated Care
SPIRIT faculty collaborate with other UW Centers and programs on innovative integrated care research, implementation and training projects. Our goal is to develop strategies and programs to support people with psychosis to effectively manage chronic medical conditions (such as diabetes and HIV) and to improve the healthcare services they receive.
Collaborative Publications
Core faculty of the SPIRIT Lab frequently collaborate with other researchers across the United States and internationally on a number of projects related to the early identification, assessment, and treatment of serious mental illness. You can learn more about these research efforts, which largely take place outside of the SPIRIT Lab, below.
- Sharma, S., Kopelovich, S. L., Janjua, A. U., Pritchett, C., Broussard, B., Dhir, M., … & Cotes, R. O. (2021). Cluster analysis of clozapine consumer perspectives and comparison to consumers on other antipsychotics. Schizophrenia Bulletin Open, 2(1), sgab043. https://doi.org/10.1093/schizbullopen/sgab043