Symposium 110 - Understanding and Overcoming Barriers Within Evidence-based Practice Implementation in Youth Community and School-based Mental Health Services

Chair(s)

• 

  Andrea Ng, M.A. (she/her/hers)

  Graduate Student
  University of Hawai’i at Manoa
  Honolulu, Hawaii, United States

Discussant(s)

• 

  Alayna Park, Ph.D. (she/her/hers)

  Assistant Professor
  University of Oregon
  Eugene, Oregon, United States

Presenter(s)

• 

  Andrea Ng, M.A. (she/her/hers)

  Graduate Student
  University of Hawai’i at Manoa
  Honolulu, Hawaii, United States
• AB

  Anna Bartuska, M.S. (she/her/hers)

  University of Oregon
  Eugene, Oregon, United States
• SY

  Stephanie Yu, Ph.D. (she/her/hers)

  Doctoral Candidate
  University of California, San Francisco
  Chicago, Illinois, United States
• AH

  Ashley Harris, M.S. (she/her/hers)

  University of California, Los Angeles
  Los Angeles, California, United States
• MM

  Marina Matsui, M.A. (she/her/hers)

  University of Hawaii at Manoa
  Honolulu, Hawaii, United States

The predominant strategy for improving the quality and effectiveness of mental healthcare has been to implement evidence-based treatments (EBTs). However, when EBTs are implemented in school and community settings, effect sizes have been lower than those reported in randomized controlled trials (RCTs). The inherent complexity of school and community settings contrasts the controlled nature of RCTs and likely contributes to these suboptimal outcomes. For example, youths referred to school and community settings often present with high rates of comorbid externalizing problems and trauma, emergent life events (i.e., unpredictable acute stressors), inconsistent engagement, and cultural-specific risk and resilience factors that are not addressed in most EBT manuals. Thus, community mental health providers (CMHPs) often modify EBTs to meet their clients’ needs, which can improve or diminish treatment potency. To support providers delivering EBTs in complex community settings and optimize client outcomes, it is imperative to understand the catalyst, nature, and impact of CMHP responses to complex circumstances. This symposium features five presentations that investigate barriers encountered by CMHPs when delivering EBTs, how they modify treatment in response to such barriers, and the effect of EBT modifications on client engagement and outcomes. Our first presenter will elucidate what happens during unscheduled “walk-in” sessions in the state of Hawai’i’s public school system. Findings suggest that CMHPs often address emergent life events during these sessions, but not necessarily using EBT skills. Our second presenter will describe emergent life event occurrences during EBT and what practices CMHPs deliver in response to such occurrences. Our third presenter will showcase associations between various EBT modifications made by CMHPs and client engagement and treatment fidelity. Our fourth presenter will describe the associations between client engagement, CMHP responses to engagement challenges, and client outcomes and highlight opportunities to leverage EBT skills to improve client outcomes. Our fifth presenter will describe the cross-cultural reliability and validity of a novel strengths-based tool that screens youth social-emotional competencies. The tool was found to be applicable to multiethnic public school students, providing an avenue for CMHPs to assess client strengths that they may call upon when modifying treatment to fit client needs (e.g., responding to acute stressors). Research and clinical implications across presentations will be discussed by an expert in youth mental health EBT dissemination and implementation. Taken together, these community-engaged studies apply novel and naturalistic methodologies (e.g., analysis of national and state health data systems, qualitative coding of session content) to investigate the conditions under which providers modify EBTs in school and community settings, the nature of such modifications, and associations with client outcomes. Findings from these studies point to opportunities for improving EBT implementation, client engagement and client outcomes, which can inform policies and procedures for improving youth mental healthcare.

Presentations:

• 4:30 PM – 6:00 PM EST

  (SYM 110) Furthering Our Understanding of Treatment Targets, Practice Elements and Youth Characteristics for Emergent Life Events in School-based Community Mental Health Settings
  

  Speaker: Andrea Ng, M.A. (she/her/hers) – University of Hawai’i at Manoa

  Co-author: Daniel P. Wilkie, PhD (he/him/his) – center for cognitive behavior therapy

  Co-author: Ayada Bonilla, M.Ed. – University of Hawai’i at Manoa

  Co-author: Brad J. Nakamura, PhD (he/him/his) – University of Hawai'i, at Manoa
• 4:30 PM – 6:00 PM EST

  (SYM 110) Community Mental Health Provider Responses to Emergent Life Events During Modular Cognitive Behavioral Treatment for Youth
  

  Speaker: Anna D. Bartuska, M.S. (she/her/hers) – University of Oregon

  Co-author: Yukihiro Kitagawa, MA (he/him/his) – University of Oregon

  Co-author: Fiona Ben-Ora, BS (she/her/hers) – ADDRESS Mental Health Lab, University of Oregon

  Co-author: Rachel Kim, PhD (she/her/hers) – Baker Center for Children and Families

  Co-author: Daniel M. Cheron, PhD, ABPP (he/him/his) – The Baker Center For Children And Families

  Co-author: Alayna L. Park, Ph.D. (she/her/hers) – University of Oregon
• 4:30 PM – 6:00 PM EST

  (SYM 110) Observing Community Therapist Augmenting Adaptations in TF-CBT Sessions and Implications for Clinical Process Outcomes with Racial/ethnic Minoritized Youth
  

  Speaker: Stephanie H. Yu, Ph.D. (she/her/hers) – University of California, San Francisco

  Co-author: Caroline E. Shanholtz, PhD – University of California, Los Angeles

  Co-author: Kenya Rodriguez-Montalvo, BA (she/her/hers) – Alta California Regional Center

  Co-author: Qiwen Jin, MA (she/her/hers) – University of Pennsylvania

  Co-author: Alyssa De Los Santos, AA, BA in progress – UCLA

  Co-author: Qiran Sun (she/her/hers) – UCLA

  Co-author: Leila Malak, N/a (she/her/hers) – UCLA

  Co-author: Mia Flores (she/her/hers) – UCLA

  Co-author: Adriana Perez, BA (she/her/hers) – California State University, Northridge

  Co-author: Eman Magzoub, BA (she/her/hers) – UCLA

  Co-author: Xuanyao Qian (he/him/his) – UCLA

  Co-author: Topaz Tabibi, BA (she/her/hers) – Alliant International University

  Co-author: Namrata Poola (she/her/hers) – UCLA

  Co-author: Sebastian Luque (he/him/his) – UCLA

  Co-author: Brissa Bejarano (she/her/hers) – UCLA

  Co-author: Erica Jones, BA (she/her/hers) – UCLA

  Co-author: Ana Berman, BA (she/her/hers) – UCLA TIES for Families

  Co-author: Umiemah Farrukh, BA (she/her/hers) – University of Southern California

  Co-author: Xinran Wang, B.A. – Vanderbilt University

  Co-author: Qasim Farrukh (he/him/his) – UCLA

  Co-author: Joanna Kim, PhD (she/her/hers) – Arizona State University

  Co-author: Lauren Brookman-Frazee, Ph.D. – University of California, San Diego

  Co-author: Anna S. Lau, Ph.D. (she/her/hers) – UCLA
• 4:30 PM – 6:00 PM EST

  (SYM 110) Addressing Barriers to Engagement and Child Outcome Trajectories in Community Mental Health Care Settings: Underlying Challenges and Opportunity Costs
  

  Speaker: Ashley Harris, M.S. (she/her/hers) – University of California, Los Angeles

  Co-author: Anna S. Lau, Ph.D. (she/her/hers) – UCLA

  Co-author: Lauren Brookman-Frazee, Ph.D. – University of California, San Diego
• 4:30 PM – 6:00 PM EST

  (SYM 110) Advancing Strength-based Practice Element Utilization Assessment: A Measurement Invariance Study Between American and Korean School Youth on Self-reported CBT Skills
  

  Speaker: Marina M. Matsui, M.A. (she/her/hers) – University of Hawaii at Manoa

  Co-author: Brad J. Nakamura, PhD (he/him/his) – University of Hawai'i, at Manoa