Symposia
Disaster Mental Health
Shannon Wiltsey Stirman, Ph.D.
Associate Professor/Acting Deputy Director
Stanford University
Menlo Park, California
Stefanie LoSavio, PhD
Clinical Associate
Duke University Medical Center
Durham, NC
Amber Calloway, Ph.D.
Research Associate
The Penn Collaborative for CBT and Implementation Science, Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
Derrick Hull, PhD
VP of Clinical Research and Development
Talkspace
New York, New York
Katherine Dondanville, ph.D.
associate professor
University of Texas Health Science Center at San Antonio
san antonio, TX
The COVID-19 pandemic has exacerbated mental health challenges for trauma-exposed individuals due to increased isolation, insufficient capacity in the mental health workforce, and mental health impacts of the pandemic itself. There is a pressing need to increase treatment capacity for individuals with trauma-related mental health problems directly related to or exacerbated by the pandemic. Digital mental health (DMH) interventions for posttraumatic stress disorder (PTSD) address well-documented barriers to traditional in-person psychotherapy or telehealth delivery of evidence-based treatments (EBTs) for PTSD, but many consumers do not remain engaged. Acceptable, efficient, and engaging forms of EBTs may reach those who are less likely to access traditional psychotherapy or use online programs. Asynchronous texting therapy platforms can facilitate treatment engagement among those who seek discrete, convenient, and affordable support.
We report on building traineed therapist capacity for a randomized, Hybrid Type 1, effectiveness-implementation trial with a factorial design to compare text-based therapies for PTSD utilizing the HIPAA-compliant secure texting platform. Participants (N= 400) who have PTSD receive Cognitive Processing Therapy-Text or Culturally-Informed Trauma Treatment via messaging. Participants will also be randomized into one of two engagement strategies: therapist reminder as usual (RAU) or RAU + retention incentive (RI). This study will provide critical information about how to promote sustained DMH engagement using unique incentive strategies and moderators of engagement and outcomes and offer first guidance on supporting quality and fidelity of messaging-based EBTs using human and automated fidelity assessment.
A key aspect of the first phase of the project is to build capacity to provide an evidence-based, trauma-focused intervention via asynchronous messaging. We have developed a strategy to transform a 6 month, 42 hour training for the face-to-face intervention into a more brief, largely asynchronous, simulation-based training. This talk will describe innovative, rapid, and scalable training methods for this format using simulated clients and other innovations. We will describe therapist-level outcomes including fidelity and ability to meet core competencies and share lessons learned in providing training, assessing fidelity and providing feedback for asynchronous evidence-based therapy.