Delivering psychotherapy via telehealth has become a necessity during the COVID-19 pandemic to ensure individuals with mental health problems continue to get access to evidence-based treatments (ESTs). Many clinical settings were unprepared for the transitioning from delivering therapy in-person into via telehealth, introducing many barriers for clinicians and patients. Several studies have found that telehealth can increase the accessibility of therapy and reduce costs associated with travel. Although telehealth has provided significant benefits, making it a potential long-term medium for delivering therapy, it has also posed several barriers that must be addressed for its use after the COVID-19 pandemic. In this study, we explored the barriers that clinicians experienced when transitioning from in-person therapy to telehealth. Data came from a Washington state-funded cognitive-behavioral therapy training initiative. Clinicians completed pre-training and post-consultation surveys. Survey questions covered a list of barriers that clinicians had to rank from a scale of 0 (not a barrier at all) to 10 (a very significant barrier). Barriers included technological problems to issues conducting clinical assessments. Descriptive statistics will be used to summarize clinicians’ responses. Clinicians may continue to use telehealth even beyond the pandemic and this may become the possible standard of care. In order to improve the delivery of ESTs via telehealth, we must understand clinicians’ barriers to using telehealth, and then identify ways to ensure using telehealth to deliver ESTs is feasible, acceptable, sustainable, and effective.

The World Health Organization (WHO) defines social determinants of health (SDH) as “the conditions in which people are born, grow, live, work, and age”, all of which shape the conditions of daily life. There is significant evidence that those who have lower socioeconomic status’ and lower education are more likely to experience various mental health disorders (GAD, depression, etc.), and often do not have adequate services available to combat those disorders. Consequently, there has been increased attention to the importance of social determinants of health (socioeconomic status, living with racism, unstable housing) in relation to providing psychotherapies. We are looking to understand if prior to cognitive behavioral therapy (CBT)+ training, clinicians had received any training in social determinants of health, and if clinicians incorporate SDH into their delivery of CBT. Our descriptive analysis examines 195 licensed clinicians, and their answers to a variety of questions on their past training on social determinants. Based on past research, it is predicted that the majority of clinicians will have received some type of prior training on social determinants in relation to their delivery of CBT. Due to the importance of considering a variety of social determinants when conducting CBT, it is also predicted that clinicians often tailor their CBT to account for different SDH that their patients might be experiencing. This analysis will give organizations knowledge of what areas of training are being utilized by clinicians, therefore, giving them insight on what further trainings may be appropriate. This study may also help guide researchers when further studies surrounding CBT, and implementation are conducted.

Autism Spectrum Disorder (ASD) is a developmental disorder that is characterized by impairments in social, communication, and behavioral skills. One particular characteristic commonly seen in individuals with ASD is the presence of repetitive behaviors which include motor movements such as hand flapping or more ritualistic behaviors such as needing to touch objects in a particular order. Repetitive behaviors in ASD are similar to those seen in certain anxiety disorders, and the presence of a comorbid anxiety disorder in an individual with ASD has been shown to increase symptom severity, such as in social and communication impairments. Given the similarity between repetitive behaviors seen in ASD and anxiety disorders and the tendency for anxiety disorders to exacerbate ASD symptoms, this research aimed to assess the severity of repetitive behaviors between those with ASD and those with ASD + anxiety. Children between the ages of 8 and 17 participated in an NIH funded study (ASD only = 145) (ASD + anxiety = 67). Parents completed the ACE Medical History interview about their child and completed the Repetitive Behavior Scale - Revised (RBS-R) which is a 44-item questionnaire that assesses repetitive behaviors on 6 different subscales. We predict that the ASD + anxiety group will have a higher severity score (total and subscales) when compared to the ASD only group. Additionally, we will explore sex differences across these relationships. Overall, the information gained in this study will shed further light on symptom severity in subsets of the ASD population, thus better informing the development of treatment for individuals.

According to the World Health Organization (WHO), more than 264 million people of all ages suffer from depression globally. Depression is associated with a variety of psychosocial and physical impairments that can each act as both a risk for and consequence of depression. In particular, sleep disturbance commonly accompanies depression and is often a target for remediation in depression treatment (e.g., CBT-I). However, some individuals are more prone to sleep problems (e.g., young adults) than others and not every individual with sleep problems or depression develops the other. Therefore, idiographic approaches that build personalized models which are sensitive to individual heterogeneity are needed to better understand day-to-day links between depression symptoms and sleep problems. In the current study, we hypothesize that the links between specific hygiene behaviors and depression symptoms from day-to-day will be different from person to person. Ambulatory assessment (AA) data was collected from young adults to test whether common sleep hygiene practices are associated with sleep quality, negative affect, anhedonia, and other depression-related phenomena uniformly across individuals. We identified the sleep hygiene behaviors that have person-specific (vs. universal) links with depression and mood across individuals. Our results will have important implications for better understanding how sleep problems exacerbate or maintain depression symptoms for each individual so that more specific aspects of behavior may be targeted in treatment (e.g., CBT-I) to improve its relevance to the individual.

Violence exposure during childhood has been associated with increased post-traumatic stress symptoms, negative physical health outcomes, and risk of future violence perpetration and victimization. Psychotherapy may help buffer against the negative consequences of violence exposure: however, little is known about how community-based clinicians address violence exposure in psychotherapy. Data for the present study came from CBT+ — a statewide, state-funded training initiative for child-focused community mental health clinicians in Washington State. As part of the training evaluation, CBT+ training participants completed a survey that assessed their comfort with addressing violence and aggression and the frequency with which they address these topics in therapy. Using data collected from this survey, we aimed to describe 1) clinicians’ comfort level in addressing issues of violence and aggression during therapy; and 2) the frequency with which clinicians address violence and aggression during therapy. Our results included descriptive data (mean, standard deviation, and range) on clinician’s comfort and frequency addressing violence and aggression, which indicated clinicians did not frequently address violence and aggression in therapy settings and did not have a high level of comfort addressing the topics . Understanding clinician’s comfort and frequency in addressing violence and aggression is an important step toward ensuring the CBT+ training is best meeting the needs of clinicians in preparing them to address these topics during therapy. Clinicians who are willing to openly discuss violence in therapy may benefit clients by helping to reduce the negative mental health effects associated with violence exposure. Findings can help inform future CBT+ trainings on addressing violence and aggression to improve clinician comfort and increase the frequency with which clinicians address violence and aggression.

Schools are an accessible setting in which to embed youth mental health care; however, anecdotal evidence indicates that caregivers may be less involved in treatment when it is school based. Previous literature examines the relationship between clinician embeddedness across different settings and the involvement of youths’ caregivers. However, it does not evaluate the quality of clinician’s contact with caregivers. This retrospective study aims to compare the frequency of clinician contact with youths’ caregivers across school versus non-school-based mental health care settings. I will extend the previous literature by evaluating the quality of clinician’s contact with caregivers (phone versus in-person). Data for this study came from a Washington State-funded cognitive-behavioral therapy (CBT+) training initiative in 2019-2020. All participants were clinicians (N=215) who attended an in-person training followed by six months of expert consultation, completed pre-training and post-consultation surveys, and received CBT+ certificates upon completion. In the surveys, participants reported demographic information, amount of school-based practice, and frequency of caregiver contact. I will conduct chi-squared tests to assess the associations between degree of school-based practice and frequency of interaction between clinicians and youths’ caregivers. I hypothesize that there will be less caregiver contact with school-based clinicians compared to non-school-based clinicians, and less caregiver contact with full-time school-based clinicians compared to part-time school-based clinicians. Next, I will use descriptive statistics to summarize the frequencies of phone versus in-person contacts between clinicians and caregivers. Findings from this study can better inform our understanding of clinician involvement with youths’ caregivers across different service settings, which could aid in efforts to improve the quality of mental health care delivered in schools.

Previous studies have shown that the anatomical structure of the visual cortex is altered in individuals who become blind early in life. Here we examine whether blindness also affects the anatomical structure of auditory cortices. In sighted individuals, there is increased folding of the primary auditory cortex in professional musicians and musically trained children. Given that blind individuals must rely heavily on auditory information, we thought it possible that auditory areas of the brain might also be structurally altered by early blindness. Our goal is to measure the effects of early blindness on auditory cortices, by measuring cortical folding, surface area, and the amount of grey matter. These measures are compared in four groups of participants: anophthalmic (individuals whose eyes never develop, so no retinal signals reach cortex during prenatal development), congenitally blind (blind at birth), late blind, and sighted individuals. The auditory cortex is identified in each individual using an anatomical template, which is further refined manually. Our results provide important insights into how the auditory cortex is affected by the loss of vision. If differences between blind and sighted subjects occur prenatally, then we expect to see altered auditory cortex structure in individuals who are anophthalmic, but not in individuals who are congenitally blind or become blind late in life. If these differences develop in early infancy, then we expect to see altered auditory cortex structure in individuals who are anophthalmic and congenitally blind, but not in individuals who became blind later in life. Any alterations in structures that are due to an ongoing increased reliance on auditory information, would be present in all blind individuals.