Current Projects

Practice Based Empirically Supported Treatments (PBEST)
Funding Source: NIMH
Principal Investigator: Bearman
The PBEST study is a five-year project that seeks to advance the use of empirically supported practices for youth depression in school settings. The study initially focused on characterizing the current practices used in the treatment of youth depression in public middle schools and involved a mixed-methods study with school-based treatment providers, youth who had received treatment and national experts in various theoretical orientations for youth treatment. These data informed the development of a coding manual with which 221 sessions of school-based “treatment as usual” were coded in order to determine the content and the processes of depression interventions delivered in the school context, as well as what processes and content are related to clinical improvement for youth. The next steps involve partnering with local schools and mental health practitioners within local schools to develop a treatment protocol that merges both elements of scientific evidence base and the emerging “practice-based evidence” in order to more effectively treat youth with depression. A small open trial to test the feasibility of this intervention is planned for 2013–2014.

Measuring Adherence to Team Decisionmaking (TDM): A Pilot Study
Funding Source: Annie E. Casey Foundation
Principal Investigator: Bearman
Team Decisionmaking (TDM) was developed as a way for child welfare agencies to collaboratively reach decisions regarding child removal when safety issues arise. It is intended to reduce out-of-home placements and non-kin foster care, and to engage families and community supports in the process. It is used in 17 states, but has never been directly tested in studies comparing TDM to alternative processes. In order to test the intervention, it is first essential to establish methods of measuring intervention integrity. To this end, a measure has been developed to assess that TDM is being implemented as intended. The purpose of the project is to determine whether the questionnaires completed by meeting participants provide accurate information about what happened during the meetings. For this project we have partnered with Dr. David Crampton of Case Western Reserve University (Co-Investigator) and with the Cuyahoga County Department for Children and Family Services.

An Observational Study of Treatment Integrity: ESPs in Effectiveness Studies
Principal Investigator: Bearman
With increasing attention focused on the mechanisms of therapeutic improvement, two schools of thought have emerged: One group of researchers has focused on identifying and refining specific treatment strategies that are associated with improvement, whereas other researchers maintain that common factors related to the therapeutic relationship and process are more potent predictors of treatment outcome than are the specific techniques associated with particular schools of therapy. Child and adolescent therapy process research has a long history, but much of the research is descriptive, with no linkage between process and outcome. An important step toward addressing this limitation has been the development and use of observational coding systems that rely on direct observation by trained observers to produce data that are objective, and detail-specific in regards to what procedures therapists actually use in-session. This study will examine recorded sessions (both video and audio) of therapists delivering therapy to children and adolescents treated in community mental health clinics as part of treatment outcome research, and use observational coding methodology to 1) characterize the therapeutic strategies used by therapists, 2) examine the adherence and competency of therapists using ESPs in real-world settings and 3) examine the use of nonspecific therapeutic strategies in “ESP” sessions delivered in real-world settings. This study involves a partnership with Dr. John R. Weisz at Harvard University and Judge Baker Children’s Center.