Thursday, April 19
University Student Commons
Implementation of Child-Focused Evidence-Based Treatments Domestically and Globally: A Focus on Supervision and Task-Sharing
The VCU Department of Psychology and VCU School of Social Work welcome Shannon Dorsey, Ph.D., associate professor of psychology at the University of Washington. Dorsey’s research is on evidence-based treatments (EBT) for children and adolescents, with a particular focus on dissemination and implementation of EBT domestically and internationally. Her work has often focused on Trauma-focused Cognitive Behavioral Therapy (TF-CBT), with hybrid research designs that include both effectiveness and implementation questions. Research has focused on adaptation for unique populations (e.g., foster care) and on training and supervision strategies to deliver TF-CBT and other EBT. Dr. Dorsey is a Principal Investigator on two NIH-funded randomized controlled trials (RCT) involving TF-CBT, both of which include implementation and clinical outcome research questions. The first, in Washington State, studies the role of supervisors in public mental health settings in supporting EBP with clinicians under their supervision. It includes both a descriptive study of common supervision practices and a RCT of supervision strategies. The second, in Tanzania and Kenya, is a RCT of TF-CBT using a task-shifting/task-sharing model in which lay counselors, with little to no prior mental health training, deliver group-based TF-CBT to children and adolescents who have experienced the death of one or both parents, under close supervision by TF-CBT experts. Dorsey is also involved in common elements/modular EBT training initiatives and research both in Washington State and internationally, in low and middle income countries. With colleagues at Johns Hopkins Bloomberg School of Public Health, she also is involved in RCT and feasibility studies in Southern and Northern Iraq, the Thailand-Burma border, Colombia, Zambia and Ethiopia.
Evidence-based treatments for mental health problems are not consistently available to children and adolescents with need. The mental health treatment gap--the gap between those with need and those who receive care--is particularly wide in low and middle income countries, where the majority of the world's children and adolescents reside. Clinical supervision and task-sharing, both of which can be used in low-resource settings, have received limited attention in the implementation science literature. I present data from two studies: 1) a study of supervision in public mental health in Washington State and from 2) a randomized controlled trial of a trauma-focused evidence-based treatment (EBT) in Tanzania and Kenya that employs task-sharing (i.e., lay counselors with little to no prior mental health training or experience who deliver treatment, under supervision). I also will provide an overview of a newly funded scale up study in Kenya, which integrates aspects from both trials, as former serve as the local trainers and supervisors for new lay counselors (teachers in schools and community health volunteers).