1. Evaluation of the Implementation of a Modular Cognitive-Behavioral Treatment for Posttraumatic Stress, Depression, and Anxiety in U.S. Community Mental Health Settings Roselyn Peterson, Doyanne Darnell, Maria Monroe-DeVita, MacKenzie Hughes, Shannon Dorsey, Laura Murray, Lucy Berliner University of Washington & Johns Hopkins Bloomberg School of Public Health INTRODUCTION Common Elements Treatment Approach (CETA) is a modularized cognitive- behavioral therapy (CBT) first piloted in low- and middle-income countries (LMIC): Southern Iraq and the Thailand/Burmese border Many trauma-exposed populations in the US and other high-income countries (HIC) lack access and resources to evidence-based CBTs for posttraumatic stress and related comorbidities While evidence-based treatments have been implemented in HIC, this was the first study of CETA being implemented in community mental health (CMH) settings in the United States Our original sample was N = 58, 8 dropped out of the Learning Collaborative consultation calls due to turnover, not enough time and the setting of the CMH agency not being a good fit for CETA LEARNING COLLABORATIVE MODEL Required Components for Clinicians 1. Attend workshop and at least 9 of the 12 consultation calls 2. Complete training evaluation surveys Clinician self-report of 17 CETA skills and implementation 3. Complete training case (using online EBP Toolkit) Had to document 6 sessions (at least) Complete outcomes measures at least two different times PHQ-9 – depression GAD-7– anxiety PSS– posttraumatic stress disorder CONCLUSION This novel approach offers many opportunities to greatly impact the way public health treats trauma-exposed populations such as prioritizing symptom reduction over the current crisis. Clinicians are learning to focus the majority of sessions on symptom reduction by doing CETA, then addressing life crises at the end of the session, showing that a structured CBT such as CETA can work in the public mental health context with difficult to treat populations. FEASIBILITY DATA Of the 50 providers: 37 (74%) providers attended at least 9 or more consultation calls 44 (88%) providers had at least 1-2 client cases 11.2 was the average number of CETA sessions providers reported with their clients 3.6 was the average number of time-points assessments were administered LIMITATIONS/FUTURE DIRECTIONS Interest is high for an Evidence Based Practice that addresses multiple outcomes and can be individually tailored Attention will be needed to address challenges of applying a brief structured intervention within the larger context of public mental health Client outcome data is preliminary and based on training cases. The outcome supports the feasibility of CETA in public mental health. Future research is needed to establish the effectiveness of CETA in these settings. Research supported by Washington State Contact: rsp3@uw.edu References available on back of handout Provider Demographic Characteristics Clinicians (N = 40) Supervisors (N = 10) Age38.4 (11.6 SD)42.2 (9.1 SD) Female Gender26 (65%)8 (80%) Years at Agency3.5 (4.0 SD)5.9 (3.0 SD) Degree MSW17 (42.5%)7 (70%) Other Masters14 (35%)3 (30%) 4 Year College6 (15%)- Doctoral Degree2 (5%)- High School or 2 Year College1 (2.5%)- PARTICIPANT OUTCOME DATA Of the 53 participants: 34 (64%) have a diagnosis of PTSD 9 are diagnosed with Major Depression 5 are diagnosed with GAD/Other Anxiety Dx 5 are diagnosed with some Other Mental Health Dx Outcomes for the 53 participants generally decreased over time: Client Demographic Characteristics Participants (N = 53) Age44.5 (9.9 SD) Female Gender29 (54.7%) Clinical Target Posttraumatic Stress38 (71.7%) Depression12 (22.6%) Anxiety3 (5.7%) Homeless/Live in Shelter7 (13.2%) Client Demographic Characteristics (Cont.) Participants (N = 53) Race/Ethnicity White29 (54.7%) Latino/Hispanic6 (11.4%) African American4 (7.5%) Asian3 (5.7%) Multiracial2 (3.8%) Not reported/Other9 (16.9%) PHQ-9 averageN = 3216.6 to 9.7 GAD-7 averageN = 2714.8 to 9.1 PSS averageN = 379.4 to 7.1 PM PTS averageN = 219.9 to 8.5 PM Anxiety averageN = 214.1 to 3.14 PM Depression averageN = 2114.9 to 10.7