UCLA Flashcards
**How did you get interested in the field of psychology/ Why do I want to be in this Lab (Summarized)?
Before College:
Child with autism/epilepsy
want to ensure psychological research/resources are disseminated to clinical populations it actually benefits.
Throughout college:
I sought out numerous clinical opportunities to work with individuals from underserved communities. And had several opportunities to share resources with these clinical communities that benefited.
I sought out intervention research work, with the hope of improving well being for various clinical populations, and realized research was something I was very passionate about.
My mentors often ask me to reflect on your “why” for conducting research. Especially when you get into the thick/weeds of a challenging project.
I am very enthusiastic about your lab because it directly aligns with my research interests and my “why”.
For instance, In one of your projects, you use an analogy that I am very fond of. In this project, (bridge analogy).
I am very interested in installing guard rails to that ramp, and renovating a bridge and making it beautiful, and advertising the community to go see the bridge.
________
One experience I really appreciated was the Family to Family department where we disseminated resources to community members and did education-based outreach (end stage renal disease). In this position, my mentor also taught me a lot about psychological research, particularly intervention research work, which is then something I aspired to pursue back at my undergraduate institution.
Throughout my UG research experiences, I realized research was something I wanted to pursue long term.
Post Bacc
Sleep Interventions
School Based Intervention (CL)
Became intrested in ensuring interventions that are genuinely helpful can actually be integrated to populations they benefit.
For example: sleep is something that is extremely easy to implement by oneself, lets get it to populations that would benefit.
-Bridge Analogy
-Modular design (vs normal protocol/intergal design)
-MAPS Managing and Adapting Practice –>CKS–>RFES Reaching Families Engagement System -Uses systems like MTT
-My research interests.
**Research Idea #1
Research Question #1
Concerns:
Bridge analogy:
Bridge of engagement
Solutions:
When thinking of possible research questions, I’ve thought about two possibilities, one that will ideally help install some guard rails and fill in some potholes on that engagement bridge,
Research Proposal:
My first question: How do we add structural integrity to the bridge?
Previous Literature:
Dr. Chopiras work with RFES I believe is an excellent way to add in some gaurd rails.
Proposal: Using this model, I would also like to implement a modular design breaking down units of intervention work into plain language to help inform youth and their families during their treatment.
When looking at Engagement:
In the teaching literature, clarity in instructions, structure of a course, assignments due on a regular basis all lead to more learning.
When looking at health psych literature, work on adherence to treatment suggests that good communication and clarity of instructions from the provider increase adherence.
Research has shown that Better-designed Canvas pages and syllabus written to be student-centered (so patient-centered warm instructions) lead to better outcomes more work etc.
I believe, that implementing a client faing plain language treatment plan broken down in a modular design format, SHOULD lead to better outcomes in engagment.
and especially visually (“Syllabus snapshot”).
How would we do that?
I would like to implement these client-facing plain languge modules into the RFES as a resource.
To test the effectiveness of this and when it may be best to implement it,
One condition where they use RFES as usual but without this plan language modular design implementation.
One condition with no RFES (so treatment as usual)
One condition where we randomly assign individuals into when this plain language would be implemented (first half, second half, or use the whole way through)
How to measure thoughts of engagement:
We can use questions from My Thoughts About Therapy for both Youth and Caregivers.
**Research Idea #2
Research Question #2
Concerns:
Getting people to that “engagement bridge” (low SES, people of color, rural background)..
The huge gap between evidence-based treatment research in RCT ACUTALLY being implemented into daily practice or into treatment plans.
Solutions:
Hopefully, increase the amount of individuals interested in visiting the bridge
And in the process, decrease the huge gap between RCT interventions not being implemented into practice
Research Proposal:
With Dr. Chopiras’s guidance, I would like to create an easily accessible client-facing database that would break down scientific jargon from randomized clinical trials into more plain language using the RFES framework.
This framework could be easily disseminated in school settings, Dr. Offices…
Using the RFES framework, it can match participants demographics and be easily accessed (within the home) treatment plans (like sleep based interventions)
It can also show them possible interventions they could receive in therapy and discuss the benefits of attending such a treatment plan.
Ideally, this will help decrease the gap of evidence-based treatments not being integrated into service.
How would we measure if this is effective in a controlled setting?
Start with one specific intervention (anxiety or depression)
Have participant take the MTT questionnaire before they access the database
Have participants fill out demographics and have RFES assign them a at home intervention to try out.
It could have a planner function that maps out a time period for them and a checkbox where they mark if the intervention was completed or not
Have participant also read through suggested treatments that could be completed in therapy and ask them to re fill out MTT questionnaire after completion of their at home treatment.
_________________________________
and let participant know significance of therapy (percentge wise liklihood that that treatment would hekp).
**What appeals to you about this program?
**Why are you interested in working with me?
Dr. Chorpita’s research
UNDERREPRESENTED GRADUATE STUDENTS IN PSYCHOLOGY: UGSP High School Outreach Committee
Your research is reflective of my “drive” of WHY I want to be a researcher.
XBruce Chorpita
The aim of Dr. Chorpita’s work has been to advance the effectiveness of current mental health practice technologies for children and adolescents.
XOur Mission:
We are dedicated to improving the effectiveness of mental health services delivered to youth and their families. We continually strive to discover better ways for mental health providers at all levels to be more effective and more empowered to deliver the highest quality, evidence-based mental health services.
**What projects of mine do you want to be involved in?
CKS –> reaching families engagement system. I find this work very interesting. It fascinates me the significant results of treatment compared to not using CKS and want to help get this practice (and similar things: PL) established in the field.
–> bridge analogy
–> modular designs
XResearch Focus
1. Mental Health Systems
Treatments and systems have led to models for improving efficiency and quality in mental health systems.
This has involved coordinating key strategies from dissemination and implementation science, quality improvement approaches, individualized care models, and evaluation and feedback systems.
(2018)
“what to do when”
Coordinated strategic action CSA is neither a commitment to any single “best” approach nor a “kitchen sink” of all of them, but rather, it involves strategic and synergistic assembly of the most relevant resources and methods in light of a chosen goal and the context in which that goal is to be achieved.
(2013) new models to connect science and service will likely emerge from novel consideration of better ways to structure and inform collaboration within mental health systems.
XResearch Focus
2. Treatment Design
Our laboratory has spent more than 15 years articulating principles of modular treatment design and have built and tested multiple working examples. Such designs open the possibility for STRUCTURED FLEXABILITY, EFFICIENT PROTOCOL REVISION, carefully controlled experimental manipulations, and collaborative multi-investigator protocol systems
Modular Treatment Design
1. involves the idea that a complex system can be divided into functional units or modules.
2. that each module is expected to produce its intended result.
3., similar to children’s “lego” building blocks that plug into each other. This property allows independently structured modules to interact and contribute to a more functional whole. It enables the rearrangement of modules without complications in their connection sequence, offering flexibility in sequencing activities
4. A therapist using a protocol doesn’t need to know specific strategies within a module, providing flexibility in arranging or substituting modules.
5: This compared to integral designs (janga building blocks for example)
Using a modular design:
-MATCH: Youth treated with MATCH showed significantly faster rates of improvement
-MATCH: required significantly fewer sessions delivered over significantly fewer days.
-The modular approach outperformed usual care and standard evidence-based treatments on multiple clinical outcome measures
-should preserve and could even enhance the efficacy of existing therapy protocols
- that are explicitly matched to the child’s individual strengths and needs
XResearch Focus
3. Technology and Clinical Reasoning
A particular innovation has involved designs for progress visualization in the context of practices delivered, allowing not only for outcomes feedback (e.g., is my case improving?) but also for integrative reasoning about practice-outcome relations (e.g., are practices used having an effect?)
(2008)
If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered.
This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.
XResearch Focus
4. Knowledge Management and Use of Evidence
This model led to a similar analytic innovation, Relevance Mapping, which simulates enrollment of youth within an actual service system in all published randomized trials, and through set minimization, can determine the smallest number of evidence based practices required to serve the largest number of youth in any service system, using any user-defined practice ontology and any user-defined standard of evidence. Our latest work involves investigation of Coordinated Knowledge Systems, which incorporate usable knowledge products into a defined decision and action cycle (e.g., planning, selecting, implementing, evaluating intervention strategies).
(2011)
The overall goal was to determine the smallest set of treatments that could serve the largest percentage of clients.
Relevance mapping methodology was used to identify optimal sets of programs and practice elements.
These results demonstrated that there are multiple ways to conceptualize treatments when planning a service array, and these options have significant implications regarding who can be served by treatments supported by evidence.
(2015)
To examine these questions, the study used relevance mapping, an empirical methodology that compares youths in a given clinical population with participants in published randomized trials to determine who may be “coverable” by EBTs and which treatments may collectively be most applicable
(2011)
This methodology offers promise for the empirically guided selection and coordination of EBTs, thereby addressing one aspect of the gap between knowledge and practice.
(2009)
The model involved initial data reduction of 615 treatment protocol descriptions by means of a set of codes describing discrete clinical strategies, referred to as practice elements. Practice elements were then summarized in profiles, which were empirically matched to client factors (i.e., observed problem, age, gender, and ethnicity). Results of a profile similarity analysis demonstrated a branching of the literature into multiple problem areas, within which some age and ethnicity special cases emerged as higher order splits. This is the 1st study to aggregate evidence-based treatment protocols empirically according to their constituent treatment procedures, and the results point both to the overall organization of therapy procedures according to matching factors and to gaps in the current child and adolescent treatment literature.
XResearch Focus
5. Measurement of Anxiety and Depression in Youth
Some of this research looked further into the The Tripartite Model: typically refers to a psychological model that involves three components or factors
Negative Affect (NA): This factor involves general feelings of distress and discomfort. It is common to both anxiety and depression.
Positive Affect (PA): This factor relates to the experience of positive emotions and mood. Low positive affect is associated with depression.
Physiological Hyperarousal (PH): This factor is specific to anxiety and involves physiological symptoms of arousal, such as increased heart rate or muscle tension.
One paper found:
a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested
(b) the tripartite model of emotion appears to have increasing support and utility in child samples
The relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.
One strand of this research led to the development of the Revised Child Anxiety and Depression Scales, now one of the most widely used measures for symptom dimensions of childhood anxiety disorders.
Clinical interview experience
It was not always appropriate to stay on script, but there was minimal structured guidance when we went off-script.
What’s a recent paper(s) you read (relevant to lab) that you found interesting? Future Directions in Youth and Family Treatment Engagement: Finishing the Bridge Between Science and Service
One recent paper I read discusses possible future directions for youth and family treatment engagement and discusses this idea of completing the bridge between science and service.
“Bridge” analogy:
The bridge is built to allow the transportation of evidence-based treatments
into practice (or service) for the clinical populations that would benefit from such work.
However, currently, this bridge is full of potholes, and debris, and there’s confusing road lines, so overall, there is several barriers making it challenging to get across the bridge from one side to the other.
The paper suggests one particular challenge to getting across that bridge is treatment engagement.
Even when community therapists deliver evidence-based care with high quality, around half of families withdraw from treatment, and many others struggle to actively participate in their care.
Of those who do enroll in treatment, between 50% and 70% terminate earlier than recommended by their therapists, meaning that they withdraw from therapy before achieving the expected benefits
Youths of color attend fewer visits within a specified timeframe and are more likely to discontinue treatment than are white youths
(I like to think of it as the engagement bridge….people who are already in service
In addition to that I’ve thought how do we make this bridge attractive and interesting for people to come take a look)
(particularly individuals from disadvantaged groups who may have mistrust with health care providers and mental health care providers.
For instance:
National survey findings suggest that only one-third of youths with mental health needs access services
Moreover, youths and families of color are even less likely to access services than are their white/European American counterparts
Other traditionally underserved groups, including those who have immigrated to the U.S. those with incomes below the poverty line and those living in rural regions have well-documented service use disparities.
__________________________________
Re-focusing on this “engagement bridge”
The paper proposes that there is a dire need for a more robust bridge and discusses four priorities related to treatment engagement: conceptualization, theory, measurement, and interventions.
Conceptualization: involves organizing ideas about how to represent a phenomenon
Example: REACH (Relationship, Expectancy, Attendance, Clarity, and Homework)
Theory: theories aim to explain phenomena by specifying how concepts relate to one another and by providing testable hypotheses
The intervention design drew on two guiding theories: coordination theory by and Knowledge to Action (KTA) framework
Measurement: Measurement involves the quantification of a phenomenon (e.g., score on an alliance survey).
My Thoughts about Therapy instruments for youths and caregivers (MTT-Y and MTT-CG, respectively).
Intervention:
Integrates the above concepts
Coordinated knowledge system–> (Reaching Families Engagement System (RFES;)
The Reaching Families Engagement System (RFES) was created as a coordinated knowledge system to support decisions in the mental health service process. It aligns with Graham et al.’s Action Cycle, addressing engagement problems, intervention selection, preparation, delivery, and evaluation. RFES incorporates three knowledge resources: MTT questionnaires for engagement assessment, a therapist worksheet for reflection and problem mapping, and a library of brief guides for specific engagement procedures. Developed based on Managing and Adapting Practice (MAP) principles, RFES follows a goal-directed clinical reasoning process, utilizing a recursive loop akin to a Deming cycle. Initial research indicates promising results in identifying and addressing engagement problems, with further investigation in larger trials needed.
Make analogy: (poetry) as a future researcher I am determined to reduce the potholes, debrie, paint the road lines, and make an overall functioning bridge. (guard rails to guide)
XMAPS (From paper that best reflects lab).
The passage emphasizes the need for a shift from traditional, static “maps” in mental health service systems to more dynamic and personalized “GPS” systems. It discusses the limitations of current approaches that lack flexibility in responding to individual client needs. The importance of modular designs, collaborative frameworks, and knowledge resources is highlighted. The Collaborative Design framework is introduced, emphasizing the balance between design-time and run-time control. The MATCH model is presented as an example of a collaborative service architecture, setting standards for performance through codified modules. The concept of “Relevance Mapping” in service systems, particularly in the Managing and Adapting Practice (MAP) system, is discussed. MAP is described as a treatment selection, design, implementation, and evaluation kit, utilizing knowledge resources and clinical dashboards to provide scientifically informed and personalized treatment options for youths. The passage underscores the significance of addressing system exceptions and ensuring access to evidence-based treatments for all youths.
