Technology-Based Tools to Enhance Quality of Care in Mental Health Treatment
Condition: Post Traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      Nearly 9 million U.S. children (1 in 8) meet criteria for at least one mental health disorder
      at any point in time. Effective treatments exist for these disorders, but children and
      families who seek services rarely receive them; mental health providers need more support in
      the delivery of these interventions to ensure that children and families are receiving the
      best quality care. This project aims to improve the delivery of best practices for families
      who seek mental health care by developing creative, technology-based resources for providers.
      Once we have completed development of the tablet-based resources, we will conduct a small
      randomized study with 20 families to examine the feasibility and prepare for a large study to
      test the effectiveness of the resources.
    

Detailed description: 
      Efficacious treatments exist for a wide range of psychiatric disorders, but these treatments
      rarely are delivered with high fidelity in mental health service settings. Research is needed
      to ensure that these treatments become more accessible in day-to-day clinical care.
      Innovative, low-cost approaches are essential, particularly in settings where resources are
      limited. Technological advances have made possible the development of low-cost and highly
      efficient (i.e., minimal time burden to providers) resources that can be delivered via
      internet, tablets, Smartphone, and other technologies to improve quality of care. Research is
      needed to inform these efforts and evaluate the feasibility and utility of this approach.
      Widespread availability of technology-based resources may represent an important step toward
      making evidence-based treatment more accessible to children and adults if research supports
      their utility. Our research team has led the development and evaluation of several e-health
      and e-learning tools for patients and providers. This has positioned us well to develop and
      rigorously evaluate a technology-based toolkit to enhance providers' delivery of
      evidence-based treatment. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), an
      empirically supported treatment for children with posttraumatic stress reactions, is widely
      used by community providers and is ideal for testing the use of technology-based resources
      because the protocol addresses multiple symptom domains as well as both children and
      caregivers. We propose to develop and examine the feasibility of a technology-based toolkit
      for TF-CBT (e-TFCBT) that is designed to enhance the quality, accessibility, and efficacy of
      treatment. The toolkit will consist of web-based applications that are optimized for use on
      mobile devices. We conducted an interview of 21 nationally certified trainers in TF-CBT to
      guide an initial list of resources that are intended to address known problems with fidelity
      and engagement. Providers will use most of these resources in session to maximize fidelity
      and enhance child engagement and learning. The resources will be alpha-tested with families
      and providers and then beta-tested with providers; qualitative data will be used to guide
      refinements to the toolkit. We will then conduct a feasibility trial with 20 families.
      Results will provide valuable preliminary data in preparation for a randomized controlled
      trial to examine the additive benefits of web-accessible resources that assist providers in
      high-fidelity delivery of evidence-based care.
    

Intervention name(s): eTF-CBT; TF-CBT
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Standard treatment with the edition of in-treatment/session iPad activities.; Treatment as usual.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment