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Heather MacPherson, PhD Candidate

Award Name Heather MacPherson, PhD Candidate

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Evaluating the implementation and effectiveness of Multi-Family Psychoeducational Psychotherapy in community settings

Heather MacPherson, PhD CandidateHeather MacPherson, PhD Candidate, is a graduate student in clinical psychology that recently received a CCTS TL1 award for her research in psychotherapy implementation and effectiveness. Under the supervision of Mary A. Fristad, PhD, she is evaluating the implementation and effectiveness of Multi-Family Psychoeducational Psychotherapy (MF-PEP) in community settings.

MF-PEP is a group-based psychotherapy for children ages 8 to12 and their parents. Up to ninety-six families will participate in MF-PEP at three of Nationwide Children’s Hospital’s Close to Home Centers. Community therapists will be trained in the intervention and all sessions will be audio-recorded. MacPherson’s goal is to evaluate the treatment when conducted in a real-world setting, to determine if the same positive effects observed in efficacy trials translate when MF-PEP is implemented in the community.

“Research has identified efficacious evidence-based treatments. However, these interventions are not always implemented in practice settings. When treatments are conducted in the community, research suggests they are not as effective as observed in rigorous efficacy trials,” MacPherson said.

In order to put this into action, MacPherson first needed to partner with community administrators and supervisors to determine if they were interested in implementing and evaluating community-based MF-PEP, then IRB approval was obtained. Subsequently, community therapists completed training with experienced clinicians or Fristad. Lastly, eligible families were recruited and completed prescreening interviews prior to starting MF-PEP.

MacPherson said this project has provided her insight into the application of effectiveness and community-based research. She’s learned how difficult community-based research can be, and the unique barriers and facilitators which set it apart from efficacy or lab-based research.

In addition, she’s learned how to partner with the community and foster open, bidirectional communication to lead to the successful implementation and evaluation of community-based interventions.

She completed a pilot study for her thesis from 2008 to 2010 with pre- and post-treatment measures. The current project started in 2011 and includes improved measures, long-term follow-up, and audio recordings for evaluating treatment fidelity. She is about one third of the way through the current project.

Though they were originally going to videotape groups, “It proved cumbersome and expensive to purchase and set-up video equipment. Families found it would be more invasive. Audio-recording proved more cost-effective and less invasive,” MacPherson said. In addition, families can complete phone assessments, rather than interviews at community clinics, for convenience.

Initial results suggest MF-PEP is acceptable to community therapists and families presenting for treatment at the Close to Home Centers and may lead to improved clinical outcomes, though more data is needed. Randomized controlled trials demonstrated that MF-PEP is an efficacious treatment when compared to a waitlist control.

Children who completed treatment demonstrated improved mood symptom severity over time. In addition, parents were more knowledgeable about mood disorders and appropriate treatments, and subsequently accessed higher-quality services for their children.

MacPherson described future plans she has regarding evaluation of community-based MF-PEP.

“The current study will determine if the same positive effects demonstrated in efficacy trials of MF-PEP are observed in the community. Future effectiveness trials using a control comparison on a larger scale and in a different practice setting will provide more definitive evidence for the effectiveness of community-based MF-PEP.”

By Nuala McSweeney, Wednesday, April 4, 2012

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