CROPP Projects

CROPP is committed to improving mental health and wellness services for underserved populations through program development, selection, and implementation consultation, as well as practice-based participatory research. In essence, CROPP helps mental health care agencies learn about and improve their services via systematic data-based feedback loops. CROPP's practice-based participatory research model entails true collaboration with practice sites in discovering high leverage learning opportunities and feasible yet rigorous research and evaluation strategies.

Below is a list of recent and current CROPP projects and products.

CHILD/ADOLESCENT INTEGRATED CARE EVALUATION
NAMI NH CONNECT SUICIDE PREVENTION PROGRAM EVALUATION
CHESIRE MEDICAL CENTER/DARTMOUTH HITCHOCK KEENE VISION 2020
INTEGRATED CARE EVALUATION
PSC THERAPUETIC RESPONSIVENESS TRAINING PROJECT
ANE RURAL COLLABORATIVE CARE PROJECT
ANE/MFS COLLABORATIVE CLINICAL CARE PROJECT
ANE/MFS ADOLESCENT BRIEF PSYCHOTHERAPY TRAINING PROJECT
SUICIDE PREVENTION PROGRAM EVALUATION
PSC TLDP TRAINING PROJECT
SERVICENET TIME-LIMITED DYNAMIC PSYCHOTHERAPY TRAINING PROJECT

CHILD/ADOLESCENT INTEGRATED CARE EVALUATION

PROJECT PARTNERS: Child Health Services

NAMI NH CONNECT SUICIDE PREVENTION PROGRAM EVALUATION

January 2010 - present
DESCRIPTION: The NH chapter of the National Alliance on Mental Illness has obtained a 1.5 million dollar grant under the Garrett Lee Smith/Youth Suicide Prevention program of the federal Substance Abuse and Mental Health Services Administration (SAMSHA). NAMI will be using this funding to implement a 3-year, statewide suicide prevention program. NAMI has awarded CROPP a 225K contract to provide program evaluation services over the 3-year term of this project. Aims of this evaluation are to identify, collect, and report information that assists NAMI NH in refining and expanding the reach of its suicide prevention and postvention initiatives. Sources of evaluation data will include interviews, surveys, tracking systems, and other records maintained by the intervention program. Evaluation will address the process, outcomes and impact of the statewide prevention program, as well as contribute to the national cross-site evaluation. The resulting evaluation data will be driven back into stakeholder-driven efforts to improve the program over time.
PROJECT PARTNERS: NAMI NH, Connect Suicide Prevention Project (NAMI NH)
FUNDING: 225K NAMI NH - 3 year contract

CHESIRE MEDICAL CENTER/DARTMOUTH HITCHOCK KEENE VISION 2020

January 2009 - present
DESCRIPTION: Initiated by Cheshire Medical Center/Dartmouth-Hitchcock Keene, this project aims "to make the Keene area the healthiest community in the country by 2020." Antioch has been contracted to develop and conduct ongoing evaluation of this initiative. CROPP faculty consult with Anne Nordstrom, the primary evaluator on the project.
PROJECT PARTNERS: Cheshire Medical Center/Dartmouth-Hitchcock Keene

INTEGRATED CARE EVALUATION

September 2009 - present
DESCRIPTION: Mental, behavioral, and substance use conditions exact a staggering toll on society and place a heavy burden on primary care, where they are commonplace yet under detected and inadequately treated. Research indicates that integrating behavioral health services within primary care can work under relatively ideal conditions, but we have little information about whether it actually works in the real world of primary care. The magnitude of the behavioral health burden, the ubiquity of these conditions in primary care, and the consequent urgency of finding more effective and practical ways to address this dimensions of health, jointly establish the importance of this study: to generate knowledge about integrated care - and how to improve it - under routine conditions of primary care.

The Integrated Care Evaluation (ICE) project moves beyond the randomized clinical trial method of research to explore and improve integrated care as financially self-sustained in four clinics serving rural and/or underserved populations. The project is designed to: 1) enhance understanding of the allocation, outcomes, and health care expenditures associate with integrated primary care as delivered in naturalistic, underserved settings; 2) demonstrate the effectiveness of participatory practice-based research - as distinct from a "dissemination" model based on randomized clinical trials - for improving health care delivery systems; and 3) advance integrated health care policy in New Hampshire (and beyond). As far as we know, this project is the first effort to formatively evaluate integrated care as practiced in naturalistic settings, to feed the resulting data back into stakeholder-driven, site-specific quality improvement initiatives, and to engage third party payers (Medicaid) in designing summative evaluation to inform health care policy.

PRODUCTS: Logic Models: ICE Logic Model, ICE Project Overview
Evaluation designs: ICE Pilot Design, ICE Baseline/QI Design

Presentations:
Fauth, J., Tremblay, G., & Blanchard, A. (2009, October). The Integrated Care Evaluation project. In J. Fauth (Chair), Practice-based Research. Symposium conducted at the Meeting of the New England Chapter of the Society for Psychotherapy Research, Williamstown, MA.
Powerpoint

Fauth, J., Tremblay, G., & Blanchard, A. (2010, June). Participatory practice based research for improving clinical practice from the ground up: The integrated care evaluation project. In J. Fauth (Chair), Beyond Randomized Clinical Trials: Alternative methodologies for enhancing knowledge, developing theory, and improving practice. Symposium conducted at the International Meeting of the Society for Psychotherapy Research, Asilomar, CA.
Abstract

FUNDING

Planning and pilot phases - 250K Endowment for Health
Application for Baseline and QI Phases - 2.4 M Agency for Healthcare Research and (resubmission submitted March, 2010)

PSC THERAPUETIC RESPONSIVENESS TRAINING PROJECT

September 2002 - present
DESCRIPTION: Since Fall 2002, CROPP, with the support of the PSC's director (Victor Pantesco, EdD) and associate director (George Tremblay, PhD), helped initiate the incorporation of the Outcome Questionnaire-45 (OQ-45), a widely utilized outcome measure, into the PSC's daily clinical practice. The OQ-45 is now given to clients every other session to aid in tracking clinical progress. The OQ-45 requires only 5-10 minutes to complete, yet yields helpful information about clients' general level of distress. Using a system originally designed with the help of Greg Gard PsyD, one of our graduates (Greg worked with the original director of CROPP, Dr. Gene Pekarik), the OQ-45 is administered electronically using either a palm pilot or computer, thereby eliminating the need for manual entry or scoring of OQ-45 data. Best of all, this method of administration and scoring yields real-time, clinically pragmatic reports that summarizes the OQ-45 data and tracks each client's progress over time, which has been shown to increase the efficiency and effectiveness of psychotherapy (e.g., Lambert, Whipple, Smart, & Vermeersch, 2001).
PROJECT PARTNERS: Psychological Services Center

ANE RURAL COLLABORATIVE CARE PROJECT

October 2006 - September 2008
DESCRIPTION: CROPP received a Planning, Convening, and Technical Assistance Grant ($42,123) from New Hampshire's Endowment for Health to develop a model program for integrating mental and behavioral health care into primary care settings in Sullivan County, a rural and medically underserved area of the state. CROPP collaborated with several major health care stakeholders in the region, including New London Hospital, Valley Regional Hospital, and West Central Behavioral Health. The planning efforts are designed to mobilize the commitment of key stakeholders via a careful planning process that balances national best practice standards with local realities and constraints. The planning process resulted in the development of a model integrative health care program, as well as funding to implement and test the model in Sullivan County. The bulk of the grant money was awarded to students to work directly with area stakeholders, conduct literature reviews on best practices, and conduct research on stakeholder readiness for integrative care.
PROJECT PARTNERS: Endowment for Health, New London Hospital, Valley Regional Hospital, West Central Behavioral Health

PRODUCTS
Reports:
Goranson, A., Fauth, J., Phillips, M. (2008). Rural integrative best practices. Prepared for Endowment for Health and Rural Integrative Care Project stakeholders.
Rural Integrative Best Practices

Phillips, M. & Fauth, J. (2008) Readiness study results: Attitudes of patients, primary care providers, and medical administrators toward integrative care at Newport Health Center. Prepared for Endowment for Health and Rural Integrative Care Project stakeholders.
Readiness Study

Goranson, A., Fauth, J., Phillips, M. (2008). Rural integrative mental health: Best practices extended bibliography. Prepared for Endowment for Health and Rural Integrative Care Project stakeholders.
Literature Review

FUNDING: 42K NH Endowment for Health

ANE/MFS COLLABORATIVE CLINICAL CARE PROJECT

PROJECT PARTNERS: Monadnock Family Services

ANE/MFS ADOLESCENT BRIEF PSYCHOTHERAPY TRAINING PROJECT

DESCRIPTION: This project was designed to study the effects of providing MFS therapists with timely client progress information and training in brief psychotherapy on the effectiveness and efficiency of their therapy with adolescent clients (age 12-18). Specifically, the objectives of the study are threefold: 1) to assess the effects of providing timely client progress information to therapists on client process and outcome; 2) to assess the effects of a brief therapy training program on client process and outcome; and 3) to assess therapists' perceptions toward and application of a brief therapy training program. Providing timely client progress information has shown to increase both the efficiency and effectiveness of psychotherapy for adult clients. This line of research has not, however, been extended to adolescent clients. Similarly, psychotherapy training is often offered in community settings, yet almost nothing is known about the effectiveness of such trainings. In fact, we are not aware of any such studies for therapists working primarily with child and adolescent clients in a naturalistic setting. Likewise, little is know about therapists' perceptions toward and application of such trainings. Overall, the hope was to the responsiveness, efficiency, and effectiveness of adolescent therapy within a context of enhanced clinical feedback, in-depth training, and supplemental consultation.

PROJECT PARTNERS: Monadnock Family Services

PRODUCTS
Presentations:
Gates, S., Boles, S., & Fauth, J. (2007, June). Organizational and cultural issues in research designed to increase the therapeutic responsiveness of adolescent psychotherapy in a community agency project. Panel Presentation at the Society for Psychotherapy Research, Madison, WI Paper.

Gates, S., Boles, S., Lord, H., & Fauth, J. (2006). Lessons learned: A community-based therapy training outcome evaluation project. Presentation at the North American Society for Psychotherapy Research 2006 Annual Conference in Columbus, Ohio Slides.

SUICIDE PREVENTION PROGRAM EVALUATION

June 2006 - December 2008
DESCRIPTION: CROPP served as the program evaluator for a suicide prevention grant awarded to Keene State College Counseling Center. Project was designed to prevent suicide on campus via gatekeeper training, social norms promotion, and town-gown collaboration. For those interested, the Keene State College Counseling website provides many helpful links to this project and the topic of suicide prevention.
PROJECT PARTNERS: Keene State College Counseling Center

PSC TLDP TRAINING PROJECT

September 2002 - July 2005
DESCRIPTION: CROPP conducted research exploring the effects of training in Time-limited Dynamic Psychotherapy (TLDP). This project lasted for three years. Results of the research revealed several interesting findings: 1) the training improved the effectiveness of the therapy provided by participants, but only during the active training phase and 2) therapists' emotions were significant predictors of the process of TLDP.
PROJECT PARTNERS: Psychological Services Center

PRODUCTS
Presentations:
Fauth, J., Mathisen, A., Smith, S. (2006). Reflections on a Time-Limited Dynamic Psychotherapy training project: New directions for brief psychotherapy training. Presentation at the North American Society of Psychotherapy Research 2006 Annual Conference in Columbus, Ohio
Abstract
Slides

Fauth, J. (2005). Novice therapists' use of self: Training issues and implications. Presentation at the American Psychological Association Conference 2005. See abstract for: "Reflections on a Time-limited Dynamic Psychotherapy training project: New directions for Brief Psychotherapy Training."

Mathisen, A, & Fauth, J. (2005). The influence of doctoral trainees' negative emotions on the process of Time-limited Dynamic Psychotherapy. Presentation at Society of Psychotherapy Research International 2005 Annual Conference in Montreal
Abstract
Slides

Smith, S., Fauth, J., & Mathisen, A (2004). A naturalistic study of the effectiveness of training in Time Limited Dynamic Psychotherapy for clinical psychology trainees. Presententation at the 2004 North American Society for PsychotherapyAnnual Conference in Springdale, UT.
Abstract
Handout

SERVICENET TIME-LIMITED DYNAMIC PSYCHOTHERAPY TRAINING PROJECT

DESCRIPTION: CROPP developed, implemented, and completed a 9-month training in Time-limited Dynamic Psychotherapy (Strupp & Binder, 1984) for interested clinicians at Servicenet, a community-based mental health center in Northhampton, MA. The trainings were co-facilitated by Jim Fauth, the director of CROPP, and Ben Skolnik, an ANE student. The training included six 3-hour workshops in which didactic information and demonstrations were presented and practice exercises were conducted. The training also included biweekly peer supervision sessions for 6 months supervised by Ben and Jim. Program evaluation revealed that the trainings were well received by clinicians but that contextual/organizational factors served as barriers to integrating the training fully into their work with clients.
PROJECT PARTNERS: Servicenet Inc.