Alayna L. Park
University of California, Los Angeles
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Publication
Featured researches published by Alayna L. Park.
Journal of Consulting and Clinical Psychology | 2017
Bruce F. Chorpita; Eric L. Daleiden; Alayna L. Park; Alyssa Ward; Michelle C. Levy; Taya Cromley; Angela W. Chiu; Andrea M. Letamendi; Katherine H. Tsai; Jennifer L. Krull
Objective: This study reports outcomes from a randomized effectiveness trial testing modular treatment versus multiple community-implemented evidence-based treatments for youth. Method: An ethnoracially diverse sample of 138 youth ages 5 to 15 (62 girls, 76 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, disruptive behavior, and/or traumatic stress were treated by community therapists randomly assigned to 1 of 2 conditions: (a) modular treatment, which involved a single modular protocol (i.e., modular approach to therapy for children; MATCH) that allowed flexible selection and sequencing of procedures to fit the chosen treatment focus in the context of measurement feedback, and (b) community-implemented treatment (CIT), which was a county-supported implementation of multiple evidence-based practices for youth. Results: Youth treated with MATCH showed significantly faster rates of improvement over time on clinical and functional outcomes relative to youth in the CIT condition and required significantly fewer sessions delivered over significantly fewer days. Caregiver-reported clinical improvement rates were significantly greater for MATCH (60%) versus CIT (36.7%). Further, youth in the CIT condition were significantly more likely to receive additional psychosocial treatment services and were significantly more likely to use a variety of psychotropic medications during the active treatment phase. Conclusions: These results extend prior findings, supporting the effectiveness and efficiency of a modular, multifocus approach that incorporates monitoring and feedback relative to community implementation of evidence-based treatments.
Administration and Policy in Mental Health | 2015
Alayna L. Park; Bruce F. Chorpita; Jennifer Regan; John R. Weisz
This study examined patterns of evidence-based treatment (EBT) implementation within community settings by evaluating integrity along separate dimensions of practice content (PC; a session included the prescribed procedure) and practice sequencing (a session occurred in the prescribed sequence) within a recent randomized effectiveness trial. We measured whether sessions showed integrity to PC and to flexible or linear practice sequences. Findings revealed that providers tended to incorporate content from the EBT protocol in most treatment sessions, but that the sequencing of the sessions was often modified, suggesting that providers are amenable to evidence-based procedures, but not necessarily their prescribed arrangement.
Journal of Clinical Child and Adolescent Psychology | 2017
Karen Guan; Alayna L. Park; Bruce F. Chorpita
Emergent life events (ELEs)—unexpected stressors disclosed in psychotherapy that have a significant negative impact on the client—commonly occur in community populations of youth and are associated with decreased provider adherence to evidence-based treatment (EBT) in session. The present study extends previous research by examining longer term associations of ELEs with (a) provider adherence to planned EBT practices in subsequent sessions and (b) clinical progress. Data were drawn from the modular EBT condition (MATCH) of the Child STEPs California trial conducted with primarily Latino youth, ages 5–15, who were 54% male (Chorpita et al., 2017). Study 1 utilized data from 57 MATCH participants who reported at least one ELE during treatment. Provider adherence was measured by identifying whether planned practices were covered in either the session in which the ELE was reported or the following session using the MATCH Consultation Record. In Study 2, clinical progress for 78 MATCH participants was assessed using weekly youth- and caregiver-ratings of symptomatology (Brief Problem Checklist) and functioning (Top Problems Assessment). Study 1 revealed that ELEs were associated with reduced adherence to planned practices for at least two sessions. Study 2 demonstrated that each disruptive ELE (i.e., an ELE for which no EBT content was covered) was associated with a 14%–20% slower rate of clinical improvement, with greater declines for functioning and externalizing symptoms. Findings suggest that ELEs can be a major barrier to the effectiveness of an EBT and require further research in order to be addressed effectively.
Journal of Clinical Child and Adolescent Psychology | 2018
Alayna L. Park; Andrew L. Moskowitz; Bruce F. Chorpita
The goal of this study is to explore providers’ patterns of implementation by investigating how community mental health providers selected therapy practice modules from a flexible, modular evidence-based treatment working with youths with comorbid mental health problems. Data were obtained from 57 youths, 5–15 years old, presenting with anxiety, depressive, and/or conduct problems and their 27 providers during their participation in an effectiveness trial involving a modular evidence-based treatment. Although all youths evidenced clinically elevated symptomatology in at least two problem areas, providers targeted youths’ comorbid problems with only about half of their study cases. Practice modules indicated for youths’ comorbid problems were typically used less frequently and with less depth relative to practice modules indicated for youths’ principal clinical problem and were often transdiagnostic in nature (i.e., designed to target more than one problem area). To determine whether providers’ decisions to target youths’ comorbid problems were systematic, multilevel, logistic regression analyses were conducted and revealed that youths’ pretreatment characteristics and time in therapy influenced providers’ patterns of module selection. Providers tend to use, but not exploit, the flexibility allowed by modular EBTs and to focus treatment on youths’ principal presenting problem. In addition, providers appear to make these practice choices in a systematic and rational manner, and whether and which choices are associated with improved outcomes is an important area of future study.
Behavior Therapy | 2018
Leslie R. Rith-Najarian; Bita Mesri; Alayna L. Park; Michael Sun; Denise A. Chavira; Bruce F. Chorpita
Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23-1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.
Journal of Clinical Child and Adolescent Psychology | 2016
Jennifer Regan; Alayna L. Park; Bruce F. Chorpita
Codifying a complex treatment intervention into a manual necessarily involves simplifying procedures, possibly resulting in developer and expert adaptations that align with but are not fully consistent with the manualized content. This study evaluated the integrity of an evidence-based treatment to two information sources (i.e., an expert consultant and the treatment manual) within youth community mental health settings. Consultant recommendations were compared with manual-prescribed therapy procedures, which identified instances of agreement between the sources as well as consultant adaptations. To determine clinicians’ integrity to each source, clinician-reported therapy procedures were compared with consultant recommendations and manual prescriptions. Participants consisted of 30 clinicians, five consultants, and 78 youths (53% male; M age = 9.73 years, SD = 2.84; 81% Latino). Findings indicated that consultants generally recommended content from the manual but also made frequent adaptations that involved changing the sequence or problem focus of practices and adding additional content. Clinicians followed both information sources in a majority of their sessions when these sources agreed but were more likely to follow only one or neither source when they disagreed. Findings suggest that consultants often make adaptations to the manual and that clinicians are more likely to employ recommendations from the manual and/or consultant when the information sources are in agreement. Although it is as yet unclear whether consultant recommendations are effective when they differ from the prescriptions of the manual, results from this study indicate that information sources that supplement treatment manuals may benefit clinical decision making.
Evidence-Based Practice in Child and Adolescent Mental Health | 2016
Karen Guan; Michael E. J. Reding; Alayna L. Park; Bruce F. Chorpita
ABSTRACT Given that providers’ perceptions of evidence-based treatments (EBTs) can influence their implementation and sustainment of these treatments, it is important to identify factors that promote provider satisfaction with EBTs. Despite literature suggesting that consultation (i.e., ongoing implementation support provided by a treatment expert) can enhance provider and client outcomes, little is known about the relationship between consultation and provider satisfaction with EBTs. The present study investigated associations between consultants and provider satisfaction with a modular EBT protocol for youth. Measures of the consultation process (i.e., frequency of discussion, modeling, and role-playing strategies; consultant–manual agreement, defined as consultant recommendation of practices that correspond to the treatment manual) were also explored as predictors of satisfaction. Data were drawn from 64 youth served by 26 providers and 5 consultants as part of a randomized effectiveness trial. Providers rated their satisfaction with the EBT protocol after the completion of each treatment case. Consultation processes were measured using consultant-reported records of their meetings with providers. Results revealed that providers’ satisfaction with the treatment’s responsiveness, but not its effectiveness, varied significantly depending on their consultant. The consultation processes employed by consultants, including level of consultant-manual agreement, were not significantly associated with satisfaction. Findings suggest that there may have been aspects of how consultants were making recommendations, rather than what they were recommending as part of the protocol, that potentially influenced provider satisfaction. Future research may benefit from considered measurement and design of the consultation process to promote provider satisfaction.
Administration and Policy in Mental Health | 2016
Katherine H. Tsai; Andrew L. Moskowitz; Todd E. Brown; Alayna L. Park; Bruce F. Chorpita
Measurement feedback systems (MFSs) can help improve clinical outcomes by enhancing clinical decision-making. Unfortunately, limited information exists to guide the use and interpretation of data from MFSs. This study examined the amount of data that would provide a reasonable and reliable prediction of a client’s rate of symptomatology in order to help inform clinical decision-making processes. Results showed that use of more data predicted greater levels of accuracy. However, there were diminishing returns on the ability for additional data to improve predictive accuracy. Findings inform efforts to develop guidelines on the interpretation of data from MFSs.
Journal of Psychopathology and Behavioral Assessment | 2016
Alayna L. Park; Chad Ebesutani; Deepika Bose; Bruce F. Chorpita
Administration and Policy in Mental Health | 2016
Alayna L. Park; Katherine H. Tsai; Karen Guan; Michael E. J. Reding; Bruce F. Chorpita; John R. Weisz