The Story of the Evolution of CBTp in Washington State
Despite an evidence base that spans more than 20 years, CBTp is not widely available in community mental health settings in the United States. Nationally, it’s estimated that only 0.1% of all licensed clinicians in the United States are trained in CBTp. There are nearly 60,000 Washingtonians who are diagnosed with schizophrenia. Prior to 2015, CBT for psychosis was unavailable among the state’s 375 community mental health agencies and, if resources did exist, few people knew where to access it. Recognizing this unmet need within the State, in 2014 Dr. Monroe-DeVita secured funding from the Division of Behavioral Health and Recovery (DBHR) and an anonymous donor to begin to train the Washington State mental health workforce in CBTp. In 2015, Dr. Kopelovich joined the UW implementation team and successfully renewed the public-private funding that has permitted for a rapid expansion of CBTp dissemination and implementation.
Presently, more than 250 clinicians across 17 counties in Washington State have been trained in CBTp from the UW CBTp implementation team. One hundred and sixteen providers have successfully completed certificate requirements, which includes a required number of consultation sessions and a CBTp session fidelity review, depending on the level of services provided. The UW CBTp implementation team recognizes that, in order to effectively address the science-to-practice gap, we must exponentially increase the number of trained CBTp providers while maintaining high standards for competence and adherence. Two recent implementation enhancements permit the expansion of dissemination and implementation efforts: introducing CBTp Stepped Care and the CBTp ECHO Clinic. See the Map of Current Sites to locate a CBTp-trained agency in your county.
Former CBTp Clients
“The voices are still there—but they seem mellower. The big change came around self-esteem. Having self-esteem is a new thing. I took a big step and asked a girl out. Even if we don’t go out, I feel like taking the risk was the important thing for me. My friends have told me I walk around more chipper—I’m not walking around with my shoulders slumped over. It’s only been five sessions but I can see a difference.”
“(CBTp) has had a positive impact and is really helping me to move forward. It helps with overcoming voices and looking at my experience. It’s very helpful in changing the way that I think about my experience.”
“CBTp has been really useful for keeping me balanced. Prior to this method of therapy, I had other therapists, but a lot of that treatment — not to dis them — did not have the same positive results that CBTp did. My therapy has been a mix of data analysis (looking at my mood chart and stuff like that) and talk therapy. The talk therapy doesn’t feel palliative because I have gained skills that I hope to use for a long time."
Mental Health Clinicians Providing CBTp
"I’ve been excited and grateful for the opportunity to receive training from the UW CBTp team. I’ve learned new skills, received excellent training and supervision supports, and have seen how helpful these skills can be for my clients. People come into my office enthusiastic about how their symptoms are decreasing and how their coping skills have increased and the positive impact this has on their lives and they're meeting their goals. One individual I am currently working with has been able to successfully reduce their medications after several previous attempts to do so. CBTp training has re-energized my approach to my work and made me optimistic about the future of community mental healthcare. -- Martha Linder, LICSW