Research

The overall goal of my research is to improve the availability, accessibility, and quality of mental health services in under-resourced communities to improve health equity for marginalized children and adolescents.

Dissertation Research

Assessing real-world access to community-based mental health services for adolescents: A mixed-methods simulated client study

My dissertation seeks to understand how to increase timely access to effective mental health services delivered in community-based outpatient health agencies that serve adolescents enrolled in Medicaid. Using mixed-methods, I am assessing access to trauma-informed psychosocial mental health services for adolescents who have Medicaid vs. private insurance within federally qualified health centers and community mental health centers during the rapid transition to telehealth.

In partnership with local public health officials and organizational leaders, my study will develop concrete policy and practice recommendations on how to increase timely access to mental health services. Given the significant gap that exists between youth who need mental health services and those who receive them, my hope is the data collected through my dissertation will be critical in informing policy and advocacy efforts as well as the development of interventions to improve access.

My dissertation has received funding from the Society for Social Work Research, the Horowitz Foundation for Social Policy, and the Crown Family School of Social Work, Policy, and Practice.

Additional Research

Predictors of turnover in community mental health settings:

Through my work as a clinical research coordinator at the University of Pennsylvania’s Center for Mental Health, I contributed to our understanding of factors that predict turnover, or attrition, of therapists within community mental health settings, and what the implications are for clients when therapists leave their agency. In one study based on qualitative interviews with therapists who had left their agency, we found that almost half of therapists reported leaving their agency due to financial reasons. In a larger study assessing predictors of evidence-based practice (EBP) use, I led an investigation that assessed the interaction between participation in a system-sponsored EBP training, therapist’s perception of financial strain, and the likelihood of leaving their agency a year later. We found that therapists who participated in an EBP training were less likely to leave their agency, even if they experienced high financial strain. These contributions lay a formative groundwork for future work developing organizational interventions to improve retention within community mental health settings.

  • Adams, D. R., Williams, N. J., Becker-Haimes, E. M., Skriner, L., Shaffer, L., DeWitt, K., Neimark, G., Jones, D. T., Beidas, R. S. (2019). Therapist financial strain and turnover: Interactions with system-level implementation of evidence-based practices. Administration and Policy in Mental Health, 46(6), 713-723. PMCID: PMC7083521.
  • Babbar, S., Adams, D. R., Becker-Haimes, E., Skriner, L., Kratz, H. E., Cliggett, L., Inacker, P., Beidas, R. S. (2018). Therapist turnover and client engagement. Child and Youth Services Review, 93, 12-16.
  • Beidas, R. S., Marcus, S., Benjamin-Wolk, C., Powell, B., Aarons, G. A., Evans, A., … Adams, D. R., Walsh, L. M., Babbar, S., Barg, F., & Mandell, D. S. (2016). A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system. Administration and Policy in Mental Health, 43(5), 640-649. PMCID: PMC4715798.

Fostering Community-academic Partnerships:

I have advanced our understanding of the development, sustainment, and history of community-academic partnerships (CAPs), especially in the fields of social work and implementation science. Community-academic partnerships are a key strategy to bridge the research-to-practice gap, reducing health disparities for marginalized populations. However, little is known about how and why they are formed and sustained, and their mechanisms of change. In an independent first-author paper, I presented a historical analysis of the role of social work in CAPs, encouraging the field to engage with this methodology more frequently given the field’s historical roots in participatory research. I co-authored a paper that deepened our understanding of the mechanisms that underlie the successful development and sustainment of CAPs in implementation research. This work has prepared me to engage with CAPs as a social work scholar and has laid the groundwork for future work that will further develop the science of CAPs.

  • Adams, D. R. (2018). Social works role in collaborative community-academic partnerships: How our past informs our future. Social Work, 64(1), 19-28.
  • Pellecchia, M., Mandell, D. S., Nuske, H., Azad, G., Benjamin-Wolk, C., Maddox, B. B., Reisinger, E. M., Skriner, L. C., Adams, D. R., Stewart, R. S., Hadley, T., Beidas, R. S. (2018). Community academic partnerships in implementation research. Journal of Community Psychology, 46(7), 941-952. PMID: 30565736.

Trauma-informed Policy and Practice:

As a research coordinator for the Philadelphia Alliance for Child Trauma Services (PACTS) through the University of Pennsylvania, I contributed to a set of studies that describe the creation and evaluation of a trauma-informed publicly funded behavioral health system for children and adolescents who have experienced a traumatic event. It is critical that youth who have experienced traumatic events have access to evidence-based interventions. Yet, evidence-based treatments for trauma are difficult to access, especially in low-resource neighborhoods. Our work on the dissemination of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) through the PACTS network has contributed to knowledge on how to implement evidence-based practices in low-resource neighborhoods. We examined the effectiveness of TF-CBT in low-resource settings and family perceptions of TF-CBT, finding that further work must be done to translate interventions to real-world settings. Contributing to these studies has prepared me to rigorously assess access to evidence-based, trauma-informed treatments for low-income youth.

  • Beidas, R. S., Adams, D. R., Kratz, H. E., Jackson, K., Berkowitz, S., Zinny, A., … & Evans, A. C. (2016). Lessons learned while building a trauma-informed public mental health system in the City of Philadelphia. Evaluation Program and Planning, 59, 21-32. PMCID: PMC5048572.
  • Rudd, B. N., Last, B., Gregor, C., Jackson, K., Berkowitz, S., Zinny, A., Kratz, H. E., Cliggitt, L., Adams, D. R., Walsh L. M., & Beidas, R. S. (2019). Benchmarking treatment effectiveness of community delivered trauma-focused cognitive behavioral therapy. American Journal of Community Psychology, 64(3-4), 438-450. PMCID: PMC7136484.
  • Last, B. S. Rudd, B., Gregor, C., Kratz, H. E., Jackson, K., Berkowitz, S., Zinny, A., Cliggitt, L., Adams, D. R., Walsh, L., Beidas, R. S. (2020). Sociodemographic characteristics of youth in a trauma-focused cognitive behavioral therapy effectiveness trial in the city of Philadelphia. Journal of Community Psychology, 48(4), 1273-1293. PMCID: PMC7261621.
  • Okamura, K. H., Skriner, L. C., Becker-Haimes, E. M., Adams, D. R., Becker, S., Kratz, H. E., Jackson, K., Berkowitz, S., Zinny, A., Cliggitt, L., & Beidas, R. S. (2020). Perceptions of evidence-based treatment among consumers receiving Trauma Focused-Cognitive Behavior Therapy. Journal of Child and Family Studies, 29, 1712-1722.

Predictors of Evidence-based Practice Use:

In my role as a clinical research coordinator at the University of Pennsylvania’s Center for Mental Health, I contributed to our understanding of individual and organizational factors that predict whether clinicians use evidence-based practices (EBPs) in community mental health centers. Increasing access to EBP in public systems is essential for improving the mental health outcomes of marginalized populations. Improved understanding of which factors predict EBP use could guide future implementation efforts to ensure effective adoption, implementation, and sustainment of evidence-based practices. We found that both individual and organizational factors significantly predict therapist use of EBPs. My role in these projects involved data collection, data cleaning, qualitative data analysis, and manuscript writing and preparation. Contributing to these studies has prepared me to rigorously assess factors that predict access to trauma-informed treatments.

  • Beidas, R. S., Stewart, R., E., Adams, D. R., Fernandez, T., Lustbader, S., Powell, B. J,… & Barg, F. (2016). A multi-level examination of stakeholder perspectives of implementation of evidence-based practices in a large urban publicly-funded mental health system. Administration and Policy in Mental Health, 43(6), 893-908. PMCID: PMC4903949.
  • Beidas, R. S., Skriner, L., Adams, D. R., Benjamin Wolk, C., Stewart, R. E., Becker-Haimes, E., Maddox, B., Rubin, R., Weaver, S., Evans, A. C., & Mandell, D. S. (2017). The relationship between consumer, clinician, and organizational characteristics and use of evidence-based and non-evidence-based therapy strategies in a public mental health system. Behavior Research and Therapy, 99, 1-10. PMCID: PMC5681428.
  • Skriner, L., Wolk, C. B., Stewart, E., Adams, D. R., Rubin, R., Evans, A., & Beidas, R. S. (2018). Therapist and organizational factors associated with participation in evidence-based practice initiatives in a large urban publicly-funded mental health system. Journal of Behavioral Health Services and Research, 45(2), 174-186. PMCID: PMC5654710.
  • Beidas, R. S., Williams, N., Becker-Haimes, E., Aarons, G., Barg, F., Evans, A., Jackson, K., Jones, D., Hadley, T., Hoagwood, K., Marcus, S., Neimark, G., Rubin, R., Schoenwald, S., Adams, D. R., Walsh, L., Zentgraf, K., & Mandell, D. S. (2019). A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia. Implementation Science, 14(67), 1-13. PMCID: PMC6588873.
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