Blacksburg VA 24061-0355
The Science and Practice Integration (SPI) research space is located at the Psychological Services Center. The SPI lab is under the direction of Lee Cooper, Ph.D. He is a faculty member in and Director of the Clinical Science program, and Director of the Psychological Services Center. The research mission of the SPI research space is to examine ways to build a bidirectional bridge between clinical research and clinical practice, with the foundation of that bridge being training, education, and adaptability. The research goals are to examine, understand, and maximize the accessibility, acceptability, and sustainability of scientifically grounded assessment, intervention, evaluation, and training in settings where practitioners directly deliver services. The research aims and projects include:
- Implementation of standardized and reliable measurement-based care through routine outcomes monitoring to improve treatment adherence, treatment effectiveness and clinical decision making
- Dissemination of adaptations of empirically supported treatments to increase generalizability of psychological interventions
- Systemization of reflective practice training in clinical practicum
Current Research Projects
Measurement-Based Care and Routine Outcome Monitoring
Measurement-based care (MBC) is the systematic evaluation of client symptoms and well-being before or during each clinical encounter to inform behavioral health treatment. At least 10 review articles state that MBC outperforms usual care, with significantly improved outcomes and decreased likelihood of client deterioration while in treatment. Although MBC has been found to improve therapeutic outcomes and is considered an evidence-based practice, it is under-utilized by clinicians due to philosophical (e g., over-reliance on clinical judgment) and practical (e g., time and measure burden) implementation barriers. As such, a gap exists between research findings about the effectiveness of MBC and clinician use of MBC in their clinical practice. To help improve clinician utilization, education and training at the earliest stages of professional development is critical, especially the primary core component of routine outcome monitoring (ROM). Additionally, measure burden, including the number of questionnaire items, ease of measure administration, and cost is an important practical concern. Hence, there is a need for brief, free, and valid measures for use in MBC, especially those that assess general psychological functioning.
Our work in this area has primarily focused on the implementation of routine outcome monitoring in our Clinical Science Ph.D. program’s community-based training clinic (Psychological Services Center: PSC). For this project, we employed an implementation science model to guide and inform our project. Additionally, we utilized a Society for the Science of Clinical Psychology Varda Shoham Clinical Science Training Initiative Grant to purchase a web-based measurement feedback system (Owl Outcomes, now Owl Insights) to house our ROM project. For this project, we were able to show that by directly addressing philosophical and practical barriers with structured training and ongoing support we improved ROM implementation via high utilization and compliance rates among clinical trainees. This six-year project including a detailed training plan was published in Training and Education in Professional Psychology (Cooper, et al., 2019), the flagship journal of the Association of Psychology Training Clinics (ATPC) and Association of Psychology Postdoctoral and Internship Centers (APPIC). Notably, this research project and its associated scholarly products (training plan, oral and poster presentations, and articles) received APTC’s 2020 Clinic Research Award.
In collaboration with colleagues at the University of Washington (Seattle), Utah State University, and Oregon Health Sciences University, we developed and evaluated the Brief Adjustment Scale-6 (BASE-6) as a reliable and valid measure of general psychological adjustment. Our goal was to fill a need in the extant literature for a brief, clinically useful and no-cost measure of functioning. The results of our study supported the reliability and validity of the BASE-6 in relation to several common measures of specific symptomology while also minimizing the time burden for the clinicians and their clients. A manuscript reporting the results of this project was accepted for publication in Psychological Services (Cruz, Peterson, Fagan, Black, & Cooper, 2019). We are currently conducting an additional parametric study of the BASE-6 to include a broader sample of ethnicity, a different collage sample, and PSC clientele.
Dissemination of Adaptations of Empirically Supported Treatments
Efficacious psychological treatments exist for a variety of mental health conditions. Most empirically supported treatments (ESTs) have been designed within randomized controlled trials (RCTs) to treat sole diagnoses. RCT methodologies purposely control a number of factors (e g., co-morbidity, cultural diversity) for scientific rigor. Critics have contested the ability of EST protocols to address the nuances of clinical problems and diversity of clients. They apply primarily to research samples that differ from the clients that front-line clinicians treat and they preclude idiographic case intervention. Subsequently, many individuals who can benefit from some adaptation of these interventions to their individual context and characteristics, and clinicians who can benefit from knowledge of adapted treatments, do not have access to them. Hence, a gap exists between research findings about efficacious treatments and the practice of providing effective services. We have taken the approach that bridging the gap of generalizability of ESTs across different settings and populations lies in a “flexibility within fidelity” approach. Flexibility within fidelity refers to the implementation of an empirically supported treatment protocol in a manner that contains the core ingredients to attain fidelity, but that adapts its implementation to be in line with the individual client presentation.
Graduate students have been primary in the development of this research area. This is where Dr. Cooper's graduate students can conduct dissemination research on the populations and interventions of their specific interest. Successful adaptations have included a case study utilizing an intentional flexibility within fidelity approach to Parent-Child Interaction Therapy (PCIT). The manuscript reporting the case methodology and outcome measures was published in Clinical Case Studies (Gordon & Cooper, 2016). Another example was extending the primary components of Acceptance and Commitment Therapy (ACT), many of which involve experiential and metaphorical exercises with adults, to the developmental stage of adolescence. This project was published in the Journal of Contextual Behavioral Science (Halliburton & Cooper, 2015). Still another example was assessing the feasibility of utilizing an on-line self-monitoring (or feedback) system by young adults to help reduce stress, anxiety, and depression. This was an instance of adapting the primary components of an evidence-based practice, feedback informed treatment, to a community (rather than clinic) sample via online technology. The manuscript of this work was published in Higher Education (Gatto, Miyazaki, & Cooper, 2020). An expansion of this self-monitoring project incorporating emotional regulation techniques is currently underway, funded by a Virginia Tech Institute for Creativity, Arts, and Technology SEAD Mini Grant.
Reflective practice is a process in which practitioners gain skills to identify, name, and change various assumptions and biases in a systematic fashion in order to increase clinical awareness, competency, and effectiveness. Reflective practice is considered a foundational competency of professional and ethical practice. It is especially useful in gaining awareness of cultural diversity issues (e g., personal biases or blind spots). Despite the presence of multiple models of reflective practice and ways of incorporating reflective practice into training, there has been scant evidence on structured and feasible methods or procedures for clinical practicum supervisors to help develop reflective practice ability in their trainees. Dr. Cooper has developed and conducted a number of strategies for student therapists over the years. This experimental work has led him to incorporate an experiential learning cycle model and a systematic process of critical inquiry within clinical supervision. The result has been the development of a feasible and effective structured approach to the training of reflective practice. A multi-year empirical project including a detailed training plan was published in Training and Education in Professional Psychology (Cooper & Wieckowski, 2017). A second phase of training designed identify the critical or necessary factors for learning and implementing reflective practice is currently in progress.
Select Publications and Presentations
- McFayden, T. C., Gatto, A. J., Dahiya, A. V., Antezana, L., Miyazaki, Y., & Cooper, L. D. (in press). Integrating measurement-based care into treatment for autism spectrum disorder: Insights from a community clinic. Journal of Autism and Developmental Disorders. Advance online publication. https://doi.org/10/1007/s10803-020-04824-6
- Gatto, A. J., Miyazaki, Y., & Cooper, L. D. (in press). Help me help myself: Exploring an electronic mental health self-monitoring system in a college population. Higher Education. Advance online publication. https://doi.org/10.1007/s10734-020-00646-8
- Cruz, R., Peterson, A. P., Fagan, C., Black, W., & Cooper, L. D. (2020). Evaluation of the Brief Adjustment Scale-6 (BASE-6): A measure of general psychological adjustment for measurement-based care. Psychological Services, 17(3), 332-342. http://dx.doi.org/10.1037/ser0000366
- Cooper, L. D., Bertagnolli, A., Botanov, Y., Jun, J. J., Valenstein-Mah, H., Washburn, J. J. & Teisler, D. (2020). Training competencies for master’s programs in health service psychology [Special issue: Contemporary issues in clinical training]. The Behavior Therapist, 43(4), 118-126. http://www.abct.org/docs/PastIssue/43n4.pdf
- Cooper, L. D., Murphy, H. G., Delk, L. A., Fraire, M. G., Van Kirk, N., Sullivan, C. P., Waldron, J. C., Halliburton, A. E., Schiefelbein, F. & Gatto, A. (2019, December 2). Implementing routine outcome monitoring in a psychology training clinic: A case study of a process model. Training and Education in Professional Psychology. Advance online publication. http://dx.doi.org/10.1037/tep0000298
- Factor, R. S., Ollendick, T. H., Cooper, L. D., Dunsmore, J. C., Rea, H. M., & Scarpa, A. (2019, July 30). All in the family: A systematic review of the effect of caregiver-administered Autism Spectrum Disorder interventions on family functioning and relationships. Clinical Child and Family Psychology Review. Advance online publication. https://doi.org/10.1007/s10567-019-00297-x
- Cooper, L. D., & Wieckowski, A. T. (2017). A structured approach to reflective practice training in a clinical practicum. Training and Education in Professional Psychology, 11(4), 252-259. http://dx/doi.org/10.1037/tep0000170
- Levine, J. C., Cruz, R. A., Cooper, L. D., Murphy, H. G., Peterson, A. P., Hurd, L. E., & Feldner, M. T. (2017). Integrating routine outcome monitoring into graduate training clinics to advance evidence-based practice. the Behavior Therapist, 40(1), 17-22.
- Gordon, H. M., & Cooper, L. D. (2016). A case study of Parent-Child Interaction Therapy: Flexible client-centered adaptation of an EST. Clinical Case Studies, 15 (2), 126-142. Doi:10.1177/1534650115603819
- Halliburton, A. & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4 (1), 1-11.
- Cooper, L. D. & Schry, A. R. (2013). Does clinical practice inform clinical research? The Clinical Psychologist, 66 (4), pp. 19-25.
The overarching concept of our research is that the state of clinical science with its multitude of empirically supported assessments and treatments along with increasing emphasis and knowledge base of dissemination and implementation affords a special opportunity to integrate science and practice (aka bridging the science-practice gap). Additionally, our in-house training clinic, the Psychological Services Center, provides an optimal platform in which to carry out at least some of this work. Moreover, we are able to further expand and integrate strengths in teaching and service into scholarly work by incorporating training and education as a critical factor in the successful bridging of science and practice. In a similar vein, we also make a concerted effort to include and mentor graduate and undergraduate students, both in and outside my lab, in every project and dissemination product.
We anticipate that with the continued support of the department, graduate students, and obtaining grant monies, we will be able to build and expand upon the current set of published, on-going, and ready-for-manuscript work. Future research goals and projects building upon or extending each of the above aims include the:
- Examination of reliability, validity, and change parameters for commonly used routine outcome measures;
- Evaluation of intervention effectiveness and trajectories of change associated with measurement-based care and routine outcome monitoring;
- Examination of the effects of COVID-19 on patient reported outcome measures within a regional health system (Carilion Clinic Behavioral Health in Roanoke);
- Implementation of measurement-based care with structured training and support of health care professionals within a regional health system (Carilion Clinic Behavioral Health in Roanoke);
- Adaptation of cognitive behavioral strategies to increase accessibility, prevention and treatment of psychopathology within adolescents and young adults; and
- Evaluation of the relationship between the utilization of reflective practice and treatment effectiveness.
We are extremely proud of the education, training, careers, and successes of I-SPI alumni. The following page provides a list of (1) graduate students who are earning, or have earned, their doctoral degree with their dissertation title and their internship, postdoctoral, and current professional positions, and (2) undergraduate students who have so wonderfully and gratefully worked within the I-SPI lab and are pursuing further advanced education and training in health service psychology.
Ph.D. Graduate Students (year of graduation)
Neville Farley Galloway-Williams (2015)
Dissertation: Component analysis study of self-as-context in non-clinical populations
Internship: Veterans Affairs Maryland Health Care System and University of Maryland, Baltimore School of Medicine
Postdoctoral Position: Veterans Affairs Maryland Health Care System, Baltimore MD
Current Position: Clinical Psychologist, PsychCare Psychological Services; Adjunct Faculty, Department of Applied Behavioral Science, University of Baltimore, Baltimore MD
Amanda Halliburton (2018)
Dissertation: Piloting the use of acceptance, cognitive defusion, and values in reducing experiential avoidance and its consequences among youth rejected by peers
Internship: Southwest Virginia Psychology Doctoral Internship Consortium (Stone Mountain Health Services), Jonesville VA
Current Position: Assistant Professor, Department of Psychological Science, University of North Georgia
Haley Gordon Murphy (2018)
Dissertation: Adapting Parent Child Interaction Therapy (PCIT) for custodial grandparents: Interviews and an online parent training course
Internship: Western Youth Services, Child Community Mental Health, Laguna CAP Postdoctoral Position: Postdoctoral Fellow, Department of Psychiatry, Child and Adolescent Psychiatry and TIES for Families, Harbor-UCLA Medical Center Current Position: Consulting Psychologist, Community Services Division, Harbor Regional Center, Los Angeles, CA
Lauren Delk (2020)
Dissertation: Assessment of criminal thinking as a predictor and mediator of behavior problems in a community youth sample
Internship: Federal Bureau of Prisons, ,Federal Correctional Complex, Butner, NC
Current Position: Clinical Psychologist, Federal Bureau of Prisons, Butner NC
Undergraduate Students (year of graduation)
Elyse Hammond (2017), Master's (MA) Program in Forensic Psychology, George Washington University,
Emily Hill (2017), Doctoral (PhD) Program in School Psychology, Northeastern University, Boston, MA
Gabriella Scalzo (2017), Doctoral (Ph.D.) Program in Clinical Psychology, Virginia Commonwealth University, Richmond VA
Katharine Waldron (2017), Clinical Psychology Doctorate (PsyD) Program, University of Indianapolis
Faith Schiefelbein (2018), Clinical Research Assistant, Defense and Veterans Brain Injury Center
Walter Reed National Military Medical Center, Bethesda, MD
Charlotte Brown, (2019), Research Assistant, Aging with Pride, University of Washington, Seattle, WA
Morgan Nutter (2019), Master's (MA) Program in Social Work, Virginia Commonwealth University, Richmond, VA
Lucy Carey (2019), Master's (MS) Program in Rehabilitation and Mental Health Counseling, Virginia Commonwealth University, Richmond, VA
Jenna Terry (2019), Behavioral Researcher, Department of Psychology, Health, and Learning Sciences, University of Houston, Houston, TX
Serena Fleming (2020), Medical Assistant, Ear Nose and Throat Practice, Northern Virginia
Harveen Pantleay (2020), Master's (MA) Program in Social Work, George Mason University, Fairfax, VA