Emily M. Becker-Haimes, PhD
Emily Becker-Haimes is an Assistant Professor at the Center for Mental Health Policy and Services Research. Dr. Becker-Haimes received her B.A. from Johns Hopkins University and her Ph.D. in Psychology from the University of Miami, where she specialized in child and adolescent clinical psychology. She completed her predoctoral internship at the Children’s Hospital of Philadelphia. Her clinical and research interests are in improving the quality of youth mental health services and ensuring that youth seeking treatment receive evidence-based care. Dr. Becker-Haimes has particular interests in developing and evaluating implementation strategies to support clinicians in delivering exposure therapy for anxiety disorders and in understanding how to best support graduate trainees to prepare them to deliver evidence-based practices long-term. Dr. Becker-Haimes is also a licensed psychologist in the state of Pennsylvania specializing in the treatment of anxiety and related disorders. She currently directs the Pennsylvania Hospital Anxiety Treatment for Children/Adolescents (PATCH) program at Hall Mercer.
Project FACTS (Fidelity Accuracy: Comparing Three Strategies)
The goal of proposed project is to strengthen the public health impact of psycho-social interventions by identifying fidelity measurement methods that can be used for research and practice. To date, fidelity has posed a thorny measurement quandary because few reliable, valid, and efficient fidelity measurement methods exist. The gold standard for measuring fidelity to psycho-social interventions, direct observation of therapist behavior, requires extensive resources. When fidelity is measured in the community, the most commonly used and least resource intensive method is self-report. Unfortunately, concordance between observation and self-report is low.
There is a critical need to identify and evaluate methods of fidelity measurement that are accurate (i.e., measure what they intend) and cost-effective. Our objective in this measurement proposal is to compare the accuracy and cost-effectiveness of three methods: self-report, chart stimulated recall and behavioral rehearsal in assessing fidelity to cognitive-behavioral therapy, an established evidence-based practice. We will randomize 135 therapists, trained in cognitive-behavioral therapy through an initiative to implement evidence-based practices in the City of Philadelphia, to 3 conditions: self-report (N = 45), chart stimulated recall (N = 45), and behavioral rehearsal (N = 45). All conditions will include direct observation using the Therapy Process Observational Coding System as the gold-standard comparison. In Aim 1, we will identify the most accurate fidelity measurement method. In Aim 2, we will estimate the economic costs and cost-effectiveness of the proposed fidelity measurement methods. In Aim 3, we will compare stakeholders’ willingness to use each method, as well as identify their perceived barriers and facilitators to use of each method. The proposed work is consistent with the NIMH strategic plan, specifically Objective 4, to strengthen the public health impact of NIMH-supported research.
This study will have a significant positive impact by producing fidelity measurement methods that can then be used by implementation scientists for research and community mental health clinics to monitor therapist fidelity, an indicator of therapy quality.
Role: Project Director
Pennsylvania Hospital Anxiety Treatment for Children/Adolescents at Hall-Mercer (PATCH)
The PATCH program provides evidence-based services to youth with anxiety and related disorders at Hall-Mercer Community Mental Health.
Role: Clinical Director