Improved Clinician Quality through Technology
 

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Overview of Problem
Mental illness and addiction exact incredible tolls on the people of Washington State. In the face of this, evidence-based counseling can be highly effective in treating mental health and addiction problems and helping individuals lead functional, satisfying lives, but only when it is delivered with high quality. Our existing mental health workforce would be more effective if we could improve the quality of their evidence-based counseling. The challenge is that learning how to do therapy well is both time-consuming and difficult, requiring many hours of practice and precise feedback on the use of counseling skills. Our current gold-standard methods of training are not scalable, as they rely on feedback from scarce expert trainers. This is a human-intensive process that limits the overall opportunities for practice, behavioral rehearsal, and expert feedback, which is exacerbated in low-resourced areas, such as rural and low income communities. If we can scale up high-quality training, we can increase access to effective therapists, treatment, and care.

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Vision
To make high-quality clinician training in evidence-based counseling accessible throughout Washington – and eventually to all regions of the US – using technology to improve clinical decision-making and the effective delivery of clinical interventions. Currently, trainees have few opportunities to practice new skills with expert feedback. Instead, via two training-focused technologies, trainees will have repeated opportunities to practice new skills and will receive immediate feedback on the quality of their skills. These technologies will reduce the human burden of training, allowing expert human trainers to focus on trainees who need extra guidance and input. Moreover, technology is instantly accessible to any trainee in any location, and in service delivery settings, these technologies can provide quality assurance and improvement to help practicing counselors maintain their skills.

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Solutions

Intelligent tutoring systems (ITS) and spoken language artificial intelligence (AI) can massively scale up both the quantity of practice for trainees as well as immediate, performance-based feedback – helping to promote high-quality clinical training and excellent treatment for patients.

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Idea 1: Enhancing counselor’s clinical decisions with intelligent tutoring
Like any skill, counseling involves knowing what to do and how to do it. Intelligent tutoring systems (ITS) have been developed by education and computer science researchers, and as their name implies, ITS are software that guides a learner through structured exercises to teach new skills. They provide both immediate and tailored feedback to learners; using simulated patient scenarios, ITS provide an ideal and efficient method to teach the clinical decision-making of counseling.

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Idea 2: Developing high quality therapy skills using artificial intelligence
Beyond decision-making, counseling involves performing the skills – speaking and interacting with patients. Spoken language technologies – based on artificial intelligence (AI) and machine learning – provide a technology-based route for feedback on counselor performance. This technology allows us to provide immediate feedback on how empathic a therapist is as well as their ability to provide specific behavioral techniques.

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Next Steps
Cutting-edge research by University of Washington researchers and their collaborators has laid the groundwork for these technologies. To accelerate these technologies, we need partners who are involved in – or have need for – training who can provide feedback and input on the technology development. These could include formal training programs as well as continuing education or quality improvement initiatives at clinical sites. The technologies would be designed for, and developed with, the therapists who will use them in the real world. We also seek funding for further development and testing of the technologies to refine them based on real-world applications.

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Get Involved
Please contact David Atkins, PhD (datkins@uw.edu) for information on how to get involved in our efforts to improve clinician quality through technology.

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Co-Chairs, Mental Health and Technology Workgroup
Patricia Areán, PhD
Dave Atkins, PhD
Patrick Raue, PhD