黑料社

Ferkauf's Sarah Kate Bearman Bridges the Chasm Between Psychological Research and Practice As a camp counselor, Sarah Kate Bearman was always intrigued by the 鈥減roblem鈥� kids鈥攖he high-energy, high-maintenance kids who had trouble following the rules and tried everyone else鈥檚 patience. Unlike many of her peers, Bearman saw children who didn鈥檛 really differ from better-adjusted, happier campers beneath the moodiness and attitude. 鈥淚 saw so much typical child behavior in these kids,鈥� she said. 鈥淲hen children first start to develop problems with anxiety or depression, they don鈥檛 look that different than other kids鈥攂ecause they鈥檙e not. The older they get, though, the wider that gap grows.鈥�

Bearman hopes to offer children effective mental health treatment in the early stages.

Bearman, now an assistant professor at 黑料社 All鈥檚 , kept thinking about that gap. It provided so much time for intervention: in theory, the earlier she could catch a child starting to slip, the more successful she could be in steering his or her developmental path back to a normal trajectory. After college, Bearman decided to become a child psychologist, completing a two-year research assistantship in pediatric pharmacology at Massachusetts General Hospital and pursuing a graduate degree at the University of Texas at Austin and a postdoctoral fellowship at Judge Baker Children鈥檚 Center of Harvard Medical School. Bearman initially planned to research how disorders such as depression developed. But when she began her externship in clinical settings, she noticed a troubling phenomenon. 鈥淚 spent all this time learning one set of treatments that were scientifically tested and shown to be helpful, but in the child guidance center where people were actually practicing, I didn鈥檛 see anyone using those treatments,鈥� Bearman said. 鈥淭hat really perplexed me. Why weren't people using the methods we had developed?鈥� It was a question she learned more and more psychologists and researchers were asking, reaching divided鈥攁nd often embittered鈥攃onclusions. Practicing clinicians are rarely trained to use scientifically-supported methods and feel allegiances to the treatments they鈥檝e used throughout their career, believing they鈥檙e effective based on personal experience. And many are skeptical of treatments developed in academia, arguing that university settings don鈥檛 resemble real practice conditions and researchers with no experience in community mental health can鈥檛 relate to the problems practicing clinicians face in the field. Researchers, in turn, are concerned that potentially life-improving treatments are being overlooked in favor of treatments that have never been tested in rigorous research trials and feel practitioners don鈥檛 do enough to seek proper training or keep up with developments in the field. But many community mental health providers aren鈥檛 psychologists鈥攎uch of the workforce that treats children are social workers or licensed mental health counselors鈥攁nd of those that are, few attended doctoral programs emphasizing empirically-supported methods. 鈥淓ven if you wanted to go out and learn these treatments as a member of the mental health community, there are barriers in your way,鈥� Bearman said. 鈥淵ou could go to a two-day training, but those are days you can鈥檛 see clients, so you lose the billing time. You might get a manual to use, but without any supervision or consultation, you鈥檇 run into difficulties using it in the real world.鈥� In the meantime, some therapies that have been proven to be ineffective or even harmful, such as group sessions for teenagers who break the law, are still being offered in mental health settings, and work being done by researchers often lacks grounding in real community practice that could make it more effective or adaptable. And the majority of children treated for mental health disorder are never offered a method that has been tested or proven to be effective. That鈥檚 where Bearman comes in. This year, Bearman launched a program supported by the National Institute of Mental Health to tailor existing scientifically supported treatments for depression and related problems for use in several New York City middle schools. 鈥淪chool guidance counselors are trained to be supportive and develop kids鈥� emotional health, not intervene in a depressive disorder,鈥� said Bearman. 鈥淏ut the truth is if they don鈥檛 intervene, kids don鈥檛 get treated. Eighty percent of kids who receive treatment for mental health problems are treated in schools鈥攅ven if counselors make referrals to psychologists, kids won鈥檛 actually go, either because they don鈥檛 have the means, their parents don鈥檛 know enough about the clinic or their disorder, or they鈥檙e afraid of the associated stigma.鈥� Working with an advisory committee of school guidance counselors, Bearman seeks to adapt empirically supported treatments for a better fit in school settings, where longer one-on-one sessions often called for in researched therapies may not be a viable option. She鈥檚 also hoping to imbue those therapies with the guidance counselors鈥� knowledge of their students and community. 鈥淚 work in that gap," explained Bearman, "trying to see how we can foster knowledge transfer from both sides to form a partnership.鈥� What do scientifically supported treatments look like? 鈥淥ne of the biggest misconceptions kids or families have is that therapy is going to involve things they鈥檝e seen on TV, lying on a couch with someone listening to them and nodding and saying cryptic things,鈥� said Bearman. 鈥淚n reality, the treatments we offer are more similar to things they鈥檝e already experienced in school. We may be teaching them to manage their mood in the same way they learn to play soccer or write an essay.鈥� In some supported therapies, psychologists give children assignments similar to homework to help them slowly build a basic skill set to replace mechanisms that aren鈥檛 working as well. In addition to the middle school program, Bearman is a co-investigator in a Cleveland study, funded by the Annie E. Casey Foundation, focusing on team decision-making by child welfare agencies and a Boston study of evidence-based practices to treat anxiety, depression and disruptive conduct in community health clinics. And she鈥檚 teaching her passion at Ferkauf, in first-year courses including Fundamentals and Applications of Empirically Supported Practices as well as advanced courses like Dissemination and Implementation of Evidence Based Practices in Youth Mental Health Settings, to help defuse the tension between researchers and practitioners right when it starts. 鈥淲e have to figure out a way that everyone can speak the same language and work together towards the same goal,鈥� said Bearman. For her, that goal is to get children effective mental health treatment early鈥攂efore their disorder becomes their identity. Learn more about Bearman's research .