An interview with Cara C. Lewis, PhD
What bothers us is often what motivates us. And it bothers me that scientific knowledge often does not inform the care people receive. A new area called “implementation science” is devoted to ensuring that evidence-informed interventions are implemented to benefit those in need.
Specifically, I’m focused on improving mental and behavioral health care by integrating evidence-based practices such as cognitive behavioral therapy into community settings. My new paper in JAMA Psychiatry discusses how to advance the integration of measurement-based care into behavioral health treatment.
While working on a study in graduate school, I found CBT worked for many young people. But at that time, cognitive behavioral therapy was largely unavailable outside of research trials. Implementation science promised to bring evidence-based care into practice. So, I decided to focus on this new field, even though no one at my university, including my mentor, was expert in this type of work.
My work with Wolverine Human Services — residential treatment centers housing teens throughout Michigan — made the impossible, possible. It was the first time, to my knowledge, that frontline staff received training to deliver cognitive behavioral therapy with fidelity. Through our five years of systematic, tailored implementation with the Beck Institute for Cognitive Behavior Therapy, Wolverine was transformed. They’ve trained most of the staff in cognitive behavioral therapy and embedded onsite coaches to ensure the program is sustainable.
Now, I’m leading an implementation evaluation of a new member of the primary care team in Kaiser Permanente Washington clinics designed to connect patients with community resources. Specifically, we’re evaluating the impact of community resource specialists on patients’ experience and care teams’ ability to work at the top of their license.
I serve on the steering committee of Kaiser Permanente's Social Needs Network for Evaluation and Translation group. We bring experts together and support them to think about how best to address social risk, build capacity and conduct pragmatic evaluations. Kaiser Permanente is at the cutting edge in terms of investing in care for the whole person and their community. Very few organizations have that vision — and the infrastructure to support this work.
Kaiser Permanente is willing to invest in implementing evidence-based care. Being embedded in a delivery system affords the opportunity to contribute to the science and the practice of implementation.
What I do most outside of work is to spend time with my 2-year-old son River. I’m an avid cyclist. I love to bike to work and bike River to school, the grocery store, you name it.
Our family is very musical, and we play music every day. I like to sing — but don’t ask me to. River and my husband Eric play all the things: We have five guitars (including River’s guitalele), a piano, drums and many other instruments. We don’t watch TV shows as a family — we watch live music videos together.
I’m proud to say River now requests Pearl Jam, a Seattle-born band that recently raised $12 million to address homelessness in our local communities. I have family nearby in British Columbia, where I was born and raised — and those are two reasons why Seattle is a great place for us to be.
Cara C. Lewis, PhD, is an associate investigator at Kaiser Permanente Washington Health Research Institute’s MacColl Center for Health Care Innovation and affiliate faculty of psychiatry and behavioral sciences at the University of Washington School of Medicine.