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Kate Hardy, PsyD

  • Kate V Hardy

Specialties

Psychology

Work and Education

Fellowship

University of California at San Francisco School of Medicine, San Francisco, CA, 4/1/2012

All Publications

Training early psychosis community clinicians in CBT for psychosis: Implementation and feasibility. Early intervention in psychiatry Hardy, K. V., Espil, F. M., Smith, C. L., Furuzawa, A., Lean, M., Zhao, Z., Godzikovskaya, J., Gilbert, A., Loewy, R. L. 2020

Abstract

OBJECTIVE: Cognitive behavioural therapy (CBT) has demonstrated efficacy for treating of psychotic symptoms and is recommended as an evidence-based practice (EBP) in early psychosis services. Despite this recommendation, there is limited information about the feasibility of training community clinicians, working in an early psychosis service, to competence in the delivery of this intervention.METHOD: Fifty clinicians working in an early psychosis service across five programs in Northern California were trained in CBT for psychosis (CBTp) between 2010 and 2014. Following the training, clinicians attended weekly group consultation and submitted taped sessions for review. Tapes were rated for competency using the Cognitive Therapy Scale-Revised (CTS-R). Clinicians who achieved competence were engaged in a train-the-trainer model to support ongoing sustainability of the training program.RESULTS: Data from 40 clinicians were reviewed for achievement of competence. Over the training period 18 clinicians achieved competence while 20 clinicians left the service before achieving competence and 12 were still in the process of achieving competence at the point of data analysis. It took on average 54weeks (range 17-130weeks) and an average of six tape reviews (range 3-18) to train clinicians to competency.CONCLUSIONS: Community clinicians working in an early psychosis program can be trained to competence in CBTp following an initial didactic period and ongoing weekly group consultation, although staff turnover hindered implementation. Challenges and opportunities for future implementation in community sites are presented in the context of further expansion of early psychosis services in the United States.

View details for DOI 10.1111/eip.13010

View details for PubMedID 32583602

Lived experience perspectives on reducing the duration of untreated psychosis: the impact of stigma on accessing treatment PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES Hardy, K. V., Dickens, C. E., Roach, E. L., Harrison, V., Desai, A., Flynn, L., Noordsy, D. L., Dauberman, J., Adelsheim, S. 2020
CBT for Psychosis: Process-Oriented Therapies and the Third Wave (Book Review) JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Book Review Authored by: Eisen, K., Hardy, K. 2020; 59 (3): 44648
Consumer and Family Perspectives on Reducing the Duration of Untreated Psychosis Hardy, K., Dickens, C., Mackintosh, T., Roach, E., Harrison, V., Noordsy, D., Adelsheim, S. WILEY. 2018: 62
Pilot Study of Group Worry Intervention for First Episode Psychosis Mackintosh, T., Olson, N., Lee, A., Weiler, R., Hardy, K. WILEY. 2018: 135
Therapeutic Potential of Physical Exercise in Early Psychosis. The American journal of psychiatry Noordsy, D. L., Burgess, J. D., Hardy, K. V., Yudofsky, L. M., Ballon, J. S. 2018; 175 (3): 20914

View details for PubMedID 29490501

Impact of age of onset of psychosis and engagement in higher education on duration of untreated psychosis JOURNAL OF MENTAL HEALTH Hardy, K. V., Noordsy, D. L., Ballon, J. S., McGovern, M. P., Salomon, C., Stirman, S. 2018; 27 (3): 25762

Abstract

The average age of onset of psychosis coincides with the age of college enrollment. Little is known about the impact of educational engagement on DUP in a college-aged population.To determine DUP, and the impact of educational engagement, for college-aged participants of the RAISE study (n=404).We conducted secondary data analyses on the publicly available RAISE dataset. Subsamples were analyzed to determine the impact of age and educational engagement on DUP.DUP was significantly shorter (p<0.02) for participants who were college-aged (18-22years, n=44) and engaged in post-secondary education (median=12weeks, mean=29weeks) compared with participants who were college-aged and not engaged in higher education (n=92, median=29weeks, mean=44weeks).Educational engagement appears to be associated with a shorter DUP. This may be partially explained by the presence of on-site wellness centers in college settings. However, even among young people who engaged in post-secondary education DUP was still at, or beyond, the upper limit of WHO recommendations in this group. Future research exploring how colleges could improve their capacity to detect and refer at risk students for treatment at an earlier stage is recommended.

View details for PubMedID 29707996

Editorial: Trauma, Psychosis and Posttraumatic Stress Disorder FRONTIERS IN PSYCHIATRY Hardy, K. V., Mueser, K. T. 2017; 8: 220

View details for PubMedID 29163239

Genetic Correlation Profile of Schizophrenia Mirrors Epidemiological Results and Suggests Link Between Polygenic and Rare Variant (22q11.2) Cases of Schizophrenia. Schizophrenia bulletin Duncan, L. E., Shen, H., Ballon, J. S., Hardy, K. V., Noordsy, D. L., Levinson, D. F. 2017

Abstract

New methods in genetics research, such as linkage disequilibrium score regression (LDSR), quantify overlap in the common genetic variants that influence diverse phenotypes. It is becoming clear that genetic effects often cut across traditional diagnostic boundaries. Here, we introduce genetic correlation analysis (using LDSR) to a nongeneticist audience and report transdisciplinary discoveries about schizophrenia. This analytical study design used publically available genome wide association study (GWAS) data from approximately 1.5 million individuals. Genetic correlations between schizophrenia and 172 medical, psychiatric, personality, and metabolomic phenotypes were calculated using LDSR, as implemented in LDHub in order to identify known and new genetic correlations. Consistent with previous research, the strongest genetic correlation was with bipolar disorder. Positive genetic correlations were also found between schizophrenia and all other psychiatric phenotypes tested, the personality traits of neuroticism and openness to experience, and cigarette smoking. Novel results were found with medical phenotypes: schizophrenia was negatively genetically correlated with serum citrate, positively correlated with inflammatory bowel disease, and negatively correlated with BMI, hip, and waist circumference. The serum citrate finding provides a potential link between rare cases of schizophrenia (strongly influenced by 22q11.2 deletions) and more typical cases of schizophrenia (with polygenic influences). Overall, these genetic correlation findings match epidemiological findings, suggesting that common variant genetic effects are part of the scaffolding underlying phenotypic comorbidity. The "genetic correlation profile" is a succinct report of shared genetic effects, is easily updated with new information (eg, from future GWAS), and should become part of basic disease knowledge about schizophrenia.

View details for PubMedID 29294133

Cognitive Interventions Targeting Brain Plasticity in the Prodromal and Early Phases of Schizophrenia ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 9 Fisher, M., Loewy, R., Hardy, K., Schlosser, D., Vinogradov, S. 2013; 9: 435-463

Abstract

Several important paradigm shifts have occurred in the field of schizophrenia treatment, including an increased focus on early detection, the development of preemptive interventions, and the view of schizophrenia as a neurodevelopmental disease characterized by decreased efficiency and abnormal connectivity in cortical and subcortical neural networks. In this review, we briefly describe some of the neural impairments that contribute to the development of schizophrenia, with an emphasis on the impact of stress and trauma on cognitively vulnerable neural systems. We then present current data on two behavioral interventions that target these critical risk factors and that aim to preempt the onset of schizophrenia in vulnerable individuals or improve the clinical course in recent-onset schizophrenia: cognitive therapy and computerized cognitive training.

View details for DOI 10.1146/annurev-clinpsy-032511-143134

View details for Web of Science ID 000321742100018

View details for PubMedID 23297786

Psychosocial interventions for adolescents at clinical high risk for psychosis: cognitive behavioral therapy Adolescent Psychiatry Hardy, K. V., Loewy, R. 2012; 2: 172-181

Abstract

The aim of this study was to describe the development of a sustainable community early psychosis programme created through an academic-community partnership in the United States to other parties interested in implementing early psychosis services founded upon evidence-based practices within community settings.The service was developed around a sustainable core of key components, founded upon evidence-based practice, with additional flexible elements that could be adapted to the needs of the individual commissioning county. This paper describes the ways in which funding was sourced and secured as well as the partnerships developed through this process.Successful development of the Prevention and Recovery from Early Psychosis (PREP) programme in San Francisco County, California. PREP clinicians have received extensive training in the evidence-based approaches that are available through the programme and treated 30 clients and their families in the first year of operation.Development of a sustainable community programme of this type in a non-universal health-care setting, which is historically seen as non-integrated, required extensive partnering with agencies familiar with local resources. Implementation of the community-academic partnership bridged the gap between research and practice with successful integration of fidelity practice at the community level. The community partners were effective in sourcing funding and allocating resources, while the academic side of the partnership provided training in evidence-based models and oversight of clinical implementation of the model. Stringent evaluation of the impact of the service is our next focus.

View details for DOI 10.1111/j.1751-7893.2011.00310.x

View details for Web of Science ID 000297018400013

View details for PubMedID 22032550

Filling the implementation gap: a community-academic partnership approach to early intervention in psychosis EARLY INTERVENTION IN PSYCHIATRY Hardy, K. V., Moore, M., Rose, D., Bennett, R., Jackson-Lane, C., Gause, M., Jackson, A., Loewy, R. 2011; 5 (4): 366-374
At risk of developing psychosis: the research perspective Experiencing psychosis: personal and professional perspectives Hardy , K. Routledge. 2011
Re-envisioning psychosis: a new language for clinical practice Current Psychiatry Rose, D., Stuart, B., Hardy, K., Loewy, R. 2010; 9: 23-28
THE SUBJECTIVE EXPERIENCE OF PEOPLE AT A HIGH RISK OF DEVELOPING PSYCHOSIS JOURNEYING INTO AND THROUGH AN EARLY DETECTION FOR PSYCHOSIS SERVICE 12th International Congress on Schizophrenia Research Hardy, K. V., Dickson, J. M., Morrison, A. P. OXFORD UNIV PRESS. 2009: 309310