2 - (SYM 71) Usefulness and Utilization of Elements of the Transdiagnostic Sleep and Circadian Intervention Among Adolescent Night Owls and Adults with Serious Mental Illness

Research has demonstrated that patient ratings of usefulness and ratings of utilization of treatment elements are associated with treatment outcome. However, few studies have examined this relationship among adolescents, in a community mental health setting, or after an extended follow-up period. This talk will present on two studies that examine which elements of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) were rated as useful and utilized in two samples: adolescents and adults. Participants in Study 1 were 64 adolescents (ages 10-18, 55% female, 61% White) with an evening circadian preference (“night owls”) who were given six sessions of TranS-C as a part of their participation in a larger NICHD-funded study. At six-month (FU6) and twelve-month follow-up (FU12), adolescents completed the Usefulness Scale, the Utilization Scale, and a seven-day sleep diary assessing total sleep time (TST) and bedtime. Participants in Study 2 were 104 adults (mean age = 47, 52% female, 42% African American) with serious mental illness (SMI) and sleep and circadian dysfunction who received eight sessions of TranS-C in a community mental health setting as a part of their participation in a larger NIMH-funded study. At FU6, they completed the Usefulness Scale, the Utilization Scale, PROMIS Sleep Disturbance (PROMIS-SD), PROMIS Sleep-Related Impairment (PROMIS-SRI), and DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (DSM-5-CC). In Study 1, on average, adolescents rated TranS-C elements as moderately useful and utilized treatment elements occasionally. Higher ratings of usefulness were associated with longer TST at FU6 (beta = 0.42, p = .01) and higher ratings of utilization were associated with a shift to an earlier bedtime from FU6 to FU12 (beta = -0.35, p = .04). In Study 2, on average, adults with SMI rated TranS-C as moderately useful and utilized treatment elements occasionally. Ratings of usefulness were associated with the PROMIS-SD, PROMIS-SRI, and DSM-5-CC at posttreatment (betas = -0.33-.20; ps = .00-.02). Ratings of utilization were not associated with outcome. The findings indicate that both adolescents, and adults with SMI, find TranS-C elements useful and utilize the treatment elements immediately, six months, and/or twelve months after completing treatment. The results offer empirical evidence for behavior maintenance theories. These studies offer preliminary evidence that ratings of usefulness and utilization may predict change following psychosocial treatments.