My research program is focused on practice-based research, which attempts to integrate science and practice. One way to achieve this goal is to use evidence-based assessment measures as the standard of care when providing mental health services. In other words, treatment decisions should, whenever possible, be informed by information provided by psychometrically validated measures of psychological symptoms and functioning.
For my research, I have collaborated with colleagues in community agencies to examine a wide range of clinical questions and issues. My collaborators include colleagues at Assumption College and mental health professionals in the University of Massachusetts Medical School Departments of Psychiatry, Medicine, and Pediatrics, as well as the Department of Psychiatry at the University of Connecticut Health Center, Community Healthlink, the Bridge of Central Massachusetts, and ServiceNet.
Because data for my research were generated through the course of routine clinical services or activities, my research has been able to address questions that are important to practicing clinicians. My research program involves close collaboration with practitioners who usually spend most of their time with clinical or administrative activities.
Here are descriptions of my current research collaborations and programs.
Child and Adolescent Psychopathology
This research examines important aspects of psychological disorders and adaptive functioning in a sample of over 300 children and adolescents who were referred for evaluation to an outpatient psychopharmacology clinic. Our most recent research focuses on co-occurring disorders, particularly co-occurring internalizing disorders (depression, anxiety) and externalizing disorders (ADHD, oppositional defiant disorder).
My collaborators for these studies are:
Daniel F. Connor, M.D., Department of Psychiatry, University of Connecticut Health Center
Jeffrey Danforth, Ph.D., Department of Psychology, Eastern Connecticut State University
Peter F. Toscano, Jr., Ph.D., Department of Psychology, Assumption College
Adam M. Volungis, Ph.D., Department of Psychology, Assumption College
Recent Publications:
Danforth, J. S., Connor, D. F., & Doerfler, L. A. (in press). The development of comorbid conduct disorder in children with ADHD: An example of an integrative developmental psychopathology perspective. Journal of Attention Disorders.
Doerfler, L. A., Connor, D. F., & Toscano, P. F. (2011). Aggression, ADHD Symptoms, and Dysphoria in Children and Adolescents Diagnosed with Bipolar Disorder and ADHD. Journal of Child and Family Studies, 20, 545-553.
Doerfler, L. A., Connor, D. F., & Toscano, P. F. (2011). The CBCL Bipolar Profile and Attention, Mood, and Behavior Dysregulation. Journal of Affective Disorders, 131, 312-319.
Doerfler, L. A., Toscano, P. F., & Connor, D. F. (2009). Sex and aggression: The relationship between gender and abuse experience in youngsters referred to residential treatment. Journal of Child and Family Studies, 18, 112-121.
College Mental Health
There is growing concern that since the 1990’s there has been a sharp increase in the number of college students who experience serious mental health problems. Some research suggests that the nature and severity of mental disorders of students who seek counseling at college counseling centers is changing and perhaps increasing, but the research on this topic is limited.
We have been examining the nature of students’ presenting problems and the types of psychotropic medications prescribed for these problems in a sample of over 500 college students who were referred to a psychiatrist by college counseling center staff for psychopharmacology evaluation and treatment.
My collaborator for these studies is:
Daniel Kirsch, M.D., Director of College Consultation Service, Department of Psychiatry, University of Massachusetts Medical Center
Recent presentations:
Kirsch, D., & Doerfler, L. A. (2013). Mental health issues among college students: Who gets referred for psychopharmacology evaluation? Poster presented at the 47th annual convention of the Association for Behavioral and Cognitive Therapies, Nashville, TN.
Kirsch, D. F., Doerfler, L. A., & Jojic, M. (2014) Antipsychotic Use Among College Students. Poster presented at…
Manuscript submitted for publication:
Kirsch, D., & Doerfler, L. A. Mental health issues among college students: Who gets referred for psychopharmacology evaluation?
Kirsch, D. F., Doerfler, L. A., & Jojic, M. Atypical Antipsychotic Medication Use Among College Students.
Adolescent Substance Abuse
This research evaluated the psychometric features of a measure of motivation or readiness to change in a sample of over 500 adolescents who had been admitted to an inpatient substance abuse treatment program. Using this same sample, we examined whether adolescents’ level of motivation and substance abuse and mental health diagnoses were able to predict which adolescents would be admitted for another cycle of inpatient treatment. In this study, 12% of adolescents were readmitted for further treatment, and 80% of readmitted adolescents returned to the inpatient program within 6 months of discharge. However, measures of motivation, substance abuse and mental disorder diagnoses, and demographic characteristics did not accurately predict which adolescents would be readmitted to the inpatient program.
Presently, we are initiating a new study to attempt to determine whether post-discharge factors like peer (e.g., partying with teens who use drugs or alcohol) and family variables (e.g., parental monitoring) have a significant association with relapse. We will also examine the relationship between personal characteristics (e.g., depression, oppositional/defiant behavior) and relapse following discharge from inpatient treatment.
My collaborators for these studies are:
Daniel Melle, MSW, LICSW, Community Healthlink
Karen Albert, MS, Center for Mental Health Services Research, University of Massachusetts Medical School
Monika Kolodziej, Ph.D., Department of Psychiatry, University of Massachusetts Medical School
Rosalie Torres Stone, Ph.D., Center for Mental Health Services Research & Department of Psychiatry, University of Massachusetts Medical School
Gina Vincent, Ph.D., Center for Mental Health Services Research & Department of Psychiatry, University of Massachusetts Medical School
Recent presentations:
Doerfler, L. A., Melle, D., & Fisher, W. H. (2012). Do SOCRATES scores predict readmission to an inpatient substance abuse program for adolescents? Paper presented at the 46th annual convention of the Association for Behavioral and Cognitive Therapies, National Harbor, MD.
Doerfler, L. A., Melle, D., Haddad, D., & Cram, M. (2011). Psychometric evaluation of the SOCRATES in adolescents admitted to an inpatient substance abuse treatment program. Paper presented at the 45th annual convention of the Association for Behavioral and Cognitive Therapies, Toronto.
Manuscripts submitted for publication:
Doerfler, L. A., Melle, D., & McLaughlin, T. Factor Structure and Sensitivity to Change of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in a Sample of Adolescents Admitted to an Inpatient Substance Abuse Treatment Program.
Doerfler, L. A., Melle, D., McLaughlin, T. J., & Fisher, W. Predictors of Readmission to an Inpatient Substance Abuse Treatment Facility for Adolescents.
Evaluating the Effectiveness of Community-Based Dialectical Behavior Therapy (DBT) Programs
Dialectical Behavior Therapy (DBT) is a form of psychotherapy developed to treat people with borderline personality disorder. Although DBT has been shown in randomized controlled trials to be effective in reducing the occurrence of suicide attempts, admission to inpatient psychiatric treatment, and non-suicidal self-injury, little is known about the efficacy of this treatment in community programs or agencies that are not affiliated with university-based research programs.
For this research, I have collaborated with colleagues in 2 non-profit community agencies to evaluate the efficacy of their DBT programs with adolescents and adults. We have completed 2 evaluations with one program, and we are about to begin collecting data at another agency to evaluate outpatient DBT programs for adolescents and adults.
My collaborators for these studies are:
Karen Albert, MS, Center for Mental Health Services Research, University of Massachusetts Medical School
James Frutkin, Vice President of Clinical Services, ServiceNet
Carl Fulwiler, M.D., Ph.D., Director of Center for Mental Health Services Research, Department of Psychiatry, University of Massachusetts Medical School
Jennifer Geertsma. Director of Applied Research, ServiceNet
Barent Walsh, Ph.D., Executive Director, the Bridge of Central Massachusetts
Recent Publications:
Walsh, B., & Doerfler, L. A. (2009). Residential treatment of self-injury. In M. Nock (Ed.), Self-injury (pp 271-290). Wshington, DC: American Psychological Association.
Walsh, B. W., Doerfler, L. A., & Perry, A. (2012). Residential Treatment in Adolescents Targeting Self-Injury and Suicidal Behavior. In B. W. Walsh, Treating self-injury: A practical guide. New York: Guilford Press.
Evaluating Child and Adolescent Mental Health Services
This research evaluated the impact of a collaborative care model that was designed for primary care pediatricians and child psychiatrists to improve access to mental health services for children and adolescents. This evaluation found that a collaborative care program could serve as a model of care that addresses the barriers to accessing pediatric mental health services.
We also are working on a project to explore the feasibility of creating an interactive video game for middle school students to deliver a cognitive-behavioral therapy intervention to reduce bullying behavior among these students.
My collaborators for these studies are:
Onesky Aupont, M.D., MPH, M.A., Ph.D., Department of Pediatrics, University of Massachusetts Medical School
Daniel F. Connor, M.D., Department of Psychiatry, University of Connecticut Health Center
Thomas McLaughlin, Sc.D., M.A., MDiv., Director of Clinical Research, Department of Pediatrics, University of Massachusetts Medical School
Recent Publication:
Aupont, O., Doerfler, L. A., Connor, D. F., Stille, C., Tisminetzky, M., & McLaughlin, T. J. (2013). A collaborative care model to improve access to pediatric mental health services. Administration and Policy in Mental Health, 40, 264-273.
Evaluating Mental Health Services in a Medical Home Program for Individuals with Intellectual Disabilities
This research will evaluate the types of medical and mental health problems experienced by individuals who receive services through the Medical Home program provided by the Intellectual Disabilities Clinic in the Psychiatry Department at UMass Memorial Health Care.
My collaborator for this research is:
Lauren Charlot, Ph.D., LICSW, Director, Neuropsychiatric Disabilities Unit, Department of Psychiatry, University of Massachusetts Medical School
Evaluating the Association of Substance Abuse, PTSD, Depression, and Anger
This research will examine the relationship of severity of substance abuse, posttraumatic stress disorder, depression, and anger in a sample of Latino males who are admitted to a residential substance abuse treatment program.
My collaborator for this research is:
Matilda Castiel, M.D., Executive Director, Latin American Health Alliance, Associate Professor, Department of Family & Community Medicine, University of Massachusetts Medical School