EDUCATION

Faculty Information:

Primary Faculty:
Department of Psychiatry and
Behavioral Sciences


Primary Faculty:
Department of Family Medicine


Affiliated Faculty


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Psychiatry in Primary Care Fellowship:
Faculty Supervisors

1. Primary Faculty, Department of Psychiatry and Behavioral Sciences and Division of Child/Adolescent Psychiatry

The Psychiatric Health Services Research Group consists of Wayne Katon, MD, Jürgen Unützer, MD, MA, MPH, Edward Walker, MD, MHA, Mark Sullivan, MD, PhD, Jesse Fann, MD, MPH, Paul Ciechanowski, MD, MPH, MPH, Kathleen Myers, MD, Elizabeth McCauley, PhD, Ann Vander Stoep, PhD, Joan Russo, PhD and Ya-Fen Chen, PhD. These faculty members work closely with fellows on the psychiatric consultation liaison service and supervise their research projects.

Wayne J. Katon, MD; Dr. Katon is Professor and Vice Chair in the Department of Psychiatry and Chief of the Division of Psychiatric Epidemiology and Health Services is Director of the NRSA fellowship. Dr. Katon is internationally renowned for his research in three major areas:

Developing population-based primary care disease management models that potentiate the ability of the primary care medical system to treat major depression and panic disorder; Improving the recognition and treatment of DSM-IV psychiatric disorders in primary care and medical specialty patients with medically unexplained symptoms such as pelvic pain or fatigue. Demonstrating the impact of effectively treating major depression in patients with chronic medical illness in reducing amplification of aversive symptoms of chronic medical illness, improving social and vocational functioning, and reducing medical costs.

Dr. Katon has been Principal Investigator on 6 NIMH awards to improve the care of depression, anxiety and somatoform disorders in primary care as well as the principal investigator of the Seattle site for two studies funded by the Hartford and MacArthur Foundations which were randomized controlled trials to study problem solving psychotherapy versus Paroxetine versus Placebo in primary care patients with minor depression and dysthymia. He helped develop an ongoing Hartford Foundation study, the IMPACT Study, which has randomized 1801 elderly depressed primary care patients to collaborative care versus usual care interventions. Dr. Katon and his research group are considered one of the preeminent research groups in the United States in studying interventions to improve the care of mental illness in the primary care system of the United States. They have developed an intervention that integrates a range of mental health professionals into primary care and provides enhanced patient education that has been shown in randomized trials to be cost effective compared to usual primary care in improving adherence to antidepressant medications, satisfaction with care and depressive outcomes.

As a member of the AHCPR Committee, Dr. Katon published Guidelines on Recognition and Treatment of Depression in Primary Care and was later commissioned by NIMH to write a book, entitled Panic Disorder in the Medical Setting. In addition, Dr. Katon and his research team have published a self-care book, The Depression Help Book (Bull Publishing). He was a member of NIMH Psychiatric Health Services Grant Review Committee for 4 years, and has received two awards for excellence in teaching psychiatry to primary care physicians. He continues to spend one day a week teaching residents and consulting on patients at Swedish Health Services' Family Medicine Clinic in Seattle.

Jürgen Unützer, MD, MA, MPH is Professor and Vice-Chair of the Department of Psychiatry and Chief of Psychiatric Services at the University of Washington and Adjunct Professor in the Department of Health Services at the UW School of Public Health. He is also an Adjunct Investigator at the Center for Health Services Research at the UCLA Neuropsychiatric Institute and Affiliate Investigator at the Center for Health Studies, Group Health Cooperative. His main research interest is in the delivery of behavioral health services in general medical settings, and he is internationally recognized as an expert in the treatment of late-life depression in primary care. Dr. Unützer has also served as Senior Scientific Advisor to the World Health Organization, where he helped develop the Global Initiative on Depression in Public Health and as an advisor to the President's New Freedom Commission on Mental Health. His most recent awards include the Paul Beeson Physician Faculty Scholars Award in Aging Research from the American Foundation for Aging Research, the Gerald L. Klerman Investigator Award from the Depression and Bipolar Support Alliance, and the Distinguished Investigator Award from the American Association of Geriatric Psychiatry.

Edward A. Walker, MD, MHA: In addition to his professorship responsibilities for the Departments of Psychiatry and Family Medicine, Dr. Walker served as Medical Director for the University of Washington Medical Center and Associate Dean for the School of Medicine from 2003-08. He is a nationally recognized researcher who has investigated the relationship of medically unexplained symptoms to psychiatric disorders and childhood physical and sexual abuse. He has completed case-control studies of patients with chronic pelvic pain, irritable bowel syndrome and fibromyalgia. In addition, Dr. Walker received a 5-year NIMH K-Award to investigate the long-term psychiatric and medical sequelae of childhood physical and sexual abuse in a large HMO population. His latest research involves improving understanding regarding the prevalence of PTSD in primary care and the impact of PTSD on health outcomes and medical costs. With over 15 years' direct experience in primary care through his work at the UW Family Medicine Clinic as a consultation-liaison psychiatrist, Dr. Walker is a widely sought after lecturer for continuing education programs for family medicine physicians and medical specialists.

Mark Sullivan, MD, PhD is a Professor of Psychiatry and Adjunct Professor of Medical History and Ethics. In addition to teaching medical students, providing psychiatric consultation and overseeing research projects, Dr. Sullivan devotes 2 half-days each week to seeing patients at the University of Washington's General Internal Medicine Clinic and Regional Heart Center. He has worked for the Division of Health Services and Psychiatric Epidemiology for nearly two decades. His research focuses on quality of life models and their relation to disease pathophysiology. In addition, Dr. Sullivan has investigated the impact of major depression on patients with chronic medical illness. Earlier studies of tinnitus and dizziness have been followed by studies of patients with coronary disease and heart failure, including palliative care. He has a longstanding interest in chronic pain management and has current research on the use of opioid therapy for chronic pain. He has received funding from the National Institute of Aging, the National Institute of Mental Health and the American Heart Association, including a 5-year career development award from NIMH. Dr. Sullivan's published works include papers on the relation between depression and competence and on the relation between pain and disability. Having earned a Ph.D. in Philosophy, Dr. Sullivan continues to teach and research on issues at the interface of bioethics and health services research. In addition, Dr. Sullivan attends on the Ethics Consultation Service at UWMC and directs CME activities for the Department of Psychiatry.

Paul Ciechanowski, MD, MPH; Dr. Ciechanowski is an Associate Professor of Psychiatry, and a Consulting Psychiatrist for the University of Washington Diabetes Care Center. Before joining the University of Washington as a psychiatry resident in 1994, Dr. Ciechanowski practiced family medicine in Canada. This experience led him to pursue further studies on the psychiatric aspects of diabetes and other chronic medical illnesses, particularly in the areas of health care communication, treatment adherence, and health care utilization and cost analyses. He has also been involved in research advancing attachment theoretical models as a way of understanding health behavior, treatment adherence, somatization, pain disorders, and the patient-provider relationship. Dr. Ciechanowski frequently lectures on treatment of depression in medical patients, on psychiatric aspects of diabetes mellitus, and on attachment theoretical approaches to understanding challenging or “difficult” patient-provider interactions. His research on the patient-provider relationship has resulted in several awards including the Thomas H. Holmes Research Scholar Award (1998), the Academy of Psychosomatic Medicine Webb Fellowship Award (1998), the American Society of Psychosomatics Scholars’ Award (1999), and the American Psychiatric Institute Research and Education (ASPIRE)/GlaxoSmithKline Health Services Research Early Career Award (2002). He received a UWMC Outstanding Consultant Award in 2002 for his work as a psychiatric consultant in the University of Washington General Internal Medicine Clinic. Dr. Ciechanowski currently has a Career Development Award to carry out questionnaire studies explaining the impact of the patient-provider relationship in treatment adherence and outcomes in diabetes. This research endeavor is being funded by the National Institutes of Diabetes and Digestive and Kidney Disease.

Jesse R. Fann, MD, MPH; In addition to serving as an Associate Professor of Psychiatry, Adjunct Associate Professor of Rehabilitation Medicine and consultation-liaison psychiatrist at the University of Washington, Dr. Fann is Director of the Psychiatry & Psychology Consultation Service at the Seattle Cancer Care Alliance and an Associate in Clinical Research at the Fred Hutchinson Cancer Research Center. Dr. Fann's research has focused on the epidemiology and treatment of psychiatric disorders in persons with neurologic disorders and cancer. He is currently studying the treatment of depression in patients with traumatic brain injury (funded by NIH) and the epidemiology and outcomes of delirium in patients undergoing hematopoietic stem cell transplantation (funded by the American Cancer Society). Dr. Fann received his B.S. in electrical engineering from Stanford University, his M.D. from Northwestern University Medical School, and his M.P.H. in epidemiology from the University of Washington School of Public Health. He was awarded the William Webb Fellowship (1994) and the Dlin/Fischer Award for Significant Achievement in Clinical Research (1998) from the Academy of Psychosomatic Medicine. He was a member of the APA Work Group on Delirium, Dementia, Amnestic, and Cognitive Disorders for the DSM-IV Text Revision.

Kathleen Myers, MD, is an Associate Professor in the Department of Psychiatry and Behavioral Sciences and Chief of the Psychiatry Consultation-Liaison Service at Seattle Children's. Dr. Myers completed a Robert Wood Johnson fellowship. Her academic work focuses on pediatric consultation-liaison psychiatry, child and adolescent mood disorders (especially biopolar disorder) and, particularly, on telepsychiatry. She is Co-Chair of the Committee on Telepsychiatry for the American Academy of Child and Adolescent Psychiatry and has written the practice parameter on telepsychiatry for the Journal of the American Academy of Child and Adolescent Psychiatry. She is actively engaged in evaluating telepsychiatry to improve access and quality of care for children living in underserved areas and to improve the treatment of psychiatric disorders within primary care.

Elizabeth McCauley, PhD, is a Professor in the Department of Psychiatry & Behavioral Sciences. Dr. McCauley is a developmental and child clinical psychologist who has built a research program designed to characterize the development, course and management of clinical depression in youth. Dr. McCauley's initial descriptive studies stimulated development and testing of preventive and intervention approaches designed to reduce risk for, and long-term sequelae of, depression in adolescence. With the support of the NIMH, Dr. McCauley and her colleagues are currently actively engaged in a series of investigations exploring familial patterns of the transmission of depression and the developmental pathways of youth with depressive disorders and co-occurring conduct problems, assessing the role of depression and anxiety in adolescents with asthma, testing the efficacy of a school-based preventive intervention for youth at risk of depression, and adapting and testing behavioral activation as a therapy for depressed adolescents.

Ann Vander Stoep, PhD, is a child psychiatric epidemiologist with a joint appointment as Associate Professor in the Departments of Psychiatry and Behavioral Sciences and Epidemiology. Her research interests include: developmental epidemiology of adolescent depression, mental health status of children in the juvenile justice system, transition to adulthood for adolescents with psychiatric disorders, development of children's mental health interventions, and participatory action research. In partnership with Dr. Elizabeth McCauley, Dr. Vander Stoep has launched the NIMH-funded Developmental Pathways Research Program, a collaborative effort with the Seattle Public School System whose goals are to understand the etiology of childhood depression and to develop effective strategies for identifying and preventing emotional distress and depression. Dr. Vander Stoep teaches Psychiatric Epidemiology and Epidemiological/Biostatistical Methods in the School of Public Health and provides research mentorship to epidemiology graduate students and junior scientists in the Division of Child an Adolescent Psychiatry.

Joan Russo, PhD; Dr. Russo is an Associate Professor of Psychiatry at the University of Washington. She received her Ph.D. in psychology from the University of Washington, with a specialization in psychiatric epidemiology and statistics. Dr. Russo serves as a statistician, methodologist and psychometrician for the department, specializing in health services and outcomes research. Dr. Russo is also responsible for managing many large databases at HMC representing all inpatient psychiatric admissions, CTU admissions, and behavioral medicine visits. These databases are used for numerous research projects with HMC faculty members. Well known for her work in the field of psychiatric outcomes assessment and data analytic skills, Dr. Russo's collaboration with UW psychiatrists and psychologists has produced over 160 refereed journal articles in the fields of psychiatry, psychology and medicine and numerous grants awards. Her research has focused on patients with severe mental illness, particularly those with comorbidities such as diabetes and hepatitis C. She is also the statistician on 3 ongoing research grants at HMC.




2. Primary Faculty, Department of Pediatrics


The Pediatrics Health Services Research Group consists of Co-Director Laura Richardson, MD, MPH, Frederick Rivara, MD, MPH, Paula Lozano, MD, MPH, Carolyn McCarty, PhD, Brian Saelens, MD, James Stout, MD, MPH and David Grossman, MD, MPH. These faculty members work closely with fellows on the pediatric service and supervise their research projects.

Laura Richardson, MD, MPH, is an Associate Professor in the Division of General Pediatrics. She is a graduate of the University of Michigan, is board-certified in Internal Medicine, Pediatrics and subspecialty certified in Adolescent Medicine. She has a Masters of Public Health in Epidemiology from the University of Washington. Her research has focused on two main areas: the evaluation of associations between psychiatric disorders, health problems related to behavioral factors such as obesity53, physical symptoms, high medical utilization, and chronic medical disorders such as asthma and diabetes38, 54, and development of health services interventions to improve the treatment of depression among adolescents in primary care settings.

Frederick Rivara, MD, MPH, is the Director of the Division of General Pediatrics, Vice Chair of the Department of Pediatrics, the George Adkins Professor of Pediatrics and Adjunct Professor of Epidemiology, University of Washington, and an affiliate investigator at GHC of Puget Sound. Dr. Rivara is also the editor of the Archives of Pediatrics and Adolescent Medicine, and deputy editor of Injury Prevention. Dr. Rivara is internationally known for his work in many different aspects of pediatric, adolescent and adult injury prevention and control.96-99 This has included the epidemiology of various injury problems (including psychiatric sequelae of trauma), the development, implementation, and evaluation of injury prevention strategies for bicycle helmets, pedestrian safety, drowning prevention, domestic violence, and problem drinking. Dr. Rivara served for 13 years as the founding director of the Harborview Injury Prevention and Research Center, considered to be one of the pre-eminent injury research programs in the country. In this role, Dr. Rivara developed many collaborative relationships across departments, schools, and institutions that will facilitate opportunities for fellows. Dr. Rivara has been principal investigator on grants from the CDC, National Institute of Alcohol Abuse and Alcoholism, NICHD, MCHB, and Robert Wood Johnson Foundation. More recently, Dr. Rivara has received funding from the Robert Wood Johnson Foundation to study the impact of interventions during childhood and adolescence to prevent the development of tobacco use, problem drinking, and violence in adults and is an active collaborator with investigators at GHC on the impact of intimate partner violence on health, health care costs and utilization of women and their children. Dr. Rivara has been a long-time collaborator with Dr. Douglas Zatzick in psychiatry, examining the psychiatric consequences of injury in adolescents and adults.

Paula Lozano, MD, MPH, is an Associate Professor and former Robert Wood Johnson Clinical Scholar. She is currently the Director of the NRSA general pediatrics primary care fellowship. She is based at the University of Washington Child Health Institute and is also an associate investigator at the GHC Center for Health Studies. Dr. Lozano is currently Principal Investigator of two trials funded by NHLBI and AHRQ to improve the translation of research into practice, specifically with regard to clinical guideline implementation and decision support for asthma and ADHD, respectively. She works with Dr. Ed Wagner on clinical research projects to adapt the Chronic Care Model to pediatric populations with a focus on self-management support in pediatric chronic illness. She is Co-Principal Investigator with Dr. Katon on his NIH-funded asthma-anxiety grant.

Carolyn McCarty, PhD, is a Research Assistant Professor and Adjunct Assistant Professor of Psychology. Her research program is devoted to understanding children’s mental health in the context of family, peer and school systems. Her research has focused on understanding the impact of familial interactions, attitudes and cultural influences on the development of emotional and behavioral problems among children and adolescents. A second and more recent focus of her research is summarizing and comparing prevention and treatment approaches in their effectiveness for ameliorating youth depression. She is particularly interested in using basic research to inform preventive intervention efforts for youth who are at risk for depression.

Brian Saelens, MD, is a health psychologist and has a joint appointment as an Associate Professor in the Departments of Pediatrics and Psychiatry. Dr. Saelens conducts research on environmental influences on physical activity and obesity, pediatric obesity treatment, and factors that influence individual’s choice among weight-related behaviors. He has prior and on-going research funding from the Robert Wood Johnson Foundation and the National Institutes of Health.

James Stout, MD, MPH, is an Associate Professor and former Clinical Scholar, whose research is focused on translating research into practice. He was Principal Investigator on an NIH grant to improve asthma care for inner city children and collaborates with Drs. Lozano and Wagner to adapt the Chronic Care Model to pediatrics. He is co-founder, and Seattle site director, of the National Initiative for Children’s Healthcare Quality. This is an independent non-profit organization whose mission is to eliminate the gap between knowledge and practice with respect to children’s health and well being. It is closely affiliated with the Institute for Health Care Improvement and with Improving Chronic Illness Care programs based at the Center for Health Studies. He currently directs the Children’s Healthcare Improvement Collaborative which is working to disseminate evidence-based practices for chronic conditions, such as ADHD and obesity, into primary care settings.

David Grossman, MD, MPH, is Professor of Health Services at the University of Washington and Director of the Department of Preventive Care, GHC (GHC). Dr. Grossman is renowned for his work in injury control, including work on accident and violence prevention in youth, suicide in Native American adolescents, and prevention of gun, fire and motor vehicle injuries. Dr. Grossman is also the chair of the American Academy of Pediatrics Committee on Native American Child Health and was PI on a randomized trial to prevent the gun injuries and gun suicides among Native Americans in remote Alaskan villages. He is collaborating with Dr. Richardson on her research on predictors of persistence of depression in adolescents.





3. Affiliated Faculty


Our psychiatric health services research group collaborates with the Center for Health Studies at Group Health Cooperative, which has resulted in 4 large, NIMH-funded grants to improve the care of depression and anxiety in primary care.

The Group Health arm of this group includes Gregory Simon, M.D., Michael Von Korff, Sc.D., and Elizabeth Lin, M.D., M.P.H. In addition to working with Dr. Katon and colleagues, Drs. Simon, Von Korff and Lin assist fellows with their research as well, which allows fellows access to Group Health’s automated prescription, diagnosis and health utilization records for a population of almost 500,000 people in Western Washington.
This unique research affiliation allows fellows contact with six clinical research faculty who are active supervisors in the NRSA fellowship including Greg Simon, MD, MPH, an internist and psychiatrist and graduate of the Robert Wood Johnson Fellowship; Michael Von Korff, ScD, an internationally renowned psychiatric and primary care epidemiologist; Elizabeth Lin, MD, MPH, a family physician and graduate of the Robert Wood Johnson Fellowship; Ed Wagner, MD, MPH, internationally known for his research in improving care of the elderly and patients with diabetes in primary care systems and developer of the Chronic Care Model; David Grossman, MD, who is nationally renowned for his injury and violence prevention work in youth; and Paula Lozano, MD, MPH, a pediatrician and Robert Wood Johnson scholar internationally renowned for her research on improving care of asthma. Several of our prior fellows have worked extensively in research with these faculty members and the large Group Health population.

Gregory Simon, MD, MPH is currently serves as a Senior Investigator at Group Health Cooperative's Center for Health Studies and holds an appointment as a Research Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. He also practices adult psychiatry in Group Health's Behavioral Health Service. Dr. Simon completed residency training in internal medicine at the University of Washington and in psychiatry at the Massachusetts General Hospital followed by fellowship training in the Robert Wood Johnson Clinical Scholars Program. Dr. Simon's research has focused on improving care for people with mood disorders. Specific research areas include epidemiology of common mental disorders, management of depression in primary care, cost-effectiveness of psychiatric treatments, comorbidity of mood disorders and general medical disorders, and psychosocial treatments for depression and bipolar disorder. He serves on the Scientific Advisory Board of the Depression and Bipolar Support Alliance and on the editorial boards of Psychological Medicine, General Hospital Psychiatry, and Current Opinion in Psychiatry. He has authored or co-authored approximately 200 scientific publications, most of them related to care of mood disorders.

Michael Von Korff, ScD is Senior Scientific Investigator at the Center for Health Studies, Group Health Cooperative. He is a health services researcher/epidemiologist whose research is focused on health care for common chronic illnesses. He has conducted major studies of the management and outcomes of depression and chronic back pain among primary care patients. He has led work on large randomized controlled trials of health care innovations, including collaborative care programs for depressive illness and self-management programs for chronic-recurrent back pain. He collaborated with Dr. Edward Wagner on the development of the Chronic Care Model. He worked on major national and international psychiatric morbidity surveys including the NIMH Epidemiologic Catchment Area surveys, the WHO Study of Psychological Problems in General Health Care, and the WHO World Mental Health Surveys. His current research concerns comorbidity of mental and physical conditions, including observational and experimental studies of diabetes-depression comorbidity, back pain-depression comorbidity, and the impact of mental-physical comorbidity on social role disability.

Elizabeth H.B. Lin, MD, MPH has conducted health services research and practiced clinical medicine in primary care settings over the last 2 decades. After graduating from Stanford Medical School and completing her clinical training in family medicine, Dr. Lin was awarded a Robert Wood Johnson Fellowship. Her research in primary care encompasses depression and chronic illness management, including diabetes, arthritis and disability. Dr. Lin and colleagues have developed successful intervention models in primary care settings where mental and behavioral health consultants, nurse case managers, and primary care physicians collaborated to improve patient outcomes. She has helped adapt pharmacologic and behavioral interventions to meet the needs of primary care patients. Her research has also entailed physician training and evaluating the effects of randomized trials on practice patterns.

Paula Lozano, MD, MPH is an Associate Professor and former Robert Wood Johnson Clinical Scholar. She is currently the Director of the NRSA general pediatrics primary care fellowship. She is based at the University of Washington Child Health Institute and is also an associate investigator at the GHC Center for Health Studies. Dr. Lozano is currently Principal Investigator of two trials funded by NHLBI and AHRQ to improve the translation of research into practice, specifically with regard to clinical guideline implementation and decision support for asthma and ADHD, respectively. She works with Dr. Ed Wagner on clinical research projects to adapt the Chronic Care Model to pediatric populations with a focus on self-management support in pediatric chronic illness. She is Co-Principal Investigator with Dr. Katon on his NIH-funded asthma-anxiety grant.

David Grossman, MD, MPH, is Professor of Health Services at the University of Washington and Director of the Department of Preventive Care, GHC (GHC). Dr. Grossman is renowned for his work in injury control, including work on accident and violence prevention in youth, suicide in Native American adolescents, and prevention of gun, fire and motor vehicle injuries. Dr. Grossman is also the chair of the American Academy of Pediatrics Committee on Native American Child Health and was PI on a randomized trial to prevent the gun injuries and gun suicides among Native Americans in remote Alaskan villages. He is collaborating with Dr. Richardson on her research on predictors of persistence of depression in adolescents.

Ed Wagner, MD, MPH, is an internist who directed the Center for Health Studies for over a decade and is internationally renowned for his research on improving outcomes of chronic disease in organized health care systems. He was Principal Investigator of a $20 million Robert Wood Johnson grant that tested innovations in improvement of chronic disease outcomes.



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