Performance Work Statement Interpersonal Psychotherap Trainign Svc.pdf

B.2 PERFORMANCE WORK STATEMENT

1.0 Background

The number of women Veterans enrolling in VA health care has grown substantially and will continue to grow.

Among Veterans receiving VHA care in FY21, 9.7% were women. Women make up 17.2% of Active-Duty military forces. The percent of women Veterans diagnosed with a mental health condition in VHA has substantially increased and is greater than the percent of men Veterans diagnosed with a mental health condition (FY21: 45% of women vs. 26% of men). In this context, VHA has made a commitment to train mental health providers to address women Veterans’ complex and unique needs, including gender-related suicide risks.

Many women Veterans using VHA services are of reproductive age. The perinatal period (pregnancy and the first year postpartum) are high-risk times for experiencing mental health complications, including suicidal thoughts.

Pregnant Veterans receiving VHA care have a higher risk of mental health burden. Among OEF/OIF Veterans, those with a pregnancy were found to be twice as likely to have a diagnosis of depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, or schizophrenia as those without a pregnancy.

Specialized adaptations of evidence-based mental health treatments are needed for women experiencing mental health problems while pregnant or postpartum. Among these, the intervention with the strongest evidence of efficacy is perinatal interpersonal psychotherapy (IPT-P). There is robust evidence that IPT-P reduces symptoms of depression and anxiety and improves relationship quality, social adjustment, and social support. IPT during pregnancy can also prevent postpartum depression and is recommended by the US

Preventive Services Task Force for this purpose. IPT-P focuses on the transition to motherhood and changes in other roles and relationships experienced during the perinatal period. It helps women develop and practice effective skills to manage perinatal role changes and stressors and to improve their social support. It is also effective for women who have post-traumatic stress disorder, as is the case for many women Veterans.

Another high-risk part of a woman’s reproductive cycle is the transition to menopause, known as perimenopause. During perimenopause, the risk of depression doubles, and the prevalence of suicidal thoughts substantially increases. The increased risk is driven in part by hormonal flux, but also by midlife losses and role transitions. IPT can also be adapted to address these losses and role transitions. Since the peak of age distribution in women Veterans is during midlife, this intervention would be of benefit to many women

Veterans.

To further VHA’s commitment to train mental health providers to address women Veterans’ complex and unique needs, we are proposing to contract with reproductive mental health (RMH) IPT experts to train a cadre of 40 VA psychotherapists in reproductive mental health adaptations of IPT. The RMH IPT experts will simultaneously train 8 VA psychotherapists to be supervisors and trainers of others, to increase access to this intervention as needed over time.

To date, though VA psychotherapists have had opportunities to learn general IPT, there has been no VA training offered in perinatal or perimenopausal adaptations of IPT. These are specialized adaptation of general IPT which requires specific training, much like a general internist would require additional specialized training to practice cardiology. The necessary training includes basic and advanced workshops, 12 weeks of small-group phone consultation on cases, portfolio reviews, and a booster course once psychotherapists have acquired some clinical experience with this treatment modality. For those who will become VA trainers, there is additional training on how to supervise for this modality. This level of specialized subject matter expertise is not currently available within VA. We are seeking to contract with trainers with not only expertise in reproductive mental health adaptations of IPT, but also with expertise in teaching these adaptations to other clinicians and training others to be supervisors and trainers of reproductive IPT.

2.0 Scope & Objectives

2.1 Scope:

Interpersonal Psychotherapy (IPT) is a form of psychotherapy for the treatment of depression and other conditions that has strong empirical support for its effectiveness. There is also strong empirical support for its use to prevent and treat depression during pregnancy and postpartum. Training VA psychotherapists to adapt IPT for use during high-risk reproductive cycle stages is consistent with VA’s support for disseminating and implementing evidence-based treatments to meet the specific needs of women Veterans. Such training goes beyond general IPT training and would require a total of 4 workdays (32 hours) of workshop training, 12 hours of case consultation, and 2 case portfolio reviews for each clinician trained. We propose to train 40 clinicians in Reproductive IPT. In addition, we propose to train 8 clinicians to become supervisors and trainers, to train other VA clinicians internally. The supervisor training requires 1 workday (8 hours) of workshop training, 12 hours of co-consultation, 12 hours of online mentoring meetings, and 2 case portfolio reviews for each clinician trained.

The trainer training requires a 16 hour (2 day) workshop, provision of 1 cohort of co-training and 1 cohort leading training.

2.2 Objectives:

This contract is to hire trainers with expertise in conducting and teaching Reproductive IPT to advance the VA Reproductive IPT Training Program. Specifically, in year 1 the contractor will conduct workshops, case supervision and portfolio reviews for up to 40 VA psychotherapists who treat women Veterans. Simultaneously, in year 1 the contractor will train 8 VA psychotherapists to become supervisors and trainers for other VA psychotherapists.

Specific objectives are:

1) Co-deliver basic, advanced and booster online workshops in Reproductive IPT to up to 40 VA psychotherapists (4 cohorts)

2) Deliver 12 one-hour sessions of phone-based case consultation to 10 total cohorts of up to 4 clinicians each, as those clinicians are delivering Reproductive IPT to Veterans. (4 cohorts)

3) Review and give individual feedback on up to 80 case portfolios (2 per clinician) to ensure fidelity to the reproductive IPT model. (4 cohorts)

4) Deliver 12 biweekly one-hour sessions of advanced phone-based case consultation to up to 8 VA clinicians identified for a supervisor training track (4 cohorts, 2 clinicians in each).

5) Review and give individual feedback on up to 16 case portfolios (2 per clinician) for each of the clinicians in the supervisor training track.

6) Co-supervise on 12 biweekly one-hour phone-based consultations with each of the supervisor training track clinicians.

7) Conduct 12 one-hour online supervisor mentoring sessions.

8) Deliver a 16-hour supervisor training course in person for the clinicians in the “train the trainer” track.

9) Conduct 12 one-hour online supervisor teacher mentoring sessions.

2.3 Target Audience

The target audience for Reproductive IPT training includes VA mental health clinicians interested in gaining skills in Reproductive Interpersonal Psychotherapy. These will be largely recruited via our network of Women’s Mental Health Champions. There is at least one Women’s Mental Health Champion at each VA. Champions have completed general Women’s Mental Training, have designed and implemented Action Plans to advance women’s mental health at their VAs, and serve as local points of contact for women’s mental health concerns, resources and training opportunities.

Participants in the Reproductive IPT supervisor training track will be recruited from among participants in the FY22 Reproductive IPT training. Contractor trainers and supervisors will identify exemplary trainees and invite them to participate in this advanced track.

2.4 Coordination

The Women’s Mental Health section of the VA Office of Mental Health and Suicide Prevention will work in collaboration with the contractor to ensure that the curriculum and training materials are relevant to VA and to women Veterans.

3.0 Specific Tasks and Deliverables (Base Year)

The Contractor shall perform the mandatory tasks and provide the specific deliverables described below within the performance period stated in this PWS:

Task 3.1 Pretraining Planning. Provide IPT textbooks and manuals to all registered participants in the reproductive IPT training, develop summaries for training accreditation, participate in Level 3 evaluation planning for IPT for RMH.

Deliverable 3.1: All participants have received a textbook and manual, summaries have been submitted to EES and accredited and evaluation plan has been finalized with EES partners.

Task 3.2: Deliver a 16-hour online workshop in reproductive adaptations of Interpersonal Psychotherapy. All faculty for this workshop will be experts in reproductive IPT and will have been trained in the skills of teaching reproductive IPT to other clinicians.

Deliverable 3.2: Completion of 16-hour workshop in reproductive IPT.

Task 3.3 Deliver an 8-hour online advanced workshop in reproductive IPT.

Deliverable 3.3: Completion of 8-hour advanced workshop in reproductive IPT.

Task 3.4 Deliver 12 one-hour biweekly phone-based case consultations to 10 groups of up to 4 clinicians each.

Deliverable 3.4: Completion of 12 hours of phone-based case consultations to 10 groups of up to 4 clinicians each.

Task 3.5 Review case portfolios to ensure fidelity to the model, and to give feedback to clinicians about their technique.

Deliverable 3.5: Completion of up to 80 case portfolio reviews (2 per participating clinician), with accompanying feedback to clinicians.

Task 3.6 Deliver a booster workshop to promote long-term retention of learning once clinicians have acquired some experience with the new techniques.

Deliverable 3.6: Completion of 8-hour booster workshop in reproductive IPT.

Task 3.7 Supervisor training: Deliver 12 one-hour biweekly phone-based advanced case consultations to up to 4 groups of 2 clinicians each.

Deliverable 3.7: Completion of 12 hours of phone-based advanced case consultation to up to 4 groups of 2 clinicians each.

Task 3.8 Supervisor training: Review case portfolios to ensure advanced level skills in reproductive IPT, giving feedback to clinicians about their technique.

Deliverable 3.8: Completion of up to 16 case portfolio reviews (2 per participating clinician), with accompanying feedback to clinicians.

Task 3.9 Supervisor training: Deliver a supervisor training workshop.

Deliverable 3.9: Completion of 8-hour supervisor training workshop for reproductive IPT.

Task 3.10 Supervisor training: Co-supervise on 12 biweekly one-hour phone-based consultations with up to 8 clinicians on the supervisor training track; 2 co-consultation sessions per each supervisor track clinician.

Deliverable 3.10: Completion of 12 co-supervised phone-based consultations with each of the clinicians on the supervisor training track.

Task 3.11 Supervisor training: Conduct 12 one-hour online supervisor mentoring sessions.

Deliverable 3.11: Completion of 12 one-hour mentoring sessions for clinicians on the supervisor training track.

Task 3.12 Trainer training: Deliver a 16 hour train the trainer workshop to 8 participants.

Deliverable 3.12 Completion of 16-hour train the trainer workshop for reproductive IPT.

Task 3.13 Provide IPT textbooks and manuals to all registered participants in the reproductive IPT training.

Deliverable 3.13: All participants have received a textbook and a manual.

Task 3.14: Deliver a 16-hour online workshop in reproductive adaptations of Interpersonal Psychotherapy. All faculty for this workshop will be experts in reproductive IPT and will have been trained in the skills of teaching reproductive IPT to other clinicians.

Deliverable 3.14: Completion of 16-hour workshop in reproductive IPT.

Task 3.15 Deliver an 8-hour online advanced workshop in reproductive IPT.

Deliverable 3.15: Completion of 8-hour advanced workshop in reproductive IPT.

Task 3.16 Deliver 12 one-hour biweekly phone-based case consultations to 10 groups of up to 4 clinicians each.

Deliverable 3.16: Completion of 12 hours of phone-based case consultations to 10 groups of up to 4 clinicians each.

Task 3.17 Review case portfolios to ensure fidelity to the model, and to give feedback to clinicians about their technique.

Deliverable 3.17: Completion of up to 80 case portfolio reviews (2 per participating clinician), with accompanying feedback to clinicians.

Task 3.18 Deliver a booster workshop to promote long-term retention of learning once clinicians have acquired some experience with the new techniques.

Deliverable 3.18: Completion of 8-hour booster workshop in reproductive IPT.

Task 3.19 Trainer Training: Deliver one hour monthly mentoring meetings for trainees.

Deliverable 3.19: Completion one hour monthly mentoring meetings.

4.0 Specific Tasks and Deliverables (Option Year-1)

In FY24, the selected cadre of VA clinicians will need supervision of training to become full trainers. When this is completed, VA will have internal capability to scale up reproductive IPT training to meet the needs of women Veterans throughout VA. Option year 1 delineates tasks and deliverables for this purpose.

The Contractor shall perform the mandatory tasks and provide the specific deliverables described below within the performance period stated in this PWS:

Task 4.1 Provide IPT textbooks and manuals to all registered participants in the reproductive IPT training.

Deliverable 4.1: All participants have received a textbook and a manual.

Task 4.2: Deliver a 16-hour online workshop in reproductive adaptations of Interpersonal Psychotherapy. All faculty for this workshop will be experts in reproductive IPT and will have been trained in the skills of teaching reproductive IPT to other clinicians.

Deliverable 4.2: Completion of 16-hour workshop in reproductive IPT.

Task 4.3 Deliver an 8-hour online advanced workshop in reproductive IPT.

Deliverable 4.3: Completion of 8-hour advanced workshop in reproductive IPT.

Task 4.4 Deliver 12 one-hour biweekly phone-based case consultations to 10 groups of up to 4 clinicians each.

Deliverable 4.4: Completion of 12 hours of phone-based case consultations to 10 groups of up to 4 clinicians each.

Task 4.5 Review case portfolios to ensure fidelity to the model, and to give feedback to clinicians about their technique.

Deliverable 3.5: Completion of up to 80 case portfolio reviews (2 per participating clinician), with accompanying feedback to clinicians.

Task 4.6 Deliver a booster workshop to promote long-term retention of learning once clinicians have acquired some experience with the new techniques.

Deliverable 4.6: Completion of 8-hour booster workshop in reproductive IPT.

6.0 DELIVERABLES

a. Distribution and Method of Delivery The Contractor shall ensure that all training materials developed are compatible with VA style guidelines, maintain Section 508 compliance and can be delivered via a VA-approved online platform.

b. Formal Acceptance or Rejection of Deliverables Acceptance by the VA of Contractor services is contingent upon the Contractor performing in accordance with the terms and conditions of the contract. Deliverables shall be completed in accordance with the specifications, schedules, and any additional criteria specified. Final approval and acceptance of documentation required herein will be by written notification from the Contracting Officer.

7.0 PERFORMANCE STANDARDS SUMMARY

ID Performance Objective

Performance Threshold

Method of Surveillance

Acceptable Quality Level

Incentives/ Disincentive

1 FY23

The contractor shall deliver IPT textbooks and manuals to all registered participants in the reproductive IPT training. (x2) The contractor shall deliver summaries for accreditation for all training cohorts.

The contractor shall partner with WMH and EES to develop Level 3 Training Evaluation Plan.

The contractor shall deliver this as described in the Delivery Section of the

PWS.

CO/COR documents comments on acceptability/final approval within 10 business days after delivery.

90% Incentives:

Favorable contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

2 The contractor shall deliver a 16-hour online workshop in reproductive adaptations of Interpersonal Psychotherapy (IPT) (x2)

The contractor shall deliver this as described in the acceptability/final approval within 10 workshop completion contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or

3 The contractor shall deliver an 8-hour advanced online workshop in reproductive adaptations of IPT (x2)

The contractor shall deliver this as described in the acceptability/final approval within 10

90% Incentives: Favorable contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

4 The contractor shall deliver 12 hours of biweekly phone-based case consultations to 10 groups of up to 4 clinicians each (x2)

The contractor shall deliver this as described in the acceptability/final approval within 10 business days after case consultation completion performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

5 The contractor shall review 2 case portfolios per trainee (up to 80 case portfolio reviews) and give feedback to each participating clinician. (x2) described in the acceptability/final approval within 10 business days after portfolio review performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

6 The contractor shall deliver an 8-hour online booster workshop. (x2) described in the acceptability/final approval within 10 performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or

7 The contractor shall deliver 12 biweekly one-hour sessions of advanced phone-based case consultation to up to 8 VA clinicians identified for a supervisor training track (4 cohorts, 2 clinicians in each).

described in the acceptability/final approval within 10 business days after completion of advanced case consultation performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

8 The contractor shall review 2 case portfolios per trainee in the supervisor training track (up to 16 case portfolio reviews) and give feedback to each participating clinician.

described in the acceptability/final approval within 10 business days after portfolio review performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

9 The contractor shall deliver an 8-hour supervisor training workshop.

described in the acceptability/final approval within 10 performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

10 The contractor shall co-supervise on 12 biweekly one-hour phone-based consultations with each of the supervisor training track clinicians.

described in the acceptability/final approval within 10 business days after completion of co-supervision.

performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

11 The contractor shall conduct 12 one-hour online supervisor mentoring sessions.

described in the acceptability/final approval within 10 business days after completion of mentoring sessions.

90% Incentives: Favorable contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

12 The contractor shall deliver a 16 hour train the trainer workshop.

described in the acceptability/final approval within 10 completion workshop.

performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

13 The contractor shall deliver one hour monthly mentoring meetings for train the trainer trainees

The contractor shall deliver this as described in the Delivery Section of the

PWS

CO/COR documents comments on acceptability/final approval within 10 business days after completion of mentoring sessions

90% Incentives: Favorable contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or

1 FY24

deliver IPT textbooks and manuals to all registered participants in the reproductive IPT training. (x2) described in the acceptability/final approval within 10 delivery.

contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or

2 The contractor shall deliver a 16-hour online workshop in reproductive adaptations of Interpersonal Psychotherapy (IPT)

The contractor shall deliver this as described in the acceptability/final approval within 10 contractor performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or

3 The contractor shall deliver an 8-hour advanced online workshop in reproductive adaptations of IPT

The contractor shall deliver this as described in the acceptability/final approval within 10 performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or termination of the task order.

4 The contractor shall deliver an 8-hour online booster workshop. (x2) described in the acceptability/final approval within 10 performance evaluation Disincentive:

Delays not approved by the COR/CO may cause cure notice action and or