Dear friends of the 4KEEPS study,

We are writing to provide an update on the 4KEEPS study. As you know we are conducting a neutral,
observational study to examine how the 6 original PEI practices spread and continue to be used by
therapists over time in Los Angeles County.

As of April 2016 a total of 813 therapists &

Full Sample 173 program managers from 66 agencies
have completed our online survey.
Online Surveys

In-Depth Sample 17 Programs

In-person 32 Program Managers

Interviews
Session Audio 79 Therapists participated
Recordings &
Questionnaires 165 Clients recorded

356 recordings and questionnaires

Attention agency program leaders! Are you interested in having your agency partici-
pate in the 4KEEPS In-depth study? Please contact us at 4KEEPS@psych.ucla.edu or (310)825-9250.
This is a unique opportunity to learn from therapists in the community delivering PEI practices. This
study will help us understand the conditions under which practices improve community mental health
services. You and your therapists are the experts. Therapists who participate can earn up to $250 in
Amazon gift cards and a new iPod.
The majority of therapists who
have completed the 4KEEPS
Online Survey report adapting What we are learning from you!
practices to make them work
for their clients.

Adaptations Therapists Have Shared with Us!

Incorporating play, songs, poems, and art into trauma narratives.
So instead of like a trauma narrative, we've been doing a lot of art on the
chalkboard.

Using the clients language to teach skills.

A lot of the relaxation techniques, like guided imagery and all these
names, Ill allow them to use whatever language they want to Most adaptations
uselike, Oh were going to practice imagination. reported may
improve engage-
ment, but still keep
Analogies to make concepts come alive.
For disruptive behavior, I use the analogy of a volcano. And I to the core of the
explain to them, like, okay, sometimes we don't express our feelings practice.
at all and we pretend like it didn't really bother us. And then it kind of
stuffs down, our feelings, well bury them and then it creates a layer.
And then as we keep continuing to stuff our feeling down, and I ask
the client, What happens to the volcano? and they usually say, It
will explode or It erupts.

If you would like more information about the 4KEEPS study, please visit our website 4keeps.psych.ucla.edu/.