Johanna Lake

Johanna Lake is a Clinician Scientist and Clinical Psychologist at the Azrieli Centre for Adult Neurodevelopmental Disabilities and Mental Health at CAMH. My clinical interests include assessment and intervention of children and youth with neurodevelopmental disabilities and mental health concerns, including individual and group based cognitive behavioural therapy and mindfulness and acceptance-based interventions. In terms of research activities, my interests fall along three lines: 1) interventions supporting caregivers; 2) the implementation of evidence-based interventions in community settings; and 3) improving medication management.

To date, a large focus of my clinical and research focus has centered on supporting families of individuals with NDDs. Parents of individuals with NDDs face significant mental health issues, including high levels of depression and anxiety. Parents who are highly stressed are less able to support their children and, when parents have better mental health, they fare better and can support their children more effectively. Despite this, the needs of parents are often neglected, with most research and supports targeted toward children. To better understand these issues, I have examined what leads to burden among caregivers of individuals with autism, and how parents perceive medication use and interactions with prescribing healthcare providers. I have also been involved in an RCT comparing a mindfulness-based parent intervention to an information group for parents of individuals with DD, and more recently, studying the delivery of web-based virtual mindfulness groups for caregivers and adults with autism across the country. Currently, I am involved in studying and facilitating Acceptance and Commitment Therapy (ACT) workshops, co-facilitated by parents alongside clinicians and researchers.

A key challenge in psychiatric rehabilitation is the implementation of interventions that have proven to be effective in funded trials in “real world” service delivery contexts. Presently, I am involved in a CIHR funded randomized controlled trial (RCT) of a transdiagnostic cognitive behavioural therapy (CBT) program targeting emotion regulation skill development in youth with NDDs. This study presents a unique opportunity to study how we translate evidence-based practice into routine clinical practice. This will involve taking a rigorous implementation science approach that considers the different stages (e.g., adoption, installation, implementation, sustainability) and levels of implementation (e.g., client/family, clinician, organization, government/policy), with the potential to inform how other evidence-based interventions can be successfully implemented across different populations in the local and international clinical community.

My research on medication use in autism has highlighted several issues related to prescriber expertise and comfort, as well as gaps in how to monitor medication use and side effects from the perspective of persons with autism. An important next step would be to take these findings and identify ways to improve and promote medication monitoring, tracking and knowledge. I am also interested in the impact of psychotropic medication use on metabolic syndromes. If we can better understand rates of these comorbid conditions among people with NDDs across the lifespan, we can identify ways to help monitor and prevent their occurrence.

Research Synopsis

Knowledge translation/moving research into practice, health service utilization, mental health issues, medication management, autism, intellectual disability, mindfulness and acceptance-based interventions, and supports for families.

Recent Publications

Lunsky, Y., Fung, K., Lake, J., Steel, L., & Bryce, K. (2018). Evaluation of acceptance and commitment therapy (ACT) for mothers of children and youth with autism spectrum disorder. Mindfulness, 9(4), 1110-1116.

Fung, K., Lunsky, Y., Lake, J.K., Steel, L., & Bryce, K.  (2018). ACT Processes in group intervention for mothers of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 1-8.

Lake, J. K., Denton, D., Lunsky, Y., Shui, A. M., Veenstra-VanderWeele, J., & Anagnostou, E. (2017). Medical Conditions and Demographic, Service and Clinical Factors Associated with Atypical Antipsychotic Medication Use Among Children with An Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(5), 1391-1402.

Weiss, J.A., Parvinchi, D., Maughan, A., & Lake, J.K. (2018). Family wellness in intellectual and developmental disabilities: A balanced approach. Current Developmental Disorders Reports, 1-8.

Vogan, V., Lake, J.K., Tint, A., Weiss, J.A., & Lunsky, Y. (2017). Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: A longitudinal study of service rates, barriers and satisfaction. Disability and Health Journal, 10(2), 264-270.

Appointments

Clinician Scientist, CAMH

Honours and Awards

Name: Faculty Teaching Award, Excellence in Small Group Teaching, Mississauga Academy of Medicine, University of Toronto, Toronto, ON, Canada
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Name: CAMH Postdoctoral Fellow Award
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Grants

Co-investigator, Special Olympics Canada, $15,000 CAD Understanding my Strong Mind: Promoting mental health literacy of Special Olympics Athletes and coaches.

 

Co-Principal Investigator, The Women’s College Hospital $15K Women’s Xchange Challenge. $15,000 CAD

Supporting female caregivers of individuals with FASD through ACT

 

Co-investigator. Ministry of Community and Social Services Developmental Services Research Grant Fund. Principal $88,746 CAD Key elements of successful housing for individuals with developmental disabilities and exceptional behavioural needs: Useful space designs and supportive residential models. 

 

Co-investigator. Autism Speaks Canada Replication Grant. $38,200 CAD Parent to parent: Caring for the caregiver.

 

Co-investigator. Autism Speaks Canada Family Services Grant. $40,400 CAD The development of virtual mindfulness groups for adults with ASD and families.

 

Co-Principal Investigator. The Women’s College Hospital $15K Women’s Xchange Challenge. $14,785 CAD

Mom to mom: Evaluation of a group intervention to improve the health and wellbeing of mothers of individuals with ASD.

Co-investigator. AGE-WELL NCE INC. $140,500 CAD PRIV-SENSE: Privacy, security and ethics of the use of emerging technologies: Development and validation of a framework for research and policy

Co-investigator.  Ministry of Community and Social Services Developmental Services Research Grant Fund. $76,070 CAD The evolving health and social needs of adults with developmental disabilities and complex mental health problems: A needs