Christianne Esposito-Smythers

Christianne Esposito-Smythers

Christianne Esposito-Smythers


Clinical Psychology: adolescent suicide, adolescent substance abuse, development of cognitive behavioral prevention and intervention programs for adolescent mental health problems

Dr. Esposito-Smythers will not be accepting a new student for Fall of 2023.

Dr. Christianne Esposito-Smythers received a B.A. from Lafayette College in 1995 where she graduated Summa Cum Laude with a double major in Psychology and English. She received her M.S. in 1997 and her Ph.D. in 2000 in Clinical Psychology (Child Track) from Virginia Tech. She completed a Postdoctoral Fellowship in Clinical Child Psychology at the Warren Alpert Medical School of Brown University from 2000-2001. She completed a T32 NIAAA funded Postdoctoral Fellowship in alcohol intervention research at the Brown University Center for Alcohol and Addiction Studies from 2001-2003. After completing this fellowship, she joined the faculty as an Assistant Professor in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University. She left Brown Medical School to join the Clinical Psychology faculty at George Mason University (GMU) in 2008. Dr. Esposito-Smythers is currently a Professor in the Psychology Department and Director of the new Center for Evidence-Based Behavioral Health at Mason. A primary mission of this Center is to support research to develop, test, and implement culturally responsive evidence-based behavioral health interventions in community settings. She is also an adjunct faculty in the Department of Behavioral and Social Sciences at Brown University. Additionally, she is a Licensed Clinical Psychologist.

Dr. Esposito-Smythers’ research interests include the the dissemination and implementation of culturally responsive evidence-based behavioral health interventions in community-based settings. She is also interested in the development and testing of cognitive-behavioral, family-focused, interventions for adolescent suicidal behavior, depression, substance abuse, and other high risk behaviors. Additionally, she studies mechanisms that underlie improvement in the context of these interventions. Her research has been funded by grants from the National Institute of Mental Health, National Institute on Alcohol Abuse and Alcoholism, National Institute of Child Health and Human Development, American Foundation for Suicide Prevention, and Adolescent Medicine Trials Network for HIV/AIDS. Her papers have appeared in the Behavior Research and Therapy, Journal of Clinical Child and Adolescent Psychology, Journal of Consulting and Clinical Psychology, Journal of the American Academy of Child and Adolescent Psychiatry, Journal of Traumatic Stress, Suicide and Life Threatening Behavior, Journal of Substance Abuse Treatment, American Journal on Addictions, Alcoholism: Clinical and Experimental Research, and many other journals. She has also served on the Scientific Advisory Council for the American Foundation for Suicide Prevention.

Dr. Esposito-Smythers uses her clinical research expertise to improve the lives of youth and families in her local community via multiple clinical research contracts. She leads the Fairfax Consortium for Evidence-Based Practice which offers training in evidence-based behavioral health interventions for youth mental health difficulties to clinicians who work with youth and families. This Consortium also offers consultation, outcome assessment, and implementation support. She also co-leads the Northern VA Regional Consortium for Evidence-Based Practice, which offers a similar service with a focus on training in trauma treatments. She also contracts with the Inova Kellar Center to improve the quality of youth mental health services through the implementation of measurement-based care. Additionally, she has served on the Fairfax County Youth Suicide Review Team and multiple Fairfax County workgroups dedicated toward improving access to evidence-based assessment and treatment for youth and families. Her work has been recognized via the “2019 George Mason University Earl C. Williams Presidential Medal for Social Impact” and a “County of Fairfax Team Excellence Award.”

Selected Publications

Selected Manuscripts (* = graduate student author)

*Whitmyre, E., Esposito-Smythers, C., Goldberg, D., Scalzo, G., *Defayette, A., & *Lopez, R., (2022). Implementation of an electronic safety plan within a measurement feedback system. Evidence-Based Practice in Child and Adolescent Mental Health. doi: 10.1080/23794925.2022.2081946

Esposito-Smythers, C., *Defayette, A., *Whitmyre, E., Steinberg, P., Goldston, D, & Asarnow, J. (2021). A community call to action: Use of quality improvement strategies to address youth suicides. Evidence-Based Practice in Child and Adolescent Mental Health, 6(3), 328-342, doi:10.1080/23794925.2021.1917020

Wolff, J., Esposito-Smythers, C., Frazier, E., Stout, R., Gomez, J., Massing-Schaffer, M., Nestor, B., Cheek, S., Graves, H., Hunt, J., & Spirito, A. (2020).  A randomized trial of integrated cognitive behavioral treatment for adolescents receiving community home-based services for co-occurring disorders. Journal of Substance Abuse Treatment, 116, 108055. doi: 10.1016/j.jsat.2020.108055

Esposito-Smythers, C., Wolff, J., Liu, R., Hunt, J., Adams, L., Kim, K., Frazier, E., Yen, S., Dickstein, D., Spirito, A. (2019). Family-focused cognitive-behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: A randomized trial. Journal of Child Psychology and Psychiatry, 60(10), 1133-1141. doi: 10.1111/jcpp.130952

Esposito-Smythers, C., Hadley, W., Curby, T., & Brown, L.K. (2017). Alcohol, self-harm, and HIV prevention among youth in mental health treatment: A randomized controlled pilot trial. Behaviour Research and Therapy. doi: 10.1016/j.brat.2016.11.005.

Esposito-Smythers, C. Brown, L.K., Wolff, J., Xu, J. Thorton, S., & Tidey, J. (2014). Integrated cognitive-behavioral and contingency management intervention for HIV infected young adults: Results of an open pilot trial. Journal of Substance Abuse Treatment, 46, 244-250. doi: 10.1016/j.jsat.2013.07.008.

Esposito-Smythers, C., Spirito, A., Kahler, C. W., Hunt, J., & Monti, P. (2011). Treatment of co-occurring substance abuse and suicidality among adolescents: A randomized trial. Journal of Consulting and Clinical Psychology, 79, 728–739. doi: 10.1037/a0026074 PMC3226923

Selected Book Chapters (* = graduate student author)

Esposito-Smythers, C., *Whitmyre, E. D., *Defayette, A. B., *López Jr., R., *Maultsby, K. D., & Spirito, A. (2022). Suicide and suicide attempts during adolescence. In G. Asmundson (Ed.), Comprehensive Clinical Psychology (2nd ed., Vol. 5, pp. 376-394). Elsevier.

Spirito, A., Esposito-Smythers, C., Cheek, S. (2021). Individual therapy techniques with suicidal adolescents. In D. Wasserman (Ed.) Oxford Textbook of Suicidology and Suicide Prevention, 2nd edition; Oxford University Press.

Esposito-Smythers, C., Spirito, A., & Wolff, J. (2019). CBT for co-occurring suicidal behavior and substance use (I-CBT). In M. Berk (Ed.) Evidence-Based Treatment Approaches for Suicidal Adolescents: Translating Science into Practice. Arlington, VA: American Psychiatric Publishing.

Goldston, D.B., Tunno, A., & Esposito-Smythers, C. (2019). Treatment of adolescents who have co-occurring substance misuse and suicidal behaviors. In I. Crome & R. Williams (Eds.) Substance Misuse and Young People. Boca Raton, FL: Taylor and Francis Group, LLC.

Esposito-Smythers, C., *Rallis, B., *Machell, K., *Williams, C. & Fischer, S. (2018).  Brief interventions for adolescents with substance abuse and comorbid psychiatric problems. In P. Monti, Colby, S, & O'Leary, T.  (Eds) Brief Interventions for Adolescents Alcohol and Substance Abuse. New York, NY: Guildford Press.

Spirito, A., Esposito-Smythers, C., & Wolff, J. (2017). Developing and testing interventions for adolescent suicidal and non-suicidal self-injury.  In J. R. Weisz & A.E. Kazdin (Eds.) Evidence-Based Psychotherapies for Children and Adolescents. New York, NY: Guilford Press.

Esposito-Smythers, C., *Perloe, A., *Machell, K., & *Rallis, B. (2016). Suicidal and non-suicidal self-harm behaviors and substance use disorders. In Y. Kaminer (Ed.), Youth Substance Abuse and Co-Occurring Disorders. Arlington, VA: American Psychiatric Association Publishing.





Grants and Fellowships

Current/Recent Grants and Contracts

Fairfax Consortium for Evidence-Based Practice

The purpose of this contract is to establish and lead a training consortium, in partnership with Healthy Minds Fairfax and the Inova Kellar Center (Inova Healthcare System), for ongoing training in evidence-based interventions for youth and family serving behavioral health providers from local health and human service agencies, public schools, and private provider networks. Training and consultation are provided in interventions for suicidal behavior as well as mental health and substance use disorders. The consortium also evaluates training outcomes and provides implementation support. Data collected will also be used  to prepare research papers/presentations and provide pilot data for grant applications.

Sponsor: Healthy Minds Fairfax (Fairfax County Government)

Dates of Contract: 12/1/17-6/30/23

Total Costs: $711,777

Role: PI

Co-Investigator: Keith Renshaw, Ph.D.


Northern Virginia Regional Consortium for Evidence-Based Practice

The purpose of this contract is to establish and lead a training consortium for ongoing training in evidence-based trauma treatments for children, adolescents, and adults. Training and consultation are provided to behavioral health providers from Community Service Boards in Alexandria, Arlington County, Fairfax County, Fairfax City, Falls Church, Loudon County, and Prince William County. The consortium also evaluates training outcomes and provides implementation support. Data collected will also be used to prepare research papers/presentations and provide pilot data for grant applications.

Sponsor: Northern Virginia Regional Management Group

Dates of Contract: 9/1/20-8/31/23

Total Costs: $703,071

Role: Co-I

PI: Keith Renshaw, Ph.D. / Co-I: Sarah Fischer, Ph.D.


Inova Kellar Center Clinical Research Service Contract

The purpose of this contract is to help the Inova Kellar Center (part of the Inova Healthcare System) develop and implement web-based routine outcomes monitoring, also known as measurement-based care (MBC), in collaboration with OWL Insights, LLC. The Kellar Center provides behavioral health treatment to children, adolescents, and their families, and offers a full continuum of services including partial hospitalization, intensive outpatient, intensive home-based services, outpatient, medication management, psychiatric evaluations, psychological testing, and a therapeutic school. Use of MBC allows the Kellar Center to use client self-report data, collected via empirically validated assessments, to guide treatment and discharge planning, monitor client progress, evaluate the efficacy of all services, and address accreditation requirements. These data are also used to prepare research papers and provide pilot data for grant applications.

Sponsor: Inova Kellar Center

Dates of Contract: 6/7/16-6/6/23

Total Costs: $559,409

Role: PI


Intensive Outpatient Protocol for High Risk Suicidal Teens

1R01MH097703 (Esposito-Smythers/Spirito, Multiple PIs)

National Institute of Mental Health

Aim: Compare the relative efficacy of an intensive outpatient cognitive behavioral treatment protocol for depressed adolescents hospitalized for a suicide crisis, with a suicide attempt, non-suicidal self-injury and/or a substance use disorder, to treatment-as-usual in community outpatient mental health services in a Stage II randomized clinical trial.

Role: Multiple PI with Anthony Spirito, Ph.D.

Dates of grant: 7/1/12-6/30/17

Total costs: $2,911,138


Integrated Mental Health Treatment and HIV Prevention for Court Involved Youth

R01MH087520 (Brown, PI)

National Institute of Mental Health

Aim: Compare the relative efficacy of an integrated mental health/substance abuse treatment and HIV prevention program to enhanced treatment-as-usual in community based outpatient mental health services for court involved youth referred for treatment through the Rhode Island Family Court and Fairfax County Juvenile Court in a Stage II randomized clinical trial. 

Role: Co-Investigator / GMU Site PI

Dates of grant: 7/1/10-6/30/15

Total costs: $3,249,659

PI/Co-Investigators: Larry Brown, M.D. (PI), Sarah Fischer, Ph.D., Marina Tolou-Shams, Ph.D., Wendy Hadley, Ph.D., & Ronald Seifer, PhD.





Courses Taught

Psyc 810: Psychological Assessment I

Psyc 811: Psychological Assessment II

Psyc 861: Cognitive Behavioral Therapy for Youth

Psyc 325: Abnormal Psychology

Psyc 414: Behavioral Disorders in Childhood




1995 B.A. Psychology/English, Lafayette College

1997 M.S. Clinical Psychology, Virginia Tech

2000 Ph.D. Clinical Psychology, Virginia Tech

Recent Presentations

Selected presentations (* = graduate student author)

*Whitmyre, E. D., Esposito-Smythers, C., Scalzo, G., *Defayette, A. B., *López Jr., R., *Maultsby, K., & Mehlenbeck, R. (2021, December). Effectiveness of clinician pre-implementation training for electronic safety planning with youth. Poster presented at the 14th Annual Science of Dissemination and Implementation (Virtual) Conference.

*López Jr., R., *Maultsby, K., *Defayette, A. B., *Whitmyre, E. D., Wolff, J., Spirito, A., & Esposito-Smythers, C. (2021, November). A prospective investigation of the relation between dysfunctional family communication and suicidal ideation severity in a clinical adolescent sample: A serial mediation model. Poster to be presented at the 2021 Association for Behavioral and Cognitive Therapies annual convention, Virtual.

Esposito-Smythers, C. (2021, June). Best practices for including adolescents with suicidal behavior in clinical research. In M. Trivedi and J. Harkavy-Friedman (Chairs), American Society of Clinical Psychopharmacology/American Foundation for Suicide Prevention Panel. Symposium presented at the American Society of Clinical Psychopharmacology Annual Meeting (Virtual).

*López Jr., R., *Defayette, A. B., *Maultsby, K., *Whitmyre, E. D., & Esposito-Smythers, C. (2021, May). A multimethod investigation of the relation between minority stress and suicide risk among sexual minority youth. Poster presented at the Association for Psychological Science (APS) 2021 Virtual Convention.

*López Jr., R., Brick, L. A., *Defayette, A. B., *Whitmyre, E. D., Wolff, J., Frazier, E., Spirito, A., & Esposito- Smythers, C. (2020, November). Depressive symptom severity mediates the association between avoidant problem-solving style and suicidal ideation. In R. López Jr., & C. Esposito-Smythers (Chairs), The impact of social factors on the onset and maintenance of self-injurious thoughts and behaviors. Symposium to be presented at the Association for Behavioral and Cognitive Therapies (ABCT) 54th Annual Convention. Philadelphia, PA.

*López Jr., R., *Williams, C. A., Franks, H., Leichtweis, R., & Esposito-Smythers, C. (2019, June). The impact of measurement-based care on key clinical outcomes within a partial hospital setting. Poster presented at the 3rd Journal of Clinical Child and Adolescent Psychology Future Directions Forum, Washington, D. C.

*Whitmyre, E.D., Adams, L. M., *Defayette, A.B., *Williams, C.A., Esposito-Smythers, C. (2018, May). Do high-risk adolescents receive mental health services in the community that are appropriately targeted to their diagnoses? Poster presented at the Association for Psychological Science 30th Annual Conference, San Francisco, CA.

Esposito-Smythers, C., Fagan, C., Mehlenbeck, R., & Peterson, A.P. (2017, August). For good measure: Hands-on experience putting measurement-based care into clinical practice (Workshop number 123). Workshop to be presented at the 125th APA Annual Convention, Washington, D.C.

Esposito-Smythers, C., Hadley, W., Brown, L.K., & Curby, T. (2015, October).  The development of a suicide, alcohol, and HIV prevention program for teens in mental health treatment.  In C. Esposito-Smythers (Chair), Adapting interventions for suicidal youth: Consideration of comorbidity, culture, and setting. Symposium presented at the International Summit on Suicide Research, New York. NY.



Dissertations Supervised

Roberto López Jr. , Problems with Problem-solving: Novel Findings from Experimental and Intensive Longitudinal Research with a Young Adult Sample at Risk for Suicide (2023)

Annamarie B. Defayette , A Multimethod Approach to Understanding the Association Between Interpersonal Stress, Inflammatory Response, and Suicidality (2022)

Emma D. Whitmyre, Implementation of Measurement Based Care and Electronic Safety Plans for Youth (2021)

Caitlin Ann Williams , A Developmental Look at the Impact of Childhood Trauma in Treatment-seeking Samples (2020)

Bethany Rallis, A Brief Peer Gatekeeper Suicide Prevention Training: Preliminary Examination of Efficacy and Individual Factors That Influence Outcomes (2016)

Alexandra Perloe, A Longitudinal Examination of the Association Between Non-Suicidal Self-Injury, Emotional Intelligence, and Family Context in Adolescents (2015)

Laura Martinson, A Longitudinal Examination of the Association Between Parenting Behavior, Social-Emotional Coping, and Adolescent Disordered Eating (2015)

Karen Schaefer, Suicidal Ideation in a U.S. Jail: Demographic and Psychiatric Correlates and a Test of Baumeister's Escape Theory (2014)

Adam Miller, A Formal Test of the Interpersonal Psychological Theory of Suicide and a Closer Look at the Role of Social Support in Adolescent Suicidal Ideation and Behavior (2014)

Julie T. Weismoore, A Proposed Model of Non-suicidal Self-injury, Negative Life Events, Coping, and Emotional Regulation (2011)