Tapestry of Care

 An ongoing project (2024-2028).

The Aim of the Study:

This project trains and supervises congregation members from eighteen churches in San Antonio, Texas, called Navigators, to deliver a behavioral activation (BA) intervention for depression to other members of their congregations. It evaluates both the quality of Navigators' delivery and the impact of the BA intervention on those receiving it. 

Study Aims: 

1. Evaluate Navigator performance: We will monitor Navigators' skills and progress to ensure high-quality care delivery and track engagement metrics among congregation members receiving the Behavioral Activation (BA) intervention.
2. Assess clinical impact: We will evaluate the impact of the BA intervention on congregation members experiencing depressive symptoms by collecting mental health and secondary outcomes from enrolled participants.

The Background:

Depression is widespread yet undertreated in the US, with fewer than one-third of adults with depression receiving any care. Even among those who do, most are prescribed medication rather than psychotherapy, despite psychosocial interventions being more effective and more preferred by patients. Faith communities offer a promising and underutilized access point: clergy are frequently the first people congregation members turn to for mental health support, making churches a natural setting for community-based depression care.

The Project Plan:

Tapestry of Care is a single-arm mixed-methods implementation study conducted across eight churches in San Antonio, Texas. The study trains and supervises congregation members - known as Navigators - to deliver a Behavioral Activation (BA) intervention for depression within their own communities.

Who is involved:

• Navigators - trained congregation members who deliver the BA intervention to individuals with depressive symptoms within their churches
• Licensed mental health clinicians from the NOW Clinic (University of Texas Health Science Center) - who supervise and support Navigators throughout delivery

What the study measures:

• Primary focus: Quality of BA delivery and Navigator competency (process and implementation metrics)
• Secondary focus: Impact of the BA intervention on mental health, functional, and well-being outcomes among congregation members receiving the intervention

How data is collected:

• Quantitative tracking of implementation and process metrics throughout delivery
• Qualitative interviews with both Navigators and congregation members receiving the BA intervention, exploring their experiences on each side of the process

No control group is included in this study.

Supporters and Project Duration:

This study is funded by the Templeton Foundation and the H.E. Butt Foundation (2024-2028). Partners include the Congregational Collective, Baylor University, and the University of Texas Health Science Center at San Antonio.

Findings:

Since February 2026, 23 congregation members representing eight churches have been trained in EMPOWER BA, and 19 have also completed EMPOWER Youth training. A celebration was held on May 8, 2026, at Family Life International Ministries to recognize those who completed training. As of June 2026, 12 congregation members had received at least one BA session by an EMPOWER-trained Navigator, with 35 total sessions delivered within faith settings.