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Jones AMK, Fitzsimmons-Craft EE, D’Adamo L, Eichen DM, Graham AK, Conlon RPK, Balantekin KN, Welch RR, Agras WS, Wilson GT, Wilfley DE. A pilot study evaluating online training for therapist delivery of interpersonal psychotherapy for eating disorders. Int J Eat Disord 2024; 57:1691-1706. [PMID: 38623931 PMCID: PMC11343679 DOI: 10.1002/eat.24197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE Individuals with eating disorders (EDs) often do not receive evidence-based care, such as interpersonal psychotherapy (IPT), partly due to lack of accessible training in these treatments. The standard method of training (i.e., in-person workshops) is expensive and time consuming, prompting a need for more scalable training tools. The primary aim of this pilot and open trial was to examine the effects of an IPT online training platform on training outcomes (i.e., IPT fidelity, knowledge, and acceptance) and, secondarily, whether online training was different from in-person training (using a comparative sample from a separate study) in terms of training outcomes and patient symptoms. METHOD Participants were therapists (N = 60) and student patients (N = 42) at 38 college counseling centers. Therapists completed baseline questionnaires and collected data from a student patient with ED symptoms. Therapists then participated in an IPT online training program and completed post-training assessments. RESULTS Following online training, acceptance of evidence-based treatments, therapist knowledge of IPT, therapist acceptance of IPT, and treatment fidelity increased; acceptance of online training was high at baseline and remained stable after training. Using the 90% confidence interval on outcome effect sizes, results suggested IPT online training was not different from in-person training on most outcomes. Results are based on 60% of therapists who originally enrolled due to high dropout rate of therapist participants. CONCLUSIONS Findings from this preliminary pilot study support the use of IPT online training, which could increase access to evidence-based ED treatment and improve patient care. PUBLIC SIGNIFICANCE Lack of accessible therapist training has contributed to many therapists not delivering, and therefore many patients not receiving, evidence-based treatment. This study evaluated a highly disseminable online training and compared outcomes to traditional in-person training and found that training and patient outcomes were not different. Online training has the potential to enhance access to evidence-base care, which could in turn optimize patient outcomes.
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Affiliation(s)
- Anna M. Karam Jones
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- University of California San Diego, San Diego, CA, USA
| | | | - Laura D’Adamo
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Andrea K. Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | | | | | - R. Robinson Welch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - W. Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - G. Terence Wilson
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Mikkonen K, Helminen EE, Saarni SI, Saarni SE. Learning Outcomes of e-Learning in Psychotherapy Training and Comparison With Conventional Training Methods: Systematic Review. J Med Internet Res 2024; 26:e54473. [PMID: 39073862 PMCID: PMC11319893 DOI: 10.2196/54473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 04/22/2024] [Accepted: 05/21/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Mental disorders pose a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially, the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming, and dependent on a small number of top-level professionals as trainers. E-learning has been proposed to enhance psychotherapy training accessibility, quality, and scalability. OBJECTIVE This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability, and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition, and application of trained content in daily practice. Furthermore, the equivalence of web-based training and conventional training methods is evaluated. METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid, MEDLINE, PsycINFO, and Scopus databases between 2008 and June 2022 was conducted. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and nonrandomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated. RESULTS The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes generally show equivalence between e-learning and conventional training methods. The overall effect size, indicating this disparity, was 0.01, suggesting no significant difference. This literature displays a high level of heterogeneity in e-learning solutions and assessment methods. CONCLUSIONS e-Learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in blended settings supported by activating learning methods are presented. However, due to the heterogeneity and limitations in the existing literature, further research is necessary to replicate these findings and to establish global standards for e-learning, as well as for the assessment of training outcomes in psychotherapy education. Research is especially needed on the effects of training on patient outcomes and optimal ways to combine e-learning and conventional training methods in blended learning settings.
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Affiliation(s)
- Kasperi Mikkonen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Eeva-Eerika Helminen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Samuli I Saarni
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Suoma E Saarni
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Psychiatry, Wellbeing Services County of Päijät-Häme, Lahti, Finland
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Kobak K, Shear MK, Skritskaya NA, Bloom C, Bottex G. A Web-Based Therapist Training Tutorial on Prolonged Grief Disorder Therapy: Pre-Post Assessment Study. JMIR MEDICAL EDUCATION 2023; 9:e44246. [PMID: 36972105 PMCID: PMC10131787 DOI: 10.2196/44246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Prolonged grief disorder (PGD) is a newly recognized mental disorder characterized by pervasive intense grief that persists longer than cultural or social expectations and interferes with functioning. The COVID-19 epidemic has resulted in increased rates of PGD, and few clinicians feel confident in treating this condition. PGD therapy (PGDT) is a simple, short-term, and evidence-based treatment developed in tandem with the validation of the PGD diagnosis. To facilitate the dissemination of PGDT training, we developed a web-based therapist tutorial that includes didactic training on PGDT concepts and principles as well as web-based multimedia patient scenarios and examples of clinical implementation of PGDT. OBJECTIVE We aimed to evaluate user satisfaction with the tutorial and whether the tutorial increased trainees' knowledge of PGDT principles and procedures. Moreover, we included a small number of pilot questions to evaluate the PGDT-related clinical skills. METHODS This study evaluated tutorial learning using a pre- and poststudy design. Participants were recruited from professional organization mailing lists, announcements to graduates of the Columbia School of Social Work, and through word of mouth. After signing consent, participants completed a brief demographic survey, a 55-item multiple-choice prestudy test on the concepts and principles of PGD and PGDT covered in the tutorial, and a 4-item pilot web-based prestudy test to gauge PGD clinical implementation skills. The link to the course content was then activated, and participants were given 8 weeks to complete the 11-module tutorial containing information, web-based exercises, simulated patient and video examples, and self-tests. RESULTS Overall, 406 clinicians signed consent, and 236 (58.1%) started the tutorial. Of these, 83.1% (196/236) completed all 11 modules. Trainee scores on our PDGT assessment improved substantially from pretraining to the postmodule assessment, with the total number of correct answers increasing from a mean of 29 (SD 5.5; 52.7% correct) to 36.7 (SD 5.2; 66.7% correct; t195=18.93; P<.001). In addition, the trainee's implementation scores on 4 clinical vignettes increased from 2.6 (SD 0.7) correct out of 4 to 3.1 (SD 0.4) out of 4 (t188=7.02; P<.001). Effect sizes (Cohen d) were 1.44 (95% CI 1.23-1.65) for PDGT assessment and 1.06 (95% CI 0.84-1.29) for implementation. Trainees found the tutorial interesting, enjoyable, clearly presented, and useful for professional development. They endorsed a mean score of 3.7 (SD 0.47) on a 1 to 4 scale of agreement with recommending the course to others and feeling satisfied with the tutorial, and a mean of 3.3 (SD 0.57) with feeling able to apply the skills with clients. CONCLUSIONS This pilot study provides support for the usefulness of this web-based training for teaching clinicians how to administer PGDT. The addition of patient scenarios for clinical implementation strategies holds promise for increasing the effectiveness of PGDT training and other evidence-based treatments. TRIAL REGISTRATION ClinicalTrials.gov NCT05121792; https://www.clinicaltrials.gov/ct2/show/NCT05121792.
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Affiliation(s)
- Kenneth Kobak
- Center for Telepsychology, Madison, WI, United States
| | - M Katherine Shear
- Columbia University School of Social Work, New York, NY, United States
| | | | - Colleen Bloom
- Columbia University School of Social Work, New York, NY, United States
| | - Gaelle Bottex
- Columbia University School of Social Work, New York, NY, United States
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Ghafoori B, Salgado C, Ramos N, Murillo K, Quintana S. Utilizing a webinar to introduce an evidence-based trauma treatment in Chile: Results from a pilot study investigating clinician attitudes and needs. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2023. [DOI: 10.1080/00207411.2023.2177478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Bita Ghafoori
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
| | | | - Nadia Ramos
- Faculty of Psychology, University of Talca, Chile
| | - Karen Murillo
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
| | - Sofia Quintana
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, CA, USA
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Lindamer L, Almklov E, Pittman JOE, Shi S, Maye J, Jak A, Twamley E, Rabin B. Multi-method study of the implementation of Cognitive Symptom Management and Rehabilitation Training (CogSMART) in real-world settings. BMC Health Serv Res 2022; 22:1542. [PMID: 36528588 PMCID: PMC9758865 DOI: 10.1186/s12913-022-08941-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Cognitive Symptom Management and Rehabilitation Training (CogSMART) and Compensatory Cognitive Training (CCT) are evidence-based compensatory cognitive training interventions that improve cognition in persons with a history of traumatic brain injury or other neuropsychiatric disorders. Despite demonstrated efficacy, use and effectiveness of CogSMART/CCT in real-world settings is not known.We used a multi-method design to collect and analyze quantitative and qualitative survey data from several domains of the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to gather information about use of CogSMART/CCT in real-world settings from provider and patient perspectives. Surveys were sent to email addresses from persons who registered on the CogSMART website seeking access to training manuals and other resources. Descriptive statistics were generated, and we used Natural Language Processing methods to study the self-report free responses. Using n-gram analysis, we identified the most frequently reported responses.We found CogSMART/CCT was broadly used in real-world settings and delivered by a variety of providers for several patient groups with high attendance and overall high satisfaction. CogSMART/CCT seemed to be offered in VA- or university-related clinics more than in private practice or rehabilitation centers. The diversity of providers and variety of formats by which to deliver CogSMART/CCT (i.e., individual, group, telehealth) seemed to play a role in its widespread implementation, as did its adaptability. Most providers made adaptations to the intervention that reduced the length or number of sessions. These changes were most likely to be based on client characteristics. The low rates of formal training, however, may have contributed to lower levels of perceived helpfulness among patients.Reach and Adoption of a cognitive rehabilitation intervention improved by increasing access to the manuals. Attention to characteristics of dissemination and implementation in the design of an intervention may enhance its use in real-world settings. The relevant outcomes, easy access to training manuals, and adaptability of CogSMART/CCT seem to have been important factors in its use in a variety of settings and for several disorders with cognitive impairment. The adoption of CogSMART/CCT by a variety of providers other than neuropsychologists suggests its use may be broadened to other healthcare providers, if adequately trained, to increase access to an intervention with demonstrated efficacy for cognitive rehabilitation for several neuropsychiatric disorders.
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Affiliation(s)
- Laurie Lindamer
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Erin Almklov
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA
| | - James O. E. Pittman
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Shuyuan Shi
- grid.17091.3e0000 0001 2288 9830Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4 Canada
| | - Jacqueline Maye
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Amy Jak
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Elizabeth Twamley
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Borsika Rabin
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
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Pfiffner LJ, Dvorsky MR, Friedman LM, Haack LM, Chung S, Charalel JM, Hawkey E, Spiess M. Development of a Web-Based Training Platform for School Clinicians in Evidence-Based Practices for ADHD. SCHOOL MENTAL HEALTH 2022; 15:49-66. [PMID: 36466742 PMCID: PMC9685070 DOI: 10.1007/s12310-022-09556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
Lack of training for school clinicians in evidence-based practices (EBPs) contributes to underutilization of such services for youth with attention-deficit/hyperactivity disorder (ADHD). Advances in web-based technology and videoconferencing have allowed for expanded access to and optimization of training. We describe the development and outcomes of a novel web-based platform for training school clinicians to gain skills in EBPs for school-age youth with ADHD. The training platform is adapted from an empirically supported, in-person training for a school-home behavioral intervention (Collaborative Life Skills program) and includes skill modules for working with teachers, parents, and students. Training methods include web-accessed manuals/handouts, skill example video clips, automated progress monitoring tools, and consultation/in-session coaching via videoconferencing. We gathered stakeholder qualitative and quantitative feedback during discovery and design phases of the iterative development. We then evaluated the usability, acceptability, fidelity and clinician and student outcomes of the remote training program. Focus group themes and qualitative feedback identified clinician preferences for remote training features (e.g., interactive, brief, role-plays/coaching methods), video tools (recorded samples of skills and therapy sessions), and progress monitoring tools (e.g., clear, easy to use). Clinician usability ratings of the platform were high with most components rated as moderately to very useful/easy to use. Clinician ratings of usability, fidelity implementing the treatment, and their EBP knowledge and confidence following training were favorable. Student's outcomes were similar to those achieved in prior studies of clinician in-person training. Results support the promise of remote, web-based clinician training for the dissemination of evidence-based practices.
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Affiliation(s)
- Linda J. Pfiffner
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Melissa R. Dvorsky
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
- Department of Pediatrics and Psychiatry, Children’s National Hospital, George Washington University School of Medicine, Washington DC, US
| | - Lauren M. Friedman
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
- Department of Psychology, Arizona State University, Tempe, AZ US
| | - Lauren M. Haack
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Sara Chung
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Julia M. Charalel
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Elizabeth Hawkey
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Madeline Spiess
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
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Maddalozzo M, Maddalozzo R. Utilization of Web-Based Training to Train Clinicians in the Prolonged Exposure Protocol. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2022. [DOI: 10.1080/15401383.2022.2142715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Eiraldi R, McCurdy BL, Khanna MS, Goldstein J, Comly R, Francisco J, Rutherford LE, Wilson T, Henson K, Farmer T, Jawad AF. Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol. Pilot Feasibility Stud 2022; 8:128. [PMID: 35710520 PMCID: PMC9205032 DOI: 10.1186/s40814-022-01082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background An increasing number of schools in rural settings are implementing multi-tier positive behavioral interventions and supports (PBIS) to address school-climate problems. PBIS can be used to provide the framework for the implementation of evidence-based practices (EBPs) to address children’s mental health concerns. Given the large service disparities for children in rural areas, offering EBPs through PBIS can improve access and lead to better long-term outcomes. A key challenge is that school personnel need technical assistance in order to implement EBPs with fidelity and clinical effectiveness. Providing ongoing on-site support is not feasible or sustainable in the majority of rural schools, due to their remote physical location. For this reason, remote training technology has been recommended for providing technical assistance to behavioral health staff (BHS) in under-served rural communities. Objectives The purpose of this study is to use the user-centered design, guided by an iterative process (rapid prototyping), to develop and evaluate the appropriateness, feasibility, acceptability, usability, and preliminary student outcomes of two online training strategies for the implementation of EBPs at PBIS Tier 2. Methods The study will employ a pragmatic design comprised of a mixed-methods approach for the development of the training platform, and a hybrid type 2, pilot randomized controlled trial to examine the implementation and student outcomes of two training strategies: Remote Video vs. Remote Video plus Coaching. Discussion There is a clear need for well-designed remote training studies focused on training in non-traditional settings. Given the lack of well-trained mental health professionals in rural settings and the stark disparities in access to services, the development and pilot-testing of a remote training strategy for BHS in under-served rural schools could have a significant public health impact. Ethics and dissemination The project was reviewed and approved by the institutional review board. Results will be submitted to ClinicalTrials.gov and disseminated to community partners and participants, peer-reviewed journals, and academic conferences. Trial registration ClinicialTrials.gov, NCT05034198 and NCT05039164
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Affiliation(s)
- Ricardo Eiraldi
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA. .,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Barry L McCurdy
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | | | - Jessica Goldstein
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA
| | - Rachel Comly
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA
| | | | | | - Tara Wilson
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA
| | - Kathryn Henson
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA
| | - Thomas Farmer
- School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Abbas F Jawad
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, 2716 South Street, Room 8293, Philadelphia, PA, 19146-2305, USA.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Carrier JD, Gallagher F, Vanasse A, Roberge P. Strategies to improve access to cognitive behavioral therapies for anxiety disorders: A scoping review. PLoS One 2022; 17:e0264368. [PMID: 35231039 PMCID: PMC8887746 DOI: 10.1371/journal.pone.0264368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background Strategies to improve access to evidence-based psychological treatments (EBPTs) include but are not limited to implementation strategies. No currently available framework accounts for the full scope of strategies available to allow stakeholders to improve access to EBPTs. Anxiety disorders are common and impactful mental conditions for which EBPTs, especially cognitive-behavioral therapies (CBT), are well-established yet often hard to access. Objective Describe and classify the various strategies reported to improve access to CBT for anxiety disorders. Methods Scoping review with a keyword search of several databases + additional grey literature documents reporting on strategies to improve access to CBT for anxiety disorders. A thematic and inductive analysis of data based on grounded theory principles was conducted using NVivo. Results We propose to classify strategies to improve access to CBT for anxiety disorders as either "Contributing to the evidence base," "Identifying CBT delivery modalities to adopt in practice," "Building capacity for CBT delivery," "Attuning the process of access to local needs," "Engaging potential service users," or "Improving programs and policies." Each of these strategies is defined, and critical information for their operationalization is provided, including the actors that could be involved in their implementation. Implications This scoping review highlights gaps in implementation research regarding improving access to EBPTs that should be accounted for in future studies.
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Affiliation(s)
- Jean-Daniel Carrier
- Department of family medicine and emergency medicine, PRIMUS research group, Université de Sherbrooke, Sherbrooke, Canada
- Department of psychiatry, Université de Sherbrooke, Sherbrooke, Canada
- * E-mail:
| | - Frances Gallagher
- School of nursing, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du CHUS, Sherbrooke, Canada
| | - Alain Vanasse
- Department of family medicine and emergency medicine, PRIMUS research group, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du CHUS, Sherbrooke, Canada
| | - Pasquale Roberge
- Department of family medicine and emergency medicine, PRIMUS research group, Université de Sherbrooke, Sherbrooke, Canada
- Department of psychiatry, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du CHUS, Sherbrooke, Canada
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Wilkerson AK, Wardle-Pinkston S, Dietch JR, Pruiksma KE, Simmons RO, Bunnell BE, Taylor DJ. Web-based provider training of cognitive behavioral therapy of insomnia: engagement rates, knowledge acquisition, and provider acceptability. Cogn Behav Ther 2022; 51:343-352. [PMID: 35099360 DOI: 10.1080/16506073.2021.1996453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Insomnia is common but severely underreported and undertreated. One possible reason for this problem is the lack of providers in cognitive behavioral therapy for insomnia (CBT-I). To address this we created CBTIweb.org, an online training platform for providers to learn the basics of sleep, assessing insomnia, and CBT-I. The present study assessed the reach of CBTIweb by examining engagement, knowledge acquisition, and perceived acceptability. Participants who registered for CBTIweb self-reported their practice setting and personal characteristics (i.e. degree, profession, licensure status). Knowledge acquisition was assessed with pre- and post-tests, and provider acceptability was assessed via a survey. In the first three months after launching CBTIweb, 2586 providers registered and 624 of these completed the training within three months of registering. Chi-square tests of independence revealed no differences in completion rates by education or profession, though trainees were more likely to initiate and complete treatment than licensed providers. Paired t tests revealed significant knowledge acquisition, and most providers positively rated the website navigation, content, aesthetics, and understanding of core CBT-I skills. This study demonstrated CBTIweb is an effective platform for training health professionals to be minimally proficient in the gold standard treatment for insomnia disorder.
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Affiliation(s)
- Allison K Wilkerson
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, SC, USA
| | - Sophie Wardle-Pinkston
- Department of Psychology, University of North Texas, Denton, TX, USA.,Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Jessica R Dietch
- Department of Psychology, University of North Texas, Denton, TX, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kristi E Pruiksma
- Department of Psychiatry and Behavioral Sciences, UT Health San Antonio, San Antonio, TX, USA
| | - Richard Oliver Simmons
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, SC, USA
| | - Brian E Bunnell
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, FL, USA
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, TX, USA.,Department of Psychology, University of Arizona, Tucson, AZ, USA
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Kasparik B, Saupe LB, Mäkitalo S, Rosner R. Online training for evidence-based child trauma treatment: evaluation of the German language TF-CBT-Web. Eur J Psychotraumatol 2022; 13:2055890. [PMID: 35401949 PMCID: PMC8986224 DOI: 10.1080/20008198.2022.2055890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Evidence-based trauma-focused interventions for treating PTSD in children and youth are barely used in practice. Web-based training has proven to be an effective way of transferring knowledge to healthcare professionals. OBJECTIVE TF-CBT Web is a web-based training programme designed to foster the dissemination of Trauma Focused Cognitive Behavioural Therapy (TF-CBT) for children and youth, and is run by the Medical University of South Carolina. This paper describes the characteristics of healthcare professionals who registered for the adapted German language version of TF-CBT Web. It evaluates the effectiveness and user friendliness of the programme. METHOD : Similar to the TF-CBT treatment manual, the German language TF-CBT Web contains 12 modules. Between 2018 and 2020, 4,020 users registered for the programme. During the registration process users provided demographic information. The knowledge of users regarding the TF-CBT components was assessed via pre-tests and post-tests in each module. RESULTS The programme was accessed by a sample of mostly German users with varying professional health care backgrounds and a wide-ranging spread of work experience. The results indicated a significant knowledge gain and high rates of user satisfaction with the programme. CONCLUSIONS In summary, the results of this study suggested that web-based training is an effective and well-accepted method for knowledge gain in trauma-focused interventions. Future research should evaluate the actual application of the taught methods in clinical practice. HIGHLIGHTS Children and adolescents with PTSD require trauma-focused treatment. However, evidence-based interventions for this patient population are barely used. Therefore, it is necessary to expand professional training for the treatment of traumatised children and adolescents.Our evaluation showed the effectiveness and feasibility of a web-based training programme for mental health practitioners in an evidence-based treatment for children and youth with PTSD (TF-CBT). Results show a significant knowledge gain of users who participate in the web-based training programme.The user satisfaction survey also revealed that users found the modus and content of the web-based training applicable and relevant for their clinical practice.
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Affiliation(s)
- Barbara Kasparik
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Laura B Saupe
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Svenja Mäkitalo
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Eichstätt, Germany
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Accurso EC, Mu KJ, Landsverk J, Guydish J. Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study. J Eat Disord 2021; 9:99. [PMID: 34389052 PMCID: PMC8360814 DOI: 10.1186/s40337-021-00454-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/04/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Family-based treatment (FBT) for anorexia nervosa is an evidence-based treatment, but its effectiveness is untested among socioeconomically disadvantaged and racially diverse youth. Adapting FBT may facilitate "scale-out" for Medicaid-insured youth served in publicly-funded settings and potentially improve outcomes for more diverse populations. METHODS This mixed methods effectiveness-implementation Hybrid Type 3 pilot study protocol included a planning period in collaboration with the San Francisco Department of Public Health, culminating in a two-day in-person FBT training for 25 therapists in the county, followed by the opportunity to engage in one year of weekly supervision. The training incorporated FBT adaptations intended to improve fit for low-income families within community-based settings. Treatment appropriateness and acceptability will be measured immediately post-training. Following the training, cases referred for FBT will only be assigned to the trained clinicians who voluntarily opted into long-term group supervision. Clinicians treating at least one FBT case during the supervision period will report on implementation, adaptations, and patient weight gain. Finally, semi-structured interviews with clinician participants will be conducted, focused on implementation challenges and facilitators, local treatment adaptations, and overall satisfaction with FBT. DISCUSSION Learning about clinician adaptations will advance knowledge about treatment of eating disorders in publicly-funded community clinics, which serve a racially/ethnically and socioeconomically diverse group of youth. This project is designed to accelerate FBT implementation in publicly-funded mental health systems, and inform service improvements for underserved youth with eating disorders.
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Affiliation(s)
- Erin C Accurso
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Karen J Mu
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,San Francisco Department of Public, Health Behavioral Health Services, San Francisco, CA, USA
| | | | - Joseph Guydish
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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El Morr C, Layal M. Effectiveness of ICT-based intimate partner violence interventions: a systematic review. BMC Public Health 2020; 20:1372. [PMID: 32894115 PMCID: PMC7476255 DOI: 10.1186/s12889-020-09408-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/18/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Intimate Partner Violence is a "global pandemic". Meanwhile, information and communication technologies (ICT), such as the internet, mobile phones, and smartphones, are spreading worldwide, including in low- and middle-income countries. We reviewed the available evidence on the use of ICT-based interventions to address intimate partner violence (IPV), evaluating the effectiveness, acceptability, and suitability of ICT for addressing different aspects of the problem (e.g., awareness, screening, prevention, treatment, mental health). METHODS We conducted a systematic review, following PRISMA guidelines, using the following databases: PubMed, PsycINFO, and Web of Science. Key search terms included women, violence, domestic violence, intimate partner violence, information, communication technology, ICT, technology, email, mobile, phone, digital, ehealth, web, computer, online, and computerized. Only articles written in English were included. RESULTS Twenty-five studies addressing screening and disclosure, IPV prevention, ICT suitability, support and women's mental health were identified. The evidence reviewed suggests that ICT-based interventions were effective mainly in screening, disclosure, and prevention. However, there is a lack of homogeneity among the studies' outcome measurements and the sample sizes, the control groups used (if any), the type of interventions, and the study recruitment space. Questions addressing safety, equity, and the unintended consequences of the use of ICT in IPV programming are virtually non-existent. CONCLUSIONS There is a clear need to develop women-centered ICT design when programming for IPV. Our study showed only one study that formally addressed software usability. The need for more research to address safety, equity, and the unintended consequences of the use of ICT in IPV programming is paramount. Studies addressing long term effects are also needed.
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Affiliation(s)
- Christo El Morr
- School of Health Policy and Management, York University, 4700 Keele St, Toronto, Ontario, Canada.
| | - Manpreet Layal
- Global Health Program, York University, 4700 Keele St, Toronto, Ontario, Canada
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Norris LA, Olino TM, Gosch EA, Compton SN, Piacentini J, Ginsburg GS, Albano AM, Walkup JT, Birmaher B, Kendall PC. Person-Centered Profiles Among Treatment-Seeking Children and Adolescents with Anxiety Disorders. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:626-638. [PMID: 31039048 DOI: 10.1080/15374416.2019.1602839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Latent profile analysis (LPA) was used to derive homogeneous subgroups within the Child/Adolescent Anxiety Multimodal Study sample (N = 488; 7-17 years, M = 10.69, SD = 2.80) and examine whether class membership predicted or moderated treatment response. Subgroups were identified on baseline multi-informant measures of variables most consistently associated with outcome (youth anxiety/diagnosis, impairment, family psychopathology/functioning). Subgroup membership was examined as a predictor/moderator of outcome across the four treatment conditions (CBT, Sertraline, CBT+Sertraline, pill placebo) at posttreatment (12 weeks) and open-extension follow-up (24 weeks). Four subgroups emerged: mild symptoms/impairment, moderate symptoms/impairment, moderate symptoms/impairment with family dysfunction/parental psychopathology, and severe symptoms/impairment. There were significant between-class differences on socioeconomic status (SES; lower reported SES in the moderate with family dysfunction/parental psychopathology class compared to the mild and moderate class) and age (older age in the severe symptoms class compared to the other three classes). Youth in the mild symptoms/impairment class showed lower posttreatment anxiety across conditions but reported significantly lower symptom severity at baseline. Controlling for demographic differences, response to treatment type did not differ across classes. Analyses indicate that elevated family dysfunction/parental psychopathology clusters primarily within one subgroup of anxious youth rather than mapping onto symptom severity, highlighting the utility of LPA for clarifying within-person combinations of predictor/moderator variables. Implications for development of interventions targeting class-relevant variables are discussed.
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Affiliation(s)
| | | | - Elizabeth A Gosch
- Department of Psychology, Philadelphia College of Osteopathic Medicine
| | - Scott N Compton
- Department of Psychiatry and Behavioral Psychology, Duke University Medical Center
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles School of Medicine
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut Health Center
| | - Anne Marie Albano
- Department of Psychiatry, New York State Psychiatric Institute-Columbia University Medical Center
| | - John T Walkup
- Department of Psychiatry, Weill Cornell Medicine, New York-Presbyterian
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh School of Medicine
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A Preliminary Test of a Social Connectedness Burnout Intervention for Mexican Mental Health Professionals. PSYCHOLOGICAL RECORD 2019. [DOI: 10.1007/s40732-019-00338-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Burn M, Tully LA, Jiang Y, Piotrowska PJ, Collins DAJ, Sargeant K, Hawes D, Moul C, Lenroot RK, Frick PJ, Anderson V, Kimonis ER, Dadds MR. Evaluating Practitioner Training to Improve Competencies and Organizational Practices for Engaging Fathers in Parenting Interventions. Child Psychiatry Hum Dev 2019; 50:230-244. [PMID: 30078112 PMCID: PMC6428790 DOI: 10.1007/s10578-018-0836-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Fathers are consistently underrepresented in parenting interventions and practitioners are an important target for change in interventions to enhance father engagement. This research examined the effects of two practitioner training programs in improving practitioner rated competencies and organizational father-inclusive practices. Two studies were conducted, each with a single group, repeated measures (pre, post and 2-month follow-up) design. Study 1 (N = 233) examined the outcomes of face-to-face training in improving practitioner ratings of competencies in engaging fathers, perceived effectiveness and use of father engagement strategies, organizational practices and rates of father engagement. Study 2 (N = 356) examined online training using the same outcome measures. Practitioners in both training formats improved in their competencies, organizational practices and rates of father engagement over time, yet those in the online format deteriorated in three competencies from post-training to follow-up. The implications for delivering practitioner training programs to enhance competencies and rates of father engagement are discussed.
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Affiliation(s)
- M. Burn
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - L. A. Tully
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - Y. Jiang
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - P. J. Piotrowska
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - D. A. J. Collins
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - K. Sargeant
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - D. Hawes
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - C. Moul
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - R. K. Lenroot
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052 Australia
| | - P. J. Frick
- 0000 0001 0662 7451grid.64337.35Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803 USA ,0000 0001 2194 1270grid.411958.0Learning Sciences Institute of Australia, Australian Catholic University, Brisbane, QLD 4000 Australia
| | - V. Anderson
- 0000 0000 9442 535Xgrid.1058.cRoyal Children’s Hospital, Murdoch Children’s Research Institute, Parkville, VIC 3052 Australia ,0000 0001 2179 088Xgrid.1008.9Department of Psychology, University of Melbourne, Parkville Campus, Melbourne, VIC 3010 Australia ,0000 0001 2179 088Xgrid.1008.9Department of Paediatrics, University of Melbourne, Parkville Campus, Melbourne, VIC 3010 Australia
| | - E. R. Kimonis
- 0000 0004 4902 0432grid.1005.4School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - M. R. Dadds
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
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Asnaani A, Gallagher T, Foa EB. Evidence‐based protocols: Merits, drawbacks, and potential solutions. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kendall PC, Crane ME, Phillips KE. Leaping ahead in clinical training. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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19
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O'Connor M, Morgan KE, Bailey-Straebler S, Fairburn CG, Cooper Z. Increasing the Availability of Psychological Treatments: A Multinational Study of a Scalable Method for Training Therapists. J Med Internet Res 2018; 20:e10386. [PMID: 29884606 PMCID: PMC6015265 DOI: 10.2196/10386] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/07/2018] [Accepted: 04/08/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. A highly scalable form of Web-centered therapist training, undertaken without external support, has recently been shown to have promise in promoting therapist competence. OBJECTIVE The aim of this study was to conduct an evaluation of the acceptability and effectiveness of a scalable independent form of Web-centered training in a multinational sample of therapists and investigate the characteristics of those most likely to benefit. METHODS A cohort of eligible therapists was recruited internationally and offered access to Web-centered training in enhanced cognitive behavioral therapy, a multicomponent, evidence-based, psychological treatment for any form of eating disorder. No external support was provided during training. Therapist competence was assessed using a validated competence measure before training and after 20 weeks. RESULTS A total of 806 therapists from 33 different countries expressed interest in the study, and 765 (94.9%) completed a pretraining assessment. The median number of training modules completed was 15 out of a possible 18 (interquartile range, IQR: 4-18), and 87.9% (531/604) reported that they treated at least one patient during training as recommended. Median pretraining competence score was 7 (IQR: 5-10, range: 0-19; N=765), and following training, it was 12 (IQR: 9-15, range: 0-20; N=577). The expected change in competence scores from pretraining to posttraining was 3.5 (95% CI 3.1-3.8; P<.001). After training, 52% (300/574) of therapists with complete competence data met or exceeded the competence threshold, and 45% (95% CI 41-50) of those who had not met this threshold before training did so after training. Compliance with training predicted both an increase in competence scores and meeting or exceeding the competence threshold. Expected change in competence score increased for each extra training module completed (0.19, 95% CI 0.13-0.25), and those who treated a suitable patient during training had an expected change in competence score 1.2 (95% CI 0.4-2.1) points higher than those who did not. Similarly, there was an association between meeting the competence threshold after training and the number of modules completed (odds ratio, OR=1.11, 95% CI 1.07-1.15), and treating at least one patient during training was associated with competence after training (OR=2.2, 95% CI 1.2-4.1). CONCLUSIONS Independent Web-centered training can successfully train large numbers of therapists dispersed across a wide geographical area. This finding is of importance because the availability of a highly scalable method of training potentially increases the number of people who might receive effective psychological treatments.
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Affiliation(s)
- Marianne O'Connor
- Centre for Research on Dissemination at Oxford, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Katy E Morgan
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Suzanne Bailey-Straebler
- Centre for Research on Dissemination at Oxford, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Christopher G Fairburn
- Centre for Research on Dissemination at Oxford, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Zafra Cooper
- Centre for Research on Dissemination at Oxford, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States
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20
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Washburn M, Parrish DE, Bordnick PS. Virtual Patient Simulations for Brief Assessment of Mental Health Disorders in Integrated Care Settings. SOCIAL WORK IN MENTAL HEALTH 2018; 18:121-148. [PMID: 32952451 PMCID: PMC7500537 DOI: 10.1080/15332985.2017.1336743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This mixed methods pilot investigation evaluated the use of virtual patient simulations for increasing self-efficacy and diagnostic accuracy for common behavioral health concerns within an integrated care setting. A two by three factorial design was employed to evaluate three different simulated training conditions with a sample of 22 Masters level behavioral health students. Results support engagement in virtual patient simulation training to increase students' self-efficacy in brief clinical assessment, and support the use of virtual patient simulations to improve diagnostic accuracy. Results further indicate that virtual patient simulations have sufficient levels of usability and acceptability as a tool for developing brief clinical interviewing skills, and that participants found this method of instruction to be a valuable adjunct to traditional classroom or field based training. Future directions and next steps for the integration of technology enhanced simulations in clinical social services education are explored.
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Affiliation(s)
- Micki Washburn
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Danielle E Parrish
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
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21
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Cooper Z, Bailey-Straebler S, Morgan KE, O'Connor ME, Caddy C, Hamadi L, Fairburn CG. Using the Internet to Train Therapists: Randomized Comparison of Two Scalable Methods. J Med Internet Res 2017; 19:e355. [PMID: 29046265 PMCID: PMC5666223 DOI: 10.2196/jmir.8336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 12/04/2022] Open
Abstract
Background One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. The currently accepted method of training is not scalable. Recently, a scalable form of training, Web-centered training, has been shown to have promise. Objective The goal of our research was to conduct a randomized comparison of the relative effects of independent and supported Web-centered training on therapist competence and investigate the persistence of the effects. Methods Eligible therapists were recruited from across the United States and Canada. They were randomly assigned to 1 of 2 forms of training in enhanced cognitive behavior therapy (CBT-E), a multicomponent evidence-based psychological treatment for any form of eating disorder. Independent training was undertaken autonomously, while supported training was accompanied by support from a nonspecialist worker. Therapist competence was assessed using a validated competence measure before training, after 20 weeks of training, and 6 months after the completion of training. Results A total of 160 therapists expressed interest in the study, and 156 (97.5%) were randomized to the 2 forms of training (81 to supported training and 75 to independent training). Mixed effects analysis showed an increase in competence scores in both groups. There was no difference between the 2 forms of training, with mean difference for the supported versus independent group being –0.06 (95% Cl –1.29 to 1.16, P=.92). A total of 58 participants (58/114, 50.9%) scored above the competence threshold; three-quarters (43/58, 74%) had not met this threshold before training. There was no difference between the 2 groups in the odds of scoring over the competence threshold (odds ratio [OR] 1.02, 95% CI 0.52 to 1.99; P=.96). At follow-up, there was no significant difference between the 2 training groups (mean difference 0.19, 95% Cl –1.27 to 1.66, P=.80). Overall, change in competence score from end of training to follow-up was not significant (mean difference –0.70, 95% CI –1.52 to 0.11, P=.09). There was also no difference at follow-up between the training groups in the odds of scoring over the competence threshold (OR 0.95, 95% Cl 0.34 to 2.62; P=.92). Conclusions Web-centered training was equally effective whether undertaken independently or accompanied by support, and its effects were sustained. The independent form of Web-centered training is particularly attractive as it provides a means of training large numbers of geographically dispersed therapists at low cost, thereby overcoming several obstacles to the widespread dissemination of psychological treatments.
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Affiliation(s)
- Zafra Cooper
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | | | - Katy E Morgan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Caroline Caddy
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Layla Hamadi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Kobak KA, Lipsitz JD, Markowitz JC, Bleiberg KL. Web-Based Therapist Training in Interpersonal Psychotherapy for Depression: Pilot Study. J Med Internet Res 2017; 19:e257. [PMID: 28716769 PMCID: PMC5537562 DOI: 10.2196/jmir.7966] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/04/2017] [Accepted: 06/05/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Training mental health professionals to deliver evidence-based therapy (EBT) is now required by most academic accreditation bodies, and evaluating the effectiveness of such training is imperative. However, shortages of time, money, and trained EBT clinician teachers make these challenges daunting. New technologies may help. The authors have developed the first empirically evaluated comprehensive Internet therapist training program for interpersonal psychotherapy (IPT). OBJECTIVE The aim of this study was to examine whether (1) the training protocol would increase clinicians' knowledge of IPT concepts and skills and (2) clinicians would deem the training feasible as measured by satisfaction and utility ratings. METHODS A total of 26 clinicians enrolled in the training, consisting of (1) a Web-based tutorial on IPT concepts and techniques; (2) live remote training via videoconference, with trainees practicing IPT techniques in a role-play using a case vignette; and (3) a Web-based portal for therapists posttraining use to help facilitate implementation of IPT and maintain adherence over time. RESULTS Trainees' knowledge of IPT concepts and skills improved significantly (P<.001). The standardized effect size for the change was large: d=2.53, 95% CI 2.23-2.92. Users found the technical features easy to use, the content useful for helping them treat depressed clients, and felt the applied training component enhanced their professional expertise. Mean rating of applied learning was 3.9 (scale range from 1=very little to 5=a great deal). Overall satisfaction rating was 3.5 (range from 1=very dissatisfied to 4=very satisfied). CONCLUSIONS Results support the efficacy and feasibility of this technology in training clinicians in EBTs and warrant further empirical evaluation.
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Affiliation(s)
| | - Joshua D Lipsitz
- Department of Psychology, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - John C Markowitz
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University College of Physicians & Surgeons, New York, NY, United States
| | - Kathryn L Bleiberg
- Weill Cornell Medicine, Department of Psychiatry, New York, NY, United States
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Anton MT, Jones DJ. Adoption of Technology-Enhanced Treatments: Conceptual and Practical Considerations. ACTA ACUST UNITED AC 2017; 24:223-240. [PMID: 28966479 DOI: 10.1111/cpsp.12197] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As the efficacy of technology-enhanced mental health service delivery models (i.e., supportive or adjunctive technological tools) are examined, we must inform and guide clinician decision-making regarding acceptance and, in turn, uptake. Accordingly, this review aims to move beyond traditional discussions of geographic barriers by integrating, reconciling, and extending literatures on dissemination and implementation, as well as technology uptake, in order to anticipate and address organizational and clinician barriers to adoption of technology-enhancements. Specifically, a five-stage model is proposed to address organizational readiness for and clinician acceptance of technology-enhancements to evidence-based treatments, as well as the relevance of current adoption strategies for technology-enhanced services. Our aim is to provide a guiding framework for future research and practice.
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Affiliation(s)
- Margaret T Anton
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Deborah J Jones
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
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Kobak KA, Wolitzky-Taylor K, Craske MG, Rose RD. Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies. COGNITIVE THERAPY AND RESEARCH 2017; 41:252-265. [PMID: 28435174 PMCID: PMC5396958 DOI: 10.1007/s10608-016-9819-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT.
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Affiliation(s)
| | - Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | | | - Raphael D. Rose
- Department of Psychology, University of California, Los Angeles
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26
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Comer JS. Introduction to the Special Series: Applying New Technologies to Extend the Scope and Accessibility of Mental Health Care. COGNITIVE AND BEHAVIORAL PRACTICE 2015. [DOI: 10.1016/j.cbpra.2015.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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