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Festschrift: Gary Bond and Fidelity Assessment
Published Online: 1 August 2012

Use of Fidelity Assessments to Train Clinicians in the CBT for PTSD Program for Clients With Serious Mental Illness

Abstract

Objective:

One barrier to disseminating evidence-based practices for persons with serious mental illness is the difficulty of training frontline clinicians. This study evaluated whether frontline clinicians could be trained to implement an empirically supported cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) among persons with serious mental illness when a standardized fidelity measure was used to provide clinicians with feedback on practice cases.

Methods:

Twenty-five clinicians (23 master's level) at five agency sites were trained in the CBT for PTSD program and delivered it to 35 clients (practice cases) over six months. Supervisors or consultants used the fidelity measure to rate audio-recorded sessions and provide feedback. A criterion of competence was established to designate program certification. Clients' PTSD and depression symptoms were monitored. Clinicians' satisfaction with training was also assessed.

Results:

Two clinicians dropped out, and 21 of the remaining 23 clinicians (91%) achieved program certification with their first case; the remaining two (9%) achieved it with their second case. Clients' symptoms, measured by the PTSD Checklist and the Beck Depression Inventory, decreased significantly during treatment, suggesting clinical benefits of the program. Clinicians reported that group supervision was very helpful and written feedback was helpful or very helpful. All rated the training as excellent.

Conclusions:

Results support the feasibility of training frontline clinicians in the CBT for PTSD program by using regular feedback based on the fidelity measure and indicate that most clinicians can achieve competence in the model with a single practice case. (Psychiatric Services 63:785–792, 2012; doi: 10.1176/appi.ps.201000458)

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Figures and Tables

Figure 1 Scores on the Beck Depression Inventory-II (BDI-II) and the PTSD Checklist (PCL) for 26 clients who completed the program
Table 1 Characteristics of 25 clinicians participating in training
Table 2 Characteristics of participants in the cognitive-behavioral therapy for posttraumatic stress disorder program for clients with serious mental illness
Table 3 Ratings on the CBT for PTSD Fidelity Scale for 25 clinicians for their first or second practice case

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Girl With Ball, by Roy Lichtenstein, 1961. Oil on canvas. Gift of Philip Johnson. The Museum of Modern Art, New York. Digital image © The Museum of Modern Art/Licensed by SCALA/Art Resource, New York.
Psychiatric Services
Pages: 785 - 792
PubMed: 22854726

History

Published online: 1 August 2012
Published in print: August 2012

Authors

Details

Weili Lu, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Philip T. Yanos, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Jennifer D. Gottlieb, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Stephanie Marcello Duva, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Steven M. Silverstein, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Haiyi Xie, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Stanley D. Rosenberg, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.
Kim T. Mueser, Ph.D.
Dr. Lu is affiliated with the Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey. Dr. Yanos is with the Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York City. Dr. Gottlieb, Dr. Xie, Dr. Rosenberg, and Dr. Mueser are with the Dartmouth Psychiatric Research Center, Dartmouth College, Lebanon, New Hampshire. Dr. Duva and Dr. Silverstein are with the Department of Psychiatry, University Behavioral Health Care and Robert Wood Johnson Medical School, Piscataway, New Jersey. Dr. Mueser and Dr. Gottlieb are also with the Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02115 (e-mail: [email protected]). This article is part of a special section, Festschrift: Gary Bond and Fidelity Assessment, for which Michelle P. Salyers, Ph.D., served as guest editor.

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