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Published Online: 1 July 2012

Training and Consultation to Promote Implementation of an Empirically Supported Treatment: A Randomized Trial

Abstract

Objective:

The study evaluated the efficacy of three training modalities and the impact of ongoing consultation after training. Cognitive-behavioral therapy (CBT) for anxiety among youths, an empirically supported treatment, was used as the exemplar. Participants were randomly assigned to one of three one-day workshops to examine the efficacy of training modality: routine training (training as usual), computer training (computerized version of training as usual), and augmented training (training that emphasized active learning). After training, all participants received three months of ongoing consultation that included case consultation, didactics, and problem solving.

Methods:

Participants were 115 community therapists (mean age of 35.9 years; 90% were women). Outcome measures included the Adherence and Skill Checklist, used to rate a performance-based role-play; a knowledge test; and the Training Satisfaction Rating Scale.

Results:

All three training modalities resulted in limited gains in therapist adherence, skill, and knowledge. There was no significant effect of modality on adherence, skill, or knowledge from pretraining to posttraining. Participants were more satisfied with augmented and routine training than with computer training. Most important, number of consultation hours after training significantly predicted higher therapist adherence and skill at the three-month follow-up.

Conclusions:

The findings suggest that training alone did not result in therapist behavior change. The inclusion of ongoing consultation was critical to influencing therapist adherence and skill. Implications for implementation science and mental health services research are discussed. (Psychiatric Services 63:660–665, 2012; doi: 10.1176/appi.ps.201100401)

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Figures and Tables

Table 1 Characteristics of 115 community therapists
Table 2 Outcomes of augmented, routine, and computer training of 115 community therapists
Table 3 Community therapists trained to criterion after a one-day workshop and three months of follow-up consultation, by training condition

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Flag on Orange Field, by Jasper Johns, 1967. Museum Ludwig, Cologne, Germany. © VAGA, New York. Photo © Erich Lessing/Art Resource, New York.
Psychiatric Services
Pages: 660 - 665
PubMed: 22549401

History

Published online: 1 July 2012
Published in print: July 2012

Authors

Details

Rinad S. Beidas, Ph.D.
Dr. Beidas is affiliated with the Department of Psychiatry, University of Pennsylvania, 3535 Market St., Room 3015, Philadelphia, PA 19104 (e-mail: [email protected]). Ms. Edmunds and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Marcus is with the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia. Portions of this work were presented at the National Institutes of Health Conference on the Science of Dissemination and Implementation, March 15–16, 2010, Bethesda, Maryland; World Congress of Behavioral and Cognitive Therapies Convention, June 2–5, 2010, Boston; and the Association for Behavioral and Cognitive Therapies Convention, November 18–21, 2010, San Francisco.
Julie M. Edmunds, M.A.
Dr. Beidas is affiliated with the Department of Psychiatry, University of Pennsylvania, 3535 Market St., Room 3015, Philadelphia, PA 19104 (e-mail: [email protected]). Ms. Edmunds and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Marcus is with the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia. Portions of this work were presented at the National Institutes of Health Conference on the Science of Dissemination and Implementation, March 15–16, 2010, Bethesda, Maryland; World Congress of Behavioral and Cognitive Therapies Convention, June 2–5, 2010, Boston; and the Association for Behavioral and Cognitive Therapies Convention, November 18–21, 2010, San Francisco.
Steven C. Marcus, Ph.D.
Dr. Beidas is affiliated with the Department of Psychiatry, University of Pennsylvania, 3535 Market St., Room 3015, Philadelphia, PA 19104 (e-mail: [email protected]). Ms. Edmunds and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Marcus is with the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia. Portions of this work were presented at the National Institutes of Health Conference on the Science of Dissemination and Implementation, March 15–16, 2010, Bethesda, Maryland; World Congress of Behavioral and Cognitive Therapies Convention, June 2–5, 2010, Boston; and the Association for Behavioral and Cognitive Therapies Convention, November 18–21, 2010, San Francisco.
Philip C. Kendall, Ph.D., A.B.P.P.
Dr. Beidas is affiliated with the Department of Psychiatry, University of Pennsylvania, 3535 Market St., Room 3015, Philadelphia, PA 19104 (e-mail: [email protected]). Ms. Edmunds and Dr. Kendall are with the Department of Psychology, Temple University, Philadelphia. Dr. Marcus is with the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and with the School of Social Policy and Practice, University of Pennsylvania, Philadelphia. Portions of this work were presented at the National Institutes of Health Conference on the Science of Dissemination and Implementation, March 15–16, 2010, Bethesda, Maryland; World Congress of Behavioral and Cognitive Therapies Convention, June 2–5, 2010, Boston; and the Association for Behavioral and Cognitive Therapies Convention, November 18–21, 2010, San Francisco.

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