scholarly journals Changes in community clinicians’ attitudes and competence following a transdiagnostic Cognitive Behavioral Therapy training

2021 ◽  
Vol 2 ◽  
pp. 263348952110302
Author(s):  
Torrey A Creed ◽  
Margaret E Crane ◽  
Amber Calloway ◽  
Thomas M Olino ◽  
Philip C Kendall ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
System Level ◽  
Evidence Based ◽  
Plain Language ◽  
Evidence Based Practices ◽  
Change Models ◽  
Intensive Training ◽  
Clinician Attitudes

Background: Although the literature suggests that attitudes toward evidence-based practices (EBPs) are associated with provider use of EBPs, less is known about the association between attitudes and how competently EBPs are delivered. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians ( N = 891) received intensive training in cognitive behavioral therapy skills followed by 6 months of consultation. Clinician attitudes were assessed using the Evidence-Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data were analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase). Results: Latent change models identified significant improvement in attitudes ( Mslatent change ⩾ 1.07, SEs ⩽ 0.19, zs ⩾ 6.85, ps < .001) and competence ( Mslatent change ⩾ 13.13, SEs ⩽ 3.53, zs ⩾ 2.30, ps < .001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training ( bs ⩾ 1.58, SEs ⩽ 1.13, z ⩾ 1.89, p < .048, β ⩾ .09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase ( b = 1.40, SE = 1.07, z = 1.31, p = .19, β = .08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training. Following participation in initial training workshops, other factors such as subjective norms, implementation culture, or system-level policy shifts may be more predictive of change in competence throughout consultation. Plain Language Summary Although previous research has suggested that a learner’s knowledge of evidence-based practices (EBPs) and their attitudes toward EBPs may be related, little is known about the association between a learner’s attitudes and their competence in delivering EBPs. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following training in an EBP. This study suggests that community clinicians’ initial attitudes about evidence-based mental health practices are related to how well they ultimately learn to deliver those practices. This finding suggests that future implementation efforts may benefit from directly targeting clinician attitudes prior to training, rather than relying on more broad-based training strategies.

scholarly journals Changes in Community Clinicians’ Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training

2020 ◽  
Author(s):  
Torrey A. Creed ◽  
Margaret Ellen Crane ◽  
Amber Calloway ◽  
Thomas M Olino ◽  
Philip C. Kendall ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Change Score ◽  
Attitude Scale ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Training Methods ◽  
Change Models ◽  
Intensive Training

Objective: Although data suggest that knowledge of evidence-based practices (EBPs) and attitudes towards EBPs may be related, the relation between attitudes and competence in delivering EBPs has not been examined. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians (N=891) received intensive training in cognitive behavioral therapy skills followed by six months of consultation. Clinician attitudes were assessed using the Evidence Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data was analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase).Results: Latent change models identified significant improvement in attitudes (Mslatent change≥1.07, SEs≤ 0.19, zs≥6.85, ps&lt; .001) and competence (Mslatent change≥13.13, SEs≤3.53, zs≥2.30, ps&lt;.001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training (bs≥1.58, SEs≤1.13, z≥1.89, p&lt;.048, β≥0.09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase (b=1.40, SE=1.07, z=1.31, p=.19, β=0.08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training.

Schools and Approaches to Psychotherapy

2017 ◽  
Author(s):  
Kathleen Someah ◽  
Christopher Edwards ◽  
Larry E. Beutler
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavior Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Positive Effects ◽  
New Approaches ◽  
The Many ◽  
Sheer Number

There are many approaches to psychotherapy, commonly called “schools” or “theories.” These schools range from psychoanalytic, to variations of insight- and conflict-based approaches, through behavioral and cognitive behavioral approaches, to humanistic/existential approaches, and finally to integrative and eclectic approaches. Different and seemingly new approaches typically have been informed by older and more established ones. For instance, cognitive behavioral therapy (CBT), one of the more widely used approaches, evolved from traditional behavior therapy but has become sufficiently distinct by adding its own complex variations so as functionally to represent an approach of its own. New approaches abound both in number and in complexity. Modern clinicians have had to become increasingly widely read and creative in trying to understand the ways in which patients may be helped. The sheer number of approaches, which has climbed into the hundreds, has challenged the field to find ways of ensuring that the treatments presented are effective. The advent of Evidence Based Practices (EBP) throughout the healthcare fields has placed the responsibility on those who advocate for particular types of treatment scientifically to demonstrate their efficacy and effectiveness. While this movement has brought standards to the field and has offered some assurance that psychotherapy is usually helpful, there remains much debate about whether the many different schools produce different results from one another. The debate about how best to optimize positive effects of psychotherapy continues, and there remain many questions to be asked of psychotherapy theories and of research on these approaches.

scholarly journals Brief Psychotherapy for Depression: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 129-151 ◽  
Author(s):  
Jason A. Nieuwsma ◽  
Ranak B. Trivedi ◽  
Jennifer McDuffie ◽  
Ian Kronish ◽  
Dinesh Benjamin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Cognitive Behavioral Therapy ◽  
Systematic Reviews ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Brief Psychotherapy ◽  
Problem Solving Therapy

Objective: Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression. Methods: We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. Results: We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I2 = 0%). Conclusions: Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.

A Model for Sustaining Evidence-Based Practices in a Statewide System

2017 ◽  
Vol 98 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Jason M. Lang ◽  
Kellie G. Randall ◽  
Michelle Delaney ◽  
Jeffrey J. Vanderploeg
Keyword(s):  
Public Health ◽  
Cognitive Behavioral Therapy ◽  
Quality Indicators ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Public ◽  
The Past ◽  
Large Systems

Over the past 20 years, efforts have been made to broadly disseminate evidence-based practices (EBPs). However, the public health impact of EBPs has yet to be realized and most EBPs are not sustained. Few structured models exist for disseminating and sustaining EBPs across large systems. This article describes the EBP Dissemination and Support Center (DSC) model and how it was used to sustain trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut. More than 600 clinicians at 35 agencies have been trained and nearly all agencies have sustained TF-CBT for up to 9 years. More than 6,200 children have received TF-CBT and have shown improvements in outcomes and quality indicators. Recommendations are made for using or adapting the DSC model.

scholarly journals Healing Interpersonal and Racial Trauma: Integrating Racial Socialization Into Trauma-Focused Cognitive Behavioral Therapy for African American Youth

2020 ◽  
pp. 107755952092145 ◽  
Author(s):  
Isha W. Metzger ◽  
Riana Elyse Anderson ◽  
Funlola Are ◽  
Tiarney Ritchwood
Keyword(s):  
African American ◽  
Cognitive Behavioral Therapy ◽  
Racial Socialization ◽  
Behavioral Therapy ◽  
African American Youth ◽  
Cognitive Behavioral ◽  
Trauma Treatment ◽  
Evidence Based ◽  
Socialization Theory ◽  
Racial Trauma

African American youth are more likely than their peers from other racial and ethnic groups to experience interpersonal traumas and traumatic racist and discriminatory encounters. Unfortunately, evidence-based trauma treatments have been less effective among these youth likely due to these treatments not being culturally tailored to address both interpersonal and racial trauma. In this article, we utilize the racial encounter coping appraisal and socialization theory to propose suggestions for adapting trauma-focused cognitive behavioral therapy—an evidence-based trauma treatment for children and adolescents—to include racial socialization or the process of transmitting culture, attitudes, and values to help youth overcome stressors associated with ethnic minority status. We conclude by discussing implications for the research and clinical community to best promote healing from both interpersonal and racial trauma for African American youth.

Trauma-Focused Cognitive–Behavioral Therapy

2013 ◽  
Author(s):  
Susan A. Green ◽  
Doyle K. Pruitt
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Posttraumatic Stress ◽  
Evidence Based Practice ◽  
Traumatic Event ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Diverse Populations ◽  
Manualized Treatment ◽  
The Individual

Trauma-focused cognitive–behavioral therapy (TF-CBT) is a manualized treatment for children 3–17 years old who have posttraumatic stress symptomology as a result of experiencing a traumatic event or series of events. This evidence-based practice allows for practitioner expertise in adapting the order and time spent on each of the treatment components to best meet the individual needs of the child and his or her caretaker. This article provides an overview of the treatment components of TF-CBT, its application across various settings, use with diverse populations, and effectiveness.

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