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< .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≥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.

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.

Training Methods in Cognitive Behavioral Therapy: Tradition and Invention

2013 ◽  
Vol 27 (1) ◽  
pp. 19-29 ◽  
Author(s):  
Robert D. Friedberg ◽  
Gina M. Brelsford
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Cognitive Flexibility ◽  
Teaching Methods ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Popular Media ◽  
Cognitive Behavioral ◽  
Training Methods ◽  
Live Supervision ◽  
Tolerance For Ambiguity

Cognitive behavioral supervisors influence new generations of clients and clinicians. Accordingly, the task is meaningful, rewarding, challenging, and critically important. This article describes traditional and unconventional approaches to supervising clinicians in cognitive behavioral therapy (CBT). Traditional methods such as the use of the Cognitive Therapy Rating Scale, videotape/audiotape review, live supervision, and cotherapy are reviewed. Further, inventive procedures for teaching supervisees cognitive flexibility, empathy, tolerance for ambiguity, and remaining steadfast when faced with negative emotional arousal are explained. Popular media, improvisation and acting exercises, and working with professional actors as teaching methods are explained.

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.

scholarly journals Emotion-Abstraction Patterns and Cognitive Interventions in a Single Case of Standard Cognitive-Behavioral Therapy

2015 ◽  
Vol 17 (2) ◽  
Author(s):  
Sandra Sassaroli ◽  
Romina Brambilla ◽  
Eva Cislaghi ◽  
Roberta Colombo ◽  
Eva Cislaghi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Therapeutic Change ◽  
Cognitive Behavioral ◽  
Therapeutic Interventions ◽  
Abstract Thinking ◽  
Cognitive Content ◽  
Cognitive Interventions

Cognitive-behavioral therapy (CBT) assumes that therapeutic change de-pends mainly on change of cognitive content, while, from a theoretical viewpoint, other processes are excluded. This study aims to explore standard CBT interventions using a model of therapeutic change that includes both emotional and cognitive processes, i.e., the therapeutic cycle model (TCM; Mergenthaler, 1985; 1996), which describes the pro-cesses of therapeutic change in terms of cycles involving both emotional arousal and ab-stract thinking activation. We classified standard CBT interventions in three main are-as: assessing, disputing, and reframing biased beliefs. In 10 individual cognitive therapy sessions with a 30-year-old patient affected by a panic disorder with agoraphobia (PDA), this study aimed to explore whether cognitive interventions are not only related to abstract thinking but also to the emotional activation phases of TCM. Three inde-pendent judges assessed the presence of cognitive therapeutic interventions using the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS; Trijsburg et al., 2002). A software program measured the TCM cognitive and emotional variables. The measures revealed significant correlations between cognitive therapeutic interventions and phases of abstract thinking activation during the therapeutic process. The results clarified the role of cognitive interventions in the therapeutic process as a useful instru-ment aimed to increase reality testing.

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.

Suitability for Short-Term Cognitive-Behavioral Therapy

2007 ◽  
Vol 21 (4) ◽  
pp. 334-345 ◽  
Author(s):  
Gail Myhr ◽  
Jeanne Talbot ◽  
Lawrence Annable ◽  
Gilbert Pinard
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Linear Regression Analysis ◽  
Cognitive Behavioral ◽  
Reliable Change Index ◽  
Short Term ◽  
Variable Model ◽  
Wide Range

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.

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.

scholarly journals Predictors of outcome for telephone and face-to-face administered cognitive behavioral therapy for depression

2015 ◽  
Vol 45 (15) ◽  
pp. 3205-3215 ◽  
Author(s):  
C. Stiles-Shields ◽  
M. E. Corden ◽  
M. J. Kwasny ◽  
S. M. Schueller ◽  
D. C. Mohr
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Classification And Regression Tree ◽  
Psychological Characteristics ◽  
Treatment Modalities ◽  
Depression Severity ◽  
Predictors Of Outcome ◽  
Face To Face

BackgroundCognitive behavioral therapy (CBT) can be delivered efficaciously through various modalities, including telephone (T-CBT) and face-to-face (FtF-CBT). The purpose of this study was to explore predictors of outcome in T-CBT and FtF-CBT for depression.MethodA total of 325 depressed participants were randomized to receive eighteen 45-min sessions of T-CBT or FtF-CBT. Depression severity was measured using the Hamilton Depression Rating Scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9). Classification and regression tree (CART) analyses were conducted with baseline participant demographics and psychological characteristics predicting depression outcomes, HAMD and PHQ-9, at end of treatment (week 18).ResultsThe demographic and psychological characteristics accurately identified 85.3% and 85.0% of treatment responders and 85.7% and 85.0% of treatment non-responders on the HAMD and PHQ-9, respectively. The Coping self-efficacy (CSE) scale predicted outcome on both the HAMD and PHQ-9; those with moderate to high CSE were likely to respond with no other variable influencing that prediction. Among those with low CSE, depression severity influenced response. Social support, physical functioning, and employment emerged as predictors only for the HAMD, and sex predicted response on the PHQ-9. Treatment delivery method (i.e. telephone or face-to-face) did not impact the prediction of outcome.ConclusionsFindings suggest that the predictors of improved depression are similar across treatment modalities. Most importantly, a moderate to high level of CSE significantly increases the chance of responding in both T-CBT and FtF-CBT. Among patients with low CSE, those with lower depressive symptom severity are more likely to do well in treatment.

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