We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy

Abstract

There has been little research on the effectiveness of different training strategies or the impact of exposure to treatment manuals alone on clinicians' ability to effectively implement empirically supported therapies. Seventy-eight community-based clinicians were assigned to 1 of 3 training conditions: review of a cognitive-behavioral therapy (CBT) manual only, review of the manual plus access to a CBT training Web site, or review of the manual plus a didactic seminar followed by supervised casework. The primary outcome measure was the clinicians' ability to demonstrate key CBT interventions, as assessed by independent ratings of structured role plays. Statistically significant differences favoring the seminar plus supervision over the manual only condition were found for adherence and skill ratings for 2 of the 3 role plays, with intermediate scores for the Web condition.

Figure 1

Role Play 1 (presenting the cognitive–behavioral therapy rationale and functional analysis): adherence scores by time and training condition. Scores range from 1 to 7, with higher scores indicating better adherence. The solid horizontal line indicates the criterion level that is typical for certification in clinical efficacy trials.

Figure 2

Role Play 1 (presenting the cognitive–behavioral therapy rationale and functional analysis): skill scores by time and training condition. Scores range from 1 to 7, with higher scores indicating better skill. The solid horizontal line indicates the criterion level that is typical for certification in clinical efficacy trials.