Online self-administered training for post-traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study

Abstract

This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-based practice; however, there is a dearth of well-controlled outcome studies of these approaches. For the current trial, 168 mental health providers treating post-traumatic stress disorder (PTSD) were assigned to web-based training plus supervision, web-based training, or training-as-usual (control). A novel standardized patient (SP) assessment was developed and implemented for objective measurement of changes in clinical skills, while on-line self-report measures were used for assessing changes in knowledge, perceived self-efficacy, and practice related to cognitive behavioral therapy (CBT) techniques. Eligible participants were all actively involved in mental health treatment of veterans with PTSD. Study methodology illustrates ways of developing training content, recruiting participants, and assessing knowledge, perceived self-efficacy, and competency-based outcomes, and demonstrates the feasibility of conducting prospective studies of training efficacy or effectiveness in large healthcare systems.

Figure 1

Example of audio dialog with photo slideshow.

Figure 2

Example interactive exercise.

Figure 3

Recruitment postcard.

Figure 4

Screening and enrollment process.

Figure 5

Study design.

Figure 6

Web-based research measures.

Figure 7

Example conditional responses from standardized script.

Figure 8

Decisional balance interactive exercise.

Figure 9

Flowchart of participant recruitment and study completion.