Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.

Rakovshik, Sarah; McManus, Freda; Vazquez-Montes, M; Muse, Kate; Ougrin, Dennis

doi:10.1037/ccp0000079

Cited by 74 publications

(75 citation statements)

References 38 publications

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“…Trainees continuing to work in similar workplace settings and see similar patient presentations may assist the consolidation of therapist competence, and contrasts with previous large-scale training initiatives where skill maintenance difficulties were partially attributed to a lack of continuity from training to the work environment (Brooker et al 2003). Therapists' continued use of regular expert supervision may also have supported maintenance of competence (Mannix et al 2006;Rakovshik et al 2016). Therapists however reported reduced use of 'live' supervision (i.e.…”

Section: Clinical Role and Supervisionmentioning

confidence: 95%

The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

et al. 2018

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The continued effectiveness of in-service psychological therapy training requires evaluation. This study assessed therapist competence and patient clinical outcome during cognitive behaviour therapy training and 12+ months post-training. Trainee competence was assessed using audio-recorded sessions rated on the Cognitive Therapy Scale Revised at the beginning (n = 33) and end of training (n = 45), and at least 12 months post-training (n = 45). Pre-to-posttreatment clinical outcome for trainees' patients during the course (n = 360) and post-training (n = 360) was evaluated using standardised self-report measures. The relationship between therapist competence and patient outcomes was explored. Trainees achieved competence during training (100%, n = 45) and largely maintained competence post-training (84%, n = 38). Patients demonstrated pre-to-posttreatment effect sizes between 1.38 and 1.89 and reliable improvement exceeding 80% during and after training. Competence was not significantly associated with patient outcome. Trainees predominantly maintained competence and achieved good clinical outcomes post-training. Structured training and continued use of regular supervision possibly supported retention of competence.

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Section: Clinical Role and Supervisionmentioning

confidence: 95%

The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

et al. 2018

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“…In recent years, multiple trials evaluating different methods of training clinicians to use evidence-based therapies have demonstrated that monitoring and supervision is significantly more effective than workshop-based training alone in a range of therapies (Beidnas & Kendall, 2010; Henggeler, Chapman, Rowland, Sheidow, & Cunningham, 2013; W.R. Miller, Yahne, Moyers, Martinez, & Pirritano, 2004; Schoenwald, Sheidow, & Chapman, 2009), including CBT (Rakovshik, McManus, Vazquez-Montes, Muse, & Ougrin, 2016; Rakovshik et al, 2013; Sholomskas et al, 2005). The lack of supervision and monitoring of clinician implementation of evidence-based treatments in clinical practice suggests that CBT and other EBPs, in practice, may bear little resemblance to the more closely monitored versions of those treatments as implemented in randomized clinical trials demonstrating their efficacy (Martino et al, 2016).…”

Section: Stage 3 and Beyond: Dissemination And Its Challengesmentioning

confidence: 99%

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Carroll¹,

Kiluk²

2017

Psychology of Addictive Behaviors

149

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Cognitive behavioral therapy (CBT) approaches have among the highest level of empirical support for the treatment of drug and alcohol use disorders. As Psychology of Addictive Behaviors marks its 30th anniversary, we review the evolution of CBT for the addictions through the lens of the Stage Model of Behavioral Therapies Development. The large evidence base from Stage II randomized clinical trials indicates a modest effect size with evidence of relatively durable effects, but limited diffusion in clinical practice, as is the case for most empirically validated approaches for mental health and addictive disorders. Technology may provide a means for CBT interventions to circumvent the ‘implementation cliff’ in Stages 3–5 by offering a flexible, low-cost, standardized means of disseminating CBT in a range of novel settings and populations. Moreover, returning to Stage 1 to reconnect clinical applications of CBT to recent developments in cognitive science and neuroscience holds great promise for accelerating understanding of mechanisms of action. It is critical that CBT not be considered as a static intervention, but rather one that constantly evolves and is refined through the Stage model until the field achieves a maximally powerful intervention that addresses core features of the addictions.

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“…Further work should focus on examining whether web-based training is sufficient to change daily working practice. There are hints that the acquisition and implementation of new interventions skills could be limited without case supervision (Edmunds, Beidas, & Kendall, 2013;Miller, Yahne, Moyers, Martinez, & Pirritano, 2004;Rakovshik, McManus, Vazquez-Montes, Muse, & Ougrin, 2016;Sholomskas et al, 2005). Therefore, the investigation of a combination of web-based training and case supervision approach to support therapists in the crucial phase of implementing the learned skills into clinical practice could be a promising starting point for future research.…”

Section: Discussionmentioning

confidence: 99%

Daring to process the trauma: using a web-based training to reduce psychotherapists’ fears and reservations around implementing trauma-focused therapy

Sansen

Saupe

Steidl

et al. 2019

European Journal of Psychotraumatology

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Although trauma-focused interventions are the first-line therapies for patients with posttraumatic stress disorder (PTSD), they are not frequently used in clinical practice. Factors preventing therapists from applying trauma-focused methods include a lack of training and negative attitudes towards trauma-focused therapy. The aim of the present study was to investigate which factors predict willingness to carry out trauma-focused therapy and to examine whether a web-based training is able to reduce negative attitudes and reservations about these interventions. In a wait-list controlled evaluation study, therapists (N = 499) were randomized into an intervention or a wait-list control group. Results show that trauma-treatment specific competencies and overcoming pre-existing concerns towards trauma-focused therapy significantly predict therapists’ willingness to utilize trauma-focused interventions. Thus, the content alignment of the web-based course is appropriate for improving therapists’ willingness to conduct trauma-focused therapy. A retrospective examination of therapists after the training and a comparison of fears and reservations before and after the training demonstrate a significant reduction of fears and reservations. In terms of perceived contraindications, no effects of the web-based training were found. The present study provides compelling evidence that web-based training in evidence-based PTSD therapy is able to reduce reservations that may prevent therapists from applying evidence-based trauma-focused interventions.

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Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.

Cited by 74 publications

References 38 publications

The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Daring to process the trauma: using a web-based training to reduce psychotherapists’ fears and reservations around implementing trauma-focused therapy

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