Training community-based clinicians in parent-child interaction therapy: The interaction between expert consultation and caseload.

Abstract

Professional psychologists are increasingly encouraged to utilize evidence-based treatments (EBTs), and therefore have a need to participate and provide the most efficient training methods for these treatments. Multicomponent trainings, which commonly include ongoing support, are more effective than brief methods such as 1-day workshops or reading treatment manuals. The present study examined the effectiveness of 1 form of ongoing support, consultation, as part of a multicomponent training protocol. Thirty-two communitybased clinicians were trained in Parent-Child Interaction Therapy (PCIT) as part of a statewide implementation effort, and data were collected on clinician and implementation outcomes at pre-, mid-, and posttraining. Simple and multiple linear regression analyses were conducted to predict posttraining knowledge, skill, acceptability, and feasibility, as well as to examine clinician variables that might moderate these relations. Greater consultation call attendance significantly predicted higher posttraining skill; however, this association was qualified by a significant interaction with PCIT caseload. Implications for training guidelines are discussed. Public Significance StatementThis study advances the importance of consultation as a training component for professional psychologists. Additionally, it highlights the significance of gaining experience through therapy cases in combination with attending consultation calls to become skillful at providing an evidence-based treatment.

Therapist training in evidence‐based interventions for mental health: A systematic review of training approaches and outcomes.

“…This extended contact involved booster training, consultation, and/or tape review. That said, studies of sustainability would benefit from longer follow-ups, as a minimum of 2 years typically represents the duration needed to determine EBI sustainability (Jackson et al, 2017;Stirman et al, 2017). Consistent with other training methods, limitations related to outcome measurement persist.…”

“…For example, Kolko et al (2012) had four full-day workshops once a week for a month, whereas Navarro-Haro et al (2019) had two separate blocks of 5-day workshops approximately 6 months apart. Other intensive trainings (e.g., Jackson et al, 2017) had an initial 40 hours of training over several days and an advanced booster training 6 months later. The Beck Initiative studies (Creed et al, 2013(Creed et al, , 2016German et al, 2017;Stirman et al, 2017) did not space out the trainings but included substantial consultation and feedback that was spread out over time.…”

Consultation in psychology: A distinct professional practice.

“…Educational programs are generally sufficient to disseminate new knowledge; however, the development of competence requires supervised practice, including additional training and supervision or consultation (Herschell, Kolko, Baumann, & Davis, 2010;Herschell, Reed, Person Mecca, & Kolko, 2014;Jackson, Herschell, Schaffner, Turiano, & McNeil, 2017;McLeod et al, 2018). Web-based and face-to-face training, followed by formal case consultation, are recommended to become proficient in evidence-based treatments (Fritz et al, 2013).…”

Making Implementation Last: Understanding the Sustainability of an Evidence-based Treatment

“…Additionally, they did not have a higher PCIT caseload at 24-months and did not report fuller use of the PCIT protocol compared to clinicians who attended less calls. This contrasts with previous research suggesting the importance of consultation as a training component for promoting implementation and sustainability (Beidas et al, 2012;Jackson et al, 2017). Few empirical studies on consultation SUSTAINABILITY OF AN EVIDENCE-BASED TREATMENT 33 have examined this training component in relation to actual use of an intervention (Schoenwald et al, 2003).…”

“…In contrast, this study found that clinicians with more training exposure and utilization delivered PCIT to a fewer number of clients since the beginning of training. During training and initial consultation calls, clinicians are often encouraged to see a high number of cases initially due to attrition (Jackson et al, 2017). While some clinicians may initially see a large number of PCIT clients due to these recommendations, they may not continue to sustain a high PCIT caseload.…”