Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.

Crits‐Christoph, Paul; Siqueland, Lynne; Chittams, Jesse; Barber, Jacques P.; Beck, Aaron T.; Frank, Arlene; Liese, Bruce S.; Luborsky, Lester; Macii, David; Mercer, Delinda; Onken, Lisa Simon; Najavits, Lisa M.; Thase, Michael E.; Woody, George

doi:10.1037/0022-006x.66.3.484

Cited by 123 publications

(132 citation statements)

References 31 publications

(34 reference statements)

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“…23 The latter has been found to be particularly important. [24][25][26] We describe a CBTI dissemination project that encompasses both elements, focusing on the challenges we met in developing the training content. The dissemination project targets mental health clinicians in the Veterans Health Administration (VHA)-the health care component of the U.S. Department of Veterans Affairs (VA) and the largest integrated health care system in the United States.…”

Section: Focus Of Training: Defining the Scope Of Cbti Trainingmentioning

confidence: 99%

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Manber

Carney

Edinger

et al. 2012

Journal of Clinical Sleep Medicine

177

124

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Strong evidence supports the effi cacy of cognitive behavioral therapy for insomnia (CBTI). A signifi cant barrier to wide dissemination of CBTI is the lack of qualifi ed practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended). Among these decisions is the question of how to balance the structure and fl exibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

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Section: Focus Of Training: Defining the Scope Of Cbti Trainingmentioning

confidence: 99%

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Manber

Carney

Edinger

et al. 2012

Journal of Clinical Sleep Medicine

177

124

View full text Add to dashboard Cite

show abstract

“…Similarly, although methods for training clinicians in manual-guided therapies for clinical efficacy trials are well established (51)(52)(53), such methods have largely been accepted on the basis of face validity (54)(55)(56). It is not known whether standard methods of training therapists will be feasible or effective when applied to real-world clinicians.…”

Section: Attention To Training Issuesmentioning

confidence: 99%

Bridging the Gap: A Hybrid Model to Link Efficacy and Effectiveness Research in Substance Abuse Treatment

Carroll¹,

Rounsaville²

2003

140

128

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Many behavioral and pharmacologic treatments for which there is strong empirical support are rarely used in clinical practice in the treatment of substance dependence. In an effort to facilitate greater emphasis on issues such as utility, practicality, and cost earlier in the evaluation of promising therapies, the authors propose a hybrid model to link efficacy and effectiveness research. A hybrid model may foster broader use of empirically validated treatments in substance abuse treatment programs and enhance the scientific yield of effectiveness research. The hybrid model retains essential features of efficacy research (randomization, use of control conditions, independent assessment of outcome, and monitoring of treatment delivery) while expanding the research questions to also address issues of importance in effectiveness studies. Such issues include diversity in settings, clinicians, and patients; cost-effectiveness of treatment; training issues; and patient and clinician satisfaction.A major issue facing virtually all areas of clinical psychiatry is the gap between research and practice and the associated call for clinical research to place a greater emphasis on effectiveness research and the evaluation of clinical utility of treatments (1-3). Disparities between research and practice are particularly apparent in drug abuse treatment (4). For example, despite overwhelming empirical support for the efficacy and cost-effectiveness of methadone maintenance (5-7), access to this form of treatment remains highly restricted in many areas of the United States (8-10). In locations in which methadone maintenance is available, this treatment is often administered in inadequate doses or with insufficient counseling and ancillary services, both of which make it much less effective (11,12). Similarly, behavioral treatments for which there is strong empirical support have rarely been implemented in clinical settings (13,14). Conversely, many treatments are widely used in clinical practice that have not undergone any evaluation of efficacy-for example, 12-step methods and auricular acupuncture (15,16). Need for new research strategiesA recent landmark report by the Institute of Medicine (4) called for a greater emphasis on effectiveness research as a strategy for bridging the gap between research and practice. However, although methods and strategies for efficacy evaluation through randomized controlled trials have been well defined for both behavioral and pharmacologic therapies (17-19), the nature of what constitutes sound effectiveness research is much less clear. Traditional strategies-for example, large-scale demonstration projects-have too frequently had a negligible impact on the clinical community, policy makers, or third-party payers. This lack of impact may be due to several factors, such as failure to target critical questions about the treatment's utility in standard clinical practice, to methodologic flaws NIH Public Access To illustrate the need to address practice-related issues in efficacy researc...

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“…However, evidence suggests that didactic training alone is insufficient for sustainable skillful administration of psychotherapy [9] and that adding a competency training component enhances training outcomes [10,11].…”

Section: Dissemination To Providersmentioning

confidence: 99%

Dissemination of CBT for Insomnia

Manber

Simpson

2016

Curr Sleep Medicine Rep

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Dissemination of cognitive behavioral therapy for insomnia (CBTI) is essential because this effective non-pharmacological intervention for insomnia is currently underutilized. In this chapter, we review past and recent dissemination efforts aimed at (1) increasing the ranks of qualified treatment providers and (2) increasing availability of direct-to-consumer CBTI treatment products. Specifically, we describe a model for training licensed mental health clinicians to competency in delivering CBTI that is currently underway in the VA Healthcare system and results from the evaluation of this dissemination effort. We also discuss existing direct-to-consumer treatment programs that use a variety of formats and modalities, and the emerging use of technologies to deliver and enhance CBTI. While significant progress has been made in disseminating CBTI, we highlight the need for future dissemination work, including the importance of developing costeffective models that blend therapist-delivered treatment with direct-to-consumer modalities, and the need to create treatment guidelines, particularly as they apply to low therapist involvement and blended models of delivery.

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Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.

Cited by 123 publications

References 31 publications

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Bridging the Gap: A Hybrid Model to Link Efficacy and Effectiveness Research in Substance Abuse Treatment

Dissemination of CBT for Insomnia

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