The ultimate goal of the final submission of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide opportunities for the applicant to acquire skills necessary for an independent research career focused on implementing evidence-based treatments (EBT) for child abuse populations in community settings. The applicant's long-term goal is to develop a programmatic line of research that is focused on understanding the process and outcome of EBT implementation in community practice. To achieve this goal, instruction and mentoring are proposed in four main areas: 1) human service implementation models, 2) training technology (cognitive science/learning principles), 3) organizational influences hypothesized to impact EBT implementation, and 4) measurement of practitioner behavior. Attention also will be focused on developing advanced knowledge regarding ethical conduct of research and applied statistics. These training experiences will enhance the applicant's strong background as a treatment provider and outcome researcher. The research plan is divided into three phases that will be implemented with the support of the training plan described above. During a brief (one year) descriptive study of treatment-as-usual (Phase I) data will be collected from chart review and audiotaping of treatment sessions to understand research feasibility, organizational climate &structure, provider experiences, clinical characteristics, and treatment procedures within community settings. Incorporating data, practitioner feedback, and experience from Phase I, Phase II will include the development of a theoretically driven, empirically informed training protocol for Abuse-Focused Cognitive Behavior Therapy. In the third phase, 55 practitioners from 4 recruited community-based mental health agencies will be randomized to receive the developed training protocol (Phase II) or traditional training. Practitioner assessments will be completed pre- training, post-training, and at 3 month follow-up. Organization- and patient-level data will be collected to examine how they support or inhibit practitioner implementation of AF-CBT as well as to preliminarily test the training protocol's impact on child outcome. Data analysis will focus on descriptions of feasibility and distributions. Together, these projects will yield information about training feasibility and effectiveness. A subsequent R01 proposal will be proposed to examine key hypotheses derived from the study findings.
