ABR's recent series of innovative randomized trials evaluating the efficacy of various strategies for training clinicians to use evidence based therapies in alcohol and drug abuse has indicated that while both in-person workshop and computer-assisted training can impart the skills necessary to deliver Cognitive Behavioral Therapy (CBT), they are not sufficient in establishing competence. Workshop training is an essential first step in providing therapists with initial exposure to basic skills and strategies, ut to assure that clinicians implement CBT and other evidence based therapies consistently, effectively, and with adequate fidelity, ongoing supervision and feedback via monitoring of clinicians'implementation of CBT are essential. However, there are no existing tools available for use by clinical supervisors to guide performance monitoring and feedback in clinicians'implementation of CBT.
The aim of this Phase II SBIR is to develop a supervision toolkit for CBT and to conduct a randomized training trial to evaluate the effectiveness of the CBT Supervisor's Toolkit on the ability of clinical supervisors in community-based settings to accurately evaluate clinicians'fidelity (e.g., adherence and competence) in delivering CBT. We have successfully completed Phase I and have demonstrated the feasibility and promise of a prototype version of the CBT Toolkit in training clinical supervisors to accurately monitor and provide effective feedback on clinicians'fidelity and skill in CBT.
Specific aims for Phase II include the following 1. Complete a full web-based multimedia training program for the CBT Supervisors Toolkit. The program would be modeled on the highly successful supervisor's toolkit for Motivational Interviewing developed by Dr. Carroll and colleagues for Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA: STEP, ://www.nida.nih.gov/blending). Accuracy in using the supervisor rating form and independent ratings of skill in providing CBT supervision, and submission of a taped example of a supervisory session that demonstrates adequate skill (clarity, completeness, support) would serve as basic criteria for certifying qualified individuals as CBT supervisors. 2. Conduct a randomized trial in which 105 clinical supervisors would be randomized to (1) the CBT Supervisor's Toolkit website, (2) a two day didactic training or (3) reading the CBT manual alone. Outcomes will include independent ratings of the supervisors'ability to conduct an effective feedback/ supervision session, the ability of the supervisors to accurately assess clinicians'adherence and competence in delivering CBT, satisfaction with training, and relative costs of the three approaches. The development and systematic evaluation of the Toolkit represents the next major step broadening the availability of high quality training and supervision in CBT and thus addresses a major gap in the ability of clinical programs to implement this and other evidence based practices (EBP) effectively.
The development and systematic evaluation of the CBT Toolkit represents the next major step broadening the availability of high quality training and supervision in CBT and thus addresses a major gap in the ability of clinical programs to implement this and other evidence based practices (EBP) effectively.