In keeping with the recommendations of the President's New Freedom Commission on Mental Health, the Texas Department of State Health Services (TDSHS) is committed to participating in the transformation of the mental health system through the implementation of evidence-based interventions to facilitate the recovery of people with serious and persistent mental illness, through the development of a workforce that can competently provide evidence-based services, and through furthering our understanding of effective strategies to disseminate evidence-based interventions through research. The following application serves this broad goal of mental health system transformation. The proposal has the three primary aims: (1) to determine if Master's degree level clinicians currently employed in public mental health clinics can be trained to an acceptable level of competency in Cognitive Therapy (CT) for major depression; (2) to assess whether weekly supervision provided until therapist competency has reached criterion levels is as effective as 6 months of weekly clinical supervision; (3) to determine if therapist competency in CT is maintained over the nine months following the completion of clinical supervision. To accomplish these aims, 16 novice therapists will be trained at a 35-hour workshop by an expert CT clinician. Therapists will receive weekly group telephone supervision with one of two models - Time- limited or Competency-based. Adults with major depression receiving services in public mental health clinics will be recruited for the study. Therapist competency will be measured by expert ratings of audio taped therapy sessions using the Cognitive Therapy Scale. Changes in symptom severity during the course of treatment will be measured with the Quick Inventory of Depressive Symptoms and the Beck Depression Inventory. This study will allow for a systematic investigation of the impact of implementation, both on the staff that receive training and support for these new skills and on the consumers who receive the intervention.
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