Our 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 by no means sufficient in establishing competence. Rather, they are an essential first step in providing therapists with initial exposure to basic skills and strategies. To assure that clinicians implement this and other evidence based therapies consistently, effectively, and with adequate fidelity to manual guidelines, 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 overall aim of this Phase I SBIR is to develop a prototype CBT Supervisor's Toolkit and to conduct a pilot feasibility study to evaluate the effectiveness of the Toolkit on the ability of clinical supervisors in community-based addiction treatment settings to accurately evaluate clinicians'fidelity (e.g., adherence and competence) in delivering CBT. If successful, Phase I would provide preliminary evidence that the CBT Supervision Toolkit is feasible and effective in training clinical supervisors to accurately assess clinicians'fidelity and skill in CBT.
Specific aims are as follows: 1. Develop a prototype of the CBT Supervisors Toolkit and supervisor workshop. If the Phase I project is successful, these materials will become the basis of a more comprehensive, interactive web-based version of the Toolkit for a Phase II application, which would be evaluated in a randomized trial of the impact of ongoing structured supervision on the ability of clinicians to conduct CBT effectively. 2. Conduct a randomized pilot trial evaluating the impact of the prototype CBT Supervision Toolkit and workshop on clinical supervisors'ability to evaluate clinicians'fidelity in delivering CBT. We will randomize 30 clinical supervisors recruited from community based clinics in New England to two groups: one group will receive the prototype CBT Supervision Toolkit and training via a workshop;the other will receive no formal training. The primary outcome measure will be condition by time differences in the supervisors'accuracy in completing the adherence/competence ratings (in comparison to a master set of expert ratings). We hypothesize that those assigned to the prototype Toolkit and workshop will have greater increases in the accuracy of their adherence and competence ratings compared to those who receive no training.
The overall aim of this Phase I SBIR is to develop a prototype Cognitive Behavioral Therapy (CBT) Supervisor's Toolkit and to conduct a pilot feasibility study to evaluate the effectiveness of the Toolkit on the ability of clinical supervisors in community-based addiction treatment settings to accurately evaluate clinicians'fidelity (e.g., adherence and competence) in delivering CBT. Supervision and feedback via monitoring of clinicians'application of CBT is essential to assure that clinicians implement CBT (and other evidenced based therapies) consistently, effectively and with sufficient fidelity to manual guidelines. If successful, Phase I would provide preliminary evidence that the CBT Supervision Toolkit is feasible and effective in training clinical supervisors to accurately assess clinicians'fidelity and skill in CBT.
