Category: Dissemination / Implementation
Keywords: Evidence-Based Practice | Training / Training Directors | Implementation
Presentation Type: Symposium
Background: While the development and study of evidence-based practice (ESP) models has increased dramatically, the availability of clinicians trained to implement EBP continues to lag. Bridging this research-practice gap can be aided by using well-established “best practices” for training clinicians in randomized controlled trials (e.g. direct observation of trainee performance, case-focused instruction and specific feedback). Additionally, case simulation, with a long tradition in medicine (e.g. Colliver & Swartz, 1997), has surprisingly been under-utilized in psychotherapy training. “Standardized patients” provide trainees the opportunity to refine both conceptual (i.e. diagnostic) and behavioral (i.e. procedure-specific) skills, under direct observation and supervisor feedback. The present study sought to combine these training practices to explore the utility of case simulation methods in doctoral level training of two EBP models- cognitive-behavioral therapy (CBT) for depression and family systems therapy (FST) for adolescent drug use and conduct problems. Study aims included examining feasibility, associations between conceptual and behavioral adherence, and predictive validity of this training method.
Methods: Clinical psychology doctoral students (CBT, N=25; FBT, N= 29-33) participated in a series of case simulations, each involving a written case formulation exercise and scene enactment. Students completed two simulations for each ESI- at the beginning and end of each practicum semester. Subsequently, research assistants completed conceptual and behavioral adherence ratings of the formulation exercise and videotaped scene enactments, respectively. Clinical supervisors independently evaluated each student’s overall clinical performance in practicum course.
Results: Results showed that conceptual adherence from the first simulation to the second improved for both CBT and FST. Associations between conceptual and behavioral adherence were mixed, with significant associations for FST (r= .36, p< .05) but not CBT. Results also suggested that for both modalities, but more so CBT than FST, conceptual and behavioral adherence were positively associated with clinical supervisor ratings (e.g. CBT case 1, r= .55 , p< .05).
Conclusion: Preliminary findings suggest that case simulation methods hold substantial promise for teaching therapists to implement EBP. However, given the cost and time-intensive nature of this approach, more work is needed to determine under what conditions and for whom case simulation training methods work best.
University of San Diego
Saturday, November 18
12:00 PM – 1:30 PM
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