Category: Dissemination / Implementation

Symposium

Which Elements of Consultation in an Evidence-Based Practice Are Associated With Fidelity and Use?

Saturday, November 18
10:15 AM - 11:15 AM
Location: Sapphire Ballroom E & F, Level 4, Sapphire Level

Keywords: Implementation | CPT (Cognitive Processing Therapy) | PTSD
Presentation Type: Symposium

Consultation for Cognitive Processing Therapy (CPT), an evidence-based practice (EBP) for posttraumatic stress disorder (PTSD), is an implementation strategy that promotes better fidelity to the protocol and improved clinical outcomes (Monson et al., Under Review). Previous studies have shown that clinician fidelity (i.e., adherence to, and competence in, delivering an intervention) to certain elements of CPT has been strongly associated with improved patient outcomes (Farmer et al., 2016). However, little research has been conducted to determine what types of activities, occurring during consultation, are most closely related to desired clinical processes and outcomes. This study examined whether specific activities performed during CPT consultation meetings were associated with better fidelity to the CPT protocol, or to improved clinical outcomes among patients (n=177) treated by therapists (n=82) who were receiving consultation. Two aspects of consultation (guidance and work sample review/feedback) were measured by consultant checklists for each consultation session (n=308), a subset of which were assessed for reliability comparison to expert observer ratings of these sessions. To examine fidelity, expert observers rated adherence and competence scores in a random sample of clinicians’ CPT sessions following consultation. The self-reported PTSD Checklist IV assessed change in PTSD symptomatology. Preliminary results indicate that more consultation/guidance was associated with greater reductions in PTSD symptoms, and that the condition that included more consultation/guidance resulted in a more consistent pattern of clinician fidelity. Detailed analyses and findings will be presented, and implications for training and implementation will be discussed.

Kera Mallard

National Center for PTSD and Palo Alto Veterans Institute for Research

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