Category: Dissemination / Implementation

Symposium

Symposium 120 - The Dissemination of CBT: National Utilization Patterns, Implementation, and Scalable Training for Therapists

Sunday, November 19
8:30 AM - 10:00 AM
Location: Aqua Salon E & F, Level 3, Aqua Level

Keywords: Exposure | Dissemination | Anxiety
Presentation Type: Symposium

One growing area of dissemination and implementation (DI) research seeks to increase the adoption of cognitive-behavioral therapy with exposure therapy (CBT-ET) by community-based providers who treat individuals with anxiety in non-academic clinical settings. This symposium presents recent data that has advanced the DI literature by: 1) shining light on how youth with anxiety are treated by private practitioners around the United States, 2) identifying the need to consider the quality of CBT-ET that is provided by community-based providers who have adopted CBT-ET into their practice, and 3) testing two scalable training options to increase the utilization of CBT-ET in graduate and post-graduate therapists who treat youth with anxiety. Adam Reid, Ph.D., will begin the symposium by presenting research that suggests private practitioners who treat youth with anxiety use exposure-based techniques less often than non-exposure cognitive-behavioral techniques, as often third-wave behavioral treatments, and more often than psychodynamic therapy. More so, a lack of training and negative beliefs about exposure were the two largest barriers to dissemination of CBT-ET. Nicholas Farrell, Ph. D., will present data collected from two studies that sampled community-based clinicians who report the use of exposure techniques in their practice. In both samples, a cluster analysis identified two types of therapists: those with an intensive (anxiety-increasing) delivery style who are confident about implementing exposures and those with a coping (anxiety-reducing) delivery style who are apprehensive about exposure implementation. These findings indicate that efforts to improve the dissemination of exposure therapy should emphasize delivery style in addition to just increasing utilization rates. Andrew Guzick, M. S., will review data examining the effectiveness of a CBT-ET training model for graduate and post-graduate psychology trainees. The model is unique in its emphasis of tiered co-therapy, with trainees progressing through different levels of therapy autonomy as they develop competence. Results suggest that this model significantly improves CBT-ET delivery, reduces biases against CBT-ET, and even reduces disgust sensitivity. Flexible applications of this model to various settings will be discussed. Brian Chu, Ph. D., will then present a second scalable training option for CBT-ET that was pilot tested in a sample of graduate or post-graduate providers. Results underscore a reoccurring theme in the literature: one-time trainings have a limited ability to change provider behavior. Three potential mechanisms for extended skill building post-didactic training were tested and results suggest an ideal follow-up model would involve a tiered program that progresses from simpler to more challenging cases, with special attention paid to challenging strategies like exposures. Jonathan Comer, Ph. D., will conclude the symposium by discussing novel approaches to closing the research to practice gap based the results presented in the symposium and his extensive experience expanding the quality, scope and accessibility of mental health care for youth.




 

Learning Objectives:

Adam M. Reid

Predoctoral Intern
McLean Hospital/Harvard Medical School

Presentation(s):

Send Email for Adam Reid

Jonathan S. Comer

Director of the Mental Health Interventions and Technology (MINT) Program; Professor of Psychology and Psychiatry
Florida International University

Presentation(s):

Send Email for Jonathan Comer

Adam M. Reid

Predoctoral Intern
McLean Hospital/Harvard Medical School

Presentation(s):

Send Email for Adam Reid

Nicholas R. Farrell

Clinical Supervisor
Rogers Memorial Hospital

Presentation(s):

Send Email for Nicholas Farrell

Andrew Guzick

Graduate Student
University of Florida

Presentation(s):

Send Email for Andrew Guzick

Brian C. Chu

Associate Professor
Rutgers University

Presentation(s):

Send Email for Brian Chu


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