The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations☆
Section snippets
Scope and definitions of evidence-based treatment
Fifteen the American Psychological Associations’ Division 12's (Clinical Psychology) Task Force on Promotion and Dissemination of Psychological Procedures (1995) offered recommendations to promote efforts to define, study and evaluate, teach, and disseminate EBTs (then labeled empirically validated treatments and renamed empirically supported treatments; Chambless et al., 1998, Chambless et al., 1996). These recommendations included increasing the availability of empirically supported
Models for dissemination of EBTs
In conjunction with refinements in these definitions, models or conceptual frameworks for the dissemination and implementation of EBTs have been proposed to guide efforts to change existing service systems and enhance overall outcomes for consumers of mental health services. The National Institute of Mental Health (2002) has defined dissemination as “the targeted distribution of information to a specific audience,” and has defined implementation as “the use of strategies to introduce or adapt
The role of training in EBTs
Community therapists and administrators have acknowledged a need for initial training as well as ongoing support, consultation, and supervision in EBT, but, at the same time, acknowledge the lack of time, support, and opportunities for learning new skills (Essock et al., 2003, Herschell et al., 2009). Concerns have also been raised about the relevance and utility of existing educational programs for professional psychologists (see Sharkin & Plageman, 2003). Recent guidelines for training
Previous reviews and context for present review
Previous reviews of therapist training studies have indicated that there is little empirical evidence to confirm that training improves therapist skills to a level that results in competent administration of treatment (e.g., Alberts & Edelstein, 1990; J. D. Ford, 1979). Instead, skill acquisition is assumed rather than confirmed (Alberts & Edelstein, 1990; J. D. Ford, 1979). Just as Alberts and Edelstein (1990) who reviewed studies from 1979 to 1990 picked up where Ford left off (reviewed 1960
Search strategy
Relevant studies were identified by using four computer-assisted searches: Psychological Abstracts (PsycINFO), Educational Resources Information Center (ERIC) database, Social Science Citation Index (SSCI), and Medline. Several keywords and authors were used as search terms such as adherence, community, community clinician, community therapist, continuing education, dissemination, empirically supported, evidence-based, evidence-based treatment, fidelity, implementation, interventions, mental
Summary of the literature: designs and types of investigations
Fifty-five studies evaluating training techniques or methods were identified. Methodologies of these studies were diverse, and included both quantitative and qualitative designs that range from single-subject designs to randomized control trials. As is demonstrated in Table 1, Table 2, Table 3, Table 4, Table 5, Table 6, each of which includes studies of different training methods (i.e., written materials (Table 1), self-directed training techniques (Table 2), workshops (Table 3), workshop
Discussion
This empirical review of 55 studies evaluating six therapist training methods has found that there are differences in the number of studies for specific training methods and their respective effectiveness. Multiple studies have been conducted on multi-component treatment packages (20), workshops (19), and workshop follow-ups (9). Fewer studies have been completed on the utility of pyramid (train-the-trainer) models (3), reading (5), and self-directed trainings (7). Not only have multi-component
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1 - The term “therapist” is used broadly and is meant to include professionals who provide psychological services to populations with clinically-significant mental or behavioral health difficulties. It is meant to include counselors, clinical social workers, psychologists, psychiatrists, and all other mental or behavior health clinicians.