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      Therapist competence, therapy quality, and therapist training

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          Abstract

          Large numbers of therapists worldwide wish to receive training in how to deliver psychological treatments. Current methods of training are poorly suited to this task as they are costly and require scarce expertise. New forms of training therefore need to be developed that are more cost-effective and scalable. Internet-based methods might fulfil these requirements whilst having the added advantage of being able to provide trainees with extensive exposure to the treatment as practised. New strategies and procedures for evaluating training outcome are also required. These need to be capable of assessing the therapist’s knowledge of the treatment and its use, as well as the therapist’s ability to apply this knowledge in clinical practice. Standardised role play-based techniques might be of value in this regard.

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          Most cited references26

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          Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective.

          Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowledge improves and attitudinal change occurs following training. However, change in therapist behaviors (e.g., adherence, competence, and skill) and client outcomes only occurs when training interventions address each level of the SC model and include active learning. Limitations as well as areas for future research are discussed.
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            The dissemination and implementation of evidence-based psychological treatments. A review of current efforts.

            Recognizing an urgent need for increased access to evidenced-based psychological treatments, public health authorities have recently allocated over $2 billion to better disseminate these interventions. In response, implementation of these programs has begun, some of it on a very large scale, with substantial implications for the science and profession of psychology. But methods to transport treatments to service delivery settings have developed independently without strong evidence for, or even a consensus on, best practices for accomplishing this task or for measuring successful outcomes of training. This article reviews current leading efforts at the national, state, and individual treatment developer levels to integrate evidence-based interventions into service delivery settings. Programs are reviewed in the context of the accumulated wisdom of dissemination and implementation science and of methods for assessment of outcomes for training efforts. Recommendations for future implementation strategies will derive from evaluating outcomes of training procedures and developing a consensus on necessary training elements to be used in these efforts. 2009 APA, all rights reserved.
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              A randomized trial of methods to help clinicians learn motivational interviewing.

              The Evaluating Methods for Motivational Enhancement Education trial evaluated methods for learning motivational interviewing (MI). Licensed substance abuse professionals (N = 140) were randomized to 5 training conditions: (a) clinical workshop only; (b) workshop plus practice feedback; (c) workshop plus individual coaching sessions; (d) workshop, feedback, and coaching; or (e) a waiting list control group of self-guided training. Audiotaped practice samples were analyzed at baseline, posttraining, and 4, 8, and 12 months later. Relative to controls, the 4 trained groups showed larger gains in proficiency. Coaching and/or feedback also increased posttraining proficiency. After delayed training, the waiting list group showed modest gains in proficiency. Posttraining proficiency was generally well maintained throughout follow-up. Clinician self-reports of MI skillfulness were unrelated to proficiency levels in observed practice. Copyright 2004 APA.
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                Author and article information

                Journal
                Behav Res Ther
                Behav Res Ther
                Behaviour Research and Therapy
                Elsevier Science
                0005-7967
                1873-622X
                June 2011
                June 2011
                : 49
                : 6-7
                : 373-378
                Affiliations
                Oxford University Department of Psychiatry, UK
                Author notes
                []Correspondence to: Professor C.G. Fairburn, Centre for Research on Dissemination at Oxford (CREDO), Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Tel.: +44 1865 226479; fax: +44 1865 226244.
                Article
                BRT2368
                10.1016/j.brat.2011.03.005
                3112491
                21492829
                f5a8cae6-5ef3-40a3-b5e8-7c24e46b2690
                © 2011 Elsevier Ltd.

                This document may be redistributed and reused, subject to certain conditions.

                History
                : 10 March 2011
                : 10 March 2011
                Categories
                Invited Essay

                Clinical Psychology & Psychiatry
                psychotherapy,training,dissemination,competence,internet,psychological treatment

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