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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1034 — Web-Based Training in Core CBT Skills: Results of a Randomized Controlled Trial with VHA PTSD Treatment Providers

Ruzek JI, National Center for PTSD; Rosen R, New England Research Institutes; Garvert D, National Center for PTSD; Marceau L, and Smith L, New England Research Institutes; Sears K, National Center for PTSD; Stoddard A, and Harty B, New England Research Institutes;

Dissemination of evidence-based treatments is required to address a range of mental health problems among Veterans, but presents formidable challenges. Evidence-based face-to-face training approaches are difficult to implement and bring to scale to address training needs. If demonstrated to be effective, web-based training can potentially provide a cost-effective and efficient means of training mental health practitioners. However, fundamental questions still need to be addressed regarding effectiveness of web-based training in improving clinical skills, knowledge and attitudes, and implementation of new practices. The goals of the present study were to compare the effectiveness of web-based training alone, web-based training plus telephone consultation, and training-as-usual. The study included telephone-facilitated measurement of clinician treatment skills assessed during simulated treatment sessions with standardized patients. The two hypotheses were that 1) clinicians receiving web-based training would demonstrate greater improvement in core CBT skills, knowledge, and efficacy than those participating in a control condition, and 2) web-training combined with telephone consultation would result in greater increases in clinician skills than web-training alone.

168 mental health clinicians who regularly treat PTSD patients were randomized into one of three groups: training-as-usual, web training only, or web training plus 5-6 sessions of telephone supervision. Three 90-minute online training modules focused on goal setting, behavioral task assignment, and motivational enhancement.

Clinicians who received web-based training alone or web training plus consultation showed significantly more improvement in overall knowledge of skills and perceived self-efficacy related to delivery of the skills. Web training plus consultation was more effective than web training alone in producing changes in actual skills implementation as measured by performance in a simulated treatment session with a standardized patient. The current study demonstrates the feasibility of successfully recruiting volunteer mental health practitioners in routine healthcare settings to receive online training.

Findings of the current investigation are consistent with suggestions that online training may represent a cost-effective and scalable approach to effective clinician training, especially when supplemented with case supervision.

Web training when supplemented by telephone consultation can provide an efficient and user-friendly means of training mental health providers across VHA and other systems of care.

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