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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;

Objectives:
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.

Methods:
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.

Results:
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.

Implications:
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.

Impacts:
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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