Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

Anxiety disorders are a major public health concern, having a profound impact on functioning, causing significant disability, loss of productivity and suffering. Effective treatments exist for these disorders, but few clinicians are trained in these methods. This project attempts to remedy this shortcoming by using web-based tools to facilitate access to this training, thus increasing the number of available therapists in order to help meet this unmet need.

Study Overview

• Status: Completed
• Conditions: PTSD; Obsessive Compulsive Disorder; Anxiety Disorders
• Intervention / Treatment: Behavioral: Internet Based CBT Training

Detailed Description

The need for evidence-based mental health treatments i.e., 'treatment based on the best available science or research evidence', has been stressed from scientific, ethical, and economic perspectives. While empirical evidence supports both the efficacy and effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, the demand for clinicians trained in these approaches far exceeds the supply. A major reason for this is the lack of trained cognitive behavior therapists. New technologies provide the opportunity to both facilitate accessibility to this specialized training by mental health professionals and to improve the quality of this training. Recent research has found that training clinicians using these new web-based technologies is highly effective, can significantly improve skills, and has significant advantages over traditional training programs. The long term goal of this project is to increase the number of available mental health professionals trained in cognitive behavior therapy for anxiety disorders by developing a set of web-based training tools enabling the widespread dissemination of this training. In Phase I the investigators developed a prototype online tutorial covering some core CBT principles and a Social Anxiety Disorder module. The investigators also tested the feasibility of live remote training through videoconferencing. In phase II investigators will expand the tutorial to include a comprehensive review of CBT principles and techniques and expand modules to include the full spectrum of anxiety and anxiety-related disorders (i.e., Obsessive Compulsive Disorder, Panic Disorder, Generalized Anxiety Disorder, Posttraumatic Stress Disorder and Social Anxiety Disorder). Investigators will also evaluate the efficacy of live remote training in improving clinical skills. A cohort of 50 clinicians from diverse educational and professional backgrounds will be recruited. Improvement in trainees' conceptual knowledge will be evaluated pre and post tutorial, and improvement in trainees' clinical skills in applying the CBT concepts will be evaluated by blind ratings of clinical adherence and competence at three time points: before on-line training, and before and after videoconference training. User satisfaction with both the on-line tutorial and the videoconference training will also be evaluated. Impact of training on post-training patient outcomes will be evaluated.

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Wisconsin
    • Madison, Wisconsin, United States, 53717
      • Center for Telepsychology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Clinicians are eligible for this therapist training study if they are a licensed health care professional or are currently in a counseling related graduate training program

Exclusion Criteria:

• None, except for above

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Internet-Based Training; On-line tutorial followed by live remote training via videoconferencing	Behavioral: Internet Based CBT Training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
System Usability Scale	User satisfaction with the technical aspects of the tutorial was assessed using the ratings on the System Usability Scale (SUS), a reliable, well-validated 10-item scale designed to evaluate the usability and user satisfaction with web-based applications and other technologies.	after completion of tutorial, an expected average of 2 weeks
CBT Concepts	Improvement in trainees' knowledge of CBT concepts will be evaluated using a 38-item pre and post test of the items covering the tutorial content.	After completing the on line tutorial, an expected average of two weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Yale Adherence and Competence Scale (YACS)	The Yale Adherence and Competence Scale (YACS) is a well-validated, scale for rating therapist adherence and competence in delivering cognitive behavioral treatments. It has been used as an outcome measure in several studies evaluating the effectiveness of different CBT rater training approaches . Therapist competence in administering specific CBT techniques is evaluated on a scale ranging from 1 (very poor) to 7 (excellent).	At day 0 (baseline) (i.e., priot to any training), and after completing the on line tutorial (an expected average of two weeks), and after completing the appled training (an exected average of 8 weeks).
User Satisfaction Questionnaire	This scale evaluates how well subjects liked the clinical content of the on-line tutorial. It contains 14 statements, each of which are rated on a 4-point scale (strongly agree, agree, disagree, strongly disagree), and covers several dimensions of the user experience . The scale ranges from 15 to 60, and has good internal consistency reliability (Cronbach's Alpha =.90, Phase I study results). An overall mean score of 45 (i.e., an average score of 3 ("agree" on all items)) is considered adequate to demonstrate acceptable user satisfaction with the clinical content.	After completing the on line tutorial (an expected average of 2 weeks)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
GAD-7	The GAD-7 is a well-validated self-report scale originally developed as a brief measure of GAD. It has since been validated as measure of anxiety across the domain of anxiety disorders.	Weekly for 8 weeks of patient treatment, post training

Collaborators and Investigators

• Sponsor: Center for Psychological Consultation
• Collaborators: National Institute of Mental Health (NIMH)

Publications and helpful links

General Publications

• Kobak KA, Craske MG, Rose RD, Wolitsky-Taylor K. Web-based therapist training on cognitive behavior therapy for anxiety disorders: a pilot study. Psychotherapy (Chic). 2013 Jun;50(2):235-47. doi: 10.1037/a0030568. Epub 2013 Feb 11.

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Actual): June 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: March 13, 2014
• First Submitted That Met QC Criteria: March 17, 2014
• First Posted (Estimate): March 18, 2014

Study Record Updates

• Last Update Posted (Estimate): February 3, 2016
• Last Update Submitted That Met QC Criteria: February 1, 2016
• Last Verified: February 1, 2016

More Information

Terms related to this study

• Keywords: Cognitive Behavior Therapy; On-line training
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease; Obsessive-Compulsive Disorder; Anxiety Disorders
• Other Study ID Numbers: R44MH086951 (U.S. NIH Grant/Contract)