Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills

doi:10.1016/j.brat.2009.07.011

Behaviour Research and Therapy

Volume 47, Issue 11, November 2009, Pages 921-930

https://doi.org/10.1016/j.brat.2009.07.011 Get rights and content

Abstract

This study evaluated the efficacy of three methods of training community mental health providers (N = 150) in Dialectical Behavior Therapy skills, including a written treatment manual; an interactive, multimedia online training (OLT); and a two-day instructor-led training workshop (ILT). A hybrid design was utilized that incorporated aspects of efficacy and effectiveness trials. Assessments were completed at baseline, post-training, and 30- and 90-days following training. The results indicate that learner satisfaction with the training was highest in OLT and ILT, and both resulted in significantly higher satisfaction ratings than the manual. OLT outperformed ILT and the manual in increasing knowledge of the treatment, whereas ILT and the manual did not differ. All three training methods resulted in comparable increases in clinicians' ability to apply course content in clinical simulations. Overall, the results provide strong support for the efficacy of technology-based OLT methods in disseminating knowledge of empirically supported treatments to community mental health providers, suggesting that OLT may be a high-quality, easily accessible, and affordable addition to traditional training methods.

Section snippets

Research comparing OLT to traditional training methods for EST dissemination

Several recent studies have formally evaluated the effectiveness of technology-based training as a method of disseminating ESTs to mental health providers. McDonough and Marks (2002) compared the efficacy of 90 min of solo computer instruction versus group face-to-face tutorial teaching in exposure therapy for phobias among a sample of medical students. The results indicated that the two training methods produced comparable gains in knowledge, although the computer instruction was rated as less

The present study

The present study compared three methods of training clinicians in ESTs: (1) written treatment manual, (2) an interactive, multimedia OLT, and (3) a two-day ILT. The OLT used in this study significantly advances the existing literature on technology-based training of ESTs in three ways. First, its development during formative and summative evaluation phases (described below) was guided by instructional design process models that are currently considered ‘gold standards.’ Second, it utilized

Recruitment and screening

All procedures were approved by the Western Institutional Review Board. Participants were recruited via email list serves of drug treatment and mental health treatment providers interested in DBT training or treating suicidal and/or substance-dependent clients, and via email contact with local agency and community mental health and drug treatment directors. Interested participants were instructed to contact our offices for more detailed information. Research assistants (RAs) responded to emails

Sample description

Participants who consented to participate in the study and completed at least one measure at baseline were considered the intent-to-train sample (N = 150). Participants were not found to significantly differ between conditions on any demographic or professional characteristics, or outcome variable at baseline (see Table 1). The prototypical participant from the overall sample reported being a Caucasian female approximately 40 years of age, having a Bachelors or Masters degree, and practicing as

Discussion

This study evaluated the efficacy of three methods of training community mental health providers in DBT skills, including a written treatment manual, OLT (an interactive, multimedia online training), and ILT (a two-day instructor-led training workshop). For teaching DBT skills, the findings favored OLT which, although sometimes comparable to other training methods, showed distinct benefits. Overall, the results provide strong support for the efficacy of technology-based OLT methods in

Acknowledgments

This research, as well as the development of the online training course, was funded by two Small Business Innovation Research (SBIR) grants from the National Institute of Mental Health (5 R44MH065790-03) and the National Institute on Drug Abuse (5 R44DA015615-03) awarded to the first author. We acknowledge and thank the following individuals and organization for their support and contributions to this research: Cecilia Spitznas, Ph.D., Enid Light, Ph.D, Marsha M. Linehan, Ph.D., Brian Knudson

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Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills

Abstract

Section snippets

Research comparing OLT to traditional training methods for EST dissemination

The present study

Recruitment and screening

Sample description

Discussion

Acknowledgments

Journal Psychiatric Research

Methods for disseminating research products and increasing evidence-based practice: promises, obstacles, and future directions

American Psychological Association

Evidence-based practice in psychology

American Psychologist

The dissemination of empirically supported treatments: a view to the future

Behaviour Research and Therapy

Unequal access and unmet need: neurotic disorders and the use of primary care services

Psychological Medicine

Neurotic disorders and the receipt of psychiatric treatment