Breakout C – October 13, 2011 (MC: Meghan Keough)
Presenter: Sara J. Landes, PhD
Authors: Sara J. Landes, National Center for PTSD, VA Palo Alto Health Care System, Marsha M. Linehan, University of Washington, Anthony P. DuBose, Behavioral Tech, LLC, and Kate Comtois, University of Washington
Abstract: Dialectical Behavior Therapy (DBT) is an efficacious and effective cognitive-behavioral treatment for suicidal patients with Borderline Personality Disorder. Given its effectiveness in a difficult-to-treat population with high service utilization, high expense, and high societal cost, DBT dissemination and training have been in high demand. In response, the treatment developer, Marsha Linehan, developed and implemented an Intensive Training Model. The model is based on training innovators and early adopters, who can become opinion leaders in their settings to facilitate implementation. The Intensive Training Model is highly experiential, team-focused, and incorporates systematic feedback and contingencies to motivate new behaviors. Each training component has a strong theoretical and empirical base. Initial data has been collected on the Intensive Training Courses. Data indicate that participant knowledge increases after training, DBT programs offered by teams post-training became more comprehensive as time progressed, training is not sufficient for therapists to reach adherence, and that training may be quite effective at providing sufficient training for development of programs that have a positive impact on client outcomes. These results will be discussed in terms of how to best improve training to make it both effective and efficient and evaluate its impact, especially in terms of assessing fidelity.
2. Increasing Access to Evidence-Based Treatments for Women with Antenatal Depression: Training Obstetric Nurses and Behavioral Health Providers in Behavioral Activation
Presenation Slides Video of Presentation
Presenter: Sam Hubley, MA
Authors: Sam Hubley, University of Colorado, Arne Beck, Kaiser Permanente, Denver, Colorado, Sherryl Goodman, Emory University, Nancy Sherwood, University of Minnesota, and Greg Simon, Group Health Research Institute
Abstract: Antenatal depresion (AD) is a common and deleterious condition. The combination of high prevalence and adverse effects for both mothers and infants constitutes a serious public health problem. Unfotunately, only a small fraction of women who experience AD are detected and receive treatment. This is due in part to the limited availability of evidence-based screening and treatment protocols in the clinical settings where pregnant women receive their majority of the antenatal healthcare (i.e. obstetrics and gynecology; OB/GYN clinics). Evidence-based psychological treatments (EBPTs), such as Behavioral Activation (BA), are the preferred choice of treatment for the majority of women with AD; yet, they are rarely, if ever, available in OB/GYN clinics. Increasing the availability of EBPTs for AD in OB/GYN clinics is a promising approach to ddressing the unmet need for treatment and mitigating the consequences of untreated AD. This presentation describes the problem of undetected and untreated AD and possible factors that contribute to low detection and treatment rates. Following a brief review of studies testing the efficacy of EBPTs for AD, we describe in detail models for disseminating and implementing EBPTs and provide recommendations for transporting EBTPs to OB/GYN settings. Recommendations include specific suggestions for the planning, implementing, evaluating, and maintaining phrases of transporting EBPTs into OB/GYN clinics. FInally, a novel approach to increasing access to EBPTs by training OB/GYN clinical providers in BA is proposed.
Presenter: Jennifer L. Villatte, MA
Authors: Jennifer L. Villatte, University of Nevada, Reno, Matthieu Villatte, University of Louisiana, Joanne Steinwachs, Private Practice, Denver, Colorado, and Stephen C. Hayes, University of Nevada, Reno
Abstract: Acceptance and Commitment Therapy (ACT) is an empirically supported treatment based on behavioral principles and relational frame theory that emphasizes flexible fidelity to a theoretical model, versus rigid adherence to a linear protocol. ACT has demonstrated efficacy in treating a range of problems in living, including depression, psychosis, and the management of chronic medical conditions. However, few studies have examined the effectiveness of ACT training strategies. Research on psychotherapy dissemination and implementation suggests that traditional instructor-led workshops may not be sufficient to achieve and sustain treatment fidelity, while a growing number of studies suggest that online training and consultation groups produce equivalent or better results.
The current pilot study compares a traditional 2-day instructor-led workshop to two styles of 8-week online training groups; one focused on ACT technical skills-training with therapy demonstration and rehearsal via role-play, and the other focused on training in behavioral theory and principles with experiential practice of ACT therapeutic processes. We will present results on the impact of these three training conditions on therapist burnout, therapeutic alliance, and treatment fidelity at pre, post, and 3-month follow up. This pilot study raises interesting questions and provides preliminary data regarding several issues in training research, including the measurement of treatment fidelity and adoption, the relationship between training satisfaction and therapist behavior, and the role of theory and experiential practice in psychotherapy training.