Symposium 3 – May 16, 2013
Scaling Up Assessment of Therapist Fidelity in Motivational Interviewing: Preliminary Development of the AutoMITI
Presentations Slides Not Available
Presenter: David C. Atkins, PhD
Authors: David C. Atkins, PhD,1 Zac E. Imel, PhD,2 Doğan Can, MSc,3 Bo Xiao,3 Panayiotis Georgiou, MEng,3 & Shrikanth Narayanan, PhD3
1University of Washington; 2University of Utah; 3University of Southern California
Abstract: Implementation and dissemination are by nature large-scale endeavors: How do we take evidence-based practices and move them to general clinical use? As such, common tools in the clinical research setting do not easily translate to general use. One example is assessing therapist fidelity, in which the typical technology for assessing fidelity is to use behavioral coding systems and human raters. This “low tech??? route to assessing fidelity does not scale up to larger applications and is a non-starter for wide-spread use. The current authors are part of a larger, interdisciplinary team developing automated methods for assessing therapist fidelity in Motivational Interviewing (MI). The current talk will provide an overview and current status of this work, discussing initial examination of automated detection of therapist reflections and empathy. Thus far, detecting reflections using linguistic tools has been quite successful, whereas assessing therapist empathy has proved more challenging. We will review both of these tasks and some reasons why there is differential effectiveness across these two domains of therapist fidelity to MI. In addition, we will briefly comment on the underlying methodology for this work, arising out of the new field of “behavioral informatics??? with tools from engineering, computer science, and related disciplines.
PracticeGround: An Online Platform to Help Therapists Learn, Implement, & Measure Impact of EBPs
Presenter: Gareth Holman, PhD
Authors: Kelly Koerner, PhD, & Gareth Holman, PhD, Evidence-Based Practice Institute, University of Washington
Abstract: Effective post-graduate training and consultation are essential to successfully disseminate and implement evidence-based practices (EBPs). However, commonly used continuing education methods produce little change in practitioner behavior. Instead intensive training models, those combining training and ongoing practice with supervision, appear most effective (Rakovshik & McManus, 2010). Yet such intensive models are expensive and difficult to take to scale. Even in the best case, in-person expert-led training and consultation can only reach a limited number of practitioners.
PracticeGround is a scalable online alternative to traditional continuing education methods. PracticeGround is a training and performance support platform through which practitioners, trainers, and researchers work together to achieve the best possible therapy outcomes for clients. PracticeGround integrates learning, implementation support and measurement into practitioners’ routine workflow. In this talk I will layout our long-range strategy to develop and test training and implementation methods using PracticeGround. I will report findings from our first three studies (training to do behavioral activation (Puspitasari et al (in press), enhance therapeutic relationship skills (Kanter et al, in press); and implement progress monitoring (Persons et al, 2012)).
Dialectical Behavior Therapy Implementation Process & Outcomes in VA & Community Settings
Presenter: Sara J. Landes, PhD
Authors: Sara J. Landes, PhD,1 & Matthew Ditty, MSW2
1National Center for PTSD, VA Palo Alto Health Care System; 2University of Pennsylvania School of Social Policy & Practice
Abstract: Dialectical Behavior Therapy (Linehan, 1993) is an evidence-based cognitive behavioral psychotherapy for suicidal individuals with Borderline Personality Disorder (BPD); it is considered the gold standard treatment for BPD, suicidal behavior, and severe behavioral dyscontrol. DBT is a comprehensive treatment and consists of four modes: group skills training, individual therapy, skills coaching outside of session, and therapist consultation team. Limited data is available about how teams in real-world settings implement full DBT programs following intensive training. Two different ongoing projects are evaluating the process of implementing DBT programs, in community settings and in Department of Veterans Affairs (VA) settings. We will present data from these studies, including what components are implemented at different time points following intensive training, barriers encountered, and qualitative descriptions of the process. We will discuss whether these data support implementation strategies that encourage implementation of all components at once or a modular approach (e.g., implementing one component at a time) and future research directions.