Abstract
The Washington State CBT+ Initiative offers a flexible training and consultation approach for community mental health providers in evidence-based practices for four child mental health targets: cognitive behavioral therapy for depression, anxiety, trauma, and behavioral difficulties. As part of consultation, clinicians used an online system to track delivery of treatment components and clinical outcomes using standardized symptom measures. The current study used these clinician-input data to examine symptom change for children using paired sample t-tests. Additionally, we explored if time elapsed or number of sessions between measurements related to symptom change using simple linear regression. Children had significant symptom reduction across all four targets. For most measures, children did not show greater improvements with increased length of time or increased number of sessions between assessment measures. Findings suggest that children treated by a CBT+ trained clinician may demonstrate symptom reduction for their primary clinical problem. Findings add to support for flexible training approaches for community mental health clinicians.
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Acknowledgements
This publication was made possible in part by funding from the Washington State Health Care Authority (HCA), DBHR that has supported the CBT+ Initiative for 15 years. We recognize and thank Washington State public and community mental health center clinicians, supervisors, and organizational leaders who have been part of CBT+. We also thank the CBT+ regional trainers from community mental health centers who co-lead all CBT+ trainings and consultation.
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CJRN, GSW, and PM contributed to study concepts and design. CJRN, NST, RM, SD, and PM conducted or interpreted statistical analyses. CJRN, AV, VG, and PM conducted data extraction. CJRN, NST, and SD drafted the manuscript with contributions from all the authors. SD and LB contributed to obtaining funding. All authors read and approved the final manuscript for publication.
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This publication was made possible in part by funding from the Washington State Department of Social and Health Services, Division of Behavioral Health Recovery (WA DBHR). Dr. Dorsey has received honoraria and consultancies for Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) as well as grants for research on TF-CBT. Additionally, Dr. Dorsey and Ms. Berliner were paid by WA DBHR to provide the training, consultation, and evaluation outlined in this study. The other authors report no financial relationships with commercial interests.
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All study activities were reviewed by the institutional review board of the University of Washington and were determined to be exempt from review. As all study activities were determined to be exempt from review, informed consent was not required of participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Rivera Nales, C.J., Triplett, N.S., Woodard, G.S. et al. CBT+ Training Initiative in Washington State Community Mental Health: An Evaluation of Child Clinical Outcomes. Community Ment Health J 60, 649–661 (2024). https://doi.org/10.1007/s10597-023-01194-y
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DOI: https://doi.org/10.1007/s10597-023-01194-y