An Examination of Behavioral Rehearsal During Consultation as a Predictor of Training Outcomes
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The training literature suggests that ongoing support following initial therapist training enhances training outcomes, yet little is known about what occurs during ongoing support and what accounts for its effectiveness. The present study examined consultation sessions provided to 99 clinicians following training in cognitive-behavioral therapy for youth anxiety. Recorded consultation sessions (N = 104) were coded for content and consultative methods. It was hypothesized that behavioral rehearsal (an active learning technique) would predict therapist adherence, skill, self-efficacy, and satisfaction at post-consultation. Regression analyses found no significant relation, however, clinician involvement during consultation sessions positively moderated the relationship between behavioral rehearsals and skill. Implications, limitations, and future directions are discussed.
KeywordsEvidence-based practices Training Ongoing support Consultation Active learning Behavioral rehearsal
Funding for this research project was supported by NIMH grants to Beidas (MH083333; MH099179) and Kendall (MH083333; MH063747). Additionally, the preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and Quality Enhancement Research Initiative (QUERI), Department of Veterans Affairs Contract, Veterans Health Administration, Office of Research & Development, Health Services Research & Development Service. Dr. Beidas is an IRI fellow.
- American Psychological Association. (2005, August). American psychological association policy statement on evidence-based practice in psychology. Retrieved from http://www.apa.org/practice/resources/evidence/evidence-based-statement.pdf.
- Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
- Beidas, R. S., Barmish, A. J., & Kendall, P. C. (2009). Training as usual: Can clinician behavior change following reading a manual and attending a brief workshop on cognitive behavioral therapy for youth anxiety? The Behavior Clinician, 32(5), 97–101.Google Scholar
- Beidas, R. S., Cross, W. F., & Dorsey, S. (2013a). Show me, don’t tell me: Behavioral rehearsal as a training and analogue fidelity tool. Cognitive and Behavioral Practice.Google Scholar
- Beidas, R. S., Edmunds, J. M., Cannuscio, C. C., Gallagher, M., Downey, M. M., & Kendall, P. C. (2013b). Therapists perspectives on the effective elements of consultation following training. Administration and Policy in Mental Health and Mental Health Services Research. doi: 10.1007/s10488-013-0475-7.
- Brodman, D. M., Edmunds, J. M., Beidas, R. S., Read, K. L., Ringle, V.A., & Kendall, P. C. (2012). Consultation during dissemination of CBT for child anxiety: The relation between the use of case discussion and therapist training outcomes. Poster presented at the Association for Behavioral and Cognitive Therapies 46th Annual Convention, National Harbor, Maryland.Google Scholar
- Caplan, G., & Caplan, R. B. (1993). Mental health consultation and collaboration. San Francisco, CA: Jossey-Bass.Google Scholar
- Cross, W. F., Seaburn, D., Gibbs, D., Schmeelk-Cone, K., White, A. M., & Caine, E. D. (2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. Journal of Primary Prevention, 32(3–4), 195–211. doi: 10.1007/s10935-011-0250-z.PubMedCrossRefGoogle Scholar
- Davis, D., O’Brien, M. A., Freemantle, N., Wolf, F. M., Mazmanian, P., & Taylor-Vaisey, A. (1999). Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? Journal of the American Medical Association, 282(9), 867–874. doi: 10.1001/jama.282.9.867.PubMedCrossRefGoogle Scholar
- Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network. Retrieved from http://ctndisseminationlibrary.org/PDF/nirnmonograph.pdf.
- Heinze, A., & Procter, C. (2006). Online communication and information technology education. Journal of Information Technology Education, 5, 235–249. Retrieved from www.jite.org/documents/Vol5/v5p235-249Heinze156.pdf.
- Kendall, P. C., & Hedtke, K. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.Google Scholar
- Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
- Milne, D. & James, I. (2000). A systematic review of effective cognitive-behavioural supervision. The British Journal of Clinical Psychology, 39(2), 111–127. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10895356.
- Pimentel, S. S., Regan, J., Comer, J. S., Hoagwood, K. E., & Albano, A. M. (2013). Disseminating evidence-based treatments for children: A microanalysis of consultation calls as an ongoing training strategy. Manuscript under review.Google Scholar
- President’s New Freedom Commission on Mental Health. (2003). Report of the President’s New Freedom Commission on Mental Health. Retrieved from http://govinfo.library.unt.edu/mentalhealthcommission/reports/reports.htm.
- Read, K. L., Edmunds, J. M., Beidas, R. S., Brodman, D. M., Ringle, V., & Kendall, P. C. (2012). The influence of exposure-specific content during consultation calls on community clinicians’ skill in preparing anxious youth for exposure tasks. Poster presented at the Association for Behavioral and Cognitive Therapies 46th Annual Convention, National Harbor, Maryland.Google Scholar
- Stirman, S., Buchhofer, R., McLaulin, B., Evans, A., & Beck, A. (2009). Public-academic partnerships: The Beck initiative: A partnership to implement cognitive therapy in a community behavioral health system. Psychiatric Services, 60(10), 1302–1304. doi: 10.1176/appi.ps.60.10.1302.PubMedCrossRefGoogle Scholar
- Weisz, J. (2004). Therapist Background Questionnaire. Boston, MA: Harvard University, Unpublished measure.Google Scholar