Leveraging routine clinical materials and mobile technology to assess CBT fidelity: the Innovative Methods to Assess Psychotherapy Practices (imAPP) study.
Leveraging routine clinical materials and mobile technology to assess CBT fidelity: the Innovative Methods to Assess Psychotherapy Practices (imAPP) study.
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DOI：
10.1186/s13012-018-0756-3
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发表时间：
2018-05-22
期刊：
影响因子：
--
通讯作者：
La Bash H
中科院分区：
文献类型：
--
作者：
Wiltsey Stirman S;Marques L;Creed TA;Gutner CA;DeRubeis R;Barnett PG;Kuhn E;Suvak M;Owen J;Vogt D;Jo B;Schoenwald S;Johnson C;Mallard K;Beristianos M;La Bash H
确定评估保真度的可扩展策略是实施科学的一个关键挑战。然而，对于心理社会干预，现有的，可靠的方法来测试治疗保真度的质量往往是劳动密集型的，和较轻的负担的策略可能无法反映实际的临床实践。认知行为疗法（CBT）为临床医生提供了一套有效的核心要素，以帮助治疗多种疾病，有证据表明，这些疾病需要忠实地提供，以最大限度地发挥潜在的客户影响。目前评估CBT的“黄金标准”是评估治疗会话的记录，这非常耗时，需要大量的初始培训。虽然CBT可以根据目标障碍而有所不同，但大多数CBT中采用的一个共同元素是使用行为识别来识别影响客户恢复能力的特定行为和想法。本研究将开发和评估一种创新的新方法来评估CBT的忠诚度，通过开发一个通用的CBT评分系统，根据治疗过程中完成的评分。为了开发CBT量表的评分系统，我们将从各种CBT量表中为一系列精神疾病汇编常见的CBT元素，并创建依从性和能力测量。我们将从过去的研究中收集档案，以测试评分系统和评估重测信度。为了评估CBT工作表评分是否准确反映了临床医生的忠诚度，我们将招募从事CBT治疗抑郁症，焦虑症和/或创伤后应激障碍的临床医生。临床医生和客户将传输会议中制作的常规治疗材料（例如，记录、临床笔记、会话记录）在每次会话后提供给研究团队。我们将比较临床医生的保真度、临床笔记和合格率，以确定评估临床医生保真度的最有效和最高效的方法。还将随机分配客户在纸质表格或移动的应用程序（app）上完成CBT问卷，以了解工作表格式是否影响临床医生和客户体验或在反映保真度方面存在差异。使用CBT量表对忠诚度进行评分可以使诊所以简短有效的方式测试忠诚度，从而提高工作场所的持续质量改进。临床医生和诊所可以使用这样的数据来提高临床医生的真实的时间保真度，从而改善患者的结果。ClinicalTrials.gov NCT03479398. 2018年3月20日注册的Retrophoresis。
Identifying scalable strategies for assessing fidelity is a key challenge in implementation science. However, for psychosocial interventions, the existing, reliable ways to test treatment fidelity quality are often labor intensive, and less burdensome strategies may not reflect actual clinical practice. Cognitive behavioral therapies (CBTs) provide clinicians with a set of effective core elements to help treat a multitude of disorders, which, evidence suggests, need to be delivered with fidelity to maximize potential client impact. The current “gold standard” for rating CBTs is rating recordings of therapy sessions, which is extremely time-consuming and requires a substantial amount of initial training. Although CBTs can vary based on the target disorder, one common element employed in most CBTs is the use of worksheets to identify specific behaviors and thoughts that affect a client’s ability to recover. The present study will develop and evaluate an innovative new approach to rate CBT fidelity, by developing a universal CBT scoring system based on worksheets completed in therapy sessions. To develop a scoring system for CBT worksheets, we will compile common CBT elements from a variety of CBT worksheets for a range of psychiatric disorders and create adherence and competence measures. We will collect archival worksheets from past studies to test the scoring system and assess test-retest reliability. To evaluate whether CBT worksheet scoring accurately reflects clinician fidelity, we will recruit clinicians who are engaged in a CBT for depression, anxiety, and/or posttraumatic stress disorder. Clinicians and clients will transmit routine therapy materials produced in session (e.g., worksheets, clinical notes, session recordings) to the study team after each session. We will compare observer-rated fidelity, clinical notes, and fidelity-rated worksheets to identify the most effective and efficient method to assess clinician fidelity. Clients will also be randomly assigned to either complete the CBT worksheets on paper forms or on a mobile application (app) to learn if worksheet format influences clinician and client experience or differs in terms of reflecting fidelity. Scoring fidelity using CBT worksheets may allow clinics to test fidelity in a short and effective manner, enhancing continuous quality improvement in the workplace. Clinicians and clinics can use such data to improve clinician fidelity in real time, leading to improved patient outcomes. ClinicalTrials.gov NCT03479398. Retrospectively registered March 20, 2018.
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影响因子：
3.6
作者：
Aarons, Gregory A.;Hoagwood, Kimberly;Landsverk, John;Glisson, Charles;Kelleher, Kelly;Cafri, Guy
通讯作者：
Cafri, Guy
影响因子：
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作者：
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DOI：
10.1007/s10488-014-0618-5
发表时间：
2016-01-01
影响因子：
2.6
作者：
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通讯作者：
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DOI：
10.1007/s10488-012-0424-x
发表时间：
2013-07
影响因子：
2.6
作者：
Ben-Zeev, Dror;Davis, Kristin E.;Kaiser, Susan;Krzsos, Izabela;Drake, Robert E.
通讯作者：
Drake, Robert E.
影响因子：
3.4
作者：
Beck, AT;Steer, RA;Ranieri, WF
通讯作者：
Ranieri, WF