Investigating Bang for Your Training Buck: A Randomized Controlled Trial Comparing Three Methods of Training Clinicians in Two Core Strategies of Dialectical Behavior Therapy
Investigating Bang for Your Training Buck: A Randomized Controlled Trial Comparing Three Methods of Training Clinicians in Two Core Strategies of Dialectical Behavior Therapy
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DOI：
10.1016/j.beth.2015.01.001
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发表时间：
2015-05-01
期刊：
影响因子：
3.7
通讯作者：
Linehan, Marsha M.
中科院分区：
文献类型：
--
作者：
Dimeff, Linda A.;Harned, Melanie S.;Linehan, Marsha M.
本研究考察了在线培训(OLT)、教师指导培训(ILT)和治疗手册(TM)对心理健康临床医生在辩证行为治疗(DBT)的两个核心策略中的培训效果：链分析和验证。一项随机对照试验比较了初出茅庐的临床医生和DBT医生(N=172)的OLT、ILT和TM，他们在基线、培训后以及培训后30、60和90天进行了评估。主要结果包括满意度、自我效能、动机、知识、临床熟练程度和临床应用。总体而言，ILT在满意度、自我效能感和动机方面优于OLT和TM，而OLT是增加知识的最有效方法。在观察者评定的临床熟练程度或自我报告的临床使用方面，这两种情况没有差异，培训后两者都上升到中等水平。此外，ILT在提高使用链分析的动机方面特别有效，而OLT在增加验证策略的知识方面特别有效。这些发现表明，这些类型的简短教学培训可能是增加新治疗策略知识的有效方法，但可能不足以使临床医生达到高水平的临床应用或熟练程度。对培训方法与治疗策略类型相匹配的可能优势的进一步研究可能有助于确定一种定制的、更有效的方法来培训临床医生进行经验性支持的治疗。
The present study examined the efficacy of online training (OLT), instructor-led training (ILT), and a treatment manual (TM) in training mental health clinicians in two core strategies of Dialectical Behavior Therapy (DBT): chain analysis and validation. A randomized controlled trial compared OLT, ILT, and TM among clinicians naive to DBT (N = 172) who were assessed at baseline, post-training, and 30, 60, and 90 days following training. Primary outcomes included satisfaction, self-efficacy, motivation, knowledge, clinical proficiency, and clinical use. Overall, ILT outperformed OLT and TM in satisfaction, self-efficacy, and motivation, whereas OLT was the most effective method for increasing knowledge. The conditions did not differ in observer-rated clinical proficiency or self-reported clinical use, which both increased to moderate levels after training. In addition, ILT was particularly effective at improving motivation to use chain analysis, whereas OLT was particularly effective at increasing knowledge of validation strategies. These findings suggest that these types of brief, didactic trainings may be effective methods of increasing knowledge of new treatment strategies, but may not be sufficient to enable clinicians to achieve a high level of clinical use or proficiency. Additional research examining the possible advantages of matching training methods to types of treatment strategies may help to determine a tailored, more effective approach to training clinicians in empirically supported treatments.