Changes in Community Clinicians' Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training.
Changes in Community Clinicians' Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training.
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DOI：
10.1177/26334895211030220
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发表时间：
2021-01-01
影响因子：
--
通讯作者：
Stirman SW
中科院分区：
文献类型：
--
作者：
Creed TA;Crane ME;Calloway A;Olino TM;Kendall PC;Stirman SW
尽管文献表明，对循证实践(EBP)的态度与提供者使用EBP有关，但关于态度与EBP交付能力之间的关联却知之甚少。这项研究考察了最初的态度和能力如何与EBP培训后态度和能力的改善有关。社区临床医生(N = 891)接受了认知行为治疗技能的强化培训，然后接受了6个月的 会诊。临床医生的态度使用循证实践态度量表进行评估，能力使用认知治疗评定量表进行评估。通过拟合三个潜在变化得分模型对数据进行分析，以考察在整个培训过程中以及培训的两个阶段(研讨会阶段、咨询阶段)态度和能力变化之间的关系。潜伏变化模型发现，在整个培训和每个阶段，态度(Mslatent Change ⩾ 1.07、SES ⩽ 0.19、Zs ⩾ 6.85、PS <； .001)和能力(Mslatent Change ⩾ 13.13、SES ⩽ 3.53、Zs ⩾ 2.30、PS <； .001)都有显著改善。更高的研讨会前态度预示着研讨会阶段和整个培训阶段能力的变化明显更大(BS ⩾ 1.58，SE ⩽ 1.13，z ⩾ 1.89，p <； .048，β ⩾ .09)；然而，与我们的假设相反，研讨会后态度并没有显著预测咨询阶段能力的变化(b = 1.40，SE = 1.07，z = 1.31，p = .19，β = .08)。在培训阶段、研讨会阶段和咨询阶段，态度的改变和能力的改变没有显著的相关性。结果表明，培训前对EBPS的态度是实施干预的目标，因为它们与整个培训过程中态度和能力的变化有关。在参加最初的培训讲习班之后，主观规范、实施文化或系统一级政策转变等其他因素可能更能预测整个磋商过程中能力的变化。尽管以前的研究表明学习者对循证实践的了解与他们对循证实践的态度可能是相关的，但关于学习者的态度与他们传递循证实践的能力之间的联系却知之甚少。这项研究考察了最初的态度和能力与EBP培训后态度和能力的改善之间的关系。这项研究表明，社区临床医生对循证心理健康做法的初始态度与他们最终学习如何提供这些做法有关。这一发现表明，未来的实施工作可能受益于在培训之前直接针对临床医生的态度，而不是依赖更广泛的培训策略。
Although the literature suggests that attitudes toward evidence-based practices (EBPs) are associated with provider use of EBPs, less is known about the association between attitudes and how competently EBPs are delivered. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Community clinicians (N = 891) received intensive training in cognitive behavioral therapy skills followed by 6 months of consultation. Clinician attitudes were assessed using the Evidence-Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data were analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase). Latent change models identified significant improvement in attitudes (Mslatent change ⩾ 1.07, SEs ⩽ 0.19, zs ⩾ 6.85, ps < .001) and competence (Mslatent change ⩾ 13.13, SEs ⩽ 3.53, zs ⩾ 2.30, ps < .001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training (bs ⩾ 1.58, SEs ⩽ 1.13, z ⩾ 1.89, p < .048, β ⩾ .09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase (b = 1.40, SE = 1.07, z = 1.31, p = .19, β = .08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training. Following participation in initial training workshops, other factors such as subjective norms, implementation culture, or system-level policy shifts may be more predictive of change in competence throughout consultation. Although previous research has suggested that a learner’s knowledge of evidence-based practices (EBPs) and their attitudes toward EBPs may be related, little is known about the association between a learner’s attitudes and their competence in delivering EBPs. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following training in an EBP. This study suggests that community clinicians’ initial attitudes about evidence-based mental health practices are related to how well they ultimately learn to deliver those practices. This finding suggests that future implementation efforts may benefit from directly targeting clinician attitudes prior to training, rather than relying on more broad-based training strategies.
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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
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
认知行为疗法在任何情况，人群或环境中的证据：系统评价和全景荟萃分析的荟萃审查。
影响因子：
6.9
作者：
Fordham B;Sugavanam T;Edwards K;Stallard P;Howard R;das Nair R;Copsey B;Lee H;Howick J;Hemming K;Lamb SE
通讯作者：
Lamb SE
DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
--
作者：
Aarons, Gregory A
通讯作者：
Aarons, Gregory A
影响因子：
3.3
作者：
Cook, Joan M.;Dinnen, Stephanie;Schnurr, Paula P.
通讯作者：
Schnurr, Paula P.