Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

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ABSTRACT The need for evidence-based mental health treatments i.e., 'treatment based on the best available science or research evidence' 1, has been stressed from scientific, ethical, and marketing perspectives3. While empirical evidence supports both the efficacy and effectiveness of cognitive behavior therapy (CBT) for anxiety disorders4-8, the demand for clinicians trained in these approaches far exceeds the supply. For example, in spite of empirical data supporting the efficacy of these approaches for anxiety disorders, only 11% of treated anxiety disorder patients received behavior therapy as their treatment, and only 16% of treated patients received cognitive therapy 9. This compares with 40% of treated patients receiving dynamic therapy, which has less empirical support for its efficacy in anxiety disorders. A major reason for this is the lack of trained cognitive behavior therapists 10. New technologies provide the opportunity to both facilitate accessibility to this specialized training by mental health professionals and to improve the quality of this training. Recent research has found that training clinicians using these new web-based technologies is highly effective, can significantly improve skills, and has significant advantages over traditional training programs11,12. These tools could be integrated into an applied academic practicum, as well as utilized by clinicians in the field through continuing education. The long term goal of this project is to increase the number of available mental health professionals trained in cognitive behavior therapy for anxiety disorders by developing a set of web-based training tools enabling the widespread dissemination of this training. In Phase I we developed a prototype on- line tutorial covering some core CBT principles and a Social Anxiety Disorder module. We also tested the feasibility of live remote training through videoconferencing. User satisfaction with both the on-line tutorial and the videoconference training was extremely high. Trainees' knowledge of CBT concepts improved significantly pre-to-post tutorial. No technical difficulties were reported with either the tutorial or the videoconference training. In phase II we will expand the tutorial prototype to include a comprehensive review of CBT principles and techniques and expand modules to include the full spectrum of anxiety disorders (i.e., Obsessive Compulsive Disorder, Panic Disorder, Generalized Anxiety Disorder, Posttraumatic Stress Disorder and Social Anxiety Disorder). We will also evaluate the efficacy of live remote training in improving clinical skills. A cohort of 50 clinicians from diverse educational and professional backgrounds will be recruited. Improvement in trainees' conceptual knowledge will be evaluated pre and post tutorial, and improvement in trainees' clinical skills in applying the CBT concepts will be evaluated by blind ratings of clinical adherence and competence before and after videoconference training. User satisfaction with both the on-line tutorial and the videoconference training will also be evaluated.