Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

摘要 需要循证心理健康治疗，即，基于最佳科学的治疗， 从科学、伦理和市场营销的角度强调了研究证据。虽然经验主义 有证据支持认知行为疗法（CBT）治疗焦虑症的疗效和有效性 疾病4 -8，对这些方法培训的临床医生的需求远远超过供应。例如在 尽管经验数据支持这些方法对焦虑症的疗效，但只有11%的治疗者 焦虑症患者接受行为疗法作为他们的治疗，只有16%的治疗患者 接受认知疗法9.相比之下，40%的接受动态治疗的患者， 对于它在焦虑症中的疗效缺乏实证支持。一个主要原因是缺乏训练有素的 认知行为治疗师10.新技术提供了一个机会，既促进了这一点的可及性， 精神卫生专业人员的专门培训，并提高这种培训的质量。最近的研究 发现，使用这些新的基于网络的技术培训临床医生是非常有效的，可以显着 提高技能，并具有显着的优势，比传统的培训方案11，12。这些工具可能是 整合到一个应用的学术实践，以及在该领域的临床医生通过继续使用 教育该项目的长期目标是增加可用的心理健康 通过开发一套基于网络的 培训工具，以便广泛传播这种培训。在第一阶段，我们开发了一个原型- 线教程涵盖一些核心CBT原则和社交焦虑症模块。我们还测试了 通过视频会议进行现场远程培训的可行性。用户对在线教程和 视频会议培训的费用非常高。学员对CBT概念的认识显著提高 事前事后辅导没有关于教程或视频会议的技术困难的报告 训练在第二阶段，我们将扩大教程原型，包括CBT原则的全面审查 和技术并扩展模块以包括焦虑症的全谱（即，强迫性 强迫症、恐慌症、广泛性焦虑症、创伤后应激障碍和社交障碍 焦虑症）。我们还将评估现场远程培训在提高临床技能方面的效果。一项队列 将招募来自不同教育和专业背景的50名临床医生。改善 学员的概念知识将在辅导前和辅导后进行评估， 应用CBT概念的技能将通过对临床依从性和能力的盲法评定来评估 视频会议培训前后用户对在线教程和 还将对视频会议培训进行评价。

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.