Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

摘要 以证据为基础的心理健康治疗的必要性，即“基于最好的可用科学或 研究证据‘1，从科学、伦理和营销角度强调了3。虽然是经验主义的 有证据支持认知行为疗法(CBT)治疗焦虑症的有效性和有效性 混乱4-8，对受过这些方法培训的临床医生的需求远远超过了供应。例如，在 尽管有经验数据支持这些方法治疗焦虑症的有效性，但只有11%的患者接受了治疗 焦虑症患者接受行为治疗，只有16%的患者接受治疗 接受认知治疗9。相比之下，接受动态治疗的患者中有40%， 对其治疗焦虑症的有效性的实证支持较少。造成这种情况的一个主要原因是缺乏训练有素的 认知行为治疗师10.新技术提供了这样的机会，既可以使人们更容易获得 由精神卫生专业人员进行专门培训，并提高这种培训的质量。最新研究 已经发现使用这些基于网络的新技术培训临床医生是非常有效的，可以显著 提高技能，与传统培训计划相比具有显著优势11、12。这些工具可能是 集成到应用学术实践中，并由现场临床医生通过继续使用 教育。该项目的长期目标是增加现有心理健康服务的数量。 通过开发一套基于网络的认知行为治疗焦虑症的专业人员进行培训 培训工具使这一培训得以广泛传播。在第一阶段，我们开发了一个原型- 在线教程，涵盖一些核心的CBT原则和社交焦虑症模块。我们还测试了 通过视频会议进行远程实况培训的可行性。用户对在线教程和 视频会议的培训非常高。学员对CBT概念的认识显著提高 事前到事后教程。没有关于教程或视频会议的技术困难的报道 训练。在第二阶段，我们将扩展教程原型，以包括对CBT原则的全面审查 和技术，并扩展模块，以包括焦虑症(即强迫症)的全部范围 强迫症、惊恐障碍、广泛性焦虑障碍、创伤后应激障碍与社会 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。一群人 来自不同教育和专业背景的50名临床医生将被招募。改善了 学员的概念性知识将在辅导前和辅导后进行评估，并对学员的临床改进进行评估 应用CBT概念的技能将通过临床依从性和能力的盲目评级进行评估 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估。

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.