Case Simulation Methods for Teaching Empirically-Validated Behavioral Treatments

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Project Summary/Abstract This proposal aims to develop and evaluate case-simulation methods for training therapists to provide empirically-validated behavioral treatments (EVBTs). Building on Arizona's existing clinical-science curriculum and lessons learned from therapist training in clinical trials, we will use case-simulation exercises to augment the teaching of three EVBTs relevant to our three- course practicum sequence: (a) cognitive and behavioral therapy for adult depression (CBT practicum), (b) family therapy for adolescent drug abuse (family therapy practicum), and (c) motivational interviewing for adult alcohol abuse (MI practicum). Each of these EVBTs fits well with the training objectives of the corresponding practicum, where graduate students work with actual patients in our in-house Psychology Department Clinic. The simulation exercises also will help more advanced students acquire skills in training and supervising front-line (masters level) EVBT clinicians. For each EVBT (and practicum) we will develop two case-simulation modules, each with conceptual-skill (case formulation) and behavioral-skill (treatment implementation) components. The case-formulation components will entail responding to written case vignettes and build on a methodology Shoham and Rohrbaugh use to study therapist development in their current NIDA R01 project. For behavioral-skill components we will then adapt a methodology widely used in medical education, wherein trainees respond to specific vignette-related scenarios enacted by standardized patients. The two case modules for each EVBT will be graded in difficulty, with the first presenting a fairly straight-forward clinical situation and the second a more complicated one (e.g. depression with a co-occurring sleep disorder). Each module also will include fidelity scales for rating both conceptual and behavioral skills, and our team will draw on relevant manuals and published literature in constructing these. Other specific aims are to evaluate the utility of case-simulation methodology as an EVBT- training tool and to develop relevant training materials suitable for dissemination. In addition to soliciting students' qualitative and quantitative feedback, we will attempt to validate the simulation methodology by tracking changes in therapist skills and correlating these changes with client outcomes. Finally, using standardized outcome measurements for Clinic patients should provide a basis for comparison with benchmarks from clinical trials. Project Narrative Although scientifically-valid behavioral treatments for mental and substance-use exist, there are not enough well-trained therapists to apply them. This project will develop and test a case-simulation approach to teaching three of these treatments (cognitive- behavioral therapy for depression, family therapy for adolescent drug abuse, and motivational interviewing for alcohol problems) in a science-based clinical psychology doctoral program. The proposed simulation methods will provide cutting-edge training experiences that clinical scientists can export to practitioners in community settings, yielding tangible public-health benefits.