Examining Behavioral Strategies for Enhancing Therapists' Delivery of Exposure Therapy

项目摘要/摘要 经过几十年的心理社会治疗研究，该领域已经建立了许多 精神障碍的循证实践(EBPS)，但一直难以广泛传播 社区环境中的这些做法。焦虑症的暴露疗法代表了 这项研究最突出的例子是实践差距。一个众所周知的障碍， 暴露疗法的传播和高质量传递是治疗师对其负面信念 对病人有潜在危险或无法忍受。这些信念甚至在治疗师中也很常见。 世卫组织报告说接受了专门培训；因此，需要进行研究以制定有针对性的培训 减少负面信念和提高交付质量的策略。初步研究 暗示特定的行为策略(即自我暴露)可能会减少负面信念 以及超越标准的教学培训(Farrell，Kemp等人，2016)。建立在这些基础上 结果，我们提出了一种新的实验疗法方法来开发和测试 社区心理样本中强化负面信念的有针对性的行为训练 健康专业人士。研究的第一阶段是案例系列分析，以确定 目标参与(即，减少信念)和确定适当的行为剂量 战略。第二阶段是行为强化训练策略的随机试验。 (打赌)反对标准的说教协议。治疗师将完成为期一天的工作坊 然后是每周咨询，同时为患有焦虑症的儿童提供暴露。 目标是证明提高投注条件在减少负面影响方面的有效性。 培训期间的信念和提高治疗师提供暴露的质量。在- 将使用经过验证的微分析编码记录和检查会话交付行为 系统。本研究将为开展有针对性的培训建立一个创新的模式 能够增加暴露治疗和其他治疗的传播和质量的干预 EBPS。

Project Summary/Abstract Following decades of psychosocial treatment research the field has established numerous evidence-based practices (EBPs) for mental disorders, but has struggled to widely disseminate these practices in community settings. Exposure therapy for anxiety disorders represents one of the most glaring examples of this research to practice gap. A well-known barrier to the dissemination and quality delivery of exposure therapy is therapists’ negative beliefs about its potential danger or intolerability for patients. These beliefs are common even among therapists who report receiving specialized training; thus, research is needed to develop targeted training strategies for reducing negative beliefs and improving delivery quality. Preliminary research suggests specific behavioral strategies (i.e., self-exposure) may reduce negative beliefs above and beyond standard didactic trainings (Farrell, Kemp et al., 2016). Building upon these findings, we propose a novel experimental therapeutics approach to developing and testing a targeted behavioral training for augmenting negative beliefs in a sample of community mental health professionals. The first phase of the study is a case-series analysis for establishing target engagement (i.e., belief reduction) and determining adequate dosing of the behavioral strategies. Phase two is a randomized trial of the behaviorally-enhanced training strategies (BeTS) against a standard didactic protocol. Therapist will complete a day-long workshop followed by weekly consultation while delivering exposure for children with anxiety disorders. The goal is to demonstrate increased effectiveness for the BeTS condition in reducing negative beliefs during training and increasing the quality with which therapists deliver exposure. In- session delivery behavior will be recorded and examined using a validated micro-analytic coding system. This study will establish an innovative model for developing a targeted training intervention capable of increasing the dissemination and quality of exposure therapy and other EBPs.