Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

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DESCRIPTION (provided by applicant): The need for evidence-based mental health treatments i.e., 'treatment based on the best available science or research evidence' has been stressed from scientific, ethical, and marketing perspectives. While empirical evidence supports both the efficacy and effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, 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. 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. 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 mental health professionals using these new technologies (i.e., multi-media, interactive, web-based tutorials for didactic training combined with live remote observation of clinical skills via videoconference) is highly effective, can significantly improve skills, and has significant advantages over traditional training programs. 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. These tools could be integrated into an applied academic practicum, as well as utilized by clinicians in the field through continuing education. The final didactic tutorial will contain a core module on the elements of CBT common to all anxiety disorders, and separate modules applying these concepts for specific anxiety disorders. Phase I will develop a prototype containing the core principles module and a social anxiety disorder module. Live observation of trainees' clinical skill in conducting CBT with a standardized patient will be done via videoconference. Pre and post tests of both conceptual knowledge and applied skills will be developed to evaluate efficacy in a sample of 24 trainees from diverse educational backgrounds. Feasibility will also be evaluated. Phase II will expand the tutorial to include modules for the spectrum of anxiety disorders (e.g., Obsessive Compulsive Disorder, panic disorder, Generalized Anxiety Disorder, Posttraumatic Stress Disorder) and a full evaluation of the efficacy of the training program. PUBLIC HEALTH RELEVANCE: Anxiety disorders are a major public health concern, having a profound impact on functioning, causing significant disability, loss of productivity and suffering. Effective treatments exist for these disorders, but few clinicians are trained in these methods. This project attempts to remedy this shortcoming by using web-based tools to facilitate access to this training, thus increasing the number of available therapists in order to help meet this unmet need.