Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

描述（由申请人提供）：对基于证据的心理健康治疗的需求，即“基于最佳可用科学或研究证据的治疗”，已经从科学，伦理和营销的角度强调了3。虽然经验证据支持认知行为疗法（CBT）治疗焦虑症的疗效和有效性[4-8]，但对接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，尽管有经验数据支持这些方法对焦虑症的疗效，但只有11%的焦虑症患者接受了行为治疗，只有16%的患者接受了认知治疗。相比之下，40%的患者接受动态治疗，而动态治疗对焦虑症的疗效缺乏经验支持。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。新技术提供了机会，既便利了精神卫生专业人员获得这种专门培训，又提高了这种培训的质量。最近的研究发现，培训临床医生使用这些新的基于网络的技术是非常有效的，可以显著提高技能，比传统的培训计划有显著的优势11,12。这些工具可以整合到应用学术实习中，也可以通过继续教育由该领域的临床医生使用。该项目的长期目标是通过开发一套基于网络的培训工具，使这种培训能够广泛传播，从而增加接受焦虑症认知行为疗法培训的精神卫生专业人员的数量。在第一阶段，我们开发了一个原型在线教程，涵盖了一些核心CBT原则和社交焦虑障碍模块。我们还测试了通过视频会议进行实时远程培训的可行性。用户对在线教程和视频会议培训的满意度都很高。学员对CBT概念的认知在辅导前后有显著提高。教程或视频会议培训均未报告出现技术困难。在第二阶段，我们将扩展教程原型，包括对CBT原理和技术的全面回顾，并扩展模块，包括所有焦虑症（即强迫症、恐慌症、广泛性焦虑症、创伤后应激障碍和社交焦虑症）。我们还将评估实时远程培训在提高临床技能方面的效果。将招募来自不同教育和专业背景的5名临床医生。通过视频会议培训前后对临床依从性和能力进行盲评，评估培训生在CBT概念知识方面的改善情况。用户对在线教程和视频会议培训的满意度也将进行评估。

DESCRIPTION (provided by APPLICANT): 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 percent of treated anxiety disorder patients received behavior therapy as their treatment, and only 16 percent of treated patients received cognitive therapy 9. This compares with 40 percent 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 5 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 clinicl adherence and competence before and after videoconference training. User satisfaction with both the on-line tutorial and the videoconference training will also be evaluated. 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.