DBT Skills Computer Training for Routine CMH Providers

描述(申请人提供)：辩证行为疗法(DBT)是一种全面的心理社会治疗，对边缘人格障碍(BPD)有效。在第一阶段，我们使用原型开发的迭代过程开发和评估了针对精神卫生提供者的DBT技能子集的创新的基于计算机的培训(CBT)原型，并在试点随机对照试验(RCT)中测试了原型的有效性。第一阶段的所有目标都达到并超过了。在随机对照试验中，在所有主要结果变量上都观察到了有利于DBT的统计上的显著结果，包括技能知识获得、回忆技能的能力以及治疗BPD患者的自我效能和动机。在第二阶段，我们建议扩展DBT技能CBT课程，增加两个模块-正念和情绪调节。我们将再次使用迭代开发过程，寻求专家和最终用户的反馈。我们建议进行一项随机对照试验(N=75)，比较三组：DBT CBT组、可比较的基于文本的课程(引导式自学)和CBT控制组。主要结果变量将包括DBT技能知识、回忆、自我效能、治疗BPD患者的动机，以及两项临床应用措施：基于绩效的评估和临床应用测试。此外，我们建议使用3个月的跟踪期来评估一段时间内的技能使用和保留情况。

DESCRIPTION (provided by applicant): Dialectical Behavior Therapy (DBT) is a comprehensive psychosocial treatment that is efficacious for borderline personality disorder (BPD). In Phase I, we developed and evaluated an innovative computer-based training (CBT) prototype of a subset of DBT skills for mental health providers using an iterative process of prototype development, and tested the prototype's efficacy in a pilot randomized controlled trial (RCT). All Phase I aims were met and exceeded. In the RCT, statistically significant results favoring DBT were observed on all major outcome variables, including skills knowledge gains, ability to recall skills, as well as self-efficacy and motivation to treat BPD clients. In Phase II, we propose to expand the DBT skills CBT curricula to include two additional modules - mindfulness and emotion regulation. We will again use an iterative process of development seeking feedback from experts and end-users. We propose to conduct a RCT (N=75) comparing three groups: the DBT CBT, a comparable text-based curriculum (Guided Self-Study), and a CBT control. Major outcome variables will include DBT skills knowledge, recall, self-efficacy, motivation to treat BPD clients, as well as two clinical application measures: a performance-based assessment and a clinical application test. In addition, we propose a 3-month follow-up period to assess skills use and retention over time.