Case Simulation Methods for Teaching Empirically-Validated Behavioral Treatments

项目总结/摘要 该提案旨在开发和评估培训治疗师的案例模拟方法， 提供经临床验证的行为治疗（EVBT）。在亚利桑那州现有的 临床科学课程和临床试验中治疗师培训的经验教训，我们将 使用案例模拟练习，以增加与我们的三个相关的三个EVBT的教学- 课程实习顺序：（a）成人抑郁症的认知和行为治疗（CBT （B）青少年药物滥用的家庭治疗（家庭治疗实习），以及（c） 成人酒精滥用动机访谈（MI Practicum）这些EVBT都很适合 与相应实习的培养目标，研究生工作与 在我们的内部心理学部门诊所的实际病人。模拟演习还将 帮助更高水平的学生掌握培训和监督前线的技能（硕士水平） EVBT临床医生。 对于每个EVBT（和实习），我们将开发两个案例模拟模块，每个模块都有 概念技能（病例制定）和行为技能（治疗实施）组成部分。 案件拟订部分将需要对书面案件说明作出回应，并以 Shoham和Rohrbaugh在他们目前的NIDA中研究治疗师发展的方法 R 01项目。对于行为技能组件，我们将采用广泛使用的方法， 医学教育，其中受训者应对特定的小插曲相关的场景颁布， 标准化患者每个EVBT的两个案例模块将按难度分级， 第一种表现出相当直接的临床情况，第二种表现出更复杂的临床情况 (e.g.抑郁症伴睡眠障碍）。每个模块还将包括保真度 评估概念和行为技能的量表，我们的团队将借鉴相关的 手册和出版的文献中构建这些。 其他具体目标是评估案例模拟方法作为EVBT的效用， 培训工具，并制定适合传播的相关培训材料。除了 征求学生的定性和定量反馈，我们将尝试验证 通过跟踪治疗师技能的变化并将这些变化关联起来， 客户的成果。最后，使用标准化的临床患者结局测量 应提供与临床试验基准进行比较的基础。项目叙述 尽管存在针对精神和物质使用的科学有效的行为治疗， 没有足够的训练有素的治疗师来应用它们。该项目将开发和 测试案例模拟方法来教授这些治疗方法中的三种（认知， 抑郁症的行为治疗，青少年药物滥用的家庭治疗， 酒精问题的动机访谈）在一个以科学为基础的临床心理学 博士课程。拟议的模拟方法将提供尖端的培训 临床科学家可以向社区环境中的从业者输出的经验， 产生切实的公共卫生效益。

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.