Examining Behavioral Strategies for Enhancing Therapists' Delivery of Exposure Therapy

项目总结/摘要 经过几十年的心理治疗研究，该领域已经建立了许多 循证实践（EBP）的精神障碍，但一直在努力广泛传播 在社区环境中的这些做法。焦虑症的暴露疗法代表了 最突出的例子就是这种研究与实践的差距。一个众所周知的障碍， 暴露疗法的传播和质量是治疗师对暴露疗法的负面信念。 对患者的潜在危险或不耐受性。这些信念甚至在治疗师中也很普遍 报告接受专门培训的妇女;因此，需要进行研究，以制定有针对性的培训 减少消极信念和提高交付质量的战略。初步研究 建议特定的行为策略（即，自我暴露）可以减少上述消极信念 并且超出标准的教学训练（Farrell，肯普等人，2016）。在此基础上， 研究结果，我们提出了一种新的实验治疗方法，以开发和测试一种 有针对性的行为训练，以增加社区心理样本中的消极信念 卫生专业人员。研究的第一阶段是一个案例系列分析， 目标接合（即，信念降低）和确定行为的适当剂量 战略布局第二阶段是行为强化训练策略的随机试验 （BeTS）反对一个标准的教学协议。治疗师将完成为期一天的研讨会 随后每周咨询一次，同时为患有焦虑症的儿童提供接触。 目标是证明BeTS条件在减少负面影响方面的有效性增加 培训过程中的信念和提高治疗师提供曝光的质量。在- 将使用经过验证的微观分析编码来记录和检查会话交付行为 系统本研究将建立一个创新的模式，为开发有针对性的培训 能够提高暴露疗法和其他疗法的传播和质量的干预 EBP。

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.