Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

描述(由申请人提供)：从科学、伦理和营销角度强调了循证心理健康治疗的必要性，即“基于最好的可用科学或研究证据的治疗”。虽然经验证据支持认知行为疗法(CBT)治疗焦虑症的有效性和有效性，但对接受过这些方法培训的临床医生的需求远远超过供应。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，接受动态治疗的患者中有40%接受动态治疗，动态治疗对焦虑症疗效的经验支持较少。造成这种情况的主要原因是缺乏训练有素的认知行为治疗师。新技术为心理健康专业人员获得这一专门培训提供了便利，并提高了这一培训的质量。最近的研究发现，使用这些新技术(即多媒体、交互式、基于网络的教学培训教程与通过视频会议现场远程观察临床技能相结合)培训精神卫生专业人员是非常有效的，可以显著提高技能，并且与传统培训计划相比具有显著优势。该项目的长期目标是通过开发一套能够广泛传播这一培训的基于网络的培训工具，增加接受过焦虑症认知行为治疗培训的心理健康专业人员的数量。这些工具可以整合到一个实用的学术实践中，并通过继续教育被现场的临床医生使用。最后的教学教程将包含一个关于所有焦虑症共同的CBT元素的核心模块，以及将这些概念应用于特定焦虑症的单独模块。第一阶段将开发一个包含核心原则模块和社交焦虑症模块的原型。将通过视频会议现场观察学员与标准化患者进行CBT的临床技能。将制定概念知识和应用技能的前后测试，以评估来自不同教育背景的24名受训人员的效果。还将对可行性进行评估。第二阶段将扩大教程的范围，包括焦虑症(如强迫症、恐慌症、广泛性焦虑症、创伤后应激障碍)的模块，并对培训计划的效果进行全面评估。公共卫生相关性：焦虑症是一个重大的公共卫生问题，对功能有深远的影响，导致严重残疾、生产力损失和痛苦。这些疾病有有效的治疗方法，但很少有临床医生接受过这些方法的培训。该项目试图通过使用基于网络的工具来帮助获得这一培训，从而增加现有治疗师的数量，以帮助满足这一未得到满足的需求，从而弥补这一缺陷。

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.