Online Training in the Principles and Procedures of Exposure Therapies

描述（由申请人提供）：这是一个第二阶段的小企业创新研究（SBIR）资助申请，以支持进一步开发一个创新的在线培训计划，以帮助传播焦虑症的暴露疗法。已经一致地和有力地发现，抗抑郁药在治疗焦虑症中是有效的。然而，这些循证治疗很少用于真实的临床环境，这似乎主要是由于临床从业人员缺乏一般暴露原则和程序的培训。该项目的主要目标是通过完成焦虑症暴露疗法中常用的暴露原则，技术和程序的创新基础课程在线培训（OLT），促进向治疗提供者传播焦虑症暴露疗法。该项目包含三个中心目标：1）使用迭代过程完成最终OLT产品的开发，该过程涉及目标最终用户和暴露专家在整个开发过程中的广泛反馈; 2）使用添加剂设计在受试者间随机对照试验（RCT）中测试暴露在线培训课程的有效性;以及3）评估增加动机性访谈（MI）程序的相对优点，包括与受试者进行两次20分钟的访谈，以确定在开始OLT之前和完成OLT时增加MI是否会对结果产生积极影响。同意参与研究的暴露-nove治疗提供者将被随机分配到三种条件之一：文本（n = 63），文本+OLT（n = 63）和文本+OLT + MI（n = 63）。将在基线、培训后以及30天和60天随访时对受试者进行评估。主要的结果变量将包括：知识、自我效能、满意度、对暴露疗法的态度变化，以及参与疾病特异性方案的进一步培训（例如，恐慌控制治疗恐慌症）。此外，受试者将完成两项基于应用的措施，包括基于表现的角色扮演。这些治疗模拟测量将在基线、试验后和60天随访时进行。公共卫生相关性：焦虑症是美国最常见的精神疾病，与重大的个人，社会和经济成本有关。绝大多数焦虑症患者没有得到治疗或治疗不足，部分原因是未能向社区精神卫生机构传播循证治疗。暴露疗法是非常有效的，基于证据的焦虑症治疗方法，可以很容易地转移到社区临床医生。该项目旨在进一步开发关于暴露原则和程序的创新在线培训，以促进暴露疗法的传播，并改善焦虑症患者的临床结果。

DESCRIPTION (provided by applicant): This is a Phase II Small Business Innovation Research (SBIR) grant application to support the further development of an innovative, online training program to aid in the dissemination of exposure therapies (ETs) for anxiety disorders. ETs have consistently and robustly been found effective in the treatment of anxiety disorders. However, these evidence-based treatments are rarely used in real world clinical settings and this appears to be due primarily to a lack of training in general exposure principles and procedures among clinical practitioners. The primary goal of this project is to facilitate the dissemination of ETs for anxiety disorders to treatment providers by completing an innovative foundational course online training (OLT) in exposure principles, techniques, and procedures commonly used in exposure therapies for anxiety disorders. The project contains three central aims: 1) to complete the development of the final OLT product using an iterative process that involves extensive feedback from target end-users and exposure experts throughout its development; 2) to test the efficacy of the exposure online training course in a between subjects randomized controlled trial (RCT) using an additive design; and 3) to evaluate the relative merit of adding a Motivational Interviewing (MI) procedure involving two 20-minute interviews with subjects to determine if the addition of MI before starting and upon completing the OLT will positively impact outcomes. Exposure-naove treatment providers who have agreed to participate in the research will be randomly assigned to one of three condition: text (n=63), text+OLT (n=63), and text+OLT+MI (n=63). Subjects will be assessed at baseline, post-training, and at a 30 day and 60 day follow up. Major outcome variables will include: knowledge, self-efficacy, satisfaction, attitudinal change about exposure therapy, and engagement in further training in disorder-specific protocols (e.g., Panic Control Treatment for panic disorder). Additionally, subjects will complete two application based measures, including a performance-based role play. These therapy simulation measures will be conducted at baseline, post-test, and at the 60 day follow up. PUBLIC HEALTH RELEVANCE: Anxiety disorders are the most common mental illness in the United States and are associated with significant personal, social, and economic costs. The vast majority of individuals with anxiety disorders receive no or inadequate treatment and this is due, in part, to a failure to disseminate evidence-based treatments to community mental health settings. Exposure therapies are highly effective, evidence-based treatments for anxiety disorders that may be readily transportable to community clinicians. This project aims to further develop an innovative online training of exposure principles and procedures to facilitate the dissemination of exposure therapies and improve clinical outcomes for individuals suffering from anxiety disorders.