Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders

• ClinicalTrials.gov Identifier: NCT02089984
• Recruitment Status: Completed
• First Posted: March 18, 2014
• Last Update Posted: February 3, 2016
• Sponsor: Center for Psychological Consultation
• Collaborator: National Institute of Mental Health (NIMH)
• Information provided by (Responsible Party): Kenneth A. Kobak, Ph.D., Center for Psychological Consultation

Study Description

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Anxiety Disorders; Obsessive Compulsive Disorder; PTSD	Behavioral: Internet Based CBT Training	Not Applicable

Detailed Description:

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 economic 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. 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 clinicians using these new web-based technologies 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. In Phase I the investigators developed a prototype online tutorial covering some core CBT principles and a Social Anxiety Disorder module. The investigators also tested the feasibility of live remote training through videoconferencing. In phase II investigators will expand the tutorial to include a comprehensive review of CBT principles and techniques and expand modules to include the full spectrum of anxiety and anxiety-related disorders (i.e., Obsessive Compulsive Disorder, Panic Disorder, Generalized Anxiety Disorder, Posttraumatic Stress Disorder and Social Anxiety Disorder). Investigators will also evaluate the efficacy of live remote training in improving clinical skills. A cohort of 50 clinicians from diverse educational and professional backgrounds will be recruited. Improvement in trainees' conceptual knowledge will be evaluated pre and post tutorial, and improvement in trainees' clinical skills in applying the CBT concepts will be evaluated by blind ratings of clinical adherence and competence at three time points: before on-line training, and before and after videoconference training. User satisfaction with both the on-line tutorial and the videoconference training will also be evaluated. Impact of training on post-training patient outcomes will be evaluated.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 70 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Official Title: Web Based Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders
• Study Start Date: September 2011
• Actual Primary Completion Date: June 2015
• Actual Study Completion Date: December 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: Internet-Based Training; On-line tutorial followed by live remote training via videoconferencing	Behavioral: Internet Based CBT Training

Outcome Measures

Primary Outcome Measures :

1. System Usability Scale [ Time Frame: after completion of tutorial, an expected average of 2 weeks ]
   User satisfaction with the technical aspects of the tutorial was assessed using the ratings on the System Usability Scale (SUS), a reliable, well-validated 10-item scale designed to evaluate the usability and user satisfaction with web-based applications and other technologies.
2. CBT Concepts [ Time Frame: After completing the on line tutorial, an expected average of two weeks ]
   Improvement in trainees' knowledge of CBT concepts will be evaluated using a 38-item pre and post test of the items covering the tutorial content.

Secondary Outcome Measures :

1. Yale Adherence and Competence Scale (YACS) [ Time Frame: At day 0 (baseline) (i.e., priot to any training), and after completing the on line tutorial (an expected average of two weeks), and after completing the appled training (an exected average of 8 weeks). ]
   The Yale Adherence and Competence Scale (YACS) is a well-validated, scale for rating therapist adherence and competence in delivering cognitive behavioral treatments. It has been used as an outcome measure in several studies evaluating the effectiveness of different CBT rater training approaches . Therapist competence in administering specific CBT techniques is evaluated on a scale ranging from 1 (very poor) to 7 (excellent).
2. User Satisfaction Questionnaire [ Time Frame: After completing the on line tutorial (an expected average of 2 weeks) ]
   This scale evaluates how well subjects liked the clinical content of the on-line tutorial. It contains 14 statements, each of which are rated on a 4-point scale (strongly agree, agree, disagree, strongly disagree), and covers several dimensions of the user experience . The scale ranges from 15 to 60, and has good internal consistency reliability (Cronbach's Alpha =.90, Phase I study results). An overall mean score of 45 (i.e., an average score of 3 ("agree" on all items)) is considered adequate to demonstrate acceptable user satisfaction with the clinical content.

Other Outcome Measures:

1. GAD-7 [ Time Frame: Weekly for 8 weeks of patient treatment, post training ]
   The GAD-7 is a well-validated self-report scale originally developed as a brief measure of GAD. It has since been validated as measure of anxiety across the domain of anxiety disorders.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Clinicians are eligible for this therapist training study if they are a licensed health care professional or are currently in a counseling related graduate training program

Exclusion Criteria:

• None, except for above

Contacts and Locations

Locations

United States, Wisconsin

Center for Telepsychology

Madison, Wisconsin, United States, 53717

Sponsors and Collaborators

Center for Psychological Consultation

National Institute of Mental Health (NIMH)

More Information

Publications:

Kobak KA, Craske MG, Rose RD, Wolitsky-Taylor K. Web-based therapist training on cognitive behavior therapy for anxiety disorders: a pilot study. Psychotherapy (Chic). 2013 Jun;50(2):235-47. doi: 10.1037/a0030568. Epub 2013 Feb 11.

• Responsible Party: Kenneth A. Kobak, Ph.D., Owner, Center for Psychological Consultation
• ClinicalTrials.gov Identifier: NCT02089984
• Other Study ID Numbers: R44MH086951 ( U.S. NIH Grant/Contract ); R44MH086951 ( U.S. NIH Grant/Contract )
• First Posted: March 18, 2014
• Last Update Posted: February 3, 2016
• Last Verified: February 2016

Keywords provided by Kenneth A. Kobak, Ph.D., Center for Psychological Consultation:

Cognitive Behavior Therapy; On-line training

Additional relevant MeSH terms:

Disease; Anxiety Disorders; Compulsive Personality Disorder; Obsessive-Compulsive Disorder; Pathologic Processes; Mental Disorders; Personality Disorders