Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies
Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment f...
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Veröffentlicht in: | Behavior therapy 2019-01, Vol.50 (1), p.36-49 |
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creator | LoSavio, Stefanie T. Dillon, Kirsten H. Murphy, Robert A. Goetz, Karen Houston, Falesha Resick, Patricia A. |
description | Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d = 1.68 and 1.28 for posttraumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.
•Effective treatments for posttraumatic stress disorder are used inconsistently•Learning Collaboratives focus on both clinical training and sustainability•This is the first reported Learning Collaborative for cognitive processing therapy•Most (68%) clinicians were rostered as approved treatment providers•At the 6-month follow-up, 95% of rostered clinicians were still using the treatment |
doi_str_mv | 10.1016/j.beth.2018.03.007 |
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•Effective treatments for posttraumatic stress disorder are used inconsistently•Learning Collaboratives focus on both clinical training and sustainability•This is the first reported Learning Collaborative for cognitive processing therapy•Most (68%) clinicians were rostered as approved treatment providers•At the 6-month follow-up, 95% of rostered clinicians were still using the treatment</description><identifier>ISSN: 0005-7894</identifier><identifier>EISSN: 1878-1888</identifier><identifier>DOI: 10.1016/j.beth.2018.03.007</identifier><identifier>PMID: 30661565</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Cognitive Behavioral Therapy - methods ; cognitive processing therapy ; Community Mental Health Services - methods ; Female ; fidelity ; Follow-Up Studies ; Health Personnel ; Humans ; implementation ; Learning ; learning collaborative ; Male ; Stress Disorders, Post-Traumatic - psychology ; Stress Disorders, Post-Traumatic - therapy ; Surveys and Questionnaires ; sustainability ; Treatment Outcome</subject><ispartof>Behavior therapy, 2019-01, Vol.50 (1), p.36-49</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-789c5c0ef4c3b6ddb15a230aa52b12acebdfcd942745a2dfcdf9ccc82f15813f3</citedby><cites>FETCH-LOGICAL-c356t-789c5c0ef4c3b6ddb15a230aa52b12acebdfcd942745a2dfcdf9ccc82f15813f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.beth.2018.03.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30661565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LoSavio, Stefanie T.</creatorcontrib><creatorcontrib>Dillon, Kirsten H.</creatorcontrib><creatorcontrib>Murphy, Robert A.</creatorcontrib><creatorcontrib>Goetz, Karen</creatorcontrib><creatorcontrib>Houston, Falesha</creatorcontrib><creatorcontrib>Resick, Patricia A.</creatorcontrib><title>Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies</title><title>Behavior therapy</title><addtitle>Behav Ther</addtitle><description>Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d = 1.68 and 1.28 for posttraumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.
•Effective treatments for posttraumatic stress disorder are used inconsistently•Learning Collaboratives focus on both clinical training and sustainability•This is the first reported Learning Collaborative for cognitive processing therapy•Most (68%) clinicians were rostered as approved treatment providers•At the 6-month follow-up, 95% of rostered clinicians were still using the treatment</description><subject>Adult</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>cognitive processing therapy</subject><subject>Community Mental Health Services - methods</subject><subject>Female</subject><subject>fidelity</subject><subject>Follow-Up Studies</subject><subject>Health Personnel</subject><subject>Humans</subject><subject>implementation</subject><subject>Learning</subject><subject>learning collaborative</subject><subject>Male</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Stress Disorders, Post-Traumatic - therapy</subject><subject>Surveys and Questionnaires</subject><subject>sustainability</subject><subject>Treatment Outcome</subject><issn>0005-7894</issn><issn>1878-1888</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EgvL4ARYoSzYJ4zhOXIkNlKdUBAtYW449Ka6SuNgpUv8ehwJLVh5pzlz5HkJOKWQUaHmxzGoc3rMcqMiAZQDVDplQUYmUCiF2yQQAeFqJaXFADkNYAjBglO-TAwZlSXnJJ6R9C7ZfJCqZo_L9OM5c26raeTXYT0yenME2GVxyY0PAzvZqwIgsevu9fvFOY_iOeH1Hr1abkZ25rltHYpNeq4AmuVpgry2GY7LXqDbgyc97RN7ubl9nD-n8-f5xdjVPNePlMP5Ycw3YFJrVpTE15SpnoBTPa5orjbVptJkWeVXExTg3U621yBvKBWUNOyLn29yVdx9rDIPsbNAYe_Xo1kHmtJqyqohsRPMtqr0LwWMjV952ym8kBTlalks5WpajZQlMRsvx6Ownf113aP5OfrVG4HILYGz5adHLEPv3Go31qAdpnP0v_wsRLZBX</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>LoSavio, Stefanie T.</creator><creator>Dillon, Kirsten H.</creator><creator>Murphy, Robert A.</creator><creator>Goetz, Karen</creator><creator>Houston, Falesha</creator><creator>Resick, Patricia A.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies</title><author>LoSavio, Stefanie T. ; Dillon, Kirsten H. ; Murphy, Robert A. ; Goetz, Karen ; Houston, Falesha ; Resick, Patricia A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-789c5c0ef4c3b6ddb15a230aa52b12acebdfcd942745a2dfcdf9ccc82f15813f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>cognitive processing therapy</topic><topic>Community Mental Health Services - methods</topic><topic>Female</topic><topic>fidelity</topic><topic>Follow-Up Studies</topic><topic>Health Personnel</topic><topic>Humans</topic><topic>implementation</topic><topic>Learning</topic><topic>learning collaborative</topic><topic>Male</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Stress Disorders, Post-Traumatic - therapy</topic><topic>Surveys and Questionnaires</topic><topic>sustainability</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LoSavio, Stefanie T.</creatorcontrib><creatorcontrib>Dillon, Kirsten H.</creatorcontrib><creatorcontrib>Murphy, Robert A.</creatorcontrib><creatorcontrib>Goetz, Karen</creatorcontrib><creatorcontrib>Houston, Falesha</creatorcontrib><creatorcontrib>Resick, Patricia A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Behavior therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LoSavio, Stefanie T.</au><au>Dillon, Kirsten H.</au><au>Murphy, Robert A.</au><au>Goetz, Karen</au><au>Houston, Falesha</au><au>Resick, Patricia A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies</atitle><jtitle>Behavior therapy</jtitle><addtitle>Behav Ther</addtitle><date>2019-01</date><risdate>2019</risdate><volume>50</volume><issue>1</issue><spage>36</spage><epage>49</epage><pages>36-49</pages><issn>0005-7894</issn><eissn>1878-1888</eissn><abstract>Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d = 1.68 and 1.28 for posttraumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.
•Effective treatments for posttraumatic stress disorder are used inconsistently•Learning Collaboratives focus on both clinical training and sustainability•This is the first reported Learning Collaborative for cognitive processing therapy•Most (68%) clinicians were rostered as approved treatment providers•At the 6-month follow-up, 95% of rostered clinicians were still using the treatment</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30661565</pmid><doi>10.1016/j.beth.2018.03.007</doi><tpages>14</tpages></addata></record> |
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subjects | Adult Cognitive Behavioral Therapy - methods cognitive processing therapy Community Mental Health Services - methods Female fidelity Follow-Up Studies Health Personnel Humans implementation Learning learning collaborative Male Stress Disorders, Post-Traumatic - psychology Stress Disorders, Post-Traumatic - therapy Surveys and Questionnaires sustainability Treatment Outcome |
title | Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies |
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