1. Implementation of Transdiagnostic Cognitive Therapy in Community Behavioral Health: The Beck Community Initiative.
- Author
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Creed, Torrey A., Frankel, Sarah A., German, Ramaris E., Green, Kelly L., Jager-Hyman, Shari, Taylor, Kristin P., Adler, Abby D., Wolk, Courtney B., Stirman, Shannon W., Waltman, Scott H., Williston, Michael A., Sherrill, Rachel, Evans, Arthur C., and Beck, Aaron T.
- Subjects
MENTAL health services ,COGNITIVE therapy ,EVIDENCE-based psychiatry - Abstract
Progress bringing evidence-based practice (EBP) to community behavioral health (CBH) has been slow. This study investigated feasibility, acceptability, and fidelity outcomes of a program to implement transdiagnostic cognitive therapy (CT) across diverse CBH settings, in response to a policy shift toward EBP. Method: Clinicians (n = 348) from 30 CBH programs participated in workshops and 6 months of consultation. Clinician retention was examined to assess feasibility, and clinician feedback and attitudes were evaluated to assess implementation acceptability. Experts rated clinicians' work samples at baseline, mid-, and end-of-consultation with the Cognitive Therapy Rating Scale (CTRS) to assess fidelity. Results: Feasibility was demonstrated through high program retention (i.e., only 4.9% of clinicians withdrew). Turnover of clinicians who participated was low (13.5%) compared to typical CBH turnover rates, even during the high-demand training period. Clinicians reported high acceptability of EBP and CT, and self-reported comfort using CT improved significantly over time. Most clinicians (79.6%) reached established benchmarks of CT competency by the final assessment point. Mixed-effects hierarchical linear models indicated that CTRS scores increased significantly from baseline to the competency assessment (p < .001), on average by 18.65 points. Outcomes did not vary significantly between settings (i.e., outpatient vs. other). Conclusions: Even clinicians motivated by policy-change rather than self-nomination may feasibly be trained to deliver a case-conceptualization driven EBP with high levels of competency and acceptability. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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