Abstract
Despite evidence that more intensive methods are more effective, many clinical settings continue to train practitioners using workshops. To more fully understand the strengths and limitations of workshops, the present investigation studied changes in practitioner behavior following a workshop in trauma-focused cognitive-behavioral therapy (TF-CBT). A chart review indicated no changes in TF-CBT use following the training, although therapists indicated that CBT was the most effective treatment for traumatized youths and was their primary approach to treating trauma. Analysis of client factors indicated weak relationships between technique use and treatment need. Implications of these findings for future training efforts are discussed.
Similar content being viewed by others
References
Becker, C. B., Zayfert, C., & Anderson, E. (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy, 42, 277–292.
Briere, J. (1996). Trauma symptom checklist for chidlren (TSCC) professional manual. Odessa, FL: Psychological Assessment Resources.
Casey, R. J., & Berman, J. S. (1985). The outcome of psychotherapy with children. Psychological Bulletin, 98(2), 388–400.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences, (2nd ed.). Hillsdale, NJ: Erlbaum.
Cohen, J., Goodman, R. F., Brown, E. J., & Mannarino, A. (2004). Treatment of childhood traumatic grief: Contributing to a newly emerging condition in the wake of community trauma. Harvard Review of Psychiatry, 12(4), 213–216.
Cook, J. M., Schnurr, P. P., & Foa, E. B. (2004). Bridging the gap between posttraumatic stress disorder research and clinical practice: The example of exposure therapy. Psychotherapy: Theory, Research, Practice, Training. Special Issue: The Psychological Impact of Trauma: Theory, Research, Assessment, and Intervention, 41(4), 374–387.
Crits-Christoph, P., Siqueland, L., Chittams, J., Barber, J. P., Beck, A. T., Frank, A., et al. (1998). Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence. Journal of Consulting and Clinical Psychology, 66(3), 484–492.
Cusack, K. J., Grubaugh, A. L., Knapp, R. G., & Frueh, B. C. (2006). Unrecognized trauma and PTSD in public mental health consumers with serious mental illness. Community Mental Health Journal, 42(5), 487–500.
Davis, D., Thomson O’Brien, M. A., Freemantle, N., Wolf, F. M., Mazmanian, P., & Taylor-Vaisey, A. (1999). Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA: Journal of the American Medical Association, 282(9), 867–874.
Deblinger, E., & Heflin, A. H. (1996). Treating sexually abused children and their nonoffending parents: A cognitive behavioral approach. Thousand Oaks, CA: Sage Publications.
Dixon, L., Lyles, A., Scott, J., Lehman, A., Postrado, L., Goldman, H., et al. (1999). Services to families of adults with schizophrenia: From treatment recommendations to dissemination. Psychiatric Services, 50(2), 233–238.
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).
Frueh, B. C., Cusack, K. J., Hiers, T. G., Monogan, S., Cousins, V. C., & Cavenaugh, S. D. (2001). Improving public mental health services for trauma victims in South Carolina. Psychiatric Services, 52(6), 812–814.
King, N. J., Tonge, B. J., Mullen, P., Myerson, N., Heyne, D., Rollings, S., et al. (2000). Treating sexually abused children with posttraumatic stress symptoms: A randomized clinical trial. Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), 1347–1355.
Kolko, D. J., Baumann, B. L., & Caldwell, N. (2003). Child abuse victims’ involvement in community agency treatment: Service correlates, short-term outcomes, and relationship to reabuse. Child Maltreatment, 8(4), 273–287.
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.
Lau, A. S., & Weisz, J. R. (2003). Reported maltreatment among clinic-referred children: Implications for presenting problems, treatment attrition, and long-term outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 42(11), 1327–1334.
McNemar, Q. (1947). Note on the sampling error of the difference between correlated proportions or percentages. Psychometrika, 12, 153–157.
Mertin, P., & Mohr, P. B. (2002). Incidence and correlates of posttrauma symptoms in children from backgrounds of domestic violence. Violence and Victims, 17(5), 555–567.
Miller, W. R., & Mount, K. A. (2001). A small study of training in motivational interviewing: Does one workshop change clinician and client behavior? Behavioural and Cognitive Psychotherapy, 29(4), 457–471.
Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72(6), 1050–1062.
Oates, R. K., O’Toole, B. I., Lynch, D. L., Stern, A., & Cooney, G. (1994). Stability and change in outcomes for sexually abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 33(7), 945–953.
Raudenbush, S., & Bryk, A. (2002). Hierarchical linear models (2nd ed.). Thousand Oaks, CA: Sage Publications, Inc.
Raudenbush, S., Bryk, A., & Congdon, R. (2005). HLM 6: Hierarchical linear and nonlinear modeling. Chicago: Scientific Software.
Ribbe, D. (1996). Psychometric review of traumatic event screening instrument for children (TESI-C). In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation (pp. 386–387). Lutherville, MD: Sidran Press.
Sadowski, C. M., & Friedrich, W. N. (2000). Psychometric properties of the trauma symptom checklist for children (TSCC) with psychiatrically hospitalized adolescents. Child Maltreatment, 5(4), 364–372.
Saunders B., Berliner L., & Hanson R. F. (Eds.) (2003). Child physical and sexual abuse: Guidelines for Treatment (Final Report: January 15, 2003). Charleston, SC: National Crime Victims Research and Treatment Center.
Shafer, M. S., Rhode, R., & Chong, J. (2004). Using distance education to promote the transfer of motivational interviewing skills among behavioral health professionals. Journal of Substance Abuse Treatment, 26(2), 141–148.
Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., & Carroll, K. M. (2005). We don’t train in vain: A dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73(1), 106–115.
Thomson O’Brien, M. A., Freemantle, N., Oxman, A. D., Wolf, F., Davis, D. A., & Herrin, J. (2001). Continuing education meetings and workshops: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 2, CD003030.
Weisz, J. R., & Jensen, A. L. (2001). Child and adolescent psychotherapy in research and practice contexts: Review of the evidence and suggestions for improving the field. European Child and Adolescent Psychiatry, 10(5), I12–I18.
Weisz, J. R., Jensen Doss, A., & Hawley, K. M. (2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist, 61, 671–689.
Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117(3), 450–468.
Zimmerman, M., & Mattia, J. I. (1999). Is posttraumatic stress disorder underdiagnosed in routine clinical settings? Journal of Nervous and Mental Disease, 187(7), 420–428.
Acknowledgements
The authors acknowledge the contributions of Kate Bushnell, Brian Doss, Christopher Wells, Mac MaGee, and Leticia Osterberg to the data collection and preparation of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Additional information
Portions of this paper were presented at the Kansas Conference in Clinical Child and Adolescent Psychology, October, 2006.
Rights and permissions
About this article
Cite this article
Jensen-Doss, A., Cusack, K.J. & de Arellano, M.A. Workshop-based Training in Trauma-focused CBT: An In-depth Analysis of Impact on Provider Practices. Community Ment Health J 44, 227–244 (2008). https://doi.org/10.1007/s10597-007-9121-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-007-9121-8