Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T23:38:08.954Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of a Trauma-Focused CBT Training Programme for IAPT services

Published online by Cambridge University Press:  28 March 2017

Hannah Murray
Hannah Murray*
Affiliation:
Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, The Old Rectory, Paradise Square, Oxford OX1 1TW
*
Correspondence to Hannah Murray, Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, The Old Rectory, Paradise Square, Oxford OX1 1TW. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research–practice gap. Aims: This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Method: Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Results: Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. Conclusions: The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training ‘trauma experts’ within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

Keywords

Post-traumatic stress disorderPTSDtrainingCBTIAPT
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 5 , September 2017 , pp. 467 - 482
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Becker, K. D. and Stirman, S. W. (2011). The science of training in evidence-based treatments in the context of implementation programs: current status and prospects for the future. Administration and Policy in Mental Health and Mental Health Services Research, 38, 217–222.Google Scholar
Becker, C. B., Zayfert, C. and Anderson, E. (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy, 42, 277–292.Google Scholar
Blackburn, I. M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A. and Reichelt, F. K. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–446.Google Scholar
Clark, D. M., Layard, R., Smithies, R., Richards, D. A., Suckling, R. and Wright, B. (2009). Improving access to psychological therapy: initial evaluation of two UK demonstration sites. Behaviour Research and Therapy, 47, 910–920.Google Scholar
Collett, D. (2003). Modelling Binary Data, 2nd edn. Chapman and Hall/CRC.Google Scholar
Corrigan, P. W., Kwartarini, W. Y. and Pramana, W. (1992). Staff perception of barriers to behavior therapy at a psychiatric hospital. Behavior Modification, 16, 132–144.Google Scholar
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E. et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658.Google Scholar
Ebert, L., Amaya-Jackson, L., Markiewicz, J. and Fairbank, J. (2012). Development and application of the NCCTS learning collaborative model for the implementation of evidence-based child trauma treatment. In McHugh, R. K. and Barlow, D. H. (eds), Dissemination and Implementation of Evidence-Based Psychological Interventions, pp. 97–123. Oxford: Oxford University Press.Google Scholar
Ehlers, A. and Clark, D. M. (2000). A cognitive model of post-traumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.CrossRefGoogle Scholar
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F. and Fennell, M. (2005). Cognitive therapy for post-traumatic stress disorder: development and evaluation. Behaviour Research and Therapy, 43, 413–431.Google Scholar
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., Herbert, C. and Mayou, R. (2003). A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder. Archives of General Psychiatry, 60, 1024–1032.Google Scholar
Fairburn, C. G. and Cooper, Z. (2011). Therapist competence, therapy quality, and therapist training. Behaviour Research and Therapy, 49, 373–378.Google Scholar
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A., Riggs, D. S., Feeny, N. C. and Yadin, E. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953.Google Scholar
Foa, E., Hembree, E. and Rothbaum, B. O. (2007). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences Therapist Guide. Oxford: Oxford University Press.Google Scholar
Gillespie, K., Duffy, M., Hackmann, A. and Clark, D. M. (2002). Community based cognitive therapy in the treatment of post-traumatic stress disorder following the Omagh bomb. Behaviour Research and Therapy, 40, 345–357.Google Scholar
Gray, M. J., Elhai, J. D. and Schmidt, L. O. (2007). Trauma professionals’ attitudes toward and utilization of evidence-based practices. Behavior Modification, 31, 732–748.Google Scholar
Health and Social Care Information Centre (2016). Psychological Therapies: Annual Report on the use of IAPT services – England, 2015–16. Available at: http://content.digital.nhs.uk/catalogue/PUB22110 Google Scholar
Karlin, B. E., Ruzek, J. I., Chard, K. M., Eftekhari, A., Monson, C. M., Hembree, E. A. et al. (2010). Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of Traumatic Stress, 23, 663–673.Google Scholar
Kennedy-Merrick, S. J., Haarhoff, B., Stenhouse, L. M., Merrick, P. L. and Kazantzis, N. (2008). Training cognitive behavioural therapy practitioners in New Zealand: from University to clinical practice. New Zealand Journal of Psychology, 37, 8–18.Google Scholar
Kirkpatrick, D.L. (1967). Evaluation of training. In Craig, R. L. and Bittel, L. R. (eds), Training and Development Handbook, pp. 87–112. New York: McGraw-Hill Google Scholar
Kirkpatrick, D. L. (1975). Evaluating Training Programs. Tata McGraw-Hill Education.Google Scholar
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The Phq-9. Journal of General Internal Medicine, 16, 606–613.Google Scholar
Mannix, K. A., Blackburn, I. M., Garland, A., Gracie, J., Moorey, S., Reid, B. et al. (2006). Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners. Palliative Medicine, 20, 579–584.CrossRefGoogle ScholarPubMed
McHugh, R. K. and Barlow, D. H. (2010). The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. American Psychologist, 65, 73.CrossRefGoogle ScholarPubMed
McMillen, J. C., Hawley, K. M. and Proctor, E. K. (2015). Mental health clinicians’ participation in web-based training for an evidence supported intervention: signs of encouragement and trouble ahead. Administration and Policy in Mental Health and Mental Health Services Research, 42, 1–12.Google Scholar
Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J. and Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72, 1050–1062.Google Scholar
Myles, P. J. and Milne, D. L. (2004). Outcome evaluation of a brief shared learning programme in cognitive behavioural therapy. Behavioural and Cognitive Psychotherapy, 32, 177–188.Google Scholar
Nakamura, B. J., Selbo-Bruns, A., Okamura, K., Chang, J., Slavin, L. and Shimabukuro, S. (2014). Developing a systematic evaluation approach for training programs within a train-the-trainer model for youth cognitive behavior therapy. Behaviour Research and Therapy, 53, 10–19.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2005). Post-Traumatic Stress Disorder (PTSD): the management of adults and children in primary and secondary care. NICE clinical guideline 26. Available at: http://www.nice.org.uk/guidance/cg26 Google Scholar
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunker, A. et al. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38, 65–76.Google Scholar
Rakovshik, S. G. and McManus, F. (2010). Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clinical Psychology Review, 30, 496–516.Google Scholar
Rasbash, J., Charlton, C., Browne, W. J., Healy, M. and Cameron, B. (2009). MLwiN, version 2.1. Centre for Multilevel Modelling, University of Bristol.Google Scholar
Resick, P. A. and Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748.Google Scholar
Roth, A. D. and Pilling, S. (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36, 129–147.Google Scholar
Schmidt, F. and Taylor, T. K. (2002). Putting empirically supported treatment into practice: Lessons learned in a children's mental health center. Professional Psychology: Research and Practice, 33, 483.Google Scholar
Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F. and 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, 106.CrossRefGoogle Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. and Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097.Google Scholar
Weiss, D. S. and Marmar, C. R. (1997). The impact of event scale-revised. Assessing Psychological Trauma and PTSD, 2, 168–189.Google Scholar
White, J. (2008). CBT and the challenge of primary care: developing effective, efficient, equitable, acceptable and accessible services for common mental health problems. Journal of Public Mental Health, 7, 32–41.Google Scholar
Young, J. and Beck, A. T. (1980). Cognitive Therapy Rating Scale Manual. University of Pennsylvania, Philadelphia.Google Scholar
Young, J. E. and Beck, A. T. (1988). The Cognitive Therapy Scale (rev edn). Philadelphia, PA: Center for Cognitive Therapy.Google Scholar
Submit a response

Comments

No Comments have been published for this article.