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ViewAttendees 8

Symposia

Dissemination & Implementation Science

Session: The Joys of Cultivating CBT Competency and EBP Fidelity

4 - (SYM 41) Trajectories in Cognitive Behavioral Therapy Skill Acquisition over Time

Friday, November 17, 2023
2:30 PM – 4:00 PM PST
Location: Sol Duc (708), Level 7
Evidence based practices (EBPs) such as cognitive behavioral therapy (CBT) are highly effective in addressing a variety of mental health concerns (Hofmann, 2012). Despite their effectiveness, EBPs are often underutilized in community settings, and large-scale efforts to implement EBPs such as CBT have been challenging, with limited success (Beidas et al., 2015). Recent developments of transdiagnostic CBT implementation programs (e.g. Creed et al., 2016; Southam-Gerow et al., 2014; Weisz et al., 2012) have been promising, and indicate that workshops combined with intensive consultation feedback groups can train community therapists to competency levels similar to CBT delivered in clinical trials (Creed et al., 2016). However, there is still limited understanding of how therapists differentially learn CBT over time. Knowledge of how therapists are differentially learning CBT, and therapist factors that inform CBT skill acquisition, could inform how implementation programs structure training and consultation, and attend to developmentally appropriate needs of therapists. We used growth mixture modeling (GMM) to (a) identify different trajectories in how community therapists (n=762) participating in a large-scale implementation program learned CBT skills over the course of intensive workshops and consultation groups, and (b) examine how attitudes about CBT and clinician burnout informed different types of CBT learning trajectories. We tested one to four group GMM models, and selected the model that minimized BIC and AIC values. Preliminary GMM analyses (BIC=11060.29; AIC=11016.56) indicated that CBT learning trajectories fell into two groups; individuals whose CBT skills steadily increased over the course of training and approached CBT competency (88.6%), and individuals whose CBT skills minimally increased over time and did not approach CBT competency (11.4%). Attitudes about CBT, but not clinician burnout, predicted membership in learning trajectory groups. Latent transition analysis will also be conducted to examine how session structure, therapeutic relational, and CBT skill specific domains shift over time. Implications for implementation of CBT, training, and consultation are discussed.