Striving to Keep Up with the Field of Evidence-Based Interventions:

1
Striving to Keep Up with the Field of
Evidence-Based Interventions Redesign of a
Child Psychotherapy Seminar Jennifer West PhD,
Wendi Cross PhD, and Pamela Schippell
PhD University of Rochester Medical Center

• Psychological practice should rest on the
• foundation of scientific knowledge (APA
• Presidential Task Force, 2006)
• Empirically based treatments (EBTs) are
• more effective than usual care (Weisz et al,
• 2006) developing competence in evidence-
• based interventions should be a primary
• objective of training programs (Kaslow et
  al.,
• 2004)
• Guidelines for accreditation require that
• training programs provide instruction in
• evidence-based practices (APA, 1996)
• Within the child and adolescent psychology
• doctoral internship at URMC, interventions
• with a solid evidence base were emphasized

Structure of the Seminar
Seminar Topics
Strengths

• Participants child psychology interns, fellows
  
• child psychiatry fellows
• Faculty Core child psychology and psychiatry
• faculty, community faculty
• Meets weekly for 2 hrs. from Sept-June
• Each section includes a syllabus with learning
• objectives, required readings
• Multicultural factors discussed in each section
• 1st hour of the seminar didactic (lecture,
• demonstrations, role plays, tape of
  supervisors
• clinical work)
• 2nd hour group supervision

• EBTs compatible with common presenting problems
  of patients seen in
• practica settings were selected
• First five meetings focus on fundamental
  techniques
• Empathic listening, limit-setting, active
  learning, treatment planning
• Final meeting focused on termination
• Topics
• Parenting Collaborative Problem Solving
• Autism Spectrum Disorders Diagnosis and
  Treatment
• Fundamentals of Family Therapy
• Parenting Behavioral Techniques
• PCIT (Eyberg), Incredible Years
  (Webster-Stratton), Defiant Child
• (Barkley)
• CBT for Depression
• CBT for Anxiety

• Strong emphasis on active learning
• Instructor peer supervision support skill
  development
• Evaluation component (trainee and instructor)
• Feedback to trainees can be integrated into
  individual
• supervision
• Quality improvement
• Dissemination of seminar DVDs to supervisors
• Increases likelihood EBT skills will be applied,
  
• reinforced
• Seminar receives high ratings from trainees
• Value opportunities to practice skills
• Value instructor feedback/supervision
• Perceived efficacy increased for all sections
• Average change ranged from 2.7-6.3 points

Supervision
Evaluation of the Seminar
Challenges

• Seminar participants complete pre- and
  post-efficacy measures
• for each section
• Faculty provide written feedback to each trainee
• Copies of the evaluation are distributed to the
  trainees, the
• Training Director, and to their outpatient
  supervisors
• Trainees complete evaluations of each instructor
• Efficacy item examples
• I feel confident in my ability to implement this
  treatment
• I feel confident in my ability to explain the
  rationale for this
• treatment approach to parents
• I am comfortable using my supervision to enhance
  my practice
• with this treatment
• Trainee performance evaluation items
• Willingness to learn practice
  treatment-specific skills
• Understanding of the theoretical model
• Skill in implementing treatment approach

• 2nd hour of the meeting group supervision
• Participants required to bring session DVDs
• Coordination with Outpatient Intake Team so
• trainees have appropriate caseloads for EBTs
• taught in the seminar
• Techniques for giving and receiving feedback
• are modeled and reinforced
• Didactic portion of each seminar meeting is
• taped DVDs made available to all supervisors
• so that they can reinforce application of
  EBTs
• in trainees individual supervision

• Determining EBTs to highlight in the seminar
• Trainees have a range of prior exposure to EBTs
• Challenging to meet learning needs of all
  participants
• Efficacy and evaluation measures require
  oversight
• Can use web-based surveys, on-line learning
  systems
• Recruitment of faculty instructors
• Faculty appointments and hospital privileges
  required,
• since they provide supervision in the seminar
• Difficult to determine the degree to which EBTs
  are being
• delivered in practica settings, and quality
  of delivery
• Plan to revise current evaluation tool to
  include
• observation component
• Difficult to measure extent that supervisors
  make use
• of seminar DVDs, reinforce content

Development of the Seminar

• Seminar aims to increase not only
• knowledge but also application
• of core skills and competencies
• Strong emphasis on active learning
• Supervision a major component
• Trainees expected to show tapes
• Dissemination of seminar DVDs to
• individual supervisors so that developing
• competence in EBTs is a major focus of
• supervision