title: Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.
abstract: This study assessed the effects of training on the performance of 65 therapists in delivering manual-guided therapies to 202 cocaine-dependent patients. Changes in ratings of therapists' adherence and competence was assessed in 3 treatment modalities: supportive-expressive dynamic therapy (SE), cognitive therapy (CT), and individual drug counseling. Effects of manual-guided training on the therapeutic alliance were also assessed. Training effects were examined through a hierarchical linear modeling approach that examined changes both within cases and across training cases. A large effect across cases was detected for training in CT. Supportive-expressive therapists and individual drug counselors demonstrated statistically significant learning trends over sessions but not over training cases. Training in SE and CT did not have a negative impact on the therapeutic alliance, although alliance scores for trainees in drug counseling initially decreased but then rebounded to initial levels.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, USA. crits@landru.cpr.upenn.edu
authors.forename: P
authors.initials: P
authors.lastname: Crits-Christoph
authors.forename: L
authors.initials: L
authors.lastname: Siqueland
authors.forename: J
authors.initials: J
authors.lastname: Chittams
authors.forename: J P
authors.initials: JP
authors.lastname: Barber
authors.forename: A T
authors.initials: AT
authors.lastname: Beck
authors.forename: A
authors.initials: A
authors.lastname: Frank
authors.forename: B
authors.initials: B
authors.lastname: Liese
authors.forename: L
authors.initials: L
authors.lastname: Luborsky
authors.forename: D
authors.initials: D
authors.lastname: Mark
authors.forename: D
authors.initials: D
authors.lastname: Mercer
authors.forename: L S
authors.initials: LS
authors.lastname: Onken
authors.forename: L M
authors.initials: LM
authors.lastname: Najavits
authors.forename: M E
authors.initials: ME
authors.lastname: Thase
authors.forename: G
authors.initials: G
authors.lastname: Woody
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000193:education*; D003376:Counseling / Q000193:education*; D003479:Curriculum; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011361:Professional Competence; D011613:Psychotherapy / Q000193:education*; D012944:Social Support