Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence.
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.
Crits-Christoph
P
P
Department of Psychiatry, University of Pennsylvania, USA. crits@landru.cpr.upenn.edu
Siqueland
L
L
Chittams
J
J
Barber
J P
JP
Beck
A T
AT
Frank
A
A
Liese
B
B
Luborsky
L
L
Mark
D
D
Mercer
D
D
Onken
L S
LS
Najavits
L M
LM
Thase
M E
ME
Woody
G
G
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