title: Training and consultation to promote implementation of an empirically supported treatment: a randomized trial.
abstract: OBJECTIVE
  The study evaluated the efficacy of three training modalities and the impact of ongoing consultation after training. Cognitive-behavioral therapy (CBT) for anxiety among youths, an empirically supported treatment, was used as the exemplar. Participants were randomly assigned to one of three one-day workshops to examine the efficacy of training modality: routine training (training as usual), computer training (computerized version of training as usual), and augmented training (training that emphasized active learning). After training, all participants received three months of ongoing consultation that included case consultation, didactics, and problem solving.
  
  
  METHODS
  Participants were 115 community therapists (mean age of 35.9 years; 90% were women). Outcome measures included the Adherence and Skill Checklist, used to rate a performance-based role-play; a knowledge test; and the Training Satisfaction Rating Scale.
  
  
  RESULTS
  All three training modalities resulted in limited gains in therapist adherence, skill, and knowledge. There was no significant effect of modality on adherence, skill, or knowledge from pretraining to posttraining. Participants were more satisfied with augmented and routine training than with computer training. Most important, number of consultation hours after training significantly predicted higher therapist adherence and skill at the three-month follow-up.
  
  
  CONCLUSIONS
  The findings suggest that training alone did not result in therapist behavior change. The inclusion of ongoing consultation was critical to influencing therapist adherence and skill. Implications for implementation science and mental health services research are discussed.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market St., Room 3015, Philadelphia, PA 19104, USA. rbeidas@upenn.edu
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
authors.forename: Julie M
authors.initials: JM
authors.lastname: Edmunds
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D002983:Clinical Competence; D015928:Cognitive Behavioral Therapy / Q000193:education* / Q000379:methods; D003194:Computer-Assisted Instruction / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D013663:Teaching / Q000379:methods*; D016896:Treatment Outcome