title: Use of fidelity assessments to train clinicians in the CBT for PTSD program for clients with serious mental illness.
abstract: OBJECTIVE
  One barrier to disseminating evidence-based practices for persons with serious mental illness is the difficulty of training frontline clinicians. This study evaluated whether frontline clinicians could be trained to implement an empirically supported cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) among persons with serious mental illness when a standardized fidelity measure was used to provide clinicians with feedback on practice cases.
  
  
  METHODS
  Twenty-five clinicians (23 master's level) at five agency sites were trained in the CBT for PTSD program and delivered it to 35 clients (practice cases) over six months. Supervisors or consultants used the fidelity measure to rate audio-recorded sessions and provide feedback. A criterion of competence was established to designate program certification. Clients' PTSD and depression symptoms were monitored. Clinicians' satisfaction with training was also assessed.
  
  
  RESULTS
  Two clinicians dropped out, and 21 of the remaining 23 clinicians (91%) achieved program certification with their first case; the remaining two (9%) achieved it with their second case. Clients' symptoms, measured by the PTSD Checklist and the Beck Depression Inventory, decreased significantly during treatment, suggesting clinical benefits of the program. Clinicians reported that group supervision was very helpful and written feedback was helpful or very helpful. All rated the training as excellent.
  
  
  CONCLUSIONS
  Results support the feasibility of training frontline clinicians in the CBT for PTSD program by using regular feedback based on the fidelity measure and indicate that most clinicians can achieve competence in the model with a single practice case.
authors.affiliation: Department of Psychiatric Rehabilitation and Counseling Professions, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey, USA.
authors.forename: Weili
authors.initials: W
authors.lastname: Lu
authors.forename: Philip T
authors.initials: PT
authors.lastname: Yanos
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Gottlieb
authors.forename: Stephanie Marcello
authors.initials: SM
authors.lastname: Duva
authors.forename: Steven M
authors.initials: SM
authors.lastname: Silverstein
authors.forename: Haiyi
authors.initials: H
authors.lastname: Xie
authors.forename: Stanley D
authors.initials: SD
authors.lastname: Rosenberg
authors.forename: Kim T
authors.initials: KT
authors.lastname: Mueser
mesh_terms: D000328:Adult; D002568:Certification / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D015928:Cognitive Behavioral Therapy / Q000193:education* / Q000592:standards; D003865:Major Depressive Disorder / Q000150:complications; D005240:Feasibility Studies; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications; D011785:Quality Assurance, Health Care / Q000592:standards*; D012559:Schizophrenia / Q000150:complications; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome