title: Exposing clinicians to exposure: a randomized controlled dissemination trial of exposure therapy for anxiety disorders.
abstract: OBJECTIVE
  The present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training.
  
  
  METHODS
  Clinicians naïve to ET (N=181, Mage=37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to (a) an interactive, multimedia online training (OLT), (b) OLT plus a brief, computerized motivational enhancement intervention (OLT+ME), or (c) OLT+ME plus a Web-based learning community (OLT+ME+LC). Assessments were completed at baseline, posttraining, and 6 and 12weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency.
  
  
  RESULTS
  All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT+ME+LC condition was superior to both other conditions in increasing knowledge of ET.
  
  
  CONCLUSIONS
  Multicomponent trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET.
authors.affiliation: Behavioral Tech Research, Inc.. Electronic address: mharned@btechresearch.com.
authors.forename: Melanie S
authors.initials: MS
authors.lastname: Harned
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Dimeff
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Woodcock
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Tim
authors.initials: T
authors.lastname: Kelly
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Jake
authors.initials: J
authors.lastname: Zavertnik
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Contreras
authors.affiliation: Behavioral Tech Research, Inc.
authors.forename: Sankirtana M
authors.initials: SM
authors.lastname: Danner
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004522:Educational Status; D018961:Educational Technology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007171:Implosive Therapy / Q000193:education*; D020407:Internet; D008297:Male; D009042:Motivation; D011613:Psychotherapy / Q000193:education*; D020377:Self Efficacy
keywords: anxiety disorders; dissemination; exposure therapy; online training