title: Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.
abstract: To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice.
  
  
  
  Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions.
  
  
  
  Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs.
  
  
  
  IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice.
authors.affiliation: Department of Psychiatry, University of Oxford.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Rakovshik
authors.affiliation: Department of Psychology, University of Stirling.
authors.forename: Freda
authors.initials: F
authors.lastname: McManus
authors.affiliation: Nuffield Department of Primary Care Health Sciences.
authors.forename: Maria
authors.initials: M
authors.lastname: Vazquez-Montes
authors.affiliation: Psychology Department, University of Worcester.
authors.forename: Kate
authors.initials: K
authors.lastname: Muse
authors.affiliation: Institute of Psychiatry, Kings College London.
authors.forename: Dennis
authors.initials: D
authors.lastname: Ougrin
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006282:Health Personnel; D006801:Humans; D020407:Internet; D008297:Male; D012017:Referral and Consultation