Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies.
BACKGROUND
Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment.


OBJECTIVE
This feasibility study explores the impact of specialized training on therapists' beliefs about trauma-focused treatment within a randomized controlled trial.


METHODS
Therapist-rated (n=16) credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed.


RESULTS
Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists' expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD) in patients with psychotic disorders (n=79), pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists.


CONCLUSIONS
These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists' credibility, burden, and harm beliefs concerning trauma-focused treatment.
Parnassia Psychiatric Institute, Den Haag, The Netherlands; d.vandenberg@parnassia.nl.
David P G
DP
van den Berg
Community Mental Health Service GGZ Noord-Holland Noord, Alkmaar, The Netherlands.
Berber M
BM
van der Vleugel
Mental Health Organization (MHO) GGZ Oost Brabant Land van Cuijk en Noord Limburg, Boxmeer, The Netherlands.
Paul A J M
PA
de Bont
Parnassia Psychiatric Institute, Den Haag, The Netherlands.
Gwen
G
Thijssen
MHO Rivierduinen, Leiden, The Netherlands.
Carlijn
C
de Roos
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.|Centre for Anxiety Disorders Overwaal, MHO Pro Persona, Nijmegen, The Netherlands.
Rianne
R
de Kleine
Parnassia Psychiatric Institute, Den Haag, The Netherlands.
Tamar
T
Kraan
Parnassia Psychiatric Institute, Den Haag, The Netherlands.
Helga
H
Ising
Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.|School of Health Sciences, Salford University, Manchester, United Kingdom.
Ad
A
de Jongh
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.|Centre for Anxiety Disorders Overwaal, MHO Pro Persona, Nijmegen, The Netherlands.
Agnes
A
van Minnen
Parnassia Psychiatric Institute, Den Haag, The Netherlands.|Department of Clinical Psychology, VU University Amsterdam and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Mark
M
van der Gaag
EMDR; PTSD; dissemination; prolonged exposure; training