Elsevier

Behaviour Research and Therapy

Volume 53, February 2014, Pages 10-19
Behaviour Research and Therapy

Developing a systematic evaluation approach for training programs within a train-the-trainer model for youth cognitive behavior therapy

https://doi.org/10.1016/j.brat.2013.12.001Get rights and content

Highlights

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    Began development of reliable observation coding schemes for supervisors' teaching and therapists' technique behaviors.

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    Examined the effects of a train-the-trainer pilot program with youth community mental health supervisors and therapists.

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    Supervisors improved with regard to their abilities for teaching certain youth cognitive behavioral techniques.

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    In turn, therapists' abilities for implementing target techniques also improved.

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    Supervisors and therapists overrated their performances for teaching and demonstrating techniques.

Abstract

The purpose of this small pilot study was three-fold: (a) to begin development of a coding scheme for supervisor and therapist skill acquisition, (b) to preliminarily investigate a pilot train-the-trainer paradigm for skill development, and (c) to evaluate self-reported versus observed indicators of skill mastery in that pilot program. Participants included four supervisor–therapist dyads (N = 8) working with public mental health sector youth. Master trainers taught cognitive-behavioral therapy techniques to supervisors, who in turn trained therapists on these techniques. Supervisor and therapist skill acquisition and supervisor use of teaching strategies were repeatedly assessed through coding of scripted role-plays with a multiple-baseline across participants and behaviors design. The coding system, the Practice Element Train the Trainer – Supervisor/Therapist Versions of the Therapy Process Observational Coding System for Child Psychotherapy, was developed and evaluated though the course of the investigation. The coding scheme demonstrated excellent reliability (ICCs [1,2] = 0.81–0.91) across 168 video recordings. As calculated through within-subject effect sizes, supervisor and therapist participants, respectively, evidenced skill improvements related to teaching and performing therapy techniques. Self-reported indicators of skill mastery were inflated in comparison to observed skill mastery. Findings lend initial support for further developing an evaluative approach for a train-the-trainer effort focused on disseminating evidence-based practices.

Section snippets

Participants

The two major types of participants in the current study were youth mental health supervisors and therapists. Supervisors and therapists were recruited for voluntary participation from local child-serving community mental health. Supervisor and therapists participated as dyads, naturally paired together through an existing supervisor–supervisee relationship. There were no study dropouts and all participants (four dyads; N = 8) initially expressing interest participated fully. Randomization,

Results

Excluding the tapes utilized for PETT-S TPOCS group development (n = 2) and training (n = 3), 43 supervisor problem-solving tapes (total N = 48) were coded using the model ICC(1,2) described above. The Teaching Content and Teaching Style scales for the problem-solving module demonstrated good (M = 0.70, SD = 0.31) and excellent reliabilities (M = 0.79, SD = 0.16), respectively. Similarly, excluding the supervisor exposure tapes used for PETT-S TPOCS group development (n = 2) and training (n

Discussion

There were three major components of the current demonstration study. First, we developed and tested the reliability of a behavioral observation coding system of supervisors' teaching and therapists' technique behaviors. Second, using our newly built coding scheme, we examined the effects of our state government's pilot train-the-trainer initiative with a sample of youth community mental health supervisors and therapists. Third, we examined the relationship between self-rated and observed

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