@Article{info:doi/10.2196/jmir.8336, author="Cooper, Zafra and Bailey-Straebler, Suzanne and Morgan, Katy E and O'Connor, Marianne E and Caddy, Caroline and Hamadi, Layla and Fairburn, Christopher G", title="Using the Internet to Train Therapists: Randomized Comparison of Two Scalable Methods", journal="J Med Internet Res", year="2017", month="Oct", day="18", volume="19", number="10", pages="e355", keywords="psychotherapy; training; Internet; eating disorders; cognitive therapy", abstract="Background: One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. The currently accepted method of training is not scalable. Recently, a scalable form of training, Web-centered training, has been shown to have promise. Objective: The goal of our research was to conduct a randomized comparison of the relative effects of independent and supported Web-centered training on therapist competence and investigate the persistence of the effects. Methods: Eligible therapists were recruited from across the United States and Canada. They were randomly assigned to 1 of 2 forms of training in enhanced cognitive behavior therapy (CBT-E), a multicomponent evidence-based psychological treatment for any form of eating disorder. Independent training was undertaken autonomously, while supported training was accompanied by support from a nonspecialist worker. Therapist competence was assessed using a validated competence measure before training, after 20 weeks of training, and 6 months after the completion of training. Results: A total of 160 therapists expressed interest in the study, and 156 (97.5{\%}) were randomized to the 2 forms of training (81 to supported training and 75 to independent training). Mixed effects analysis showed an increase in competence scores in both groups. There was no difference between the 2 forms of training, with mean difference for the supported versus independent group being --0.06 (95{\%} Cl --1.29 to 1.16, P=.92). A total of 58 participants (58/114, 50.9{\%}) scored above the competence threshold; three-quarters (43/58, 74{\%}) had not met this threshold before training. There was no difference between the 2 groups in the odds of scoring over the competence threshold (odds ratio [OR] 1.02, 95{\%} CI 0.52 to 1.99; P=.96). At follow-up, there was no significant difference between the 2 training groups (mean difference 0.19, 95{\%} Cl --1.27 to 1.66, P=.80). Overall, change in competence score from end of training to follow-up was not significant (mean difference --0.70, 95{\%} CI --1.52 to 0.11, P=.09). There was also no difference at follow-up between the training groups in the odds of scoring over the competence threshold (OR 0.95, 95{\%} Cl 0.34 to 2.62; P=.92). Conclusions: Web-centered training was equally effective whether undertaken independently or accompanied by support, and its effects were sustained. The independent form of Web-centered training is particularly attractive as it provides a means of training large numbers of geographically dispersed therapists at low cost, thereby overcoming several obstacles to the widespread dissemination of psychological treatments. ", issn="1438-8871", doi="10.2196/jmir.8336", url="http://www.jmir.org/2017/10/e355/", url="https://doi.org/10.2196/jmir.8336", url="http://www.ncbi.nlm.nih.gov/pubmed/29046265" }