TY  - JOUR
AU  - Cooper, Zafra
AU  - Bailey-Straebler, Suzanne
AU  - Morgan, Katy E
AU  - O'Connor, Marianne E
AU  - Caddy, Caroline
AU  - Hamadi, Layla
AU  - Fairburn, Christopher G
PY  - 2017
DA  - 2017/10/18
TI  - Using the Internet to Train Therapists: Randomized Comparison of Two Scalable Methods
JO  - J Med Internet Res
SP  - e355
VL  - 19
IS  - 10
KW  - psychotherapy
KW  - training
KW  - Internet
KW  - eating disorders
KW  - cognitive therapy
AB  - 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. 
SN  - 1438-8871
UR  - http://www.jmir.org/2017/10/e355/
UR  - https://doi.org/10.2196/jmir.8336
UR  - http://www.ncbi.nlm.nih.gov/pubmed/29046265
DO  - 10.2196/jmir.8336
ID  - info:doi/10.2196/jmir.8336
ER  -