Training Models for Implementing Evidence-Based Psychological Treatment: A Cluster-Randomized Trial in College...

Area of Science:

• Psychiatry
• Psychology
• Clinical Training

Background:

• Evidence-based treatments for psychiatric disorders are not consistently delivered in routine clinical settings.
• A scalable method for training clinicians in these effective treatments is crucial for improving patient care.
• Interpersonal psychotherapy (IPT) is an evidence-based treatment for depression and eating disorders.

Purpose of the Study:

• To compare the effectiveness of a train-the-trainer (TTT) model versus an expert-led model for training therapists in IPT.
• To evaluate implementation outcomes, including therapist fidelity (adherence and competence) and knowledge of IPT.
• To explore potential moderating factors influencing training outcomes.

Main Methods:

• A cluster-randomized trial involving 184 therapists across 24 US college counseling centers (October 2012–December 2017).
• Centers were randomized to either an expert condition (workshop + consultation) or a TTT condition (staff trained to train peers).
• Therapist fidelity was assessed via audio recordings of therapy sessions; knowledge was assessed via testing.

Main Results:

• Both TTT and expert conditions significantly improved therapist adherence and competence in IPT, with large effect sizes.
• The TTT condition demonstrated superior outcomes in therapist competence compared to the expert condition (P=.03).
• Therapist knowledge of IPT improved significantly in both groups, with no significant difference between conditions.

Conclusions:

• The train-the-trainer model is a viable and effective method for disseminating interpersonal psychotherapy.
• TTT training yields outcomes comparable to expert training for adherence and superior outcomes for competence.
• This model holds significant potential for scalable, widespread implementation of evidence-based psychological treatments.