Cargando…

Improving practice in community-based settings: a randomized trial of supervision – study protocol

BACKGROUND: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggest...

Descripción completa

Detalles Bibliográficos
Autores principales: Dorsey, Shannon, Pullmann, Michael D, Deblinger, Esther, Berliner, Lucy, Kerns, Suzanne E, Thompson, Kelly, Unützer, Jürgen, Weisz, John R, Garland, Ann F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751139/
https://www.ncbi.nlm.nih.gov/pubmed/23937766
http://dx.doi.org/10.1186/1748-5908-8-89
_version_ 1782281542769311744
author Dorsey, Shannon
Pullmann, Michael D
Deblinger, Esther
Berliner, Lucy
Kerns, Suzanne E
Thompson, Kelly
Unützer, Jürgen
Weisz, John R
Garland, Ann F
author_facet Dorsey, Shannon
Pullmann, Michael D
Deblinger, Esther
Berliner, Lucy
Kerns, Suzanne E
Thompson, Kelly
Unützer, Jürgen
Weisz, John R
Garland, Ann F
author_sort Dorsey, Shannon
collection PubMed
description BACKGROUND: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes ‘gold standard’ supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. METHODS/DESIGN: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. DISCUSSION: This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01800266
format Online
Article
Text
id pubmed-3751139
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-37511392013-08-24 Improving practice in community-based settings: a randomized trial of supervision – study protocol Dorsey, Shannon Pullmann, Michael D Deblinger, Esther Berliner, Lucy Kerns, Suzanne E Thompson, Kelly Unützer, Jürgen Weisz, John R Garland, Ann F Implement Sci Study Protocol BACKGROUND: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes ‘gold standard’ supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. METHODS/DESIGN: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. DISCUSSION: This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01800266 BioMed Central 2013-08-10 /pmc/articles/PMC3751139/ /pubmed/23937766 http://dx.doi.org/10.1186/1748-5908-8-89 Text en Copyright © 2013 Dorsey et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Dorsey, Shannon
Pullmann, Michael D
Deblinger, Esther
Berliner, Lucy
Kerns, Suzanne E
Thompson, Kelly
Unützer, Jürgen
Weisz, John R
Garland, Ann F
Improving practice in community-based settings: a randomized trial of supervision – study protocol
title Improving practice in community-based settings: a randomized trial of supervision – study protocol
title_full Improving practice in community-based settings: a randomized trial of supervision – study protocol
title_fullStr Improving practice in community-based settings: a randomized trial of supervision – study protocol
title_full_unstemmed Improving practice in community-based settings: a randomized trial of supervision – study protocol
title_short Improving practice in community-based settings: a randomized trial of supervision – study protocol
title_sort improving practice in community-based settings: a randomized trial of supervision – study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751139/
https://www.ncbi.nlm.nih.gov/pubmed/23937766
http://dx.doi.org/10.1186/1748-5908-8-89
work_keys_str_mv AT dorseyshannon improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT pullmannmichaeld improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT deblingeresther improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT berlinerlucy improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT kernssuzannee improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT thompsonkelly improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT unutzerjurgen improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT weiszjohnr improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol
AT garlandannf improvingpracticeincommunitybasedsettingsarandomizedtrialofsupervisionstudyprotocol