Web Based Therapist Training on Complicated Grief Therapy

基于网络的治疗师复杂悲伤治疗培训

• 批准号: 9892031
• 负责人: Kenneth A Kobak
• 金额: $ 24.93万
• 依托单位: CENTER FOR PSYCHOLOGICAL CONSULTATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-12 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9892031
• 关键词: Access to Information; Address; Adherence; Adopted; Architecture; Area; Award; Budgets; Clinical; Clinical Skills; Communication; Complex; DSM-V; Data; Disease; Distress; Effectiveness; Ensure; Evaluation; Evidence based intervention; Evidence based treatment; Feedback; Focus Groups; Funding; Goals; Grief reaction; Health Personnel; Health Services; Health system; Impairment; Information Technology; Internet; Intervention; Intervention Studies; Knowledge; Major Depressive Disorder; Measures; Mental Health; Methods; National Institute of Mental Health; Nature; Online Systems; Outcome; Patient Recruitments; Patients; Phase; Pragmatic clinical trial; Pre-Post Tests; Prevention; Procedures; Process; Professional Organizations; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Readiness; Research; Small Business Innovation Research Grant; Small Business Technology Transfer Research; Supervision; System; Technology; Test Result; Testing; Text Messaging; Training; Training Programs; Translating; Trauma; Treatment outcome; United States National Institutes of Health; Videoconferences; Work; World Health Organization; base; behavioral health; design; experience; improved; innovation; meetings; new technology; novel; pragmatic trial; randomized trial; recruit; satisfaction; service intervention; skills; symptomatology; technology development; therapeutic development; tool; user-friendly

Complicated Grief (CG) is a prevalent and debilitating disorder associated with significant distress and impairment. It differs from major depression in its treatment and symptomatology. CG is listed in DSM5 as a subtype of Trauma and Greif Disorder. The World Health Organization will include CG as a stand-alone disorder in ICD11, and it is expected that the DSM 5.1 subcommittee will follow suit. Traditional forms of therapy have not been successful in the treatment of CG. However a short-term, manualized Complicated Grief Treatment (CGT) has been developed and found efficacious in three large NIMH sponsored randomized controlled trials. As with other evidence based treatments (EBTs), lack of dissemination and implementation is a major issue, due in large part to a shortage of trained clinicians. Facilitating access to training in EBTs has been identified as a national priority by both mental health professional organizations and NIMH. One way to help disseminate therapist training on EBT of CG is through the use of new technologies. In prior NIMH-funded studies, we have shown that internet-based technologies can successfully train clinicians in EBTs, improving both didactic knowledge, clinical skills, and patient treatment outcomes. In the current application, we will use new technologies to develop a comprehensive on-line therapist training protocol for CGT consisting of three components: 1) An interactive on-line tutorial covering the didactic material; 2) Live, web-based videoconference group supervision following didactic training to practice and reinforce skills; 3) A patient app to help facilitate implementation of CGT including automated text-messaging system to provide messages of encouragement and support to patients between sessions, and improve homework compliance. Thirty clinician-trainees will be recruited. Trainees will take the on-line tutorial at their own pace, followed by 3 live group videoconference supervision sessions. Pre- and post-training measures of didactic knowledge and clinical skill, and evaluations of user-satisfaction will be obtained. The patient app will be developed in parallel to the training package, and follow a parallel but separate evaluation process. Evaluation of the patient app will be done through focus groups with 16 patients recruited from the practices of therapists who are currently providing CGT. Patients will be provided access to the patient app and will explore the app for two weeks, after which they will attend a focus group to obtain their feedback. A focus group of CGT therapists will also be used to evaluate the app. In phase I, we will evaluate feasibility, user satisfaction, and generate pilot data on the effectiveness of these components in improving knowledge and skill. We will also have ongoing meetings with the Director of the NYS Division of Behavioral Health Services in order to recruit phase I patients and lay the groundwork for phase II, where we will integrate and test the training protocol in the NYS mental health system as part of a randomized pragmatic trial. Meetings will help identify the barriers and facilitators to phase II implementation. Our aim is to develop a viable public health-relevant product. 1

复杂的悲伤（CG）是一种普遍且使人衰弱的障碍，与严重的困扰和 损害。它的治疗和症状学不同。 CG在DSM5中列为 创伤和Greif疾病的亚型。世界卫生组织将包括CG作为独立 ICD11中的疾病，预计DSM 5.1小组委员会将效仿。传统形式的形式 治疗在CG的治疗方面尚未成功。但是短期，手动的复杂 悲伤疗法（CGT）已开发并在三个大型NIMH赞助的随机发起的大型NIMH中有效 对照试验。与其他基于证据的治疗（EBT）一样，缺乏传播和实施是 一个主要问题，很大程度上是由于训练有素的临床医生短缺。促进在EBTS中获得培训的机会 精神卫生专业组织和NIMH都被确定为国家优先事项。一种方法 通过使用新技术，帮助传播对CG EBT的治疗师培训。在先前的NIMH资助中 研究，我们表明，基于互联网的技术可以成功地培训EBT的临床医生，从而改善 教学知识，临床技能和患者治疗结果均两者。在当前的应用程序中，我们将使用 为CGT制定全面的在线治疗师培训方案，由三个组成 组件：1）涵盖教义材料的交互式在线教程； 2）实时，基于网络 在教学培训后进行练习和增强技能的视频会议小组监督； 3）患者应用程序 帮助促进CGT的实施，包括自动文本消息系统，以提供信息 鼓励和支持会议之间的患者，并提高作业合规性。三十 将招募临床医生培训。学员将按照自己的步伐进行在线教程，然后进行3个现场直播 小组视频会议监督会议。教学知识的训练前和训练后措施 将获得临床技能和对用户满意度的评估。该患者应用将平行开发 到培训包，并遵循平行但单独的评估过程。评估患者应用程序 将通过焦点小组进行，从目前的治疗师的做法中招募16名患者 提供CGT。将为患者提供患者应用程序的访问权限，并将探索该应用程序两个星期， 之后，他们将参加焦点小组以获取反馈。 CGT治疗师的焦点组也将是 用于评估应用程序。在第一阶段，我们将评估可行性，用户满意度，并生成试点数据 这些组成部分在改善知识和技能方面的有效性。我们还将举行持续的会议 与纽约州行为卫生服务部主任一起招募I期患者 第二阶段的基础，我们将在纽约市心理健康中整合和测试培训方案 系统作为随机务实试验的一部分。会议将有助于确定障碍和促进者的阶段 II实施。我们的目的是开发可行的公共卫生与公共健康相关的产品。 1