A Statewide Trial to Compare Three Training Models for Implementing an Evidence-based Treatment (EBT)

NCT02543359 | Completed DMC

• 2 other identifiers: PRO120605295R01MH095750-02
• Study Type: interventional
• Target: 648
• Locations: 1 country
• Sites: 1

Brief Summary

Evidence-based treatments (EBTs) are available for treating Disruptive Behavior Disorders ( DBDs) including Parent-Child Interaction Therapy (PCIT). Despite EBTs' potential to help children and families, they have primarily remained in university settings. Recognized field leaders have expressed concern over the discrepancy between treatment research and clinical practice, and have indicated that EBT implementation is a priority. Little empirical evidence exists regarding how effective commonly used training models are in changing clinician behavior, achieving full implementation (e.g., increasing treatment fidelity, integrating into service settings), and supporting positive client outcomes. This novel application will evaluate the effectiveness of three training models (Learning Collaborative, Train-the-Trainer, and Web-Supported Self-Study) to implement a well-established EBT in real-world, community settings. To accomplish this goal, the project will be guided by three specific aims:

1. 1.to build knowledge about training outcomes,
2. 2.to build knowledge about implementation outcomes, and
3. 3.to understand the impact of training clinicians using LC, TTT, and SS models on key client outcomes.
4. 4.Learning Collaborative (LC),
5. 5.Train-the-Trainer (TTT), or
6. 6.Web-Supported Self-Study (SS).

Conditions

Training of Mental Health Professionals; Disruptive Behavior Disorders

Keywords

Training; Implementation; Community-Based Mental Health Services; Parent-Child Interaction Therapy; Children

Outcome Measures

Primary Outcomes (3)

• Change in Clinician knowledge of treatment based on PCIT Coaches Quiz

  The PCIT Coaches Quiz measures clinicians' knowledge of PCIT concepts; a scale to assess clinicians' knowledge of PCIT concepts and coaching scenarios, and is a mixed question format of multiple choice and short answer. It was created by PCIT Developers based on training content.

  Measured at baseline, 6, 12, and 24 months

• Change in Clinician PCIT skill competency based on Therapist Competency Checklist

  Therapist Competency Checklist evaluates competency criteria based on established Training Guidelines. The criteria are divided into five categories representing the full PCIT protocol (e.g., assessment, treatment, coaching). These pre-determined, skill-based competency items are rated by the trainer after observing trainees behavior over 1 year.

  Measured at baseline and 6, 12, and 24 months

• Change in Clinician attitudes about training based on Feedback Surveys

  The following areas are measured: satisfaction with implementation condition,treatment acceptability,understanding, feasibility, and systems support; and satisfaction with training content, format, and presenters.

  Measured at baseline and 6, 12 months and 24 months

Secondary Outcomes (2)

• Change in PCIT administrative interviews

  Measured at baseline and 6, 12 months and 24 months

• Change in PCIT patient functioning

  Measured at baseline, 3, 6 and 12 months

Study Arms (3)

Clinicians and Supervisors

EXPERIMENTAL

After randomization clinicians and supervisors from community behavioral health agencies receive training in one of three PCIT training models: Train the Trainer (TTT), Learning Collaborative (LC) or Web-Supported Self Study (SS).

Behavioral: Training Models of PCIT

Administrators

EXPERIMENTAL

After randomization administrators from participating community behavioral health agencies receive one of three treatments for PCIT (1/3 Learning Collaborative, 1/3 other treatment - none, and 1/3 other treatment - none).

Behavioral: Training Models of PCIT

Parent-Child Dyads

EXPERIMENTAL

Parent-child dyads receive Parent-Child Interaction Therapy (PCIT) treatment from trained clinicians/supervisors.

Behavioral: Parent-Child Interaction Therapy (PCIT) Treatment

Interventions

Training Models of PCIT BEHAVIORAL

Agency participants are trained in one of three training model strategies: Train the Trainer Model (TTT), Learning Collaborative (LC), or Web-Supported Self Study (SS).One third of participating agencies will be randomized to the Train the Trainer training model.One third of participating agencies will be randomized to the Learning Collaborative training model.One third of participating agencies will be randomized to the Web-Supported Self Study.

Clinicians and Supervisors

Parent-Child Interaction Therapy (PCIT) Treatment BEHAVIORAL

Parent-Child Interaction Therapy (PCIT), a parent coaching evidence-based protocol is given to each family from clinicians and supervisors in each training model.

Parent-Child Dyads

Eligibility Criteria

• Age: 1 Year+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Administrators group
• must be employed at an agency selected to participate in training as an Executive Director, Chief Financial Officer, or other person responsible for daily operations.
• Clinicians/Supervisors group
• a masters or doctoral level professional in the human services field (e.g., social work, psychology, education),
• licensed in his/her field or receiving supervision from a licensed individual,
• actively seeing children and families who are appropriate for PCIT,
• receptive to training in PCIT but not previously trained in PCIT,
• amenable to study tasks (e.g., video-taping, completing assessments).
• Parent-Child Dyads group
• Any parent-child dyad who a trained clinician enrolls in PCIT services

You may not qualify if:

• Administrators group
• not employed at an agency selected to participate in training as an Executive Director, Chief Financial Officer, or other person responsible for daily operations.
• Clinicians group
• a bachelors or lower level professional in the human services field,
• unlicensed in his/her field or not receiving supervision from a licensed individual,
• not actively seeing children and families who are appropriate for PCIT,
• not receptive to training in PCIT but not previously trained in PCIT, and/or
• not amenable to study tasks. Interns also will be excluded.
• Parent-Child Dyads group
• \- if he/she is a ward of the state or living in state custody

Sponsors & Collaborators

• West Virginia University: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Pittsburgh School of Medicine

Pittsburgh, Pennsylvania, 15203, United States

Location

Related Publications (5)

• Jackson CB, Macphee FL, Hunter LJ, Herschell AD, Carter MJ. Enrolling Family Participants in a Statewide Implementation Trial of an Evidence-Based Treatment. Prog Community Health Partnersh. 2017;11(3):233-241. doi: 10.1353/cpr.2017.0028.

  PMID: 29056615 BACKGROUND

• Herschell AD, Scudder AB, Schaffner KF, Slagel LA. Feasibility and Effectiveness of Parent-Child Interaction Therapy with Victims of Domestic Violence: A Pilot Study. J Child Fam Stud. 2017 Jan;26(1):271-283. doi: 10.1007/s10826-016-0546-y. Epub 2016 Sep 19.

  PMID: 28503060 BACKGROUND

• Herschell AD, Kolko DJ, Scudder AT, Taber-Thomas S, Schaffner KF, Hiegel SA, Iyengar S, Chaffin M, Mrozowski S. Protocol for a statewide randomized controlled trial to compare three training models for implementing an evidence-based treatment. Implement Sci. 2015 Sep 28;10:133. doi: 10.1186/s13012-015-0324-z.

  PMID: 26416029 BACKGROUND

• Scudder AT, Taber-Thomas SM, Schaffner K, Pemberton JR, Hunter L, Herschell AD. A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. Health Res Policy Syst. 2017 Dec 7;15(1):102. doi: 10.1186/s12961-017-0230-8.

  PMID: 29216886 BACKGROUND

• Herschell AD, Kolko DJ, Scudder AT, Taber-Thomas SM, Schaffner KF, Hart JA, Mrozowski SJ, Hiegel SA, Iyengar S, Metzger A, Jackson CB. A Statewide Randomized Controlled Trial to Compare Three Models for Implementing Parent Child Interaction Therapy. J Clin Child Adolesc Psychol. 2023 Nov-Dec;52(6):780-796. doi: 10.1080/15374416.2021.2001745. Epub 2021 Dec 20.

  PMID: 34928748 DERIVED

MeSH Terms

Conditions

Attention Deficit and Disruptive Behavior Disorders

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Amy D Herschell, PhD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Psychiatry and Psychology

Study Record Dates

• First Submitted: August 27, 2015
• First Posted: September 7, 2015
• Study Start: September 1, 2012
• Primary Completion: November 2, 2017
• Study Completion: December 31, 2017
• Last Updated: May 3, 2018

Record last verified: 2018-04

Locations

US (1)