Implementation of Evidence-based Treatments for On-campus Eating Disorders

The Washington University

Status: Completed

Conditions: Eating Disorders (Excluding Anorexia Nervosa); Depression

Treatments: Behavioral: Low Intensity Strategy: Expert Consultation; Behavioral: High Intensity Strategy: Train-the-trainer

Study type: Interventional

Funder types: Other; Other U.S. Federal agency; NIH

Identifiers

NCT02079142

1R01MH095748-01

1R01MH095748 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study is to evaluate two training methods of IPT with mental health service providers in college counseling centers.

Full description

Although there have been major advances in developing evidence-based psychotherapies, the adoption of such treatments by community therapists has been slow. One of the problems is the difficulty therapists in practice have in learning how to conduct an evidence-based psychotherapy. Hence, this study will investigate two methods of teaching therapists interpersonal therapy (IPT), an evidence based treatment for eating disorders and depression, at 40 college or University counseling centers.

Current approaches to training therapists to conduct new treatments typically consist of a one or two day workshop delivered by an expert and provision of a manual for the therapy in question. Recent reviews have concluded that while workshops increase therapists' knowledge, their impact on skills may be short-lived without further consultation. Thus, investigators will supplement IPT training manuals and workshops by offering monthly consultation calls to participating therapists for 12 months following the workshop. The consultation calls are not designed to be case supervision per se. Rather, they are to be seen as extended training on IPT. This training condition is referred to as expert consultation.

The second training strategy, referred to as train-the-trainer, features expertise capacity building within each organization. There is a strong theoretical case for this implementation strategy as it is based on the principles of social cognitive theory, featuring active learning via modeling, feedback on performance, building self-efficacy, and supportive interactions among therapists developing IPT skills. This 'train-the-trainer' approach involves active learning which centers around development of an internal coach and champion, and has been recommended as the most effective means of changing actual therapist behaviors rather than just attitudes and self-reported proficiency. Roth et al. have made the case that effective implementation of evidence-based treatment in routine clinical services requires that the training approximate that which characterized the research context (e.g., continuing feedback and supervision and monitoring of treatment fidelity). Our train-the-trainer strategy offers a practical means of accomplishing this goal.

Enrollment: 223 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Currently employed in a participating university counseling center
• Providing regular student-client services

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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223 participants in 2 patient groups

High Intensity Strategy: Train-the-trainer

Experimental group

Description:

One therapist from each counseling center randomized to this arm will be selected to become the trainer and will be trained to train their colleagues.

Treatment:

Behavioral: High Intensity Strategy: Train-the-trainer

Low Intensity Strategy: Expert Consultation

Active Comparator group

Description:

The IPT expert from Washington University will travel to all counseling centers randomized to this condition and train all participating therapists on site and be available for monthly phone consultation for up to one year following training on site.

Treatment:

Behavioral: Low Intensity Strategy: Expert Consultation