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Improving Delivery Behaviors during Exposure for Pediatric OCD: A Multiple Baseline Training Trial with Community Therapists
- Source :
- Behav Ther
- Publication Year :
- 2020
-
Abstract
- This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.
- Subjects :
- 050103 clinical psychology
medicine.medical_specialty
Obsessive-Compulsive Disorder
Adolescent
medicine.medical_treatment
Exposure therapy
Implosive Therapy
Training trial
behavioral disciplines and activities
Article
03 medical and health sciences
0302 clinical medicine
Primary outcome
Intervention (counseling)
medicine
Humans
0501 psychology and cognitive sciences
Child
Cognitive Behavioral Therapy
Random assignment
05 social sciences
Mental health
030227 psychiatry
Clinical trial
Clinical Psychology
Benchmarking
Multiple baseline design
Treatment Outcome
Research Design
Physical therapy
Psychology
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Behav Ther
- Accession number :
- edsair.doi.dedup.....43520963cf10b5c7fd8e93ed7eb436e4