Evaluation of an Internet-Based Training System for Improving Peer Supervisor Ratings of Therapist Performance in Dialectical Behavior Therapy.

摘要

Therapist continuing training and retraining in empirically supported treatments (ESTs) tends to be costly and not widely available, which limits retraining opportunities and access to evidence-based care. Moreover, training that is available typically lacks efficacy data. This study evaluated an Internet-based system designed to improve a peer supervisor's ability to accurately discriminate more effective from less effective therapist in-session behaviors in Dialectical Behavior Therapy (DBT). In DBT, providing peer supervision is an essential skill, and improving these skills provides one way to enhance the quality of continuing training and retraining. Participants watched and provided feedback on eight mock DBT sessions. After evaluating each session, they were shown expert feedback and analysis of the same session, and compared that with their own in an attempt to improve their own discrimination and rating skills as peer supervisors. One-hundred- and-forty-one DBT therapists began the training, and 77 completed all eight videos. Overall, we observed a significant increase in rating skill (shared variance with experts increased 1.5x), with participants who reported having less access to DBT resources (e.g., expert peers) and less prior training tending to benefit the most. Participants perceived improvements in their DBT knowledge and skills, and reported high levels of satisfaction with the training. Additional studies are needed to replicate these findings. However, present findings suggest a promising future for this type of self-directed Internet-based training for clinicians in DBT and other treatments.