Therapist Training for PTSD

(SMART Trial)

Recruiting at 3 trial locations

Overseen By Rebecca K Sripada, PhD MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Not licensed, Already CPT certified

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

240 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

Cognitive Processing Therapy (CPT) is highly effective in randomized controlled trials, but its effectiveness drops substantially in standard clinical practice, largely due to therapist "drift" from fidelity to the protocol. What remains unknown is which components of CPT training yield high therapist fidelity. Thus, there is a critical need to use empirical approaches to identify the most effective components of CPT training and to develop an adaptive training model for CPT by testing sequences of empirically-supported training strategies. The long-term goal of this research is to develop a sustainable model of therapy training that is personalized to the needs of the therapist trainee.

The overall objective of this application is to empirically optimize an adaptive model for CPT training. The rationale is that developing an adaptive training model will improve efficiency and personalization, yield higher fidelity, and ultimately improve Veteran outcomes. We expect that completion of this project will produce an adaptive CPT training program that yields high therapist fidelity. Improving CPT fidelity in VHA will have a positive impact on the health and wellbeing of Veterans with PTSD.

Who Is on the Research Team?

Rebecca Kaufman Sripada, PhD MS

Principal Investigator

VA Ann Arbor Healthcare System, Ann Arbor, MI

Are You a Good Fit for This Trial?

This trial is for licensed mental health clinicians or trainees in VA services who regularly provide psychotherapy to Veterans and can implement CPT. They must have support to participate for 9 months, including those on a 6-month rotation with supervisor approval.

Inclusion Criteria

Participants must have local/supervisor support to implement CPT and fully participate in all training and consultation activities

Participants must be able to participate for 9 months

Participating trainees (e.g. psychology interns) on a 6-month training rotation must have permission from their supervisors to continue the study into their next rotation

Exclusion Criteria

Participant is not a licensed mental health clinician

Participant is already certified in CPT

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Training Phase

Participants undergo Web-Based Training and Work-Sample Review to assess initial therapist fidelity

4 months

Monthly evaluations

Adaptive Training Phase

Participants are re-randomized based on fidelity progress to either continue standard consultation or adjust training intensity

8 months

Evaluations at 6, 9, and 12 months

Follow-up

Participants are monitored for therapist fidelity and competence after training completion

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• SMART Therapist Training

Trial Overview The study tests different training methods for Cognitive Processing Therapy (CPT) fidelity. It includes Standard Consultation, Web-Based Training, Work Sample Review, and other steps to find the most effective training sequence.

How Is the Trial Designed?

Group I: Condition 4-D Experimental Treatment 3 Interventions

Standard Training (ST) + Standard Consultation (SC) + fidelity in progress + continue in Standard Consultation.

Group II: Condition 4-C Experimental Treatment 3 Interventions

Standard Training (ST) + Standard Consultation (SC) + fidelity in progress + step up to session audio review.

Group III: Condition 4-B Experimental Treatment 3 Interventions

Standard Training (ST) + Standard Consultation (SC) + early fidelity + continue in Standard Consultation.

Group IV: Condition 4-A Experimental Treatment 3 Interventions

Standard Training (ST) + Standard Consultation (SC) + early fidelity + step down to fidelity self-monitoring.

Group V: Condition 3-D Experimental Treatment 3 Interventions

Standard Training (ST) + Work-Sample Review (WR)+ fidelity in progress + continue in Standard Consultation.

Group VI: Condition 3-C Experimental Treatment 3 Interventions

Standard Training (ST) + Work-Sample Review (WR) + fidelity in progress + step up to session audio review.

Group VII: Condition 3-B Experimental Treatment 2 Interventions

Standard Training (ST) + Work-Sample Review (WR) + early fidelity + continue in Standard Consultation.

Group VIII: Condition 3-A Experimental Treatment 3 Interventions

Standard Training (ST) + Work-Sample Review (WR) + early fidelity + step down to fidelity self-monitoring.

Group IX: Condition 2-D Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Standard Consultation (SC) + fidelity in progress + continue in Standard Consultation.

Group X: Condition 2-C Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Standard Consultation (SC) + fidelity in progress + step up to session audio review.

Group XI: Condition 2-B Experimental Treatment 2 Interventions

Web-Based Training (WBT) + Standard Consultation (SC) + early fidelity + continue in Standard Consultation.

Group XII: Condition 2-A Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Standard Consultation (SC) + early fidelity + step down to fidelity self-monitoring.

Group XIII: Condition 1-D Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Work-Sample Review (WR)+ fidelity in progress + continue in Standard Consultation.

Group XIV: Condition 1-C Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Work-Sample Review (WR) + fidelity in progress + step up to session audio review.

Group XV: Condition 1-B Experimental Treatment 2 Interventions

Web-Based Training (WBT) + Work-Sample Review (WR) + early fidelity + continue in Standard Consultation.

Group XVI: Condition 1-A Experimental Treatment 3 Interventions

Web-Based Training (WBT) + Work-Sample Review (WR) + early fidelity + step down to fidelity self-monitoring.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+