Transforming Training and Delivery of Mental Health EBPs Kelly - - PowerPoint PPT Presentation

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Transforming Training and Delivery of Mental Health EBPs Kelly - - PowerPoint PPT Presentation

Jan 20, 2023 308 likes •625 views

Transforming Training and Delivery of Mental Health EBPs Kelly Koerner, PhD kelly@ebpi.org Presented by Gareth Holman, PhD gareth@ebpi.org What is the big goal? The Problem: workflow prevents learning & using EBPs Window opens to

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Transforming Training and Delivery of Mental Health EBPs

Kelly Koerner, PhD kelly@ebpi.org Presented by Gareth Holman, PhD gareth@ebpi.org

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What is the big goal?

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The Problem:

workflow prevents learning & using EBPs

Window

  • pens to

learn, reflect… Window

  • pens to

learn, reflect…

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Life becomes easier with EBPs…

  • open your laptop
  • see your day’s clients
  • at a glance, remember, see

status, plan today’s work.

  • See problems, easily reach for

help

  • Tools, education, peers

and you feel justifiably confident you give the best possible care. What if a therapist’s life was easier…?

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you could get EBPs…

  • as self-help (cCBT)
  • as computer-assisted therapy
  • at a glance, remember

homework, see progress.

and you feel justifiably confident you get the best possible care. What if a client’s progress wasn’t

constrained by therapist’s workflow?

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Betting the Farm on 3 Ideas

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scalability

(modular + technology + community)

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train clinical expertise

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BIG data

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scalability

(modular + technology + community)

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Progress Monitoring Behavior Activation Therapeutic Relationship Values Defusion Validation, especially emotion-focused work

PracticeGround’s Starter Modules Modular Approach

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Specify how skill difficulty and cost of training method relate to client outcome

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for employment counselors for psychiatry residents + cultural competency (and so on)

Sudak Kanter

Puspitasari Martell

insert target audience here

Then tailor:

BA

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nurture ongoing learning communities

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BE generous

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scalability

modular competencies technology-based training communities of practice

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train clinical expertise

the amateur plateau deliberate practice + feedback

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After a few months to a year, amateurs stop improving

Why?

The good-enough level The curse of automaticity The Amateur Plateau

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Experts keep improving for ~10 years—WHY?

  • Deliberate Practice

– Identify a specific target

  • f achievement

– Break it into pieces – Repetition of each piece with a focus on mastery

  • Informative Feedback

– Immediate indication of whether performance is effective or ineffective

  • K. Anders Ericsson, The Road to

Excellence

20 40 60 80 100 120 140 months 2 months 6 months 2 years

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How can you scale what’s actually needed for clinical expertise?

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Step-wise research plan

  • 1. Establish naturalistic baseline of minimal

intervention/TAU

  • 2. Beef-up key components

– strengthen experimental design – assessment of skill acquisition/fidelity – training support – establish feedback mechanisms

  • 3. Etc…
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1.You can teach therapists to regularly monitor progress with online tools in 4 sessions

  • 1. How to use OPT
  • 2. Inviting client to

use OPT

  • 3. Handling

noncompliance

  • 4. Using data to

guide decision- making

  • 5. Handling lack of

progress

10 20 30 40 50 60 70 80 90 100

Pre Tool + Post

* *

DASS idiographic

  • ther standarized

% clients in caseload

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but use 6 and 12 mo follow up to understand minimal intervention

% clients in caseload

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  • 1. Self assessment of

interpersonal skills and vulnerabilities.

  • 2. Functional case

conceptualization

  • 3. Intersection

between the two

  • 4. Deliberate practice

asking hard questions, appreciating, giving feedback, etc.

235 240 245 250 255 260 265 270 275 280 Time 1 Time 2 Time 3 FAPIS Scores Group 1 Group 2

FAPIS scores for both groups across time.

  • 2. Improve experimental design: Training

to improve therapy relationships.

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  • 3. Flip the course, with baked in

assessment of fidelity

Session 1 Session 3 Session 4

Measure competency in each skill via structured role plays

Skill 1 Skill 2 Skill 3 Skill 4

Practice

Session 2

Practice Practice

Pre Post

Self-paced, online, reading Self-paced online videos, live demos Train skill-by-skill online

Behavioral Skills Training Model:

1. Instruction

  • 2. Modeling
  • 3. Practice
  • 4. Feedback
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  • 4. Feedback in routine workflow
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train clinical expertise

the amateur plateau deliberate practice + feedback

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BIG data

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Chris Lintott What to Do With 500,000 Scientists

“Citizen” Science

  • ver a pint in an

Oxford pub 

  • ½ million volunteers

sorting galaxies

  • 250 million

classifications

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THANK YOU

Kelly Koerner, PhD kelly@ebpi.org Gareth Holman, PhD gareth@ebpi.org www.practiceground.org