Course syllabus

Course title Evidence Based Psychotherapy: Dissemination and Implementation

Instructor Ryan M. Beveridge, Ph.D. , Associate Professor

Contact details rbeveridge@psych.udel.edu

Affiliation University of Delaware, USA

Course format Seminar and skills training

Number of hours 27

Number of ECTS credits 3

Brief course description Students will learn principles and models of how clinical psychologists work to disseminate and implement evidence-based psychotherapy (EBP) from research laboratories into community mental health systems. Students will explore how psychotherapy researchers, trainers, mental health administrators and clinicians are all an integral part of expanding the impact of clinical psychology as a field and reducing the burden of mental illness on society. Students will learn and practice the basic skills of one EBP, Parent Child Interaction Therapy (PCIT) as a vehicle to understanding the challenges and opportunities of disseminating manualized treatments into complex community mental health systems.

Full course description This course is designed to give students an introduction to the theoretical and practical issues surrounding the current movement to more widely disseminate Evidence-Based Psychotherapies (EBP) in community settings. As such, this course will give students an understanding of the complexities involved with insuring that community members receive psychotherapy that is informed by rigorous research through effective dissemination efforts. Specifically, this course will focus on questions such as: 1) Why is the EBP movement important, and how do we understand the

“gap” between science and practice? 2) How do we define what constitutes an EBP? 3) What are the strengths and limitations of the EBP movement? 4) What are the current theoretical models that guide the dissemination

of EBP’s in community mental health settings? 5) Are EBP’s effective in community settings? 6) How does culture affect dissemination? 7) How can we evaluate what are the most effective dissemination

methods?

Parent Child Interaction Therapy (PCIT), a well-known EBP for children with oppositional behavior disorders, will be used throughout the course to illustrate how the questions above apply to a specific manualized psychotherapy model that is currently being widely disseminated. That is,

PCIT will be used as an example to show how a therapy model becomes “evidence-based,” how therapy models are disseminated in the community, why the process of dissemination in the community is difficult, and how evaluation efforts regarding therapy outcomes and dissemination efforts take place. As part of this learning process, students will have the opportunity to learn and practice basic PCIT therapy skills used to manage oppositional children’s problematic behaviors (these skills will be taught through in-class role-plays and demonstrations). While this training will not certify students as PCIT therapists, it will provide students useful interaction skills with behavior disordered children and their parents, and begin to illustrate the complexities of delivering, training, implementing, and evaluating an EBP such as PCIT.

Learning outcomes 1. Students will demonstrate a basic knowledge of how psychotherapy models are developed in the laboratory and how they later become defined as evidence-based practices (EBP)

2. Students will describe a translational science process of effective psychotherapy development and dissemination

3. Students will demonstrate knowledge of the strengths and weaknesses of the EBP movement in clinical psychology and community mental health

4. Students will accurately identify the common principles and theories of dissemination and implementation models

5. Students will demonstrate knowledge of the basic techniques of Parent Child Interaction Therapy (PCIT)

Learning activities and teaching methods

1. Lectures in form of PowerPoint presentations 2. Video and audio recordings of relevant scientific and clinical

presentations 3. Video demonstrations and explanations of Parent Child Interaction

Therapy (PCIT) 4. Group discussions 5. Group presentations 6. In-class role plays of PCIT skills

List of topics/classes and bibliography

1. Introduction to Evidence-Based Psychotherapy, Translational Clinical Science, and the Science to Service “Gap”

Steele, Roberts, Elkin (2008) Evidence-based therapies for children and adolescents: Problems and prospects (p. 3-8)*used for group project

Shoham, V., Rohrbaugh, M.J., Onken, L.S., Cuthbert, B.N., Beveridge, R.M., & Fowles, T.R. (2014). Redefining clinical science training: Purpose and products of the Delaware Project. Clinical Psychological Science, 2, (1), 8-21.

Weisz, J. R., Ng, M. Y., & Bearman, S. K. (2014). Odd Couple? Reenvisioning the Relation Between Science and Practice in the Dissemination-Implementation Era. Clinical Psychological Science, 2(1), 58–74.

https://doi.org/10.1177/2167702613501307

Baker, T., McFall, R., & Shoham, V. (November 15, 2009). Is your therapist a little behind the times? Washington Post. https://www3.nd.edu/~ghaeffel/WashPost%20copy.pdf

Flay, B. R., Biglan, A., Boruch, R. F., Gonzalez, F., Gottfredson, D., Kellam, S., et al. (2005) Standards of evidence: Criteria for efficacy, effectiveness, and dissemination. Prevention Science, 6, 151-175.

2. Dissemination and Implementation Models, Principles, Questions and Practice with PCIT as an Example

Chambers (2007). Disseminating and implementing evidence-bases practices for mental health. In Handbook on Communicating and Disseminating Behavioral Science, 365-389.

Beveridge, R.M., Fowles, T.R., Masse, J.J., Parrish, B.P., Smith, M.S., Circo, G., Widdoes, N.S. (2015). The dissemination and implementation of Parent-Child Interaction Therapy (PCIT): Lessons learned from a state-wide system of care. Children and Youth Services Review, 48, 38-48.

Brinkmeyer, M.Y. & Eyberg, S.M. (2003). Parent-Child Interaction Therapy for Oppositional Children. In Parent Child Interaction Therapy, p. 204-223.

Wiltsey Stirman, S., Crits-Christoph, P., & DeRubeis, R.J. (2004). Achieving successful dissemination of empirically supported psychotherapies: A synthesis of dissemination theory. Clinical Psychology : Science and Practice, 11(4), 343-359.

Chorpita, B.F. & Nakamura, B.J. (2004). Four considerations for dissemination of intervention innovations. Clinical Psychology : Science and Practice, 11(4), 364-367.

Weisz, J. R., Ugueto, A. M., Herren, J., Afienko, S. R., & Rutt, C. (2011). Kernels vs. ears, and other questions for a science of treatment dissemination. Clinical Psychology: Science and Practice, 18, 41-46.

Dearing, J.W. (2009). Applying diffusion of innovation theory to intervention development. Research on Social Work Practice, 19 (5), 503-518.

Chamberlain, P., Roberts, R., Jones, H., Marsenich, L., Sosna, T., & Price, J. M. (2012). Three collaborative models for scaling up evidence-based practices. Administration and Policy in Mental Health and Mental Health Services Research, 39(4), 278-290.

3. Usual Care and Therapist Perspectives on Implementing EBPs

Garland, A. F., Bickman, L., & Chorpita, B. F. (2010). Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health and Mental Health Services Research, 37, 15-26.

Borntrager, C. F., Chorpita, B. F., Higa-McMillan, C. K., Weisz, J. R., & the Network on Youth Mental Health. (2009). Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals? Psychiatric Services, 60(5), 677–681.

Stirman et al. (2013) Modifications made to cognitive therapy by community mental health providers: Implications for sustainability. Psychiatric Services, 64 (10), 1056-1059.

4. Cultural Adaptations and Location Specific Considerations for the Dissemination and Implementation of EBPs

Bjorseth, A., Wromdal, A.K., & Chen, Y. (2011). PCIT around the world. In Parent Child Interaction Therapy, 421-427.

Murray, L.K., Tol, W., Jordans,M., Sabir Zangana, G., Amin, A., Bolton, P. et al., (2014). Dissemination and implementation of evidence based mental health interventions in post conflict, low resource settings. Intervention, 12 (1), 94-112.

Assessment methods and criteria

1) In-class group assignments and quizzes (30% of total grade): Students will complete several in-class assignments and quizzes covering readings, lectures, and in-class discussions.

2) In-class group presentation (30% of total grade): Students will be assigned to small groups in order to complete a group activity aimed at understanding dissemination of Evidence Based Psychotherapy from the point of view of a mental health professional (e.g., clinician, mental health administrator, psychology faculty or graduate student). This presentation will require students within their groups to select and interview a mental health professional regarding their views of, and experiences with, Evidence Based Psychotherapy. Groups will then be required to organize the interview information into a short group presentation (approximately 15 minutes) to be given in class. Students will be given a reading before class begins that is an overview of Evidence-Based Psychotherapy. Students should use this reading to guide their discussions with the professional of their choosing. Students will also be provided with an interview template to guide their interviews, and instructions regarding the format of the group presentation.

3) Final exam (40% of total grade): Students will complete a comprehensive final exam on the last day of the class that requires them to understand and expound on readings, in-class lectures and activities, their interviews with a mental the health professional, and their own culture. The exam will consist of multiple choice questions.

Attendance rules Attendance is obligatory. One unexcused absence and two additional excused absences are allowed without penalty and will not affect your grade. Missing more than three classes will result in not passing the course.

Prerequisites Completed course on psychotherapy

Academic honesty Students must respect the principles of academic integrity. Cheating and plagiarism (including copying work from other students, internet or other sources) are serious violations that are punishable and instructors are required to report all cases to the administration.

Basket 1. Clinical

Remarks Due to the condensed nature of the course, students will be provided the group assignment instructions and a corresponding required reading via email before the course begins. This will allow students to form small groups and begin planning the interview of a mental health professional and the in-class presentation occurring on the last few days of class.