What is CBT+?
CBT+ is an efficient and practical method of training community mental health providers in four Evidence Based Interventions (EBI): CBT for depression, CBT for anxiety, Trauma-Focused CBT, and parent management training.
The interventions are all based on cognitive behavioral and behavioral theory, consist of common components, and involve the application of common skills. These interventions address the typical clinical outcomes of child maltreatment. Providers trained in these four interventions have the capacity to reach a large majority of children seen in public mental health where most children in the CWS are served. The CBT+ approach encourages providers to adhere to a selected model but permits combined application of one of the other interventions or systematically selected modules from another when clinically indicated (e.g., child has an internalizing and an externalizing condition). CBT+ is being evaluated in Washington State and findings show increases in provider self reported understanding and skill in delivering the interventions.
How do we teach CBT+?
The CBT+ training approach is consistent with current empirical knowledge regarding effective EBP teaching methods. It addresses organizational implementation factors, and consists of a 3 day in-person learning session followed by 6 months of bi-weekly expert telephone consultation. Providers document of delivery of the model to at least two cases as demonstrated by entry of standardized assessment data and documentation of model adherence. The learning session incorporates adult learning principles and active learning methods (e.g., slides, video clips, role-plays, live practice, feedback, desk tools).
The CBT+ learning session teaches the core principles of CBT and behavioral therapy; assessment and engagement/motivational enhancement as common core elements; and the specific components of each of the EBIs. Providers learn to administer standardized measures and provide feedback to clients, specific evidence-based engagement and motivational strategies and skills, and the components of each EBI; TF-CBT follows the model developed by Cohen, Mannarino and Deblinger.
Extensive supports are available for implementing and delivering CBT+. There is a web-based CBT+ Notebook containing cheat sheets, handouts and materials for providers and clinical materials including free standardized measures and handouts to use with clients. A web-based Toolkit is used for documenting competence, scoring measures and documenting client progress, and provider rostering.