SEATTLE, WA, United States

Behavioral Tech Research, Inc.
SEATTLE, WA, United States
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Harned M.S.,Seattle University | Harned M.S.,Behavioral Tech Research, Inc. | Dimeff L.A.,Behavioral Tech Research, Inc. | Woodcock E.A.,Behavioral Tech Research, Inc. | Skutch J.M.,Behavioral Tech Research, Inc.
Journal of Anxiety Disorders | Year: 2011

The present study evaluated methods for training mental health providers (N= 46) in exposure therapies (ETs) for anxiety disorders. A pilot randomized controlled trial compared: (1) an interactive, multimedia online training (ET OLT), (2) the ET OLT plus a brief Motivational Interviewing-based intervention (ET OLT. +. MI), and (3) a placebo control OLT. Assessments were completed at baseline, post-training, and one-week following training. Both ET OLT and ET OLT. +. MI received high satisfaction ratings and were comparably effective at increasing knowledge of ETs as well as clinicians' overt efforts to learn and use the treatment. ET OLT. +. MI was the most effective method for improving clinicians' attitudes toward ETs. Results indicate that OLT is effective for disseminating knowledge about ETs to clinicians, and suggest that supplementing OLT with a brief MI-based intervention may be a promising direction to address potential attitudinal barriers to adopting these highly efficacious treatments. © 2010 Elsevier Ltd.

PubMed | University of Washington and Behavioral Tech Research, Inc.
Type: | Journal: Journal of clinical psychology | Year: 2016

The present study examined the usability and effectiveness of the Linehan Suicide Safety Net (LSSN), a web-based, multimedia tool designed to support clinicians working with individuals who are suicidal. The core feature of LSSN is the Linehan Risk Assessment and Management Protocol (LRAMP), an empirically derived protocol that provides a structured checklist for assessing, managing, and documenting suicide risk.Mental health professionals (N = 44) completed assessments at baseline and monthly during a 3-month evaluation period.The LSSN was rated as acceptable and highly usable. Use of the LSSN was associated with a significant increase in confidence in conducting suicide risk assessment and management and a decrease in concerns related to treating suicidal clients.The LSSN appears to be a promising tool for clinicians working with suicidal clients.

Hubley S.,University of Colorado at Boulder | Woodcock E.A.,Behavioral Tech Research, Inc. | Dimeff L.A.,Behavioral Tech Research, Inc. | Dimidjian S.,University of Colorado at Boulder
Behavioural and Cognitive Psychotherapy | Year: 2015

Background: Despite the availability of evidence-based treatments for depression, large gaps exist between empirical research and clinical practice. Aims: To make preliminary steps toward the dissemination of Behavioural Activation (BA) via online training by examining clinicians' interest in learning BA via online training and the effects of a preliminary version of BA online training. Method: In study 1, practising clinicians (n = 540) completed a survey that assessed attitudes towards learning BA using an online training format. In study 2, we conducted a small, pilot randomized controlled trial (n = 46) to examine preliminary efficacy of teaching BA principles and treatment strategies with a precursor version of BA online training. Results: Study findings suggest that clinicians have interest in learning about BA via online training and that clinicians participating in BA online training evidence high satisfaction and significant gains in self-efficacy using BA and knowledge of BA terms and concepts. Conclusions: These results support the importance of efforts to disseminate BA and the viability of online training as an easily accessible and affordable training option. © 2014 British Association for Behavioural and Cognitive Psychotherapies.

Dimeff L.A.,Behavioral Tech Research, Inc. | Harned M.S.,Behavioral Tech Research, Inc. | Woodcock E.A.,Behavioral Tech Research, Inc. | Skutch J.M.,Behavioral Tech Research, Inc. | And 2 more authors.
Behavior Therapy | Year: 2015

The present study examined the efficacy of online training (OLT), instructor-led training (ILT), and a treatment manual (TM) in training mental health clinicians in two core strategies of Dialectical Behavior Therapy (DBT): chain analysis and validation. A randomized controlled trial compared OLT, ILT, and TM among clinicians naïve to DBT (N. =. 172) who were assessed at baseline, post-training, and 30, 60, and 90. days following training. Primary outcomes included satisfaction, self-efficacy, motivation, knowledge, clinical proficiency, and clinical use. Overall, ILT outperformed OLT and TM in satisfaction, self-efficacy, and motivation, whereas OLT was the most effective method for increasing knowledge. The conditions did not differ in observer-rated clinical proficiency or self-reported clinical use, which both increased to moderate levels after training. In addition, ILT was particularly effective at improving motivation to use chain analysis, whereas OLT was particularly effective at increasing knowledge of validation strategies. These findings suggest that these types of brief, didactic trainings may be effective methods of increasing knowledge of new treatment strategies, but may not be sufficient to enable clinicians to achieve a high level of clinical use or proficiency. Additional research examining the possible advantages of matching training methods to types of treatment strategies may help to determine a tailored, more effective approach to training clinicians in empirically supported treatments. © 2015.

Harned M.S.,Behavioral Tech Research, Inc. | Dimeff L.A.,Behavioral Tech Research, Inc. | Woodcock E.A.,Behavioral Tech Research, Inc. | Kelly T.,Behavioral Tech Research, Inc. | And 3 more authors.
Behavior Therapy | Year: 2014

Objective: The present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training. Method: Clinicians naïve to ET (N=181, Mage=37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to (a) an interactive, multimedia online training (OLT), (b) OLT plus a brief, computerized motivational enhancement intervention (OLT+ME), or (c) OLT+ME plus a Web-based learning community (OLT+ME+LC). Assessments were completed at baseline, posttraining, and 6 and 12weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency. Results: All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT + ME + LC condition was superior to both other conditions in increasing knowledge of ET. Conclusions: Multicomponent trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET. © 2014 Association for Behavioral and Cognitive Therapies.

Harned M.S.,Behavioral Tech Research, Inc. | Dimeff L.A.,Behavioral Tech Research, Inc. | Woodcock E.A.,Behavioral Tech Research, Inc. | Contreras I.,Behavioral Tech Research, Inc.
Journal of Anxiety Disorders | Year: 2013

The present study examined organizational, client, and therapist characteristics as predictors of use of and proficiency in exposure therapy (ET) after training. Therapists naïve to ET (N= 181) were randomized to: (1) online training (OLT), (2) OLT plus motivational enhancement (ME), or (3) OLT. +. ME plus a learning community. Twelve weeks after training, self-reported use of ET in clinical practice was high (87.5%) and therapists demonstrated moderate clinical proficiency. Use of ET was predicted by therapist degree, self-efficacy, and knowledge. Clinical proficiency was predicted by therapist anxiety sensitivity, attitudes, and knowledge, as well as organizational and client barriers. Several of these effects were moderated by training condition, indicating that therapists who received more comprehensive training were less impacted by barriers and showed enhanced adoption in the presence of facilitating factors. Overall, these results suggest that the primary barriers to the adoption of ET are therapist, not organizational or client, factors. © 2013 Elsevier Ltd.

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 225.80K | Year: 2012

DESCRIPTION (provided by applicant): Suicide is the 11th leading cause of death in the United States, accounting for approximately 34,000 deaths per year [1]. Despite the prevalence, many clinical research trials routinely exclude suicidal individuals dueto the lack of appropriate tools and protocols to adequately manage suicide risk. Similarly, clinicians are hesitant to treat suicidal patients, fearing the possibility of legal action by bereft family members should their loved one kill him/herself. Theoverarching goal of this project is to improve the availability and quality of mental health care for suicidal individuals by: 1) increasing the ability of clinicians'to implement best practice techniques for suicide risk assessment and management, and 2)reducing clinicians' fear of litigation following a suicide by reducing the actual risk of litigatin. This will be accomplished by designing and developing an innovative, web- based tool that guides clinicians through an empirically-derived suicide risk assessment and management protocol, while also providing thorough documentation that suicide risk was managed according to state-of-the- art procedures. Suicide Safety Net: Multimedia Tools for Reliable Risk Management Documentation (SSN) is based on the University of Washington Risk Assessment and Management Protocol (UWRAMP), a tool developed and used extensively by Linehan and colleagues at the UW, and by other treatment outcome researchers working with highly suicidal patients. All content will be thoroughly reviewed and critiqued by a consortium of suicide and forensic experts for accuracy of content. Specific aims for the present Phase I application are as follows. Aim 1: Iteratively develop content and implementation guidelines for a Suicide Safety Net(SSN) prototype utilizing a consortium of forensic suicide experts. Aim 2: Conduct a formative evaluation of the SSN prototype to determine usability, acceptability and perceived barriers to use among target end-users (i.e., clinicians and researchers). Aim 3: Conduct an open feasibility trial with practicing clinicians (N=30) who treat suicidal patients from eight diverse settings to evaluate the SSN prototype and identify additional barriers to use. Pending positive Phase I outcomes, we will: 1) complete development of the full SSN system, 2) produce an e-Learning curricula providing instruction in how to use the SSN in routine clinical practice and within clinical research trials, and 3) conduct a pilot feasibility trial with clinicians in mutiple mental health settings using the full SSN system with suicidal adult clients.

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 182.30K | Year: 2011

DESCRIPTION (provided by applicant): Post-traumatic stress disorder (PTSD) is a common anxiety disorder with lifetime prevalence in the U.S. of 6.8%. Prolonged Exposure (PE), an exposure-based treatment developed by Edna Foa, Ph.D. and colleagues, is a highly efficacious treatment for PTSD. PE is considered the gold-standard in psychosocial interventions for PTSD, but is rarely used in routine clinical practice. This Phase I Small Business Innovation Research (SBIR) grant represents a cooperative partnership between Dr. Foa and BTECH Research. Our primary goal is to facilitate the widespread dissemination of PE by creating a PE Computer-Assisted Therapy Program (PE-CAT) to assist clinicians in implementing PE in real time. The PE-CAT program will be designedfor clinicians and patients to use together during therapy sessions and will provide step-by-step guidance through each PE session. This innovative training approach provides a rapid and efficient method of disseminating PE to a large number of clinicians, while also maximizing the likelihood that trained clinicians both use and adhere to PE. We will use an iterative development process involving feedback from end-users throughout all stages of prototype development. Given the novelty of computer-assistedtherapy as a method of psychological treatment delivery, in Phase 1 we plan to conduct an extensive formative evaluation to confirm and ensure proof of concept. Specifically, we propose to test the product's usability, acceptability, and feasibility by gathering in-depth qualitative and quantitative data from clinicians and patients. In the event of a successful Phase I formative evaluation, we will complete development of all elements of the PE-CAT program in Phase II. At that time, we intend to conduct anopen trial to extensively evaluate the feasibility and effectiveness of the PE-CAT program in a large Health Maintenance Organization where client and therapist outcomes can be collected. PUBLIC HEALTH RELEVANCE: Despite the prevalence and often disabling impact of post-traumatic stress disorder (PTSD), the majority of patients with PTSD receive no or inadequate treatment due largely to a lack of training opportunities for treatment providers. Prolonged Exposure (PE) therapy for PTSD is considered the gold standard in psychosocial interventions for PTSD, but is rarely used in routine practice settings. The primary goal of this project is to facilitate the widespread dissemination of PE by developing a PE Computer- Assisted Therapy Program (PE-CAT) toassist clinicians in implementing and adhering to PE in the context of typical clinical practice.

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 1.22M | Year: 2010

DESCRIPTION (provided by applicant): Panic attacks (PA) impact about 23% of adults in community samples. Panic disorder with or without agoraphobia (PDA) tends to be a chronic condition with a lifetime prevalence of 4.7%. When untreated, panic disorder (PD) often leads to debilitating problems, with severe financial and interpersonal costs. Panic Control Treatment (PCT) is an efficacious treatment for PD. The overarching goal of this project is to facilitate the dissemination of PCT (aka MAP; Mastery of Your Anxiety and Panic) to clinicians who treat PD by creating the Online PCT Training for Clinicians (PCT OLT). In Phase I, we produced an innovative OLT prototype comprised of 143 screens using an iterative process of development with feedback from target end-users and PCT experts. A randomized controlled trial (RCT; N=31) was then conducted comparing the PCT OLT to a control OLT. PCT OLT subjects significantly outperformed controls on all outcome variables, including knowledge, recall, and self-efficacy. Results were maintained at the one week follow up. The proposed Phase II project extends this work by expanding the OLT and its evaluation in Phase II. Specifically, we will include all remaining content from the PCT manuals and add additional clinical scenarios and performance-based interactivities. We will test the program's efficacy in a RCT (N=180) using an additive research design of three training approaches: text (n=60), text + PCT OLT (PCT OLT; n=60), vs. text + PCT OLT + expert weekly consultation (Hybrid; n= 60). Outcome variables will again include PCT knowledge, as well as self-efficacy in treating PDA clients with PCT. We will expand the assessments to include a computer- generated clinical application test of competence and fidelity to PCT and course completion. Subjects will be assessed pre- and post-training, then again at 30-day and 60-day post-training follow-ups. PUBLIC HEALTH RELEVANCE: Although empirically-based treatments do exist for people diagnosed with panic disorder (PD), only a relatively small percentage of this population will receive such treatments. Panic Control Treatment (aka Mastery of Anxiety and Panic; MAP) is an efficacious treatment for PD. The intent of this project is to develop a uniquely comprehensive and interactive online training in MAP, to aid in the dissemination of this evidence based treatment, in order to improve clinical outcomes for patients suffering from PD.

Agency: Department of Health and Human Services | Branch: | Program: STTR | Phase: Phase I | Award Amount: 115.57K | Year: 2012

DESCRIPTION (provided by applicant): The limitations of standard means of obtaining informed consent for psychiatric clinical trials have been well documented. Empirical data suggests that, aided by multimedia learning methods, psychiatric patients can betaught or primed with general knowledge about clinical trials and about the informed consent itself and that such priming facilitates each person's ability to efficiently and effectively participate in the consent process during and after review of consent forms for specific clinical trial protocols. The present application is being proposed through a partnership between Behavioral Tech Research, Inc., a small business concern with expertise in developing and marketing web-based multimedia health educational materials, and investigators at the University of California, San Diego (UCSD) who have expertise in issues of decisional capacity and enhancing informed consent for psychiatric research. Specific aims for the present Phase 1 application are as follows. Aim 1: to develop a web-based multimedia tool that can be used to educate subjects about research and informed consent prior to beginning review of protocol specific information. This tool will also incorporate standardized assessment of participant comprehension of disclosed information. Aim 2: to conduct a randomized controlled comparison of the consent aid prototype (versus routine consent) among 30 patients participating in phase III pharmacologic clinical trials for schizophrenia or bipolar disorder. Data on the effectiveness of consent aid, as well as participant opinions/reactions, and feedback from an expert advisory panel will inform further refinement of the prototype consent tool. Phase II (for which we will apply upon successful completion ofPhase I) will focus on larger scale adaptation/refinement and testing for subsequent marketing and widespread dissemination. PUBLIC HEALTH RELEVANCE: There is a clear need for clinical trials to identify safer and more effective treatments for persons with serious mental illness. Yet, it is also critical from a humanitarian and ethical standpoint that those volunteering for participation in the clinical trials only be enrolled with their voluntary and capable informed consent to do so. This projectwill develop and validate a web-media consent tool designed to assess participant comprehension. It will also foster deeper comprehension among potential clinical trials participants about psychiatric clinical trials and the informed consent process itself, to aid each person in more actively and effectively engaging in the consent process for individual clinical trial protocols.

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