Behavior Therapy Seminar Series: A Model for Teaching Evidence- Based Practice Thad R. Leffingwell, Ph.D. Oklahoma State University

What is the BTSS?  Major project in context of graduate Behavior Therapy course  Student/instructor teams prepare 2.5-hour workshops for classmates, 4-6 workshops in total  Involve expertise of faculty  Multimedia archiving on CD  Major project in context of graduate Behavior Therapy course  Student/instructor teams prepare 2.5-hour workshops for classmates, 4-6 workshops in total  Involve expertise of faculty  Multimedia archiving on CD

Objectives of BTSS  Students learn about empirically-supported treatments  Students learn about one treatment in depth  Students learn how to conduct training  Students learn how to learn about treatment research evidence and procedures  Students learn how to create and present (practitioner-friendly) systematic reviews  Provide service to broader psychology community (?)  Students learn about empirically-supported treatments  Students learn about one treatment in depth  Students learn how to conduct training  Students learn how to learn about treatment research evidence and procedures  Students learn how to create and present (practitioner-friendly) systematic reviews  Provide service to broader psychology community (?)

Workshop Format  Modeled after “ beginner level ” workshop at professional meetings (like ABCT)  Content of workshop similar across topics – Theoretical and technical overview – Review of empirical support – Case demonstration/vignettes  Supplemental Materials – “ Quick scan ” table of empirical studies – Consumer-oriented “ fact sheet ” summarizing treatment and evidence-base  Modeled after “ beginner level ” workshop at professional meetings (like ABCT)  Content of workshop similar across topics – Theoretical and technical overview – Review of empirical support – Case demonstration/vignettes  Supplemental Materials – “ Quick scan ” table of empirical studies – Consumer-oriented “ fact sheet ” summarizing treatment and evidence-base

Evaluation of Empirical Studies  Provided with guide for evaluating methodology and evaluation of empirical studies  Based upon Borkovek ’ s(1993) classic article and CONSORT guidelines (new Behar & Borkovec, 2005)  Borrowed Consumer Report ’ s style of representing poor ( ), good ( ), and excellent ( ) characteristics – Design – Methodology – Sample Characteristics – Therapist Characteristics – Dependent Variable Considerations – Data Analysis  Provided with guide for evaluating methodology and evaluation of empirical studies  Based upon Borkovek ’ s(1993) classic article and CONSORT guidelines (new Behar & Borkovec, 2005)  Borrowed Consumer Report ’ s style of representing poor ( ), good ( ), and excellent ( ) characteristics – Design – Methodology – Sample Characteristics – Therapist Characteristics – Dependent Variable Considerations – Data Analysis

Methodology  Minimal specification of treatment; statistical control of client variables in absence of random assignment  Treatment manual; session parameters specified and controlled; expectancy/credibility checks  Adherence ratings; expert supervision or ratings of competence  Minimal specification of treatment; statistical control of client variables in absence of random assignment  Treatment manual; session parameters specified and controlled; expectancy/credibility checks  Adherence ratings; expert supervision or ratings of competence

Finger-tapping Desensitization and Reprocessing Therapy (FTDR) Quick-scan table summarizing empirical findings. Study Design Method Sample Therapist Effects Dependent Variable Analyses Results Comments Wellington All improved Small, exploratory study using & * + ~ ~ ~ + 3 of 6 PSTD- multiple - baseline design. Herskowitz free post-tx Promising results, but flaws limit (1995) confidence without replication. Seymour FTDR>TAU, Randomized trial w/ treatment & * % improved manual, more diverse traumas, Butz at post-test no information about therapists, (1997) Immediate post-test only Note: FTDR = Finger-tapping Desensitization and Reprocessing, TAU = treatment as usual, * = Excellent, + = Good, ~ = Fair to Poor, - = Below minimum = no information available Quick-scan table summarizing empirical findings. Study Design Method Sample Therapist Effects Dependent Variable Analyses Results Comments Wellington All improved Small, exploratory study using & * + ~ ~ ~ + 3 of 6 PSTD- multiple - baseline design. Herskowitz free post-tx Promising results, but flaws limit (1995) confidence without replication. Seymour FTDR>TAU, Randomized trial w/ treatment & * % improved manual, more diverse traumas, Butz at post-test no information about therapists, (1997) Immediate post-test only Note: FTDR = Finger-tapping Desensitization and Reprocessing, TAU = treatment as usual, * = Excellent, + = Good, ~ = Fair to Poor, - = Below minimum = no information available

Empirical Support Suggested Outline  What studies have been done?  Does the treatment appear to have support for short-term efficacy?  Does the treatment appear to have support for long-term efficacy?  Is any evidence available for treatment effectiveness?  How does the treatment compare to alternative treatments?  Who does the treatment work for? (gender, diagnosis, severity, comorbidity, etc.)  Is there any evidence why the treatment works? (mechanisms, principles of change)  Where is the research heading? What important questions remain?  (Consider clinical significance as well as statistical significance in answers)  What studies have been done?  Does the treatment appear to have support for short-term efficacy?  Does the treatment appear to have support for long-term efficacy?  Is any evidence available for treatment effectiveness?  How does the treatment compare to alternative treatments?  Who does the treatment work for? (gender, diagnosis, severity, comorbidity, etc.)  Is there any evidence why the treatment works? (mechanisms, principles of change)  Where is the research heading? What important questions remain?  (Consider clinical significance as well as statistical significance in answers)

“ Fact Sheet ” Content  Description of treatment  Non-technical description of efficacy data (clinical significance)  Risks and benefits of treatment  Alternatives to treatment  May be useful as treatment induction and/or informed consent procedures  Description of treatment  Non-technical description of efficacy data (clinical significance)  Risks and benefits of treatment  Alternatives to treatment  May be useful as treatment induction and/or informed consent procedures

BTSS Recent Topics CBT for Bulimia Nervosa -Multisystemic Therapy for Antisocial Youth -CBT for Cocaine Dependence -Parent Management Training for ADHD Anger Management Training -Dialectical Behavior Therapy -CBT for Generalized Anxiety Disorder -Parent-child Interaction Therapy Integrative Behavioral Couple Therapy -Seeking Safety Treatment for PTSD/Substance Abuse -CBT for OCD -PSST/PMT for CD CBT for Bulimia Nervosa -Multisystemic Therapy for Antisocial Youth -CBT for Cocaine Dependence -Parent Management Training for ADHD Anger Management Training -Dialectical Behavior Therapy -CBT for Generalized Anxiety Disorder -Parent-child Interaction Therapy Integrative Behavioral Couple Therapy -Seeking Safety Treatment for PTSD/Substance Abuse -CBT for OCD -PSST/PMT for CD

For more information Concurrent discussion groups Concurrent discussion groups