Oxford University, Department of Psychiatry, Warneford Hospital, United Kingdom.
Clin Psychol Rev. 2010 Jul;30(5):496-516. doi: 10.1016/j.cpr.2010.03.004. Epub 2010 Mar 27.
Cognitive behavior therapy's (CBT) demonstrated efficacy has prompted calls for its increased dissemination to routine clinical practice settings. For the widespread dissemination of CBT to be successful in achieving effects similar to the original efficacy trials, there must also be effective dissemination of CBT training practices. However, as yet, CBT training is not evidence-based. This review examines what can be learned from existing research into the efficacy and effectiveness of CBT training. Due to the paucity of research specifically investigating CBT training, CBT effectiveness and dissemination studies are also examined to glean information about potentially effective training practices. In order to draw conclusions about effective training practices, comparisons are drawn between studies according to the clinical outcomes that they achieved. Training approaches are compared according to dose and active training elements, and theoretical models of learning are applied to interpret the findings. The limitations of the existing literature are discussed, as well as recommendations for improving training research to meet the standards evident in treatment trials (e.g., random allocation, control conditions, self-report and blind assessment, and adherence monitoring). Finally, the process of developing efficacious CBT treatment protocols is offered as a template for developing evidence-based CBT training protocols.
认知行为疗法（CBT）的显著疗效促使人们呼吁将其更多地推广到常规临床实践环境中。为了使 CBT 的广泛传播在实现与原始疗效试验相似的效果方面取得成功，还必须有效推广 CBT 培训实践。然而，到目前为止，CBT 培训还没有循证依据。本综述考察了从现有的关于 CBT 培训的疗效和有效性研究中可以学到什么。由于专门研究 CBT 培训的研究很少，因此还对 CBT 有效性和传播研究进行了考察，以获取有关潜在有效培训实践的信息。为了得出有效的培训实践结论，根据他们所取得的临床结果对研究进行了比较。根据剂量和主动培训要素比较培训方法，并应用学习理论模型来解释研究结果。讨论了现有文献的局限性，并提出了改进培训研究的建议，以达到治疗试验中明显的标准（例如，随机分配、对照条件、自我报告和盲法评估以及依从性监测）。最后，提供了开发有效的 CBT 治疗方案的过程，作为开发基于证据的 CBT 培训方案的模板。
