Integrated Substance Abuse Programs, University of California, Los Angeles, CA 90075-7535, USA.
Subst Abus. 2013;34(2):108-17. doi: 10.1080/08897077.2012.691445.
This study evaluated the effectiveness of 3 approaches to transferring cognitive behavioral therapy (CBT) to addiction clinicians in the Republic of South Africa (RSA).
Clinicians (N = 143) were assigned to 3 training conditions: ( 1 ) an in vivo (IV) approach in which clinicians received in-person training and coaching; ( 2 ) a distance learning (DL) approach providing training via videoconference and coaching through teleconferencing; and ( 3 ) a control condition (C) providing a manual and 2-hour orientation.
Frequency of use of CBT skills increased significantly with the IV and DL approaches compared with the C approach, and the IV approach facilitated greater use of CBT skills than the DL approach. During the active phase of the study, skill quality declined significantly for clinicians trained in the C condition, whereas those in the DL approach maintained skill quality and those in the IV approach improved skill quality. After coaching was discontinued, clinicians in the IV and DL approaches declined in skill quality. However, those in the IV approach maintained a higher level of skill quality compared with the other approaches. Cost of the IV condition was double that of the DL condition and 10 times greater than the C condition.
In vivo supervision and distance learning methods appear to be effective dissemination and implementation strategies, and distance learning has significant potential to be less costly.
本研究评估了三种方法在南非共和国（RSA）将认知行为疗法（CBT）转移给成瘾临床医生的效果。
临床医生（N=143）被分配到三种培训条件：（1）现场（IV）方法，临床医生接受面对面培训和指导；（2）远程学习（DL）方法，通过视频会议提供培训，并通过电话会议提供指导；（3）对照条件（C）提供手册和 2 小时的介绍。
与 C 条件相比，IV 和 DL 方法的 CBT 技能使用频率显著增加，IV 方法比 DL 方法更有利于 CBT 技能的使用。在研究的活跃阶段，C 条件下培训的临床医生的技能质量显著下降，而 DL 方法下的临床医生保持了技能质量，IV 方法下的临床医生则提高了技能质量。停止指导后，IV 和 DL 方法的临床医生的技能质量下降。然而，IV 方法组的技能质量水平仍高于其他方法。IV 条件的成本是 DL 条件的两倍，是 C 条件的 10 倍。
现场监督和远程学习方法似乎是有效的传播和实施策略，远程学习具有显著的成本效益潜力。
