Clinical Translation of Cognitive Behavioural Therapy for Anxiety and Depression: Adapted for Brain Injury (CBT-ABI): How Do We Train Competent Clinicians?

Abstract

Depression and anxiety are common following acquired brain injury (ABI) and can be effectively treated using cognitive behaviour therapy (CBT) that has been adapted to compensate for cognitive difficulties (CBT-ABI). Training clinicians to deliver CBT-ABI is a crucial step in effective translation into clinical practice. This study evaluated the outcome of didactic and skill-based training on competencies in delivering CBT-ABI. Participants were 39 registered psychologists who attended a day-long workshop on using CBT-ABI to treat anxiety and depression after ABI, which included knowledge and skill-based content. Fourteen participants completed three additional supervision sessions reviewing audio recordings of their use of CBT-ABI with clients. Training outcomes were measured using surveys rating the usefulness of the various workshop components, a checklist of competencies in CBT-ABI on which participants rated themselves pre-workshop and post-workshop and post-supervision, and the Cognitive Therapy Scale (CTS), used by supervisors and a blinded expert to evaluate supervisees’ skills. Participant-rated competencies in CBT-ABI significantly improved following workshop training, with no further change after supervision. CTS ratings of the supervisor, but not the blinded expert, showed significant improvement after short-term supervision. At 16-month follow-up, self-rated competency gains were maintained, and therapist confidence and competence were no longer major barriers to using CBT-ABI in the workplace. These findings suggest targeted training is important for clinical translation of this evidence-based intervention.