Behavior Therapy Seminar Series:A Model for Teaching Evidence- Based Practice

Thad R. Leffingwell, Ph.D. Oklahoma State University

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

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 (?)

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

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

MethodologyMethodology

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

& * + + @ + + 89% 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 standards, @ = 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

& * + + @ + + 89% 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 standards, @ = no information available

QuickTime™ and aTIFF (LZW) decompressor

are needed to see this picture.

Empirical Support Suggested OutlineEmpirical 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)

“Fact Sheet” Content“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

BTSS Recent TopicsBTSS Recent Topics

2003 - CBT for Bulimia Nervosa - Multisystemic Therapy for Antisocial Youth - CBT for Cocaine Dependence - Parent Management Training for ADHD 2004 - Anger Management Training - Dialectical Behavior Therapy - CBT for Generalized Anxiety Disorder - Parent-child Interaction Therapy 2005 - Integrative Behavioral Couple Therapy - Seeking Safety Treatment for PTSD/Substance Abuse - CBT for OCD

- PSST/PMT for CD

2003 - CBT for Bulimia Nervosa - Multisystemic Therapy for Antisocial Youth - CBT for Cocaine Dependence - Parent Management Training for ADHD 2004 - Anger Management Training - Dialectical Behavior Therapy - CBT for Generalized Anxiety Disorder - Parent-child Interaction Therapy 2005 - Integrative Behavioral Couple Therapy - Seeking Safety Treatment for PTSD/Substance Abuse - CBT for OCD

- PSST/PMT for CD

For more information......

Concurrent discussion groups

thad.leffingwell@okstate.edu

http://psychology.okstate.edu/faculty/leffingwell/btss/