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BACKGROUND/RATIONALE:
Persons in treatment for substance use disorders (SUDs) commonly present with comorbid depressive disorders. Research indicates that up to 50% of individuals in treatment for substance disorders report symptomatology consistent with a diagnosis of major depressive disorder. Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for depression equal in effectiveness to antidepressant medications but it is rarely offered to the SUD treatment population.
OBJECTIVE(S):
The objectives of this study are 1) to develop and alpha-test (initial test in a "laboratory setting") a web-based manual for addiction therapists to be trained in CBT for depression, 2) to develop and alpha-test a new "gold standard" supervision plan to accompany the web manual, 3) to develop and alpha test a companion guided self-help workbook for veterans to be accessed via My HealtheVet, and 4) to beta-test (initial field test) the web-based training manual, supervision plan, and veteran workbook.
METHODS:
Investigators will convert an existing CBT manual (4 modules) into web-based training prototypes (Objective 1a). The development process will include formative evaluation--iterative cycles of vignette/module development, stakeholder feedback via focus groups (n= 4 therapists), and product revisions. Next, a sample of 10 therapists will participate in the web training prototype Alpha Test (Objective 1b). The manual will be tested for feasibility, acceptability, and effectiveness of knowledge transfer. Formative evaluation (key informant interviews, satisfaction surveys, and knowledge transfer tests) will provide stakeholder feedback and effectiveness data on learning, which will be followed by product revisions in preparation for the field testing. Next, these same 10 counselors will participate in prototype development of the supervision plan (Objective 2a) and an Alpha Test of the supervision plan (Objective 2b). The prototype development will be based on the paper manual's current supervision plan. The Alpha Test of the supervision plan will involve the completion of 2 "rounds" of the group CBT for depression by the addiction therapists with frequent audio taping of sessions and review/feedback by PhD supervisors. Formative evaluation (focus groups, interviews, and competence/fidelity testing) will provide stakeholder feedback and supervision effectiveness data necessary for revision of the supervision plan in preparation for the beta test. Parallel to these Alpha tests, a web-based workbook for CBT group members will be developed and tested in much the same manner. A focus group of veterans (n=4) will be used for feedback on prototypes (Objective 3a), and a sample of 10 veterans will be used to test feasibility, acceptability, and effectiveness of knowledge transfer of the workbook (Objective 3b). A new sample of counselors and veterans (20 each) will participate in the Beta-Test of the web training manuals, supervision plan, and workbook (Objective 4).
FINDINGS/RESULTS:
No findings at this time.
IMPACT:
When converted to an Internet-based format, the CBT manual has the opportunity to reach all VHA addiction counselors in a highly efficient manner.
PUBLICATIONS:
None at this time.
DRA:
Substance Abuse, Addictive Disorders
DRE:
Treatment
Keywords:
Education (provider)
MeSH Terms:
none
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