Skip to main content
SpringerLink
Log in

Therapists Perspectives on the Effective Elements of Consultation Following Training

  • Original Paper
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Ethnicity data were missing for 6 % of participants.

References

  • Accurso, E. C., Taylor, R. M., & Garland, A. F. (2011). Evidence-based practices addressed in community-based children’s mental health clinical supervision. Training and Education in Professional Psychology, 5(2), 88–96. doi:10.1037/a0023537.

    Article  Google Scholar 

  • American Psychological Association. (2005). American Psychological Association policy statement on evidence-based practice in psychology. Washington, DC: American Psychological Association.

    Google Scholar 

  • Beidas, R. S., Barmish, A. J., & Kendall, P. C. (2009). Training as usual: Can therapist behavior change after reading a manual and attending a brief workshop on cognitive behavioral therapy for youth anxiety? The Behavior Therapist, 32, 97–101.

    Google Scholar 

  • Beidas, R. S., Edmunds, J. E., Marcus, S. C., & Kendall, P. C. (2012a). Training and consultation to promote implementation of an empirically supported treatment: A randomized trial. Psychiatric Services, 63, 660–665.

    Google Scholar 

  • Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17(1), 1–30. doi:10.1111/j.1468-2850.2009.01187.x.

    Article  Google Scholar 

  • Beidas, R. S., Koerner, K., Weingardt, K. R., & Kendall, P. C. (2011). Training research: Practical recommendations for maximum impact. Administration and Policy in Mental Health and Mental Health Services Research, 38(4), 223–237. doi:10.1007/s10488-011-0338-z.

    Article  PubMed  Google Scholar 

  • Beidas, R. S., Mychailyszyn, M. P., Edmunds, J. M., Khanna, M. S., Downey, M. M., & Kendall, P. C. (2012b). Training school mental health providers to deliver cognitive-behavioral therapy. School Mental Health, 4, 197–206.

  • Bennett-Levy, J., & Lee, N. K. (2012). Self-Practice and self-reflection in cognitive behaviour therapy Training: What Factors Influence Trainees’ Engagement and Experience of Benefit? Behavioral and Cognitve Psychotherapy, 1–17. doi: 10.1017/S1352465812000781.

  • Bennett-Levy, J., McManus, F., Westling, B. E., & Fennell, M. (2009). Acquiring and refining CBT skills and competencies: which training methods are perceived to be most effective? Behavioral and Cognitive Psychotherapy, 37(5), 571–583. doi:10.1017/S1352465809990270.

    Article  Google Scholar 

  • Benshoff, J. (1994). Peer supervision in counselor training. The Clinical Supervisor, 11(2), 89–102.

    Article  Google Scholar 

  • Caplan, G., & Caplan, R. B. (1993). Mental health consultation and collaboration. San Francisco, CA: Jossey-Bass Publishers.

    Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7–18.

    Article  PubMed  CAS  Google Scholar 

  • Cross, W. F., Seaburn, D., Gibbs, D., Schmeelk-Cone, K., White, A. M., & Caine, E. D. (2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. Journal of Primary Prevention, 32(3–4), 195–211. doi:10.1007/s10935-011-0250-z.

    Article  PubMed  Google Scholar 

  • Dimeff, L. A., Koerner, K., Woodcock, E. A., Beadnell, B., Brown, M. Z., Skutch, J. M., et al. (2009). Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills. Behaviour Research and Therapy, 47(11), 921–930. doi:10.1016/j.brat.2009.07.011.

    Article  PubMed  Google Scholar 

  • Ebert, L., Amaya-Jackson, L., Markiewicz, J., & Fairbank, J. (2012). Development and application of the NCCTS Learning Collaborative model for the implementation of evidence-based child trauma treatment. In R. K. McHugh & D. Barlow (Eds.), Dissemination and implementation of evidence-based psychological interventions (pp. 97–116). New York, NY: Oxford University Press.

    Google Scholar 

  • Edmunds, J. M., Kendall, P. C., Ringle, V. A., Read, K. L., Brodman, D. M., Pimentel, S. S., & Beidas, R. S. (2013). An examination of behavioral rehearsal during consultation as a predictor of training outcomes. Administration and Policy in Mental Health and Mental Health Services Research.

  • Farmer, A. P., Légaré, F., Turcot, L., Grimshaw, J., Harvey, E., McGowan, J. L., Wolf F. (2008). Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 7. doi:10.1002/14651858.CD004398.pub2.

  • Giguère, A., Légaré, F., Grimshaw, J., Turcotte, S., Fiander, M., Grudniewicz, A., Makosso-Kallyth, S., Wolf, F. M., Farmer, A. P., Gagnon, M.P. (2012). Printed educational materials: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 11. doi:10.1002/14651858.CD004398.pub3.

  • Guba, Y., & Lincoln, E. (1985). Naturalistic Inquiry. Beverly Hills, CA: Sage Publishers.

    Google Scholar 

  • Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clinical Psychology Review, 30(4), 448–466. doi:10.1016/j.cpr.2010.02.005.

    Article  PubMed  Google Scholar 

  • Herschell, A. D., McNeil, C. B., & McNeil, D. (2004). Clinical child psychology’s progress in disseminating empirically supported treatments. Clinical Psychology: Science and Practice, 11, 267–288.

    Article  Google Scholar 

  • Hill, C., Knox, S., Thompson, B., Williams, E., Hess, S., & Ladany, N. (2005). Consensual qualitative research: An update. Retrieved from http://epublications.marquette.edu/edu.fac/18. Accessed 1 Sep 2012.

  • Hill, C., Thompson, B., & Williams, E. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572.

    Article  Google Scholar 

  • Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O’Brien, M. A., Johansen, M., Grimshaw, J., Oxman, A. D. (2012). Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6), CD000259. doi:10.1002/14651858.CD000259.pub3.

  • Johnston, L. H., & Milne, D. L. (2012). How do supervisee’s learn during supervision? A Grounded Theory study of the perceived developmental process. The Cognitive Behaviour Therapist, 5(01), 1–23. doi:10.1017/s1754470x12000013.

    Article  Google Scholar 

  • Kendall, P. C., & Hedtke, K. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual. Ardmore, PA: Workbook Publishing.

    Google Scholar 

  • Kilminster, S. M., & Jolly, B. C. (2000). Effective supervision in clinical practice settings: A literature review. Medical Education, 34(10), 827–840.

    Article  PubMed  CAS  Google Scholar 

  • Landis, J., & Koch, G. (1977). The measurement of observer agreement for categorical data. Biometrics, 45, 233–268.

    Google Scholar 

  • Lomas, J. (1993). Diffusion, dissemination, and implementation: Who should do what? Annals of the New York Academy of Sciences, 703, 226–235.

    Article  PubMed  CAS  Google Scholar 

  • McHugh, R. K., & Barlow, D. H. (2010). The dissemination and implementation of evidence-based psychological treatments. A review of current efforts. American Psychologist, 65(2), 73–84. doi:10.1037/a0018121.

    Article  PubMed  Google Scholar 

  • Milne, D., Aylott, H., Fitzpatrick, H., & Ellis, M. (2008). How does clinical supervision work? Using a “best evidence synthesis” approach to construct a basic model of supervision. The Clinical Supervisor, 27(2). doi:10.1080/07325220802487915.

  • Nadeem, E., Gleacher, A., & Beidas, R. (in review). Consultation as an implementation strategy for evidence-based practices across multiple contexts: Unpacking the black box.

  • Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M., & Landsverk, J. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 44–53. doi:10.1007/s10488-010-0314-z.

    Article  PubMed  Google Scholar 

  • Palinkas, L. A., Schoenwald, S. K., Hoagwood, K., Landsverk, J., Chorpita, B. F., & Weisz, J. R. (2008). An ethnographic study of implementation of evidence-based treatments in child mental health: First steps. Psychiatric Services, 59(7), 738–746. doi:10.1176/appi.ps.59.7.738.

    Article  PubMed  Google Scholar 

  • Powell, B. J., McMillen, J. C., Proctor, E. K., Carpenter, C. R., Griffey, R. T., Bunger, A. C., et al. (2011). A compilation of strategies for implementing clinical innovations in health and mental health. Medical Care Research and Review,. doi:10.1177/1077558711430690.

    PubMed  Google Scholar 

  • President’s New Freedom Commission on Mental Health. (2003). Report of the President’s New Freedom Commission on Mental Health. Washington, DC.

  • Prieto, L. (1996). Group supervision: Still widely practiced but poorly understood. Counselor Education and Supervision, 35, 295–307.

    Article  Google Scholar 

  • Rakovshik, S. G., & McManus, F. (2010). Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance. Clinical Psychology Review, 30(5), 496–516. doi:10.1016/j.cpr.2010.03.004.

    Article  PubMed  Google Scholar 

  • Schoenwald, S. K., Sheidow, A. J., & Letourneau, E. J. (2004). Toward effective quality assurance in evidence-based practice: links between expert consultation, therapist fidelity, and child outcomes. Journal of Clinical Child and Adolescent Psychology, 33(1), 94–104. doi:10.1207/S15374424JCCP3301_10.

    Article  PubMed  Google Scholar 

  • Simons, A. D., Padesky, C. A., Montemarano, J., Lewis, C. C., Murakami, J., Lamb, K., et al. (2010). Training and dissemination of cognitive behavior therapy for depression in adults: A preliminary examination of therapist competence and client outcomes. Journal of Consulting and Clinical Psychology, 78(5), 751–756. doi:10.1037/a0020569.

    Article  PubMed  Google Scholar 

  • Spoth, R., Clair, S., Greenberg, M., Redmond, C., & Shin, C. (2007). Toward dissemination of evidence-based family interventions: Maintenance of community-based partnership recruitment results and associated factors. Journal of Family Psychology, 21(2), 137–146. doi:10.1037/0893-3200.21.2.137.

    Article  PubMed  Google Scholar 

  • Stirman, S. W., Gutierrez-Colina, A., Toder, K., Esposito, G., Barg, F., Castro, F., et al. (2012). Clinicians’ perspectives on cognitive therapy in community mental health settings: Implications for training and implementation. Administration and Policy in Mental Health and Mental Health Services Research,. doi:10.1007/s10488-012-0418-8.

    Google Scholar 

  • Wandersman, A., Chien, V. H., & Katz, J. (2012). Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement. American Journal of Community Psychology,. doi:10.1007/s10464-012-9509-7.

    Google Scholar 

  • Weisz, J. R., Ugueto, A. M., Herren, J., Afienko, S. R., & Rutt, C. (2011). Kernels vs. ears, and other questions for a science of treatment dissemination. Clinical Psychology: Science and Practice, 18(1), 41–46. doi:10.1111/j.1468-2850.2010.01233.x.

    Article  Google Scholar 

  • Williams, C. (2008). Cognitive behaviour therapy within assertive outreach teams: Barriers to implementation: A qualitative peer audit. Journal of Psychiatric and Mental Health Nursing, 15, 850–856.

    Article  PubMed  CAS  Google Scholar 

  • Worthen, V. E., & Lambert, M. J. (2007). Outcome oriented supervision: Advantages of adding systematic client tracking to supportive consultations. Counseling and Psychotherapy Research, 7(1), 48–53. doi:10.1080/14733140601140873.

    Article  Google Scholar 

  • Yerkes, R., & Dodson, J. (1908). The relation of strength of stimulus to rapidity of habit formation. Journal of Comparative Neurology and Psychology, 18, 459–482.

    Article  Google Scholar 

Download references

Acknowledgments

Funding for this research project was supported by the following Grants from NIMH: Beidas (F31 MH083333; K23 MH099179); Kendall (F31 MH083333; U01 MH063747). Additionally, the preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and Quality Enhancement Research Initiative (QUERI), Department of Veterans Affairs Contract, Veterans Health Administration, Office of Research & Development, Health Services Research & Development Service. Dr. Beidas is an IRI fellow.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA

    Rinad S. Beidas, Mark Gallagher & Margaret Mary Downey

  2. Department of Psychology, Temple University, Philadelphia, PA, USA

    Julie M. Edmunds & Philip C. Kendall

  3. Mixed Methods Research Laboratory, Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Carolyn C. Cannuscio

Authors
  1. Rinad S. Beidas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie M. Edmunds
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carolyn C. Cannuscio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Margaret Mary Downey
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Philip C. Kendall
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rinad S. Beidas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Beidas, R.S., Edmunds, J.M., Cannuscio, C.C. et al. Therapists Perspectives on the Effective Elements of Consultation Following Training. Adm Policy Ment Health 40, 507–517 (2013). https://doi.org/10.1007/s10488-013-0475-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-013-0475-7

Keywords

Search

Navigation