An Examination of Active Learning as an Ingredient of Consultation Following Training in Cognitive-Behavioral Therapy for Youth Anxiety

Abstract

The training literature suggests that ongoing support (e.g., consultation) following initial training enhances training outcomes, yet little is known about the critical components of ongoing support and the lasting effects of ongoing support. The present study examined components of consultation calls that were provided to 99 community clinicians following training in the delivery of cognitive-behavioral therapy (CBT) for youth anxiety. The 104 recorded consultation calls were coded for content and consultative methods present. A subset of the training sample (N = 50) completed a 2-year follow-up interview during which they reported on their implementation rates of CBT since ending consultation. They also completed measures assessing CBT knowledge and attitudes toward evidence-based practices (EBPs). It was hypothesized that active learning (i.e., role-plays) would predict therapist adherence, skill, self-efficacy, and satisfaction at postconsultation, but regression analyses found no significant relation. However, level of clinician involvement during consultation calls significantly positively moderated the relation between active learning and clinician skill. Analyses of the follow-up data indicated (a) high implementation rates of CBT and (b) maintenance of overall attitudes toward EBPs, willingness to implement EBPs if mandated, views regarding the appeal of EBPs, and beliefs regarding the clinical utility of EBPs. A significant decline in CBT knowledge and openness toward EBPs was observed. Consultation call attendance positively predicted therapist CBT knowledge, overall attitudes toward EBPs, and attitudes regarding the appeal and clinical utility of EBPs at the 2-year follow-up. Implications, strengths and limitations, and future directions are discussed.