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J Subst Abuse Treat. 2009 Oct;37(3):219-27. doi: 10.1016/j.jsat.2009.01.002. Epub 2009 Mar 31.

A randomized trial comparing two models of web-based training in cognitive-behavioral therapy for substance abuse counselors.

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  • 1Center for Health Care Evaluation, VA Palo Alto Health Care System and, Stanford University School of Medicine, Palo Alto, CA, USA.


This study compared training outcomes obtained by 147 substance abuse counselors who completed eight self-paced online modules on cognitive-behavioral therapy (CBT) and attended a series of four weekly group supervision sessions using Web conferencing software. Participants were randomly assigned to two conditions that systematically varied the degree to which they explicitly promoted adherence to the CBT protocol and the degree of control that they afforded participants over the sequence and relative emphasis of the training curriculum. Outcomes were assessed at baseline and immediately following training. Counselors in both conditions demonstrated similar improvements in CBT knowledge and self-efficacy. Counselors in the low-fidelity condition demonstrated greater improvement on one of three measures of job-related burnout when compared to the high-fidelity condition. The study concludes that it is feasible to implement a technology-based training intervention with a geographically diverse sample of practitioners, that two training conditions applied to these samples of real-world counselors do not produce statistically or clinically significant differences in knowledge or self-efficacy, and that further research is needed to evaluate how a flexible training model may influence clinician behavior and patient outcomes.

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