Overall Functioning Clinical Trial
Official title:
Improving Practice in Community-based Settings: A Randomized Trial of Supervision Strategies
The primary goal of this study is to examine the impact of varying supervision strategies on
clinician fidelity and client outcomes in a community-based setting. Prior research has
established that training approaches that do not include a period of intervention-specific
supervision or consultation are ineffective and that implementation efforts that include
only an initial period of supervision show an eventual attenuation of gains in knowledge and
fidelity in practice. Ongoing supervision may be required for effective and sustained
implementation of evidence-based practices (EBPs) in community-based settings. However,
supervision is one of the least investigated aspects of training. "Gold standard" elements
of supervision from efficacy trials include review of sessions, standardized procedures for
monitoring client outcomes and model fidelity, and ongoing skill-building (e.g., behavioral
rehearsal). The degree (e.g., frequency, intensity) to which these strategies are used in
community-based settings is unknown.
There are a growing number of national and statewide efforts to increase the reach of EBPs
through dissemination and implementation initiatives. There are 18 statewide initiatives to
implement Trauma-focused Cognitive Behavioral Therapy (TF-CBT), an EBP for child trauma
exposure and sequelae. Many of the community based TF-CBT implementation efforts, and those
for other EBPs, include a specific focus on supervisors. However, the limited scientific
literature provides very little guidance for these efforts. Aims of the current trial
include 1) studying supervision with existing implementation supports; particularly presence
of gold standard elements; 2) evaluating the effects of varying supervision strategies on
fidelity and client outcomes; and 3) testing the mediating effect of treatment fidelity on
the relationship between supervision type and client outcomes. We propose a two-phased,
within-subjects and between subjects design. In Phase I (9 months), we examined supervision
with implementation support. In Phase II (30 months), we will examine two specific
supervision conditions, each including varying EBP supervision elements.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT01499797 -
The CareWell-programme for Community-dwelling Frail Elderly Persons.
|
N/A |