Practically Speaking: Behind the Episode - Improving Our EBP Practice by “Doing” Instead of “Knowing.”
Teaching is hard. Ask any teacher you know, whether they teach preschool or graduate school. No matter how much they love their job, their answer will probably reveal some weariness.
I love my job as a CDP faculty member, but it’s not always easy. Although we’re not in the business of writing hall passes or grading homework, adult learners bring their own set of challenges to our classrooms. How do we meet the needs of a large audience with varying clinical and educational backgrounds? How do we help them stay engaged for one or two full days despite competing demands? How do we help providers take what they just learned and actually put it into clinical practice? And how do we accomplish all that in a virtual classroom when we need to? On today’s episode, we use science and creativity to answer those questions and more.
Listen to the full discussion here: Improving Our EBP Practice by “Doing” Instead of “Knowing.”
Unfortunately, the research literature on dissemination and implementation of evidence-based psychotherapies (EBPs) is not encouraging. Studies and meta-analyses suggest that teaching an intervention to providers does not guarantee that the provider is going to actually implement those interventions in clinical practice. One study (Shiner et al, 2018) examined the implementation of EBPs in the VA health care system. For context, the VA has prioritized EBPs in the past decade, dedicating a lot of money and resources to several nationwide dissemination programs. That’s why the conclusions from Shiner et al’s study are so disappointing: less than half of participants with PTSD in VA residential treatment programs received ONE session of PE or CPT (the two EBPs included in this study).
There are no clear answers to how we can “move the needle” for providers, making them more likely to deliver the treatments they’ve been trained in. Researchers have made suggestions (add a consultation tail, use a train-the-trainer model, do more role plays), but the outcome data is inconsistent. Clearly, doing the same thing we’ve always done is not helpful.
On this episode of CDP’s Practical for Your Practice, we’re joined by our original host and perpetual Friend of CDP, Dr. Andy Santanello. For the past 2 years, Andy has been focused on dissemination and implementation science through The ACT Academy, and returns to the P4P Podcast to share ideas about how we can deliver EBPs more consistently and competently. His suggestions are not just aspirational or “fanciful,” but rather small tweaks that we can make to existing training, supervision, and consultation efforts.
As I observe in this episode, one of the dissemination and implementation challenges that we face is that providers “can sit in a 16-hour workshop and never do the treatment that
just learned, never have the opportunity to do it, never go back to the materials that
learn. It's one thing to sit in the workshop. It's quite another to put it into practice.” While research demonstrates that provider knowledge increases after attending a workshop, something gets in the way of them putting that knowledge into practice. As Andy says, “we're treating what's essentially a ‘doing’ problem, actually doing EBPs, as if it were a ‘knowing’ problem. There's a big difference between knowing about something and being able to do it.”
For that reason, we discuss multiple ways of “doing” more in our workshops. While the didactic components are necessary, adult learners could benefit from more experiential practice. And in addition to role plays, is there benefit in conducting “real plays?”
Tune in to this episode of Practical for Your Practice to listen in as we discuss ways to merge cutting-edge science with practical applications for learners, instructors, supervisors, consultants, and everyone in between. And if you’ve discovered ways to move from “knowing” to “doing,” we want to hear from you! Let us know in the comments or reach out to us on our dedicated P4P feedback page: https://www.speakpipe.com/cdpp4p
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Carin Lefkowitz, Psy.D., is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Dr. Lefkowitz earned her M.A. and Psy.D. in clinical psychology at Widener University, with a concentration in cognitive-behavioral therapy.
References:
Shiner B, Leonard Westgate C, Simiola V, Thompson R, Schnurr PP, Cook JM. Measuring Use of
Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and
Electronic Medical Record Templates. Mil Med. 2018 Sep 1;183(9-10):e539-e546. doi:
10.1093/milmed/usy008. PMID: 29547909; PMCID: PMC6115864.
Teaching is hard. Ask any teacher you know, whether they teach preschool or graduate school. No matter how much they love their job, their answer will probably reveal some weariness.
I love my job as a CDP faculty member, but it’s not always easy. Although we’re not in the business of writing hall passes or grading homework, adult learners bring their own set of challenges to our classrooms. How do we meet the needs of a large audience with varying clinical and educational backgrounds? How do we help them stay engaged for one or two full days despite competing demands? How do we help providers take what they just learned and actually put it into clinical practice? And how do we accomplish all that in a virtual classroom when we need to? On today’s episode, we use science and creativity to answer those questions and more.
Listen to the full discussion here: Improving Our EBP Practice by “Doing” Instead of “Knowing.”
Unfortunately, the research literature on dissemination and implementation of evidence-based psychotherapies (EBPs) is not encouraging. Studies and meta-analyses suggest that teaching an intervention to providers does not guarantee that the provider is going to actually implement those interventions in clinical practice. One study (Shiner et al, 2018) examined the implementation of EBPs in the VA health care system. For context, the VA has prioritized EBPs in the past decade, dedicating a lot of money and resources to several nationwide dissemination programs. That’s why the conclusions from Shiner et al’s study are so disappointing: less than half of participants with PTSD in VA residential treatment programs received ONE session of PE or CPT (the two EBPs included in this study).
There are no clear answers to how we can “move the needle” for providers, making them more likely to deliver the treatments they’ve been trained in. Researchers have made suggestions (add a consultation tail, use a train-the-trainer model, do more role plays), but the outcome data is inconsistent. Clearly, doing the same thing we’ve always done is not helpful.
On this episode of CDP’s Practical for Your Practice, we’re joined by our original host and perpetual Friend of CDP, Dr. Andy Santanello. For the past 2 years, Andy has been focused on dissemination and implementation science through The ACT Academy, and returns to the P4P Podcast to share ideas about how we can deliver EBPs more consistently and competently. His suggestions are not just aspirational or “fanciful,” but rather small tweaks that we can make to existing training, supervision, and consultation efforts.
As I observe in this episode, one of the dissemination and implementation challenges that we face is that providers “can sit in a 16-hour workshop and never do the treatment that
For that reason, we discuss multiple ways of “doing” more in our workshops. While the didactic components are necessary, adult learners could benefit from more experiential practice. And in addition to role plays, is there benefit in conducting “real plays?”
Tune in to this episode of Practical for Your Practice to listen in as we discuss ways to merge cutting-edge science with practical applications for learners, instructors, supervisors, consultants, and everyone in between. And if you’ve discovered ways to move from “knowing” to “doing,” we want to hear from you! Let us know in the comments or reach out to us on our dedicated P4P feedback page: https://www.speakpipe.com/cdpp4p
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Carin Lefkowitz, Psy.D., is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Dr. Lefkowitz earned her M.A. and Psy.D. in clinical psychology at Widener University, with a concentration in cognitive-behavioral therapy.
References:
Shiner B, Leonard Westgate C, Simiola V, Thompson R, Schnurr PP, Cook JM. Measuring Use of
Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and
Electronic Medical Record Templates. Mil Med. 2018 Sep 1;183(9-10):e539-e546. doi:
10.1093/milmed/usy008. PMID: 29547909; PMCID: PMC6115864.