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An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

Received March 28, 2008; revised August 7, 2008; accepted November 6, 2008. Drs. Manassis, Ickowicz, Mendlowitz, and Monga are affiliated with Psychiatry at the Hospital for Sick Children in Toronto; Dr. Picard is affiliated with the Windsor-Essex Catholic District School Board in Ontario; Until her untimely death in the fall of 2006, Dr. Antle was an Academic and Clinical Specialist in Social Work and Director of the PKU Program at the Hospital for Sick Children; Dr. McNeill and Ms. Chahauver are affiliated with Social Work at the Hospital for Sick Children in Ontario; Dr. Adler-Nevo is affiliated with Psychiatry at Sunnybrook Health Sciences Centre in Ontario. Address correspondence to Katharina Manassis, M.D., Hospital for Sick Children, Psychiatry, 555 University Ave., Toronto, Ontario, M5G 1X8 Canada; katharina.manassis{at}sickkids.ca (e-mail).

OBJECTIVE: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by experienced CBT therapists from an academic center. METHODS: Twenty-two practitioners from four community mental health agencies completed the training in four groups (one for each agency); one group was trained by videoconference. The authors assessed outcomes immediately after the training and at 6-month follow-up using a mixed-method design including quantitative and qualitative methods to ensure a comprehensive evaluation. RESULTS: Participants’ knowledge on a multiple-choice test of child CBT increased with training, as did their self-reported confidence using CBT and desire to do further child CBT. Therapist age and use of an intake diagnostic screen related to positive outcomes, and participants advocated for more structured training. CONCLUSION: Child CBT can be successfully taught to community practitioners using this training model, but refinement based on participant feedback and further studies that include direct observation of CBT skills are needed.

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