Consultation competencies in prolonged exposure therapy for posttraumatic stress disorder.

INTRODUCTION: The Emory University Prolonged Exposure (PE) Consultant Training Program seeks to develop a national network of competent PE consultants. Comprehensive training in empirically supported treatment (EST), such as PE, includes a didactic training followed by a period of experiential learning through consultation during real-world clinical practice (Karlin & Cross, 2014). Expert consultants are needed to meet demand as ESTs are disseminated. METHOD: The Emory program has developed a training model to develop 18 consultation skills within five competency domains: the consultation relationship, general psychotherapy skills, PE-specific skills, trainee barriers to delivery, and implementation. RESULTS: The current article outlines these domains and discusses their theoretical background and applied value for PE consultant training, drawing on examples from the Emory program. DISCUSSION: Just as manualizing therapy has allowed for EST dissemination, the operationalizing of consultation competencies can provide a first step in disseminating evidence-based consultation practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Creating a national network of community-based consultants in prolonged exposure for PTSD: Outcomes and lessons learned from a consultant training program.

OBJECTIVE: Dissemination of prolonged exposure (PE) for the treatment of posttraumatic stress disorder (PTSD) requires the availability of consultants who can help mental health clinicians learn to deliver the protocol faithfully and effectively. However, there is a dearth of PE consultants. We created a training program that aims to develop a national network of community-based PE consultants. The purpose of the study is to evaluate program effectiveness. METHOD: Our training program requires each consultant to provide consultation to two trainees, each of whom must treat two patients. Our team observes consultants engage with their trainees during virtual meetings and then provides feedback on each consultant's performance. Throughout the training, we collect outcome data on consultants, their trainees, and the patients of their trainees. RESULTS: We have graduated 36 consultants, representing 14 American states. The vast majority of consultants (90%) were able to meet training requirements and expectations. Additionally, the majority of the consultants' trainees (60%) demonstrated competence for independent practice as evidenced primarily by high treatment fidelity ratings across two patients. Among consultants' trainees who reached competency benchmarks, their patients had a robust decrease in PTSD symptom severity from pretreatment to posttreatment (Cohen's d = 1.69). Lastly, follow-up survey data indicated that consultants and their trainees spent more time providing PE consultation and delivering PE, respectively, after completing their training. CONCLUSIONS: Outcome data from the first six cohorts indicate feasibility and effectiveness in PE consultant training. We share lessons learned in the development, maintenance, and improvement of our consultant training program. (PsycInfo Database Record (c) 2021 APA, all rights reserved).