Implementing Web-Based Common Evidence-Based Practice Elements Training: Lessons Learned

Background and Purpose:  One of the most critical issues in behavioral health services research is bringing evidence-based practices (EBPs) into routine care in community settings. The purpose of this study was to examine ways to improve organizational capacity for implementing EBPs, in addition to increasing the accessibility and availability of training opportunities, through the development of common EBP elements web-based training modules. The current method of training front-line service providers in EBPs ignores these common elements by focusing on each EBP as a discrete intervention. The specific objectives of this study involved: 1) Developing a standardized training in the common elements of EBPs for behavioral health workers. 2) Testing the common elements web-based training modules among supervisors, and workers in behavioral health settings.

Methods: The first phase included a literature review of the common EBP elements used in the State in working with adults with behavioral disorders. Based on this review and in consultation with key stakeholders a total of 6 common EBP elements modules were developed.  The modules included:  Relationship Building Skills, Cognitive Behavioral Skills, Behavioral Skills, Motivational Enhancement Skills, Problem-Solving Skills, and Acceptance –Based Skills. The second phase involved key informant interviews with supervisors across the State before and after the implementation of the web-based modules training at their sites and pre and post surveys with the workers who they supervised.  Supervisors and workers were recruited from all regions in the State (28 supervisors and 58 workers participated). The workers included: Clinicians (34%); Nurses (30%); Case Managers/Care Managers (27%); Peer Advocates (5%) and the rest a range of positions. The supervisor pre and post interviews and worker pre and post surveys focused on the usefulness of the modules for learning core skills and the implementation/ supervision process used to monitor learning.  Interviews with supervisors were analyzed using Nvivo 10. with specific attention paid to how supervisors used the modules in day to day practice.  In addition, SPSS 20 was used to analyze the pre and post surveys from workers. 

Results:  Findings from the supervisor interviews and the worker surveys were very positive as it related to the web-based training. For many workers the information was a review but they reported the role plays and focus on skills was very helpful to their practice.  Workers particularly found the practical information provided in the modules to help them in learning how to implement the skills in practice.  The supervision models used varied considerably with minimal supervisory review of the learning in the modules to direct observation of workers using the skills. Supervisors found that having the modules improved monitoring of worker skills.

Conclusions:  Development of web-based training modules shows promise for improving the knowledge and skill base of the behavioral health workforce. In addition, understanding the best supervision models to use in implementing web-based trainings is also an area that needs further study.  Using technology to enhance core skills that cross EBPs may ensure that all consumers will have workers who are using EBP skills.