The present study examined 115 service providers’ adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety before training, postworkshop training, and after 3 months of weekly consultation. Adherence was measured using a role play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings after consultation. Findings indicated that somatic arousal identification and relaxation were the most used treatment components before training. Adherence to all components of CBT increased after workshop training, except the usage of problem-solving. Adherence to problem-solving, positive reinforcement, the identification of anxious self-talk, and the creation of coping thoughts increased after consultation but usage of problem-solving remained low compared with other treatment components. Overall adherence remained less than optimal at the final measurement point. The number of consultation sessions attended predicted postconsultation adherence to identification of somatic arousal, identification of anxious self-talk, and positive reinforcement. Implications include tailoring future training based on baseline levels of adherence and spending more time during training and consultation on underutilized CBT components, such as problem-solving. Limitations of the present study, including how adherence was measured, are discussed. This study adds to the implementation science literature by providing more nuanced information on changes in adherence over the course of training and consultation of service providers.

中文翻译：

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在培训和咨询后检查青少年焦虑认知行为疗法的依从性。


本研究调查了 115 名服务提供者在培训前、研讨会培训后以及 3 个月的每周咨询后对青少年焦虑认知行为疗法 (CBT) 各组成部分的遵守情况。依从性是通过与训练有素的演员进行角色扮演来衡量的。我们研究了不同时间段内个人对 CBT 组成部分的依从性差异，以及参加咨询会议的次数与咨询后依从性评分之间的关​​系。研究结果表明，躯体唤醒识别和放松是训练前最常用的治疗成分。研讨会培训后，除了使用解决问题的方法外，对 CBT 所有组成部分的遵守程度都得到了提高。咨询后，对解决问题、积极强化、焦虑自言自语的识别以及应对想法的产生的坚持有所增加，但与其他治疗成分相比，解决问题的使用率仍然较低。在最终测量点，总体依从性仍达不到最佳水平。参加咨询会议的次数可以预测咨询后对躯体唤醒识别、焦虑自言自语识别和积极强化的遵守情况。影响包括根据基线遵守水平定制未来的培训，以及在培训和咨询过程中花费更多时间来解决未充分利用的 CBT 组件，例如解决问题。讨论了本研究的局限性，包括如何测量依从性。这项研究通过提供有关服务提供商培训和咨询过程中依从性变化的更细致的信息，丰富了实施科学文献。