Although extensive efforts have been made to train clinicians in evidence‐based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD), relatively few PTSD patients are considered appropriate for and therefore receive these treatments. The dialectical behavior therapy prolonged exposure (DBT PE) protocol was developed to expand the reach of EBPs for PTSD to suicidal patients with severe comorbidities, but methods of training clinicians to deliver this treatment have not been evaluated. We examined the impact of DBT PE workshops on clinician beliefs, adoption, and perceived patient outcomes. Clinicians (N = 266) attended 2‐ or 4‐day workshops and completed surveys at pretraining, posttraining, and 3‐ and 6‐month follow‐ups. From pretraining to 6‐month follow‐up, there were significant improvements in clinician concerns regarding worsening, perceived treatment credibility, and self‐efficacy that did not differ by workshop length, R²s = .20–.45. At 6‐months posttraining, 53.5% of clinicians (38.8% 2‐day, 66.3% 4‐day) reported using DBT PE with 241 patients. Higher posttraining ratings of self‐efficacy and perceived treatment credibility predicted later DBT PE use, R² = .28. Among adopting clinicians, 81.3% reported that, on average, their patients’ PTSD improved and 66.7% reported that patients were much to very much improved on average. Most clinicians reported that their patients’ comorbid problems did not worsen during DBT PE and if worsening occurred, it typically involved temporary increases in distress. Workshops may be an effective method of changing clinician beliefs and promoting the use of DBT PE in a manner that clinicians experience as effective and safe for their patients.

中文翻译：

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辩证行为疗法长期暴露协议研讨会培训对临床医生信念、采用和感知临床结果的影响

尽管已经做出了广泛的努力来培训临床医生针对创伤后应激障碍 (PTSD) 的循证心理治疗 (EBP)，但相对较少的 PTSD 患者被认为适合并因此接受这些治疗。辩证行为疗法延长暴露 (DBT PE) 协议旨在将 PTSD 的 EBP 范围扩大到有严重合并症的自杀患者，但尚未评估培训临床医生提供这种治疗的方法。我们研究了 DBT PE 研讨会对临床医生信念、采用和感知患者结果的影响。临床医生 ( N= 266) 参加了 2 天或 4 天的研讨会并完成了培训前、培训后以及 3 个月和 6 个月的随访调查。从训练前到 6 个月的随访，临床医生对恶化、感知治疗可信度和自我效能的担忧有显着改善，这与研讨会长度没有区别，R ² s = .20-.45。在训练后 6 个月，53.5% 的临床医生（38.8% 2 天，66.3% 4 天）报告对 241 名患者使用 DBT PE。更高的训练后自我效能和感知治疗可信度预测 DBT PE 使用，R ²= .28。在采用的临床医生中，81.3% 的人报告说，平均而言，他们的患者的 PTSD 有所改善，66.7% 的人报告说，患者的平均改善幅度很大。大多数临床医生报告说，他们的患者的合并症在 DBT PE 期间没有恶化，如果恶化，通常会导致痛苦的暂时增加。研讨会可能是一种有效的方法，可以改变临床医生的信念，并以临床医生认为对患者有效和安全的方式促进 DBT PE 的使用。