The implementation of evidence-based psychotherapies often requires significant commitments of time and expense from mental health providers. Psychotherapy protocols with rapid and efficient training and supervision requirements may have higher levels of uptake in publicly funded clinics. Family-focused therapy (FFT) is a 4-month, 12-session treatment for bipolar and psychosis patients consisting of psychoeducation, communication training, and problem-solving skills training. In a pilot randomized trial, we compared two methods of training community clinicians in FFT: (a) high intensity (n = 24), consisting of a 6-hour in-person didactic workshop followed by telephone supervision for every session with training cases; or (b) low-intensity training (n = 23), consisting of a 4-hour online workshop covering the same material as the in-person workshop followed by telephone supervision after every third session with training cases. Of 47 clinician participants, 18 (11 randomly assigned to high intensity, 7 to low) enrolled 34 patients with mood or psychotic disorders (mean age 16.5 ± 2.0 years; 44.1% female) in an FFT implementation phase. Expert supervisors rated clinicians’ fidelity to the FFT manual based on taped family sessions. We detected no differences in fidelity scores between clinicians in the two training conditions, nor did patients treated by clinicians in high- versus low-intensity training differ in end-of-treatment depression or mania symptoms. Levels of parent/offspring conflict improved in both conditions. Although based on a pilot study, the results suggest that low-intensity training of community clinicians in FFT is feasible and can result in rapid achievement of fidelity benchmarks without apparent loss of treatment efficacy.

中文翻译：

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高强度与低强度临床医生培训对青少年情绪和精神病患者实施以家庭为中心的治疗的影响

实施循证心理治疗通常需要心理健康提供者投入大量时间和费用。具有快速有效培训和监督要求的心理治疗方案可能在公共资助的诊所中具有更高的接受度。以家庭为中心的治疗 (FFT) 是针对双相和精神病患者的为期 4 个月、12 个疗程的治疗，包括心理教育、沟通培训和解决问题的技能培训。在一项试点随机试验中，我们比较了两种在 FFT 中培训社区临床医生的方法：（a）高强度（n = 24），包括 6 小时的面对面教学研讨会，然后对每次培训案例进行电话监督；或 (b) 低强度训练 ( n = 23)，包括一个 4 小时的在线研讨会，涵盖与现场研讨会相同的材料，然后在每第三节培训案例后进行电话监督。在 47 名临床医生参与者中，18 名（11 名随机分配到高强度，7 名随机分配到低强度）在 FFT 实施阶段招募了 34 名情绪或精神病患者（平均年龄 16.5 ± 2.0 岁；44.1% 女性）。专家监督员根据录音家庭会议评估临床医生对 FFT 手册的忠诚度。我们检测到两种训练条件下临床医生之间的保真度评分没有差异，临床医生在高强度和低强度训练中治疗的患者在治疗结束时的抑郁或躁狂症状也没有差异。在这两种情况下，父母/后代冲突的程度都有所提高。虽然基于试点研究，