Master's Project Title:

Implementation and Dissemination of Evidence-Based Practices: The Use of a Learning Collaborative Model to Train Mental Health Providers in Trauma-Focused Cognitive Behavioral Therapy

MCH Student:

Heidi Flessert

Date of Defense:

September 20, 2012


In an effort to increase access to evidence-based practices for high-risk and traumatized families and children in Minnesota, Ambit Network at the University of Minnesota provided training in an evidence-based practice called Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) to community mental health agencies across the state. Research has demonstrated that TF-CBT is an effective treatment for decreasing behavior problems and inappropriate sexual behaviors as well as reducing symptoms of depression, anxiety, and post traumatic stress disorder (PTSD) in children who have experienced trauma. Training (or lack thereof) has been identified as a barrier to implementation and dissemination of evidence-based practices (EBPs) into community settings.

Near the end of 2008, Ambit Network recruited and trained 19 mental health providers in TF-CBT using a training model called the Learning Collaborative (LC). Trainees attended in-person trainings and participated in bimonthly consultation calls over the 18-month LC period. As part of the LC, trainees were required to deliver TF-CBT to child and adolescent clients, conduct trauma-informed assessments and document fidelity to the treatment model throughout the course of each client’s treatment.

Research has shown that the LC model is effective in improving the quality of care in numerous medical settings; however, there is limited research on its effectiveness in improving care in mental health care settings. The purpose of this evaluation was to determine if the LC model was appropriate for training mental health providers in TF-CBT. More specifically, this evaluation documents whether the LC was delivered as planned, what trainee participation looked like, and whether trainees would be eligible to seek certification as a TF-CBT therapist at the conclusion of the LC.

Results from this evaluation indicate that Ambit Network successfully delivered the LC as outlined in their federal grant proposal, with satisfactory participation by trainees. The majority of trainees (85%) attended all in-person trainings, and average attendance on consultation calls (x=13.7) was higher than the minimum required for national certification. Trainees also assessed more than twice the expected number of children for trauma and TF-CBT, and were successful in completing trauma-informed assessments at baseline and at least one follow-up interview for the majority of clients that received treatment. At the conclusion of the LC, more than half of trainees (n=13) met the proposed requirements for certification.

Based on these results, the following recommendations were made for future direction for Ambit Network.

  1. Continue to train providers in TF-CBT using the current LC model.
  2. Modify the content of in-person trainings to provide more in-depth training in challenge areas (e.g., trauma-informed assessment at each three-month follow-up interview).
  3. Continue to provide technical assistance to those individuals who do not currently meet the certification requirements for completed client cases, including scoring of clinical assessments and tracking of follow-up interviews