Family Therapy Training and Implementation Platform (FTTIP): An Innovative Web-based Tool for Long-term Practice Improvement

Family Therapy Training and Implementation Platform (FTTIP): An Innovative Web-based Tool for Long-term Practice Improvement

The goal of this clinical trial is to compare whether mental health therapists trained by a Family Therapy Training and Implementation Platform (FTTIP) or those trained in traditional face-to-face training differ on learning key family therapy domains, including competencies, agency readiness, and client outcomes. The main questions it aims to answer are:

• Will 75 FTTIP mental health therapists show improvement in all core family therapy competencies that are not inferior to 75 providers receiving traditional in person family therapy training?
• Will 150 families (child, parent, dyad) receiving CIFFTA family therapy show adequate retention in treatment therapeutic alliance and significant pre-post treatment improvements on family environment and presenting problems?
• Will 15 agency leaders receiving FTTIP agency readiness consultations show more pre and post change in agency readiness and knowledge than 15 leaders receiving agency engagement as usual?

Participants will participate in:

• Complete pre and post surveys
• 20 hours of training in an evidenced based family therapy treatment
• 24 weeks of biweekly coaching to implement the treatment
• 24 weeks of implementation of the treatment with one family
• Agency leaders will complete 2 weeks of organizational readiness engagement

Researchers will compare the Family Therapy Training and Implementation Platform (FTTIP) and traditional face-to-face training to see if FTTIP is not inferior to traditional training in key domains, including competencies, agency readiness, and client outcomes in mental health therapists.

Family therapy has emerged as one of the most efficacious interventions for child and adolescent behavioral and psychiatric issues and for chronic health conditions. However, widespread implementation of family therapy is often hampered by high training costs, re-training needs following staff turnover, low agency readiness to support new practices, and training strategies that lack ongoing implementation support and are prohibitively expensive. To better address the treatment needs of children and families, and to address long standing training and implementation challenges, we developed an innovative Family Therapy Training and Implementation Platform (FTTIP). FTTIP: 1) is guided by advances in implementation science, agency readiness, and knowledge of what it takes to sustain an evidence-based treatment; 2) uses adaptive training and consultation processes that provide a dynamic and data-driven procedure in which a competency is taught, measured, and the success or failure of the learning informs the next step of training in real time; 3) provides interactive practice of skills in which the trainee records interventions in response to simulation and receives personalized feedback; and 4) provides optional learning paths that allow the learner to explore additional ways to master the skills. Our Phase I study demonstrated the feasibility of FTTIP and set the stage for a fully-powered multisite Phase II Randomized Controlled Trial that will investigate whether FTTIP is "not inferior" to traditional face-to-face training on all key domains, including trainee competencies, agency readiness, and client outcomes. The Phase II study aims to: 1) Complete learning, practice and competency testing paths that provide the learner multiple learning options and to increase the dynamic nature of the platform; 2) Demonstrate that 75 FTTIP trainees show improvement in all core family therapy competencies that are not inferior to 75 providers receiving traditional in-person family therapy training as tested using pre and post training measures in a clinical trial; 3) Demonstrate that 150 families (child/parent dyad) receiving CIFFTA family therapy show adequate retention in treatment, therapeutic alliance, and significant pre-post treatment improvements on family environment and presenting problems; 4) Establish the process (e.g., initiation and delays in training new staff) and cost associated with training in each of the two conditions; 5) Demonstrate that 15 agency leaders receiving FTTIP agency readiness consultations show more pre and post change in agency readiness and knowledge than 15 leaders receiving agency engagement as usual. FTTIP's commercial application is that national, state, and local treatment services funders and providers will find FTTIP to be a highly cost effective, flexible, and engaging way to improve the quality of their evidence-based treatments (EBTs). By better preparing the nation's workforce on EBTs, and providing the support and coaching they need to reach full mastery, our FTTIP product has the potential to significantly improve the wellbeing and mental health in our nation and internationally.

Inclusion Criteria:

• 150 Bachelor's level counselors with 2 years of experience or Master's level counselors and therapists who have not had family therapy training in the past year and who are broadly representative of the potential trainees in the general population, including educational background and job experience with different client populations (e.g., varied demographics and presenting problems). All therapists must be actively providing treatment to youth and be willing to deliver the family intervention to at least one family during the project period.
• For each trainee that is part of the research study, we will select one client family (1 child and 1 caregiver) that we will assess and follow during the study. Once a trainee completes training and begins coaching, the next child/family that is assigned to the trainee, meets criteria for CIFFTA, and consent/assents to participate will be considered a participant in the study. The child must be between the ages of 11-18 years. Other than that, there are no exclusion of any specific age or age range group in the rest of the study participants (agency leaders, counselors)
• 30 leaders will be randomized to the two conditions. To be included in the study, agency leaders must have the authority to allocate agency resources (e.g., giving trainees protected time to participate in training activities, allowing smaller caseloads as they begin implementation) and be willing to participate in agency readiness and implementation consultation.

Exclusion Criteria:

• We are not limiting inclusion of any group by sex/gender, race, and/or ethnicity
• Agencies that are unwilling to participate in all study activities, that have nontraditional funding sources (e.g., totally charity funded), or that are so small they cannot assign sufficient counselors to the study.