What Would You Rather Learn: 17 Treatment Manuals or Flexible Competencies?

“an ever-expanding list of multi-component manuals” make it “increasingly difficult to teach what is known or to focus on what is essential” (Hayes, et al, 2006).   

What do you need to know to get good outcomes for your clients?

I’d argue that to teach what is known and focus on what’s essential, we need modular competencies, those therapist competencies that are common across the effective therapies.

With a modular competencies approach, you focus on learning essential core strategies that overlap across manuals (i.e., you don’t have to learn 17 slightly different treatment manuals).  Clinic directors don’t have to finagle a way for the whole staff to get trained in the newest, shiny package. Modular competencies are efficient.

Modular competencies are effective. When therapists flexibly integrated interventions drawn from the common elements of evidence-based protocols for depressed, anxious, and conduct disordered youth, they got better and quicker outcomes than usual care or using a standard, separate protocol ‘by-the-book’ (Weisz, et al, 2012). I think the Unified Protocol similarly combines a short set of therapist competencies for depression and all the anxiety disorders (Ellard, et al, 2010; Farchione, et al, 2012). I think about and use Dialectical Behavior Therapy this way, too (Koerner, 2013).  Ditto for behavioral activation and Acceptance and Commitment Therapy.  To me, it’s easier to learn and use principles and procedures as modular competencies.

Because modular competencies look to be efficient and effective, our work helps colleagues master essential core strategies. We’re building:

    • Self-paced elearning on core competencies (e.g., check out Gareth Holman’s new piece on functional analysis. Matthieu Villatte has a cool one on Values Work coming out next month.)
    • Modular competency tracks in the 2014 EBP Learning Community. Skill-up on the core competencies from:
      • Dialectical Behavior Therapy
      • Acceptance and Commitment Therapy
      • Behavioral Activation and the Unified Protocol.
      • To get the early invite to the 2014 EBP Learning Community, sign up here. Note: current EBP members will already receive this invite, so no need to sign up.
    • Master clinician-led courses that distill research into essential competencies. For example, this fall, Kate Comtois and Stephen O’Connor, experts in assessment and treatment of suicide, designed a fantastic course. The brief approach they teach distills what is known into practical how-to competencies.  Listen to this 4-minute audio clip of Stephen talking about the upcoming course.

The dream we are working on is to help colleagues easily learn, use, and measure how common elements of evidence-based protocols work for their clients.  More on this next time when I can announce the details on the first release of our Online Progress Tracking software!