Core Competency Training Series

Core Competency Cognitive-Behavioral Therapy (CC-CBT)

Requirements for Participation

Practicing clinicians providing treatment services to children and families in Fairfax County, Virginia or clinical supervisors of clinicians offering these services. Interested applicants must meet the following criteria and agree to the terms below:

 

Practicing Clinicians:

  1. Be licensed in Virginia, or currently completing supervision hours in pursuit of licensure.
  2. Currently providing treatment services to youth (ages 12-17) and families in Fairfax County
  3. Attendance at all 4 days of training in their entirety (5 if attending optional trauma training).
  4. Participation in virtual group consultation every other week for 6 months.
  5. Treat at least two new clients using the CC-CBT during the 6 month consultation period and staff these cases during Consultation calls.
  6. Complete brief surveys used to evaluate the training, including before the training, immediately after the training, and 3 to 6 months after the training.
  7. Administer a brief evidence-based assessment to track client progress at each session.
  8. Complete brief adherence checklists to track use of the treatment at the end of each session.
  9. Submit required fully de-identified paperwork to guide the consultation sessions (case conceptualization worksheet, treatment planning worksheet, scores, adherence checklists).

 

Clinical Supervisors:

  1. Currently supervising clinicians providing treatment services to youth (ages 12-17) and families in Fairfax County.
  2. Attendance at all 4 days of training in their entirety (5 if attending optional trauma training)
  3. Participation in virtual group consultation every other week for 6 months (if possible).
  4. Participation in a monthly clinical supervisors meeting.

 

Cognitive-behavioral therapy is one of the most widely used and efficacious treatments for youth depression, anxiety, disruptive behavior, substance use, trauma, and high risk behaviors. The Core Competency Cognitive-Behavioral Treatment (CC-CBT) protocol integrates cognitive and behavioral techniques to address adolescent suicidal ideation/behavior, substance abuse, and other mental health conditions (depression, anxiety, disruptive behavior). It also employs motivational enhancement to improve motivation for change and treatment engagement. The CC-CBT is manualized and modular with a menu of sessions for the clinician to choose from which allows for tailoring of the protocol to each adolescent and his/her family. The CC-CBT incorporates “core” adolescent skill modules to address skill deficits common to substance abuse, suicidality, and other mental health problems (depression, anxiety, disruptive behavior). It also includes “supplemental” skill modules that are used, as needed, to address emergent crises (e.g., suicide assessment, chain analysis). In this sense, the CCT is a transdiagnostic protocol, i.e. it is designed to accommodate, rather than exclude, adolescents with comorbid psychiatric disorders. Acknowledging that adolescents exist within multiple systems (family, peer, school), and that problems within these systems prevents optimal treatment gains, this intervention contains modules for cognitive-behavioral individual therapy, cognitive-behavioral family therapy, and behavioral parent training. Coordination of services across providers (e.g., psychiatrists, pediatricians) and settings (e.g., schools) is also conducted.

The CC-CBT protocol is based on a treatment developed and tested for adolescents with co-occurring substance abuse and suicidality referred to as Integrated Cognitive-Behavioral Therapy (I-CBT). This I-CBT protocol, when delivered to youth with co-occurring substance use disorders and suicidality, showed preliminary efficacy in reducing the incidence of suicide attempts, emergency room visits, hospitalizations, heavy drinking, and marijuana use, relative to an enhanced treatment as usual condition. Supplemental analyses also suggested moderate to large effects on rates of mood, anxiety, disruptive-behavior, and substance use disorders. I-CBT was delivered by therapists in a medical school setting. I-CBT is rated as a treatment with evidence for reductions in suicide attempts in the Substance Abuse and Mental Health Services Administration (SAMHSA; 2020) publication, Treatment for Suicidal Ideation, Self-harm, and Suicide Attempts Among Youth and a recent review of the scientific literature. It has also been featured in a recent book entitled Evidence-Based Treatment Approaches for Suicidal Adolescents: Translating Science into Practice. The I-CBT model, which includes the integration of individual and family-based CBT, with motivational enhancement, has also been deemed a well-established treatment model for adolescent substance abuse in a recent literature review. Please see the Lab for Adolescent Mental Health Promotion to learn more about this intervention and associated publications.

CC-CBT is a modified version of I-CBT. Adaptations were made to the training and consultation protocol as well as the treatment manual to improve disseminability in community settings. Core skills were retained in the adaptation process. The modifications were made in collaboration with community partners through the FC-EBP. Clinicians trained in CC-CBT report statistically significant increases in knowledge and self-efficacy in the use of I-CBT skills from pre- to post-training. Clinicians also report statistically significant increases in use of CC-CBT skills with clients at 3-month follow-up as well as good fidelity to the treatment modules.

Trainers: Dr. Christy Esposito-Smythers, Dr. Sarah Fischer, Dr. Jenna Calton