Development and initial testing of CBIT-Trainer: An interactive online program for training therapists in comprehensive behavioral intervention for tic disorders

Psyc Tech, Ltd, Houston TX

Investigators

Abstract

Project Summary/Abstract This Phase I SBIR proposes to develop and demonstrate the feasibility of an innovative computer-based program for training therapists to administer Comprehensive Behavioral Intervention for Tics (CBIT); an empirically supported nonpharmacological intervention for children and adults with Chronic Tic Disorders (CTD; including Tourette Disorder). CTD represents a class of neuropsychiatric disorders, occurring in 1-3% of the population that can lead to significant impairments in physical, social, academic, and interpersonal functioning and reduced quality of life. There is currently no cure for CTD, however in large-scale randomized controlled trials, CBIT has been shown to reduce tics without the adverse side effects associated with pharmacotherapy. A therapist-guided, empirically validated CBIT protocol is available, however the vast majority of individuals who desire CBIT do not have access to therapists trained in the delivery of this intervention. Given the need for nonpharmacological treatment options for individuals with CTD, a desire for such treatments by potential end-users, and the absence of practitioners adequately trained in the treatment, there is a clear need for innovative modes of dissemination. The current proposal partners two of the primary developers of CBIT with PsycTech, a company that specializes in developing effective computer-based products for repetitive behavior disorders. In the proposed project, we will use competency-based training methods and an innovative, contextualized technology adaptation process (CTAP) to adapt CBIT into an innovative online training program; a process that has been shown to increase satisfaction and adoption among stakeholders. In addition, to inform implementation, we will use an established conceptual model of evidence-based practice implementation whereby we will engage multiple stakeholders early in the product development process in order to begin to identify provider-level factors (e.g., attitudes, values, openness) and organizational-level factors (e.g., priorities, values, structural fit) shown to influence adoption and implementation of adapted interventions in other health-care models and settings. The resulting product (CBIT- Trainer) will be tested for feasibility, usability, and end-user satisfaction. This Phase I project will accomplish four aims: (1) To develop CBIT-Trainer concept materials and program flow through an iterative end-user feedback and development process; (2) To develop working online prototypes to train two core CBIT therapeutic techniques: education training and HRT; (3) To conduct usability, acceptability, and feasibility tests on the education and HRT CBIT-Trainer prototypes using CBIT-naïve therapists; and (4) identify, early in the development process, provider and organizational factors that could impede adoption and implementation. !