***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Therapists of many persuasions emphasize the therapy relationship in their work , a priority backed by strong empirical evidence . Training in how to maximize the power and potential of the therapy relationship , however , has lagged behind . A novel approach to using the therapy relationship and to training therapists in its use is provided by Functional Analytic Psychotherapy ( FAP ) . FAP training involves eight 2-hr weekly training sessions conducted online using web-conferencing technology . The training integrates behavioral principles with a focus on trainee-trainer and trainee-trainee relationships in a highly structured course that evokes the desirable FAP therapist-trainee behaviors and collectively shapes the behaviors through reinforcement by the trainer and other trainees . In a preliminary study , 16 therapist-trainees were r and omly assigned to receive either immediate FAP training or training after a waitlist period . Significant and large effects of training were found on both self-reported and observer-assessed measures for the first training group , and the waitlist training group replicated the first training group with significant within-subject change over the course of training . Finally , qualitative feedback from therapists indicated high satisfaction with the primary elements of the training protocol . Several important limitations to this preliminary study are discussed OBJECTIVE The authors conducted a feasibility assessment of online training plus an online learning collaborative to support implementation of an evidence -based psychosocial treatment in a community mental health system . METHODS Two mental health centers were r and omly allocated to in-person training with local supervision , and three were assigned to online training plus an online learning collaborative supported by expert clinicians .  Participants ( N=36 ) were clinicians interested in interpersonal and social rhythm therapy ( IPSRT ) , an evidence -based psychotherapy for bipolar disorder . After training , 136 patients reported monthly on the extent to which clinicians used 19 IPSRT techniques . RESULTS Clinicians from both training groups increased use of IPSRT techniques .  Patients of clinicians receiving Internet-supported e-learning and of those receiving in-person training reported comparable clinician use of IPSRT techniques . CONCLUSIONS Internet-supported e-learning by community clinicians was found to be feasible and led to uptake of an evidence -based psychotherapy comparable to that by clinicians who received face-to-face training The present study examined the efficacy of online training ( OLT ) , instructor-led training ( ILT ) , and a treatment manual ( TM ) in training mental health clinicians in two core strategies of  Dialectical Behavior Therapy ( DBT ) :  chain analysis and validation . A r and omized controlled trial compared OLT , ILT , and TM among clinicians naïve to DBT ( N=172 ) who were assessed at baseline , post-training , and 30 , 60 , and 90 days following training . Primary outcomes included satisfaction , self-efficacy , motivation , knowledge , clinical proficiency , and clinical use . Overall , ILT outperformed OLT and  TM  in satisfaction , self-efficacy , and motivation , whereas OLT was the most effective method for increasing knowledge . The conditions did not differ in observer-rated clinical proficiency or self-reported clinical use , which both increased to moderate levels after training . In addition , ILT was particularly effective at improving motivation to use chain analysis , whereas OLT was particularly effective at increasing knowledge of validation strategies . These findings suggest that these types of brief , didactic trainings may be effective methods of increasing knowledge of new treatment strategies , but may not be sufficient to enable clinicians to achieve a high level of clinical use or proficiency . Additional research examining the possible advantages of matching training methods to types of treatment strategies may help to determine a tailored , more effective approach to training clinicians in empirically supported treatments The Evaluating Methods for Motivational Enhancement Education trial evaluated methods for learning motivational interviewing ( MI ) .  Licensed substance abuse professionals ( N = 140 ) were r and omized to 5 training conditions : ( a ) clinical workshop only ; ( b ) workshop plus practice feedback ; ( c ) workshop plus individual coaching sessions ; ( d ) workshop , feedback , and coaching ; or ( e ) a waiting list control group of self-guided training . Audiotaped practice sample s were analyzed at baseline , posttraining , and 4 , 8 , and 12 months later . Relative to controls , the 4 trained groups showed larger gains in proficiency . Coaching and /or feedback also increased posttraining proficiency . After delayed training , the waiting list group showed modest gains in proficiency . Posttraining proficiency was generally well maintained throughout follow-up . Clinician self-reports of MI skillfulness were unrelated to proficiency levels in observed practice Objective Due to the gap in suicide-specific intervention training for mental health students and professionals , e-learning is one solution to improving provider skills in the Veterans Affairs ( VA ) health system . This study focused on the development and evaluation of an equivalent e-learning alternative to the Collaborative Assessment and Management of Suicidality  ( CAMS ) in-person training approach at a Veteran Health Affairs medical center . Methods The study used a multicenter , r and omized , cluster , and three group design . the development of e-CAMS was an iterative process and included pilot testing . Eligible and consenting mental health providers , who completed a CAMS pre-survey , were r and omized .  Provider satisfaction was assessed using the st and ard VA evaluation of training consisting of 20 items . Two post training focus groups , divided by learning conditions , were conducted to assess practice adoption using a protocol focused on experiences with training and delivery of CAMS . Results A total of 215 providers in five sites were r and omized to three conditions : 69 to e-learning , 70 to in-person , 76 to the control . The providers were primarily female , Caucasian , midlife providers . Based on frequency scores of satisfaction items , both learning groups rated the trainings positively . In focus groups representing divided by learning conditions , participants described positive reactions to CAMS training and similar individual and institutional barriers to full implementation of CAMS . Conclusions This is the first evaluation study of a suicide-specific e-learning training within the VA . The e-CAMS appears equivalent to the in-person CAMS in terms of provider satisfaction with training and practice adoption , consistent with other comparisons of training deliveries across specialty areas . Additional evaluation of provider confidence and adoption and patient outcomes is in progress . The e-CAMS has the potential to provide ongoing training for VA and military mental health providers and serve as a tutorial for psychiatrists in preparation for specialty boards This study compared training outcomes obtained by 147 substance abuse counselors who completed eight self-paced online modules on cognitive-behavioral therapy ( CBT ) and attended a series of four weekly group supervision sessions using Web conferencing software .  Participants were r and omly assigned to two conditions that systematic ally varied the degree to which they explicitly promoted adherence to the CBT protocol and the degree of control that they afforded participants over the sequence and relative emphasis of the training curriculum . Outcomes were assessed at baseline and immediately following training . Counselors in both conditions demonstrated similar improvements in CBT knowledge and self-efficacy . Counselors in the low-fidelity condition demonstrated greater improvement on one of three measures of job-related burnout when compared to the high-fidelity condition . The study concludes that it is feasible to implement a technology-based training intervention with a geographically diverse sample of practitioners , that two training conditions applied to these sample s of real-world counselors do not produce statistically or clinical ly significant differences in knowledge or self-efficacy , and that further research is needed to evaluate how a flexible training model may influence clinician behavior and patient outcomes Background Face-to-face gatekeeper training can be an effective strategy in the enhancement of gatekeepers ’ knowledge and self-efficacy in adolescent suicide prevention . However , barriers related to access ( eg , time , re sources ) may hamper participation in face-to-face training sessions . The transition to a Web-based setting could address obstacles associated with face-to-face gatekeeper training . Although Web-based suicide prevention training targeting adolescents exists , so far no r and omized controlled trials ( RCTs ) have been conducted to investigate their efficacy . Objective This RCT study investigated the efficacy of a Web-based adolescent suicide prevention program entitled Mental Health Online , which aim ed to improve the knowledge and self-confidence of gatekeepers working with adolescents ( 12 - 20 years old ) . The program consisted of 8 short e-learning modules each capturing an important aspect of the process of early recognition , guidance , and referral of suicidal adolescents , alongside additional information on the topic of ( adolescent ) suicide prevention . Methods A total of 190 gatekeepers ( ages 21 to 62 years ) participated in this study and were r and omized to either the experimental group or waitlist control group . The intervention was not masked . Participants from both groups completed 3 Web-based assessment s ( pretest , posttest , and 3-month follow-up ) . The outcome measures of this study were actual knowledge , and participants ’ ratings of perceived knowledge and perceived self-confidence using question naires developed specifically for this study . Results The actual knowledge , perceived knowledge , and perceived self-confidence of gatekeepers in the experimental group improved significantly compared to those in the waitlist control group at posttest , and the effects remained significant at 3-month follow-up . The overall effect sizes were 0.76 , 1.20 , and 1.02 , respectively , across assessment s. Conclusions The findings of this study indicate that Web-based suicide prevention e-learning modules can be an effective educational method to enhance knowledge and self-confidence of gatekeepers with regard to adolescent suicide prevention . Gatekeepers with limited time and re sources can benefit from the accessibility , simplicity , and flexibility of Web-based training . Trial Registration Netherl and s Trial Register NTR3625 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=3625 ( Archived by WebCite at http://www.webcitation.org/6eHvyRh6 M OBJECTIVE The present study evaluated three technology-based methods of training mental health providers in exposure therapy ( ET ) for anxiety disorders . Training methods were design ed to address common barriers to the dissemination of ET , including limited access to training , negative clinician attitudes toward ET , and lack of support during and following training . METHOD Clinicians naïve to ET ( N=181 , Mage=37.4 , 71.3 % female , 72.1 % Caucasian ) were r and omly assigned to ( a ) an interactive , multimedia online training ( OLT ) , ( b ) OLT plus a brief , computerized motivational enhancement intervention ( OLT+ME ) , or ( c ) OLT+ME plus a Web-based learning community ( OLT+ME+LC ) . Assessment s were completed at baseline , posttraining , and 6 and 12weeks following training . Outcomes include satisfaction , knowledge , self-efficacy , attitudes , self-reported clinical use , and observer-rated clinical proficiency . RESULTS All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET , indicating that OLT alone was sufficient for improving these outcomes . The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone . Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone . The OLT+ME+LC condition was superior to both other conditions in increasing knowledge of ET . CONCLUSIONS Multicomponent trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes .  Technology-based training methods offer a satisfactory , effective , and scalable way to train mental health providers in evidence -based treatments such as ET This study assessed the usability and desired enhancements for the MacArthur Foundation ’s Depression and Primary Care ( MDPC ) Web site to determine if re sources for integrated depression care that are disseminated through the Web site are incorporated into routine clinical care . Since its launch in 2003 , more than 20,000 users registered as members of the MDPC website to read and download depression care re sources . Subjects were r and omly selected from MDPC Web site users who had previously downloaded the depression toolkit .  Web-based survey , which was administered anonymously , included the following domains : ( 1 ) socio-demographic data , ( 2 ) confidence in managing depression ( 3 ) Web site content and design features , ( 4 ) desired enhancements to Web site and content , ( 5 ) use of re sources downloaded from the Web site , and ( 6 ) importance of depression care re sources . Of the 3,478 r and omly selected participants , 666 ( 19.1 % ) responded .  Web site content was rated “ good ” or “ excellent ” for screening and diagnosis ( 84.3 % ) , treatment ( 69.8 % ) , patient education ( 66.2 % ) , and care management ( 66.9 % ) . The Patient Health Question naire-9 ( PHQ-9 ) was rated “ very useful ” by 68.3 % ; 47.1 % reported using it in at least 25 % of encounters with patients who are depressed . PHQ-9 use was significantly associated with higher self-confidence in managing depression ( P = 0.05 ) . Evidence -based re sources for depression care can be disseminated effectively through a dedicated Web site and may help clinicians incorporate effective care models into routine practice OBJECTIVE To investigate the effect of Internet-based training ( IBT ) , with and without supervision , on therapists ' ( N = 61 )  cognitive-behavioral therapy (  CBT ) skills in routine clinical practice . METHOD Participants were r and omized into 3 conditions : ( 1 ) Internet-based training with use of a consultation worksheet ( IBT-CW ) ; ( 2 ) Internet-based training with CBT supervision via Skype ( IBT-S ) ;  and ( 3 ) " delayed-training " controls ( DTs ) , who did not receive the training until all data collection was completed . The  IBT 
    Output:
    
Results indicated that the serial instruction training method was the most commonly studied web-based training method .
While the current review has several notable limitations , findings indicate that participating in a web-based training may result in greater post-training knowledge and skill , in comparison to baseline scores .