A Model for Teaching Empirically Supported Therapies in a Graduate Course: The Behavior Therapy Seminar Series

movement that gained traction withthe initial reports on empirically sup-ported psychological procedures bythe American Psychological AssociationDivision 12 Task Force on Promotion andDissemination of Psychological Procedures(1995; Chambless et al., 1998) has continuedto gather momentum, as evidenced by arecent policy statement and presidential taskforce report from the American PsychologicalAssociation on evidence-based practice(2005a, 2005b). While controversial, at leastin some quarters, acknowledgment of the im-portance of integrating evidence-basedpractice seems to be gaining consensus. Although most of the attention has beendirected at the list of empirically supportedtreatments (ESTs) assembled by the TaskForce (Chambless et al., 1998), one of thecomplementary goals of the committee was togain an understanding of the current status oftraining in evidence-based psychological prac-tices among graduate training programs, pre-doctoral internships, and advanced trainingfor practicing professionals. Early studies eval-uating the status of training in ESTs (thencalled “empirically validated treatments”) re-vealed that many programs failed to provideeven introductory coverage for the vast major-ity of evidence-based procedures (Crits-Christoph, Frank, Chambless, Brody, & Karp,1995). The American PsychologicalAssociated added an emphasis on the “empiri-cal basis for all methods involved in psycho-logical practice” to its guidelines for programaccreditation (1996, p. 3). Both Crits-Christoph et al. (1995) and the original TaskForce report (1995) called on APA site visitorsto make training in ESTs a high-prioritycriteria for accreditation decisions. Theoriginal Task Force report also called for in-creased availability of treatment manuals tofacilitate training and dissemination, and asubsequent committee report provided a com-prehensive list of all known available manualsdescribing procedures of treatments on the listof ESTs (Woody & Sanderson, 1998). Calhoun, Moras, Pilkonis, and Rehm (1998)published a “call to arms” encouraging all sci-entist-practitioner training programs to re-double their efforts to integrate training inESTs into their training models. At the pre-doctoral graduate training program level,they encouraged programs to set the stage forfuture learning by providing didactics, super-vised practica, and modeling in the effectiveuse of ESTs. While generally supporting theidea of enhancing graduate training in ESTs,both Davison (1998) and Ingram, Hayes, andScott (2000) offer appropriate cautions thattraining in manualized ESTs may be a neces-sary, but far from sufficient, component ofclinical training programs. Clearly one effectof the EST and evidence-based practice move-ment has been an increased emphasis upontraining and dissemination of empirically sup-ported treatments at all levels, including pre-doctoral graduate training.Unfortunately, there is little evidence thatthese recommendations have been heeded.Although some studies have suggested aslight increase in attention to training in ESTsat the internship level (Hays et al., 2002;Horan & Blanchard, 2001), a recent study ofcurrent graduate student trainees suggeststhat the recommendations and admonitionsfrom the EST movement have had relativelylittle impact upon current predoctoralgraduate training (Karekla, Lundgren, &Forsyth, 2004). An estimated one-third toone-half of students who participated in theirsurvey had little to no exposure to ESTs. One potential hindrance to the wider inte-gration of training in ESTs in graduatetraining programs is a lack of models for doingso. A few examples do exist in the current liter-ature. For example, Roberts (1998) describes atraining program in clinical child psychologythat integrates training in ESTs across the cur-riculum but provides few details on the prag-matics of how that is accomplished.Cukrowicz et al. (2005) briefly described apolicy supporting the use of ESTs in agraduate program training clinic, andprovided evidence for improved client out-comes as a result of the policy, but again in-cluded few details of the pragmatics ofimplementation. Finally, Karekla et al. (2004)included in their discussion a brief example ofhow their graduate program introduces stu-dents to EST and empirically oriented ap-proaches to clinical practice via a course called“The Scientist Practitioner,” but again detailsare thin. The current article describes one model forproviding graduate students of clinical psy-chology with an introduction to EST and in-troductory training in a number of specificESTs in the context of a graduate course in be-havior therapy. This training model includes anumber of innovative teaching methods, andhas been replicated (in whole or in part) atthree other Big XII peer institutions with sim-ilar graduate training programs.