Strategies that promote therapist engagement in active and experiential learning: micro-level sequential analysis

ABSTRACT

Therapists’ active learning increases treatment fidelity, but research is needed on supervisory strategies to engage therapists in active learning. This study used sequential analysis to examine consultant behaviors associated with increased and decreased probability of eliciting therapists’ active learning. The study included 162 consultation sessions from 27 community therapists implementing Attachment and Biobehavioral Catch-up. Consultants’ client discussion, information provision, and modeling were associated with reduced likelihood of active learning. Consultants’ questions, engagement in active learning strategies, use of video, and silence were associated with greater likelihood of therapist active learning. These findings inform supervisors’ attempts to encourage active learning.

KEYWORDS:

• Supervision
• consultation
• active learning
• active ingredients
• implementation
• sequential analysis

Acknowledgments

We gratefully acknowledge the parent coaches and consultants who participated in this study. We also would like to thank Victoria Kager for her assistance with coding consultation session videos. Preliminary descriptive data from the current study were published as a dissertation (Caron, 2017), but have not previously been published in a peer-reviewed journal. Sequential analyses are novel and have never before been published.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health under Grants R01 MH052135, R01 MH074374, and R01 MH084135, and a Dissertation Award from the University of Delaware Department of Psychological and Brain Sciences.

Notes on contributors

EB Caron

EB Caron, Ph.D., is an Assistant Professor of Psychological Science at Fitchburg State University in Massachusetts. She received her B.A. from Stanford University and her Ph.D. in Clinical Science from University of Delaware. While at the University of Delaware, Dr. Caron developed and validated a measure of fidelity, as well as fidelity-focused consultation procedures, for the Attachment and Biobehavioral Catch-up (ABC) intervention, a home-based preventive parenting intervention for high-risk infants and toddlers. Dr. Caron completed her internship at Terry Children’s Center in Delaware and her postdoctoral training at UConn Health. She was a 2019 NIMH Child Intervention, Prevention, and Services (CHIPS) fellow. Her research focuses on implementation of evidence-based practices for children.

Teresa A. Lind

Teresa A. Lind, Ph.D., is an Assistant Professor of Child and Family Development at San Diego State University. She received her A.B. from Harvard College and her Ph.D. in Clinical Science from University of Delaware. She completed her predoctoral psychology internship at the University of Arkansas for Medical Sciences and her postdoctoral training at the University of California, San Diego and the Child and Adolescent Services Research Center (CASRC) in San Diego, CA. She was a 2018 NIMH Child Intervention, Prevention, and Services (CHIPS) fellow. Her research focuses on the effects of early adversity on the development of emotional, physiological, and behavioral regulation capabilities in young children. In addition, she is interested in improving mental health services for these at-risk populations through the implementation of evidence-based practices (EBPs).

Mary Dozier

Mary Dozier is Professor of Psychological and Brain Sciences at the University of Delaware. She obtained her Ph.D. from Duke University in 1983. She was named the Amy E. DuPont Chair in Child Development in 2007, and in 2016 was named the Francis Alison Professor, the university’s highest faculty honor. Over the last 25 years, she has studied the development of young children in foster care and young children living with neglecting birth parents, examining challenges in attachment and regulatory capabilities. Along with her graduate students and research team, she developed an intervention, Attachment and Biobehavioral Catch-up, that targets specific issues that have been identified as problematic for young children who have experienced adversity. This intervention has been shown to enhance children’s ability to form secure attachments, and to regulate physiology and behavior normatively, among other things.