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. Author manuscript; available in PMC: 2019 Jul 1.
Published in final edited form as: Adm Policy Ment Health. 2018 Jul;45(4):587–610. doi: 10.1007/s10488-018-0847-0

Table 2.

Studies Including a Serial Instruction Training Method

Nat
han
&
Gor
man
(200
2)
Crit
eria
Autho
rs
Sampl
e
Interve
ntion &
Conditi
on to
Treat
Intend
ed
Traine
es
Ong
oing
Sup
port
Design Measurement
Method
Finding
s &
Effect
Size

Ran
dom
Assi
gn.
# and
Comp.
Group
s
Trai
ning
Dos
age
Foll
ow-
up
Do
mai
n
Ty
pe
Stan
dard-
ized
Meas
ure
1 Bennett-Levy et al., 2012 40 mental health professionals CBT, no specific condition Counsellors Yes, C Yes 2:
1. SI
2. SI+OS
22.5 hours 4 weeks K, S, C, SE SR No SI + OS = SI for knowledge (g = .07), skill (g = .07), self-efficacy (g = .04); SI + OS > SI for training completion
3 Bray et al., 2009 62 counselors Substance use prevention Counsellors No No 0
(pre-post)
3-hours none I, P, SE SR No Increase in awareness of importance (g = .71), preparedness (g = .33) to deliver the intervention, and self-efficacy (g = .32)
3 Brose et al., 2012 778 stop smoking practitioners Smoking cessation Community practitioners No No 0
(pre-post)
2.5-hours none K N/A No Increase in knowledge (g = .89)
3 Brownlow et al., 2015 187 health professionals Eating disorder treatment Clinicians in community and medical settings No No 0
(pre-post)
17.5-hours none A, K, SE, S SR No Increase in knowledge (g = .23), skill (g = .23), and self-efficacy (g = X); Decrease in stigmatized beliefs (attitudes) (g = .84) about eating disorders
2 Chu et al., 2017 35 providers CBT for anxiety Clinicians in youth service settings Yes, C Yes 3
1. SI+OS
2. SI+PC
3. SI+WM
6.5 hours none K, S, U, SA, SE SR No All conditions: Increases in use (g = .76), decreases in knowledge (g = −1.7) and skill (g = −2.1)
SI + PC: Decreases in knowledge (g = −1.1), skill (g = −1.47), and implementation potential (g = −.2.1) compared to SI + WM
SI + OS: Did not differ from SI + PC
1 Cohen et al., 2016 129 mental health practitioners CBT for trauma Therapists Yes, C Yes 2:
1. SI+OS
2. SI+FTF+OS
10 hours none X, E, F SR Yes SI + FTF + OS > SI + OS for engagement (g = X), fidelity (g = .58), and completing treatment with clients (g = .41)
3 Crawford et al., 2015 49 clinicians Behavioral activation for depression Cognitive/behavioral clinicians No Yes 2:
1. SI
2. C
2–3 hours 1 week K, SA, SE SR No SI > C for knowledge (g = .78) and self-efficacy (g = 1.34); High rates of satisfaction (g = X)
2 Dimeff et al., 2009 174 clinicians DBT for borderline personality disorder Substance use and mental health providers No Yes 3:
1. WM
2. SI
3. FTF
20 hours online, 2 days in-person 90 days K, SA, S, U SR, BO No SI > FTF for knowledge (g = .37), skill (g = .21)
FTF, WM > SI for use (g = .46)
FTF > SI for satisfaction (g = X)
2 Dimeff et al., 2011 132 providers DBT for borderline personality disorder Community behavioral health providers No Yes 3:
1. WM
2. SI
3. C
N/A 2, 7, & 11 weeks K, SE, SA, U SR No SI > C for knowledge (g = 3.4), self-efficacy (g = .77), and use (g = .05)
WM > C for knowledge (g = 2.8), self-efficacy (g = .42), and use (g = .65)
SI produced better long-term outcomes
1 Dimeff et al., 2015 172 clinicians DBT for borderline personality disorder Clinicians that treat borderline personality disorder No Yes 3:
1. WM
2. SI
3. FTF
8 hours 30, 60, 90 days K, S, SA, SE, U SR, BO Yes Self-efficacy:
SI > WM (g = .15)
FTF > SI (g = .80)
Knowledge:
SI > WM (g = .49)
SI > FTF (g = .49)
Satisfaction greater for FTF (g = X)
No differences in condition for skill, use
3 Fairburn et al., 2017 139 clinicians CBT for eating disorders Mental health providers No No 0 (pre-post) 9 hours none K SR Yes Significant improvements in knowledge (g = X)
3 German et al., in press 362 clinicians CBT, no specific condition Community clinicians Yes, C No 2:
1. FTF
2. SI
FTF: 22 hrs.
SI: 6 hrs.
none K, S SR Yes SI not inferior to FTF with no differences in knowledge; SI clinicians less likely to be competent (g = − .1) than FTF
1 Ghoncheh et al., 2016 190 gatekeepers Suicide prevention Gatekeepers (e.g., school staff, police, primary healthcare providers) No Yes 2:
1. SI
2. C
8 modules 3 months K, SE SR No SI > C for knowledge (g = 1.1) and self-efficacy (g = .56)
3 Gryglewicz et al., 2017 178 mental health providers Question, Persuade, Refer, Treat for suicidality Mental health providers No No 0 (pre-post) 8–12 hours No K, SA SR No Significant improvements in knowledge (g = .93); High rates of satisfaction (g = X)
2 Harned et al., 2011 46 mental health providers Exposure therapy for anxiety disorders Mental health providers No Yes 3:
1. SI
2. SI+ME
3. C
10 hours 1 week A, K, S, SE SR No SI = SI + ME > C for knowledge (g = 2.1; 3.1), self-efficacy (g = 1.41; 1.8), and satisfaction (g = .85; 1.12)
SI + ME > SI for attitudes (g = .02)
1 Harned et al., 2014 181 clinicians Exposure therapy for anxiety disorders Mental health providers Yes, C Yes 3:
1. SI/SM
2. SI/SM+ME
3. SI/SM + ME + OS
10 hours 6 & 12 weeks A, K, SA, S BO, SR Mixed SI/SM + ME + OS showed greatest improvements in knowledge (g = .38), attitudes (g = 43), and skill (g = .39); All conditions equal for satisfaction and use
3 Heck et al., 2015 123,848 trainees CBT for trauma Any professional working with child trauma victims No No 0
(pre-post)
20 hours none K N/A No Increase in knowledge (g = .77)
3 Kobak et al., 2013 39 clinicians CBT for anxiety disorders Mental health clinicians No No 2:
1. SI
2. SI+VC
10 modules None K, S SR
BO
Yes Knowledge:
SI (g = 4.7)
Skill:
SI + VC (g = .96)
3 Kobak et al., 2017 70 clinicians CBT for anxiety disorders Community clinicians No No 0 (pre-post) 9 modules No K, S, U, X SR Yes Improvements in knowledge (g = 3.65), skill (g = 1.53), use (g = 1.15), client outcomes (g = .85)
3 Larson et al., 2009 38 counselors CBT for substance use Substance use counselors No No 0
(pre-post)
8 modules none AC, FE, SA SR No High rates of acceptability (g = X), feasibility (g = X), and satisfaction (g = X)
1 Larson et al., 2013 127 counselors from 54 addiction units CBT for substance use Substance use counselors No Yes 2:
1. SI
2. C
8 modules 3 months S SR
BO
No Increase in skill (g = X) for SI and C with no differences between groups
1 Leykin et al., 2011 149 substance use counselors CBT for substance use Substance use counselors Yes, S Yes 2:
1. VC
2. SI
8 modules 6 months B SR Yes Burnout:
SI > VC (g = .31)
1 Marshall et al., 2014 215 VA providers Suicide prevention Behavioral health providers No Yes 3:
1. SI
2. FTF
3. C
4 modules none SA,U SR No SI = FTF > C for both satisfaction (g = X) and use (g = X)
3 Martino et al., 2011 26 counselors Motivational
Interviewing for substance use
Substance use counselors Yes, S No 0 (step-wise method) 4 hours 24 weeks SA, F, S SR, BO No SI only led to higher rates of skill (g = X) and fidelity (g = X); Positive satisfaction with course
1 McPherson et al., 2006 192 health promotion professionals Substance use prevention Health promotion professionals No Yes 2:
1. SI
2. WM
5 modules none K, SA, SE N/A No No differences between groups on knowledge or satisfaction; SI > WM for self-efficacy (g = 1.72)
3 Mignogna et al., 2014 9 therapists CBT for medically ill patients with depressive and anxiety Primary care therapists Yes, C No 0
(pre-post)
6 30–45 min. sessions none AC, FE, F BO, SR No High rates of fidelity (g = X) and feasibility (g = X); Moderate acceptability (g = X)
3 Puspitasari et al., 2013 Study 1:
N = 8
Study 2:
N = 9 mental health providers
Behavioral activation for depression Mental health providers No No 0
(pre-post)
3 modules Study 1: none
Study 2: 6 weeks
Study 1: U, SA,
Study 2: U, S, SA, SE
1: SR
2: BO, SR
No Increases in use (g = X), satisfaction (g = X), and skill (g = X)
1 Rakovshik et al., 2016 61 practicing mental health providers CBT for anxiety disorders Therapists Yes, S Yes 3:
1. SI
2. SI + OS
3. C
20 hours none S BO Yes SI + OS > SI (g = .95) and C (g = 1.01) for skill
3 Reid et al., 2005 133 public health practitioners Disaster mental health Public health providers No No 0
(pre-post)
5 days/modules none K, S SR No Increase in knowledge (g = X) and skill (g = X)
1 Rheingold et al., 2012 188 child care professionals Child abuse prevention Child care professionals No Yes 3:
1: FTF
2: SI
3: C
2.5 hours none AC SR No SI = FTF for acceptability (g = X)
1 Ruzek et al., 2014 168 VHA mental health clinicians CBT for trauma Mental health clinicians Yes, C Yes 3:
1: SI
2: SI+OS
3: C
No info. provided none K, SE, S SR Mixed Knowledge:
SI+OS > C (g = .86)
SI > C (g = .41)
Self-efficacy: SI+OS > C (g = .91)
SI > C (g = .72)
Use:
No differences between groups
3 Samuelson et al., 2014 73 primary care providers Psychoed. for PTSD Primary care providers No No 0 (pre-post) 4 modules 30 days K, SE SR No Increase in knowledge (g = 3.23) and self-efficacy (g = X)
1 Stein et al., 2015 36 clinicians Interpersonal psychotherapy for bipolar disorder Clinicians Yes, S Yes 2:
1. FTF
2. SI
12 hours once a month for one year U SR Yes Increased in use (g = X) for both groups
3 Stone et al., 2005 1200 participants Suicide prevention Public officials, service providers, community coalitions No No 2:
1. SI
2. VC
3 modules none K SR No Increases in knowledge (g = X); Conclusions not made between groups
3 Vismara et al., 2009 10 therapists Early intervention for autism spectrum disorder Community-based therapists Yes, S No 2:
1. SI
2. FTF
5 months of didactic training, 5 months of parent coaching none X, F, SA BO, SR Yes Fidelity: FTF > SI (g = 1.89)
SI > baseline (g = 1.65)
Satisfaction:
FTF > SI (g = 2.46) Improvement in child behavior in both groups (g = X)
1 Weingardt et al., 2006 166 substance abuse counselors CBT for substance use Substance use counselors No Yes 3:
1. FTF
2. SI
3. C
60 minutes none K N/A No FTF = SI > C for knowledge (g = 1.29)
3 Weingardt et al., 2009 147 substance use counselors CBT for substance use Substance use counselors Yes, S Yes 2:
1. High fidelity SI
2. Low fidelity SI
8 modules None K, SE, B SR Yes No differences in knowledge or self-efficacy; Low-fidelity group< burnout (g = .28) than high-fidelity group

Note. Ongoing Support: C = Consultation, S = Supervision; Comparison Groups: C = Non-Training Control, FTF = Face-To-Face or In-Person, ME = Motivational Enhancement, OS = Ongoing Support, PC = Peer Consultation, SD = Self Directed, SI = Serial Instruction, SM = Simulation, VC = Virtual Classroom, WM = Written Materials; Measurement Domains: A = Attitudes, AC = Acceptability, B = Burnout, BA = Barriers, C = Training Completion, E = Engagement, F = Fidelity or Adherence, FE = Feasibility, I = Importance, K = Knowledge, P = Preparedness, S = Skill, SA = Satisfaction, SE = Self-Efficacy or Confidence, U = Use, X = Client Outcomes; Measurement Type: BO = Behavioral Observation, SR = Self Report; Effect Size: X: Insufficient information to calculate effect size.