Training During a Pandemic: Successes, Challenges, and Practical Guidance From a Virtual Facilitated Learning Collaborative Training Program for Written Exposure Therapy

Abstract

In response to COVID-19, continued workforce training is essential to ensure that evidence-based treatments are available on the frontline to meet communities' ongoing and emerging mental health needs. However, training during a pandemic imposes many new challenges. This paper describes a multisite training and implementation pilot program, facets of which allowed for continued training despite the onset of the COVID-19 pandemic and subsequent social distancing guidelines. This virtual facilitated learning collaborative in Written Exposure Therapy, an evidence-based treatment for posttraumatic stress disorder, included virtual workshop training, phone-based clinical consultation, implementation-focused video calls for program leadership, and program evaluation. Data are presented about program enrollees and patient impact following the onset of COVID-19-related social distancing restrictions. Challenges, successes, and practical guidance are discussed to inform the field regarding training strategies likely to be durable in an uncertain, dynamic healthcare landscape. A key task of the mental health field is the dissemination and implementation of effective interventions. Numerous factors contribute to the gap between research and practice, including the broad sociopolitical context; organizational factors, such as leadership support and availability of resources; provider motivation, attitudes, and skills; and characteristics of the interventions themselves (Chen et al., 2017; Stirman et al., 2016). Research suggests that training alone is insufficient to fully implement and sustain effective interventions over the longer term (Godley et al., 2011; Herschell et al., 2010) and that factors at the system, organizational, and individual levels need to be addressed simultaneously to facilitate successful implementation (Beidas et al., 2010; Stirman et al., 2010).

Resilience in Adult Health Science Revisited—A Narrative Review Synthesis of Process-Oriented Approaches

“…Another key mechanism might be how individuals incorporate their experiences into a his/her narrative identity, which is defined as an individual's internalized life story (Infurna and Jayawickreme, 2019 ). The recent high resonance of narrative-based therapies in trauma research may give this hypothesis a further boost (Lely et al, 2019 ; Worley et al, 2020 ). Furthermore, a narrative-based resilience mechanism may represent a link to an interdisciplinary approach of social sciences with the humanities, an area that deserves more attention in light of the call for more interdisciplinary work (Richter, 2017 ; Lindert et al, 2018 ).…”

Effectiveness of written exposure therapy for posttraumatic stress disorder in the Department of Veterans Affairs Healthcare System.

“…Previous research has demonstrated that PTSD treatments delivered via TMH are acceptable, effective, and noninferior to in-person treatment delivery (see Morland et al, 2020 for a review); however, comparisons of delivery modality have not yet been reported for WET. Data about WET’s effectiveness via TMH is particularly important because the COVID-19 pandemic has forced much of VA service to shift from in-person care to TMH (Rosen et al, 2020; Worley et al, 2020).…”

Optimal Sense-Making and Resilience in Times of Pandemic: Integrating Rationality and Meaning in Psychotherapy

“…Based on these pilot trials, specific protocols could be developed to train practitioners and professionals to better handle future crisis. Encouraging evidence from recent multisite training and implementation of pilot programs during the pandemic support such directions (see, for example, Worley et al, 2020 ). Furthermore, given that video and virtual formats have been shown to be effective similarly to in-person care (e.g., Morland et al, 2017 ), this may be another flexible route for adapted therapists training during the current crisis.…”