A Randomized Controlled Trial of an Online, Modular, Active Learning Training Program for Behavioral Activation Treatment for Depression

Abstract

This randomized-controlled trial was conducted in 2013-2014 and aimed to evaluate the efficacy of an online, trainer-led Behavioral Activation (BA) training when compared to an online, self-paced BA training. Graduate students (N = 80) in Clinical Psychology, Counseling Psychology, Social Work, and Psychiatry Residency programs were recruited. Participants were randomly assigned to either the trainer-led BA training (N = 40) or the self-paced BA training (N = 40). The trainer-led BA training consisted of four 90-minute trainer-led online sessions guided by a BA trainer and training activities included didactic, modeling, practice, and feedback. The self-paced BA training consisted of four 30-minute sessions audio-guided by an undisclosed BA trainer who provided the didactic. Both training focused on four BA core skills: providing BA rationale, BA assessment, activity scheduling, and strategies targeting avoidance. Primary outcome measures were Behavioral Activation Skills Assessment (BASA) and self-report questionnaires to assess BA implementation, confidence, and satisfaction towards BA training. Mixed between-within analysis of variance (ANOVA) and t-tests using intent-to-treat analyses based on last observation carried forward were conducted to compare changes on the outcome measures between training groups from pre- to post-training. Results indicated a significant greater increases (F(1,75) = 5.762, p = .019, partial eta squared = .071) of total BA skills for participants in the trainer-led BA training than those in self-paced training. Similar findings were found for providing BA rationale, BA assessment, and activity scheduling but not strategies targeting avoidance. Participants across groups also reported significant increases in total BA confidence although differences between groups were not significant. Increases on reported BA implementation for both groups were observed for both groups, however,even at post-training only approximately half of participants in each group reported using at least one BA strategy in clinical practice. Lastly, participants in both training groups also reported high satisfaction towards the BA training that they received. This pilot study provided evidence for the efficacy of the online trainer-led BA training on improving trainees’ BA skills, implementation, and confidence. There was also evidence that the self-paced BA training was effective in improving BA skills, although improvement was not as strong as the trainer-led BA training.