SMART Therapist Training: A Hybrid Factorial-SMART Design

Recruiting now · Not applicable

Conditions studied: Stress Disorders, Post-Traumatic, Psychotherapy

In brief

Cognitive Processing Therapy (CPT) is highly effective in randomized controlled trials, but its effectiveness drops substantially in standard clinical practice, largely due to therapist "drift" from fidelity to the protocol. What remains unknown is which components of CPT training yield high therapist fidelity. Thus, there is a critical need to use empirical approaches to identify the most effective components of CPT training and to develop an adaptive training model for CPT by testing sequences of empirically-supported training strategies. The long-term goal of this research is to develop a sustainable model of therapy training that is personalized to the needs of the therapist trainee. The overall objective of this application is to empirically optimize an adaptive model for CPT training. The rationale is that developing an adaptive training model will improve efficiency and personalization, yield higher fidelity, and ultimately improve Veteran outcomes. The investigators expect that completion of this project will produce an adaptive CPT training program that yields high therapist fidelity. Improving CPT fidelity in VHA will have a positive impact on the health and wellbeing of Veterans with PTSD.

Key facts

Study ID: NCT07010770
Run by: VA Office of Research and Development
People needed: 240
Starts: 2025-08-15
Expected to finish: 2030-08-31
Last updated by the study team: 2026-07-31

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

We have designed the sample to be representative of therapists who are eligible for CPT rollout training.
Participants must be licensed mental health clinicians or a mental health trainee in VA service (e.g., practicum students, psychology interns, postdoctoral fellows) whose formal job responsibilities include the provision of psychotherapy services to Veterans on a regular basis
Participants must be able to participate for 9 months.
Participants must work in a setting where CPT may be implemented (12 weekly 60-minute individual sessions or 90-minute group sessions).
Participants must have local/supervisor support to implement CPT and fully participate in all training and consultation activities.
Participating trainees (e.g. psychology interns) on a 6-month training rotation must have permission from their supervisors to continue the study into their next rotation.

You may not qualify if…

Participant is not a licensed mental health clinician
Participant is already certified in CPT

Where it is running

VA Palo Alto Health Care System, Palo Alto, CA — Palo Alto, California, United States (enrolling)
VA Ann Arbor Healthcare System, Ann Arbor, MI — Ann Arbor, Michigan, United States (enrolling)
Minneapolis VA Health Care System, Minneapolis, MN — Minneapolis, Minnesota, United States (enrolling)
Cincinnati VA Medical Center, Cincinnati, OH — Cincinnati, Ohio, United States (enrolling)

Full record on ClinicalTrials.gov

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