NCT03722654: MTFS-FT-CBT

Measurement Training and Feedback System: Family Therapy and CBT

Completed NA Last updated 31 August 2023

What this trial tests

NA trial testing MTFS-I Installation in Adolescent Behavior in 42 participants. Completed in 30 June 2022.

Timeline

1 September 2020

Primary endpoint
1 June 2022

30 June 2022

Quick facts

Lead sponsor	The National Center on Addiction and Substance Abuse at Columbia University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	treatment
Enrollment	42
Start date	1 September 2020
Primary completion	1 June 2022
Estimated completion	30 June 2022
Sites	3 locations across United States

Drugs / interventions tested

• MTFS-I Installation

Conditions studied

• Adolescent Behavior — all drugs for Adolescent Behavior →

Sponsor

The National Center on Addiction and Substance Abuse at Columbia University

Who can join

Eligibility, any sex, with Adolescent Behavior. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

This study aims to advance the science of mental health services for adolescent externalizing problems (AEPs) by developing therapist training procedures to increase fidelity to evidence-based interventions (EBIs) in usual care. Two widely endorsed approaches are consistently effective for treating AEPs: family therapy and CBT. Importantly, stronger fidelity to core EBIs of these approaches predicts better outcomes in research and community settings. Yet these EBIs are not widely implemented with fidelity. To help close this quality gap in adolescent services, investigators will develop an online intervention to strengthen fidelity to these EBIs in routine care: Measurement Training and Feedback System for implementation (MTFS-I). MTFS-I will target two essential aspects of EBI fidelity: Training components will seek to improve EBI self-monitoring, and a Feedback component will seek to increase EBI utilization. In keeping with NIMH's Experimental Therapeutics paradigm, this study will examine whether an Intervention (MTFS-I) has direct impact on immediate Targets (EBI self-monitoring and utilization).

If promising, future R01 studies will examine links among intervention, targets, and ultimate outcomes (AEPs). The MTFS-I package will be an online quality assurance system completed by therapists and supervisors that can be readily sustained in usual care. Two weekly Training components will adapt gold-standard observational fidelity coding procedures to promote improved self-monitoring of the targeted EBIs, and a monthly Feedback component will adapt a measurement feedback system to promote increased utilization of these EBIs in everyday practice. To maximize provider investment, sites will delineate their own fidelity standards for family therapy and CBT and help design feedback report templates.

The proposed study will be among the first to (1) test whether training therapists in observational assessment of EBI fidelity increases the accuracy with which they self-monitor use of those EBIs and (2) adapt measurement feedback procedures to track and improve therapist utilization of EBIs. To achieve study aims the investigators will first partner with two community clinics to develop sustainable MTFS-I procedures using a three-phase Pilot process. Investigators will then initiate an experimental Trial during which therapists (n = 32, treating 192 clients) at four different clinics will be randomized to MTFS-I versus no-intervention Control. In both conditions two kinds of data will be collected: therapist-report checklists on use of core family therapy and CBT techniques with adolescent cases and treatment session audio recordings. MTFS-I uptake will be tracked electronically for online components (Aim 1: MTFS feasibility). Session recordings will be coded by observers for three facets of EBI fidelity: adherence (extent of EBI utilization), working alliance, and therapist competence. Observer ratings will measure the strength of EBI self-monitoring (Aim 2: therapist reliability and accuracy) and fidelity (Aim 3 \[EBI utilization\] \& Aim 4 \[alliance, competence\]). If effective, MTFS-I could be adapted to promote EBI fidelity for a variety of clinical populations and approaches.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

1. Measurement training and feedback system for implementation of evidence-based treatment for adolescent externalizing problems: protocol for a randomized trial of pragmatic clinician training.
   Hogue A, Bobek M, MacLean A, Porter N, et al · · 2019 · cited 8× · PMID 31822294 · DOI 10.1186/s13063-019-3783-8
2. Training Community Therapists in Core Elements of CBT and Family Therapy for Adolescent Externalizing Problems.
   Hogue A, MacLean A, Bobek M, Dunnsue S, et al · · 2025 · cited 3× · PMID 37314326 · DOI 10.1080/15374416.2023.2222405