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SMART Therapist Training: A Hybrid Factorial-SMART Design
Who can join
Ages 18 and older · All sexes
Full eligibility criteria
Inclusion Criteria: 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. Exclusion Criteria: * Participant is not a licensed mental health clinician * Participant is already certified in CPT
About the study
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.
What is being tested
- Web-Based Training (WBT) (other)
- Work Sample Review (WR) (other)
- Step down to fidelity self-monitoring (other)
- Step up to session audio review (other)
- Standard Consultation (SC) (other)
- Standard Training (ST) (other)
Sponsor: VA Office of Research and Development · Participants: 240 · Started: Aug 15, 2025
Contact the study team
- Rebecca K Sripada, PhD MS · Phone: (734) 222-7432
Official record on ClinicalTrials.gov — NCT07010770
Locations in the U.S.
Conditions
From ClinicalTrials.gov, data retrieved Sep 29, 2026. Each study sets its own eligibility; the study team decides who can join.