Training Methods and Strategies

Target Audiences

Training in mental health tends to focus on one of five target audiences. These include: the graduate education of professionals; the initial training of direct care workers; training of peer specialists; training of family members; and continuing education of all those working in the field. The content and process of training for these different audiences tend to vary widely. 


Logic Model for Effective Training

Historically, the focus on training in healthcare placed a major emphasis on the delivery of information to students or workers using passive learner methods, such as lectures. The emergence of evidence revealing that such methods have limited impact on learner skills and subsequent professional practice led to an emphasis on more comprehensive approaches that ideally involve the following elements as part of a training logic model:

1.    Identification of the competencies to be taught
2.    Development of curricula based on those competencies
3.    Use of evidence-based teaching methods for training delivery
4.    Use of technology assisted instruction to increase access to and the effectiveness of learning
5.    Assessment of competencies after training. 


Evidence-Based Teaching Methods

Research in healthcare has demonstrated that there are no simple “magic bullets” in the form of single strategies to achieve effective training. Rather, there are numbers of training strategies that each appear to have a small positive effect on learning. The more of these strategies that are used, the more effective the learning and practice changes appear to be. Examples of these strategies include: social marketing to learners about the value of the training; teaching sessions that are interactive; outreach or academic detailing visits by educators to learners; audit of learners’ practice; feedback to learners on their practice; and use of opinion leaders within an organization to encourage peers to use newly learned skills. 


Advanced Learning Models That Involve Training

The Mental Health Technology Transfer Center (MHTTC) Network is a structure for delivering training nationally and regionally through the various Centers that comprise the Network. 

Much of the training being provided to the mental health workforce is focused on evidence-based practices (EBPs), which have support for their effectiveness from research studies. EBPs in mental health tend to have clearly defined workforce competencies, curricula, evidence-based teaching methods, technology-assisted instruction, and fidelity measures to assess the competency of workers and adherence of services provided by workers to the EBP model. 

With advances in Internet speed and access, distance learning has played a much more prominent role in training, particularly with respect to continuing education. Research findings have suggested that this approach is more effective when paired with some form of interactive education, such as supervised practice or coaching. 

Training has been incorporated into more comprehensive system change initiatives based on implementation science. In this approach, organizational change occurs to promote practice change among workers who are receiving training, supervision, and/or coaching in a specific prevention, treatment, or recovery practice.


Learning Collaboratives

Learning collaboratives have been widely used in general healthcare and in behavioral health as a strategy for quality improvement and implementation of evidence-based practices. The MHTTC Network Coordinating Office commissioned a review of learning collaboratives to assist technical assistance providers in better understanding and using this implementation strategy and approach to change management. Conducted by the Annapolis Coalition on the Behavioral Health Workforce, these resources include the review, a supplement of resources, and a webinar on collaboratives.

Learning Collaboratives: A Strategy for Quality Improvement & Implementation in Behavioral Health

In 1995, The Institute for Healthcare Improvement (IHI) launched its Breakthrough Series (BTS) collaboratives to improve healthcare. These are often referred to as learning collaboratives. Key elements of these BTS learning collaboratives included: selecting a specific improvement topic, recruiting expert faculty, enrolling organizations and teams, face-to-face learning sessions, Plan-Do-Study-Act cycles of change, technical assistance to teams, inter-agency sharing and learning, and summation of results and lessons learned. The IHI model was widely disseminated and adopted nationally and internationally. Since its launch, the model has been adapted, modified, and used across a variety of healthcare settings, including behavioral health.

Based on a literature review and key informant interviews with leaders in learning collaboratives, this report addresses: what are learning collaboratives; what is the evidence for their effectiveness; what are their key elements; how have they been applied in behavioral health; and what are best practices for use in behavioral health? The report concludes with a summary of key findings and a set of recommendations for technical assistance providers. Download the full report.

Resources on Planning and Conducting Learning Collaboratives

A supplement to the full report identifies resources that are available to assist technical assistance providers in developing and offering learning collaboratives. Download the resources supplement.

Learning Session on the Learning Collaboratives Report

In October 2020, Michael Hoge, Manual Paris, Jr., and Heather Gotham provided a learning session on the report, including a review of the findings and recommendations, followed by facilitated discussion with technical assistance providers.  View the learning collaborative webinar.


Resources

Addiction Technology Transfer Center Network
https://attcnetwork.org

American Psychological Association. Continuing Education Programs in Psychology
https://www.apa.org/education/ce
Note: This is an example of online continuing education programs offered by a professional mental health association.

Council on Social Work Education (CSWE), Directory of Accredited Online and Distance Education Programs.
https://www.cswe.org/Accreditation/Directory-of-Accredited-Programs.aspx
Note: This is an example of the directories of online educational programs maintained by mental health professional associations and accrediting bodies.

Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2005). Implementation research: A synthesis of the literature. 
https://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdf
Note: this is an overview of the concept Implementation Science written by mental health professionals.

Mental Health Technology Transfer Center Network
https://mhttcnetwork.org/

Substance Abuse and Mental Health Services Administration. Evidence-Based Practices Resource Center.
https://www.samhsa.gov/ebp-resource-center

World Health Organization, Mental Health
https://www.who.int/mental_health/en/
Note: WHO has a large number of resources available on mental health training.

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