(PS11-19) Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) Consultants: What Qualities Matter Most?

Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) is an evidence-based psychotherapy designed to reduce the likelihood of future suicidal behaviors. CBT-SP is the most strongly recommend treatment by the Veteran Affairs/Department of Defense (VA/DoD) Clinical Practice Guidelines (CPG) for the Assessment and Management of Patients at Risk for Suicide (2019) and is a part of the United States Veteran Affairs’ (VA) National Strategy for Preventing Veteran Suicide (2018-2028) plan to reduce Veteran suicide deaths. CBT-SP is one of the four evidence-based practices (EBPs) within the greater Suicide Prevention 2.0 Clinical Telehealth Program. Suicide prevention (SP) therapists hired into the SP 2.0 Clinical Telehealth Program are virtually trained in these EBPs and continue to provide this gold-standard care to Veterans using the VA virtual platform.

The CBT-SP Training Program is based on a Trainer and Consultant model, like many EBPs found in the VA system of care (e.g., Cognitive Processing Therapy, etc.). Historically, EBPs in the VA use a train-the-trainer model (Gabriele & Lyons, 2013), such that therapists who have successfully completed an EBP training may become consultants. However, many of these EBP programs do not include a formalized training for consultants, nor guarantee participation in training cohorts.

The CBT-SP Consultant training is a formalized 12-hour didactic and experiential workshop which covers how to: bolster trainee learning, conduct behavioral rehearsals, utilize objective rating measures with inter-rater reliability, and practice verbal/written training feedback. Following this training, six monthly booster sessions and ongoing monthly training team meetings support CBT-SP Consultants and improve inter-rater reliability and feedback consistency. Within one month of completing Consultant training, CBT-SP Consultants are expected to facilitate experiential small groups during the live, virtual provider training workshop. Following the provider workshop, Consultants support SP therapists in a 26-week consultation model. Consultants rate trainee recordings for fidelity and competency to the protocol using two objective measures. Individualized learning plans (coaching from CBT-SP Consultants) are implemented for SP therapists not meeting fidelity. Therapists rate satisfaction with consultants’ service at the end of consultation on 19 items.

Over 130 therapists have completed the CBT-SP provider workshop, and 124 have successfully completed consultation across 9 training cohorts. Three additional cohorts will complete consultation by October 2024. To date, overall satisfaction scores demonstrated very good to excellent consultant services. On average, highest satisfaction scores were reported for consultant knowledge about theory, practice and implementation of CBT-SP, ability to explain rationale and suicide-specific CBT-SP techniques clearly and effectively, consultation call consistency, prioritization of urgent case questions, valued and integrated therapist knowledge and skill, and empowered therapists to feel confident and competent in delivering CBT-SP post-consultation. Final results and analyses for the full 12 cohorts will be illustrated.