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Introduction to this PDF Document CFIT Online Learning Center © Vanderbilt University, All rights reserved CFIT Dear Providence Staff Member: In response to your requests, this PDF * version of the Common Factor module has been made available for you to print and share with staff within your region/office only. Before you continue, please take a moment to read this cover page. You’ll still need to go through the online version of the module in E-learning in order for your completion status to appear and be updated, and to have access to the self-test and module evaluation. Your completion status can be viewed within the E-learning system. Most importantly, please remember that only some regions across the country were randomly assigned to receive this additional training on common factors. During the evaluation of CFIT, only staff within those select regions will have access to these modules in E-learning. To preserve the integrity of the evaluation, under no circumstances should you share this PDF, either in paper or electronic form, with anyone outside your office. Similarly, you should not share access to the online modules in E-learning. This is a large document and may take a while to print. Providence, and our Vanderbilt consultants, greatly appreciate your support for this important quality enhancement initiative. If you have any questions or comments, please do not hesitate to contact us at [email protected] * To view this document, you’ll need Adobe® Reader®. Adobe® Reader® allows you to view documents which have been created in the Portable Document Format (PDF). Adobe® Reader® is freely available. If you do not have a version of it already on your computer, you can download it at: http://www.adobe.com/products/acrobat/readstep2.html . If you do not know whether you have the appropriate software to operate CFIT, please contact the technical support of your office or any person in your office that may know.

CFIT Online Learning Center - Vanderbilt Universitypeabody.vanderbilt.edu/docs/pdf/cepi/CFIT_Module_1_Orientation.pdfThe CFIT Online Learning Center provides counselors with information

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Introduction to this PDF Document

CFIT Online Learning Center

© Vanderbilt University, All rights reserved

CFIT

Dear Providence Staff Member:

In response to your requests, this PDF* version of the Common Factor module has been made available for you to print and share with staff within your region/office only. Before you continue, please take a moment to read this cover page.

You’ll still need to go through the online version of the module in E-learning in order for your completion status to appear and be updated, and to have access to the self-test and module evaluation. Your completion status can be viewed within the E-learning system.

Most importantly, please remember that only some regions across the country were randomly assigned to receive this additional training on common factors. During the evaluation of CFIT, only staff within those select regions will have access to these modules in E-learning. To preserve the integrity of the evaluation, under no circumstances should you share this PDF, either in paper or electronic form, with anyone outside your office. Similarly, you should not share access to the online modules in E-learning.

This is a large document and may take a while to print.

Providence, and our Vanderbilt consultants, greatly appreciate your support for this important quality enhancement initiative. If you have any questions or comments, please do not hesitate to contact us at [email protected]

* To view this document, you’ll need Adobe® Reader®. Adobe® Reader® allows you to view documents which have been created in the Portable Document Format (PDF). Adobe® Reader® is freely available. If you do not have a version of it already on your computer, you can download it at: http://www.adobe.com/products/acrobat/readstep2.html. If you do not know whether you have the appropriate software to operate CFIT, please contact the technical support of your office or any person in your office that may know.

CFIT Online Learning Center:Orientation to the CFITLearning Modules

Version 1.1

Susan Douglas Kelley, Ph.D., Susan E. Casey, M.S.W., & Sarah E. Dew, M.S.

Editors: Susan Douglas Kelley, Ph.D. and Susan E. Casey, M.S.W.

Acknowledgements

The development of this training module was made possible with the collaborative efforts of Vanderbilt University and Providence Service Corporation. We would also like to thank Sitening for their contributions to web design.

Partially supported by NIMH Grant R01-MH068589, Leonard Bickman, Ph.D. (Principal Investigator)

ORIENTATION TO THE CFIT LEARNING MODULES

© Vanderbilt University, All rights reserved

CFIT

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You are entering the only section for this module.

It should take approximately 15 minutes to complete, with a total of 29 pages.

ORIENTATION TO THE CFIT LEARNING MODULES

© Vanderbilt University, All rights reserved

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• What is the CFIT online learning center?– Common factors– Relevance to…

• Your clinical work• Providence Service Corporation• CFIT Questionnaires

• Navigating the training modules

ORIENTATION TO THE CFIT LEARNING MODULES

© Vanderbilt University, All rights reserved

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As you may remember from previous training, CFIT stands for Contextualized Feedback Intervention and Training.

• C – Developed for the Providence Service Corporation, with customization available to meet each state’s needs

• F – CFIT questionnaires provide feedback on both treatment progress and process for clients and caregivers

• I – Regular feedback provides counselors, supervisors, and regional directors better access to vital information for intervening

• T – Training and ongoing support are provided in your region and online, including this training

What is the CFIT online learning center?

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The CFIT Online Learning Center provides counselors with information on how to optimize therapeutic processes related to a common-factor approach rather than a specific therapeutic modality.

Common factors are the elements that are not particular to any therapeutic modality, but are common across all therapies. Research indicates that these common factors are responsible for many of the benefits of therapy.

Common factors can be classified into five broad categories: client characteristics, therapist qualities, change processes, treatment structure, and therapeutic relationship. The importance of these factors in determining outcomes is well established and fits with Providence’s belief in a strength-based approach.

Common factors

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The CFIT Online Learning Center is designed for counselors who work with youth aged 11 to 18 years and their families. There are no education or experience prerequisites necessary. The individual modules were developed to:

• Enhance your existing practices, not replace them

• Provide useful tools for practice, reflection, and supervision

• Fit into your busy clinical schedule by offering online convenience

Each module represents an extensive collaboration between academic and clinical experts to provide you with the most up-to-date, clinically relevant information available. The modules have undergone internal and external review for clinical utility and scientific accuracy. Planned updates in the future will incorporate any recent developments in the field and your suggestions.

Relevance to your clinical work

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The CFIT training modules support all six of the core values of Providence Service Corporation.

Community- based & multi-

systemic services

Identifying and building on strengths

Respectful organizational

culture

Local viability that is

nationally supported

Best practice models

Cultural diversity

Relevance to PSC

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Because providing services in a client's own community with his/her family and natural supports may be a helpful approach, all of the CFIT training modules are readily adaptable to counselors providing home- or community- based counseling.

Community- based & multi-

systemic services

Identifying and building

strengths

All modules within the CFIT Online Learning Center incorporate a strengths-based approach to counseling. This allows counselors to utilize additional skills to identify and build from client and family strengths.

Local viability that is

nationally supported

The CFIT Online Learning Center supports the professional growth of counselors and supervisors in each region. In addition, local staff are encouraged to submit suggestions for improvement and practical tools for consideration in future training efforts.

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The CFIT Online Learning Center is designed to respect and complement the knowledge, wisdom, and experience that each counselor already possesses.

Respectful organization

al culture

Best practice models

Because the CFIT training modules focus on building and enhancing the common factors of counseling, they can be utilized regardless of the treatment being used. This ensures that counselors’ use of best practice treatments will be supported by their CFIT training.

Cultural diversity

The CFIT training modules activate processes and characteristics that are common across diverse clients. Thus, this approach may help counselors be sensitive to their clients culture.

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Currently, three individual training modules are available in the CFIT Online Learning Center.

What training modules are available?

Collaborative Planning

Expectancies about Counseling

Building and Repairing Therapeutic Alliance

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The training modules provide information and clinical techniques to activate common factors in the following areas:

Building and Repairing Therapeutic AllianceIncludes strategies to strengthen clinician engagement with clients and caregivers through the use of attending skills, empathy, genuineness, and active listening. Given that alliance ruptures can occur even in healthy working relationships, the module also includes information on identifying and addressing alliance ruptures.

Addressing Expectancies about Counseling Includes information and strategies to assess and build on client and caregiver expectations about roles, treatment process, and treatment outcomes.

Collaborative Treatment PlanningThis module stresses a collaborative approach to the initial development and clarification of treatment goals, and ongoing negotiation of the tasks and strategies used in the treatment process.

Each module uses a strengths-based perspective

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With a focus on common factors, the training modules are very relevant to the CFIT questionnaires, particularly those related to treatment process. Together with regular supervision, these modules are a vital resource for problem-solving and practical strategies to use in conjunction with CFIT feedback results.

The following pages contain a brief review of the CFIT questionnaires on treatment process for clients and caregivers. We would also encourage you to review relevant training materials from the CFIT Implementation training as well as the questionnaires themselves.

Relevance to the CFIT questionnaires

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• How motivated is this youth to participate in treatment?– Motivation (rated by youth and counselor)

• How much impact does this youth think my counseling has?– Counseling Impact (rated by youth)

• How strong is the quality of my therapeutic alliance?– Alliance (rated by youth and counselor)

© Vanderbilt University, All rights reserved

How is treatment going for the youth?

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• Name: Motivation for Youth’s Treatment (MYTS)• Title in questionnaire: “How You Feel About Counseling”• Youth version only (10 items)

The youth version of the MYTS assesses internal motivation to stay and participate in treatment including:

• problem recognition• the desire for help• treatment readiness (or acceptance)

© Vanderbilt University, All rights reserved

Youth: Motivation

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• Name: Youth Counseling Impact Scale (YCIS)• Title in questionnaire: “Your Counseling Session”• Youth version only (11 items)

The YCIS has two dimensions: (a) immediate session-based task impact and (b) prolonged counseling impact on client behavior. It focuses on the helpfulness of therapeutic tasks and if counseling has affected the youth’s behavior over the past two weeks such as:

• used things they learned in counseling • felt better about themselves, and • if they changed their behavior either at school or at home as a result of

counseling.

© Vanderbilt University, All rights reserved

Youth: Counseling Impact

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• Name: Therapeutic Alliance Quality Scale (TAQS)• Title in questionnaire: “Your Relationship with Your Counselor” (13

items)

The youth questionnaire includes three components: • agreement on therapeutic goals• agreement on therapeutic tasks • the bond between the client and therapist.

Client-therapist bond is assessed by items on communication, trust, and general the relationship, as well as items describing the perceived competence and usefulness of the therapist. Some bond items can indicate if a problem in the relationship, or a rupture, has occurred. The items on this questionnaire are confidential, with summary scores only reported within the CFIT system.

© Vanderbilt University, All rights reserved

Youth: Alliance Youth Questionnaire

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• Name: Therapeutic Alliance Quality Rating (TAQ-R)• Title in questionnaire: “Therapeutic Alliance Quality Rating” (2 items)

The counselor rating includes two items. One rates counselors’ perceptions of the level of their alliance with their adolescent client. The other item estimates the level of alliance counselors think the youth reported about their relationship with the counselor.

© Vanderbilt University, All rights reserved

Youth: Alliance Counselor Questionnaire

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• How motivated is this caregiver to participate in treatment?– Motivation

• How strong is the quality of my therapeutic alliance with this caregiver?– Alliance

© Vanderbilt University, All rights reserved

How is treatment going for the caregiver?

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Caregiver Questionnaire• Name: Therapeutic Alliance Quality Scale (TAQS)• Title in questionnaire: “Your Relationship with This Youth’s

Counselor” (10 items)

Counselor Questionnaire• Name: Therapeutic Alliance Quality Rating (TAQ-R)• Title in questionnaire: “Therapeutic Alliance Quality Rating” (2 items)

The TAQS and the TAQ-R are similar to the alliance questionnaires about the youth. Here, instead of asking about the client-therapist relationship, the questionnaires ask about the caregiver-therapist relationship. The items on this TAQS are confidential, with summary scores only reported within the CFIT system.

© Vanderbilt University, All rights reserved

Caregiver: Alliance

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• Name: Motivation for Youth’s Treatment (MYTS)• Title in questionnaire: “How You Feel About This Youth's Counseling”• Caregiver version only (9 items)

© Vanderbilt University, All rights reserved

The caregiver version of the MYTS assesses internal motivation of the caregiver to participate in youth’s treatment including:

• problem recognition (of youth as well as caregiver) • the desire for help and support• readiness to participate

Caregiver: Motivation

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In addition to the youth and caregiver questionnaires reviewed on the previous pages, there are two CFIT questionnaires related to addressing expectancies about counseling.

These questionnaires are given only at the initial assessment. Related feedback from these questionnaires is available only to those counselors who currently have access to weekly feedback.

The two questionnaires are reviewed on the next page.

© Vanderbilt University, All rights reserved

Other questionnaires

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• Name: Treatment Outcome Expectancies Scale (TOES) (10 items)• Title in questionnaires:

– Youth version: “What You Expect Counseling to Do for You”– Caregiver version: “What You Expect Counseling to Do for This Youth”

• Name: Treatment Process Expectancies Questionnaire (TPE) (9 items)• Title in questionnaires: “What You Expect Counseling to Be Like”

Expectations about treatment are assessed with two questionnaires, the TOES and the TPE. The TOES assesses youths’ and caregivers’ expectations about the outcomes of services, resulting in a total score. The TPE looks at process and role expectancies about treatment. Items assess issues such as concerns about confidentiality, school involvement, etc. No summary score is available for the TPE—instead, individual items are presented.

© Vanderbilt University, All rights reserved

Initial Assessment: Treatment ExpectationsHow CFIT WorksHow CFIT WorksCFIT Implementation TrainingCFIT Implementation Training

CFIT

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Each module is designed to take approximately two hours to complete. At the beginning of each section is a page that tells you about how long it may take to complete that section. This way, you don’t have to set aside hours at time, but can use the CFIT Online Learning Center when it is convenient to you.

Navigating the CFIT Online Learning Center

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Each of the modules are organized the same way with the following sections:

• Welcome: A brief introduction to the module and how it is relevant to your clinical practice.

• Clinical Practice: This section includes two parts. The first is General Applications, with a review of relevant information, and how to apply concepts in practice. The second is Specific Scenarios, which presents clinical situations you may encounter with tips for activities and dialogue.

• Bridging Concepts: This section reviews the theoretical foundations and evidence base for the information presented in the module, in addition to linking it to the common factors covered in the other modules.

• Resources: Several additional sources for further information are provided for your continued learning.

• Module Evaluation: In the final section, you will find a brief evaluation of the module. Your responses provide us with valuable feedback for continued improvement.

Keeping it organized

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When you have finished with all the sections in a module, be sure to click on the button for the Self-Test available on the CareLogic CFIT Training Page. After you complete the self-test (each is only seven questions long), your score will be sent to your supervisor. This will let your supervisor know that you have completed the module. Information about module completion status is included on the weekly CFIT supervisor feedback reports.

In addition to reviewing these modules, your supervisor has received intensive training on common factors. Your supervisor is a vital resource for you in gaining information and building skills in the common factors of therapy.

At any time in the future, you may want to review a module, or a section of a module, either individually or together with your supervisor. You can always come back to any section within any module. Just click on CFIT Training in the left-hand CareLogic menu.

Supervision and Support

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To enhance your online learning experience, three types of hyperlinks were used.

These links are represented in the modules by highlighted words or specific images. When you click on a hyperlink, your computer will open the document in another window. You can scroll through the window, print, etc. just as you normally would.

When you’re ready to get back to the module, just click on the red X at the top right corner of the window to close it.

Using hyperlinks

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Glossary

When you see an underlined word in purple, you can click on the link to access the glossary, which includes definitions for several concepts contained in the modules. The glossary is linked to that word the first time it appears within each section of a module.

Additional Information Available

When you see an underlined word in blue, you can click on the link to access additional information, such as sample dialogue or more detailed explanations.

Hyperlinks: Highlighted words

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Hyperlinks: ImagesWhenever you see the ‘dancing’ toolbox that means you have

come to a page that has activities and exercises for use. Just click on the image to the left to open the tool. There are three types of tools included in the modules:

PracticeFor use in clinical sessions with clients and caregivers

SupervisionExplore cases together with your supervisor

ReflectionQuestions to consider for professional growth

For your convenience, you can click on a link in the Resources section to print out all the tools at once.

ToolboxTimes3

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Congratulations! You have completed this module.

Click on the finish button below to get back to the list of training modules.

Section complete

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