A statewide training of community clinicians to treat traumatized youths involved with child welfare.

Despite considerable investment in efforts to disseminate evidence-based treatments (EBTs), few data are available on how frequently clinicians achieve competence in delivering the treatments or on whether clinical outcomes actually improve. The Louisiana Child Welfare Trauma Project (LCTP) was a 5-year demonstration project funded by the Children's Bureau. One of the aims of the LCTP was to train community clinicians statewide in an EBT for posttraumatic stress disorder (PTSD). A training model was designed to reach any willing community practitioner, with minimal travel, cost, and time involved for trainees and trainer. Of the 335 clinicians who attended a 1-day training in youth PTSD treatment (YPT; Scheeringa & Weems, 2014), a manualized treatment for youths with PTSD, 117 began consultation calls. Forty-five (38%) clinicians who began calls achieved "Advanced" training, completing at least 1 case using YPT and attending weekly calls. Of the 102 clients discussed during calls, 64 (63%) completed YPT. Pre- and posttreatment measures were available for 17 (27%) of the completers. All 17 clients showed decreases in their PTSD symptoms by youth or caregiver report, with 12 (71%) showing a decrease in symptom count by at least half of the pretreatment score. This is the first known report of the proportion of community clinicians who voluntarily completed consultation calls to achieve competence following initial training in an EBT. The results suggest that effectiveness of an EBT is possible in community settings but is likely constrained by clinicians' being willing and/or able to complete training requirements geared toward achieving competency in and fidelity to the protocol. Because the majority of clinicians did not complete training requirements, this suggests major limitations in the current models of dissemination.