Understanding the Effectiveness of the Cascading Model to Implement Parent-Child Interaction Therapy.

Few community-based behavioral health clinicians are trained in evidence-based practices (EBPs). The Cascading Model (CM), a training model in which expert-trained clinicians train others at their agency, may help increase the number of EBP-trained clinicians. This study is one of the first to describe CM training methods and to examine differences between clinicians trained by an expert, and those trained through a within-agency training (WAT) by a fellow clinician. Results indicate that 56% of the 38 eligible clinicians chose to become trainers and 50% of the 56% conducted WATs to train others. This represents a 50% increase in EBP-trained clinicians within the study timeframe. Clinicians trained by an expert reported higher knowledge and training satisfaction than those trained through a WAT. Of note, clinicians trained through a WAT reported increases in EBP knowledge and were more diverse (race/ethnicity, employment status), suggesting that the CM may improve access to EBPs.