www.TheCJP.ca The Canadian Journal of Psychiatry, Vol 58, No 6, June 2013 W 335 CanJPsychiatry 2013;58(6):335–343 Key Words: continuing education, capacity building, community mental health services, psychotherapy, health education, knowledge translation Received September 2012, revised, and accepted November 2012. Original Research Continuing Education To Go: Capacity Building in Psychotherapies for Front-Line Mental Health Workers in Underserviced Communities Paula Ravitz, MD, FRCPC 1 ; Robert G Cooke, MD, FRCPC 2 ; Scott Mitchell, BA 3 ; Scott Reeves, PhD 4 ; John Teshima, MD, FRCPC 5 ; Bhadra Lokuge, BSc 6 ; Andrea Lawson, PhD 7 ; Nancy McNaughton, PhD 8 ; Wayne Skinner, MSW, RSW 9 ; Carolynne Cooper, MSW, RSW 10 ; Mark Fefergrad, MD, FRCPC 11 ; Ari Zaretsky, MD, FRCPC 12 1 Associate Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Morgan Firestone Psychotherapy Chair, Mount Sinai Hospital, Department of Psychiatry, Joseph and Wolf Lebovic Health Complex, Toronto, Ontario. Correspondence: Mt Sinai Hospital, Department of Psychiatry, Joseph & Wolf Lebovic Health Complex, 600 University Avenue, Toronto, ON M5G 1X5; pravitz@mtsinai.on.ca. 2 Associate Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Director, Ontario Psychiatric Outreach Programme, Toronto, Ontario. 3 Director, Knowledge Transfer, Canadian Mental Health Association, Toronto, Ontario. 4 Founding Director of the Center of Innovation for Interprofessional Education, University of California, San Francisco, California; Scientist, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, Ontario. 5 Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Staff Psychiatrist, Sunnybrook Health Sciences Centre, Toronto, Ontario. 6 Senior Research Coordinator, Temmy Latner Centre for Palliative Care, Mount Sinai Hospital, Toronto, Ontario. 7 Senior Research Coordinator, Mount Sinai Hospital, Department of Psychiatry, Toronto, Ontario. 8 Associate Director, Standardized Patient Program, University of Toronto, Toronto, Ontario. 9 Deputy Clinical Director, Addictions Program, Centre for Addiction and Mental Health, Toronto, Ontario. 10 Social Worker, Problem Gambling Institute of Ontario, Centre for Addiction and Mental Health, Toronto, Ontario. 11 Assistant Professor and Residency Director of Postgraduate Psychiatry Education, Department of Psychiatry, University of Toronto, Toronto, Ontario; Staff Psychiatrist, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. 12 Associate Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Psychiatrist-in-Chief, Sunnybrook Health Sciences Centre, Toronto, Ontario. Objective: To address the gaps between need and access, and between treatment guidelines and their implementation for mental illness, through capacity building of front-line health workers. Methods: Following a learning needs assessment, work-based continuing education courses in evidence-supported psychotherapies were developed for front-line workers in underserviced community settings. The 5-hour courses on the fundamentals of cognitive- behavioural therapy, interpersonal psychotherapy, motivational interviewing, and dialectical behaviour therapy each included videotaped captioned simulations, interactive lesson plans, and clinical practice behaviour reminders. Two courses, sequentially offered in 7 underserviced settings, were subjected to a mixed methods evaluation. Ninety-three nonmedical front-line workers enrolled in the program. Repeated measures analysis of variance was used to assess pre- and postintervention changes in knowledge and self- effcacy. Qualitative data from 5 semistructured focus groups with 25 participants were also analyzed. Results: Signifcant pre- and postintervention changes in knowledge (P < 0.001) were found in course completers. Counselling self-effcacy improved in participants who took the frst course offered (P = 0.001). Dropouts were much less frequent in peer-led, small-group learning than in a self-directed format. Qualitative analysis revealed improved confdence, morale, self-reported practice behaviour changes, and increased comfort in working with diffcult clients. Conclusion: This work-based, multimodal, interactive, interprofessional curriculum for knowledge translation of psychotherapeutic techniques is feasible and helpful. A peer-led group format is preferred over self-directed learning. Its application can build capacity of front-line health workers in helping patients who suffer from common mental disorders.