Level 3: Train-the-Trainers (TTT) Program

76% of active MDFT sites have a local or agency-based trainer.

Train-the-Trainer (TTT) training, where trainees master a particular method and go on to train others in the approach, has been used in a wide variety of fields. Although Train-the-Trainers programs have not been widely studied, there is a growing consensus concerning their advantages over Expert/Purveyor-Led Training, including increased access to training, reduced costs and time required for training, increased program sustainability, and benefits of having on-site trainers who are knowledgeable of local, agency, and systems issues. The MDFT training program, whether Expert/Purveyor-Led or Train-the-Trainers, is multicomponent. Herschell, Kolko, Baumann, & Davis (2010) report that multicomponent training programs have the best training outcomes in comparison to other training methods. MDFT includes all the components of multicomponent training: comprehensive treatment manual, intensive didactic and experiential workshops, expert consultation on actual work, live or recorded review of client sessions, supervision training, booster training, and completion of at least one training case.

MDFT began providing TTT in 2006 in the State of Connecticut with two state-level trainers. Connecticut now has 6 state trainers who train therapists in over 20 publically funded individual programs throughout the State. Since 2006, MDFT’s TTT program has grown to over 40 agency, county, regional, state, or country-based trainers around the world. In our experience, it has enabled agencies to sustain MDFT more effectively and reduce costs of MDFT implementation.

MDFT International, Inc. provides TTT to individual provider agencies or groups of agencies. We call these trainers Agency-Based Trainers. Once trained, they are granted permission by MDFT International to train new staff at their agency (e.g., Children’s Aid Society in New York). We also train county (e.g. Riverside County Department of Mental Health), regional (e.g., Western Pennsylvania) state (e.g., Iowa), and national trainers (e.g., the Netherlands). These trainers continue to work closely with MDFT International to deliver the highest quality training to new therapists.

Each year, MDFT International hosts a meeting for all Agency-Based Trainers in Miami, FL. The meeting gives trainers a chance to share their work, build relationships with other trainers in both work and casual settings, and work directly with Dr. Liddle and MDFT International trainers.

Despite the ongoing collaboration and support from MDFT International, it is very important to recognize that individuals who successfully complete the intensive TTT are able to train new therapists on their own and do not need MDFT International trainers every time they want to expand their services or need to train replacement therapists. The cost savings can be enormous! MDFT International still provides ongoing coaching and implementation support services, but these are much less expensive than training new therapists. In MDFT, the first year of training new therapists and supervisors is the most expensive. Subsequent year’s services are less intensive and less expensive. This is true for programs with or without the TTT program.

The MDFT TTT, like its clinician training, is multicomponent and includes intensive workshops, live and video review of training, consultation calls, and at least one TTT training case (i.e., the trainer in training must have at least one therapist to train). The training process is identical to having MDFT International trainers conduct the training, but for a fraction of the costs.

The Train-the-Trainers program is not for everybody, but it is extremely useful for agencies, counties, regions, states or countries that are committed to MDFT over the long-term, have dedicated high-level MDFT supervisors who are good candidates to become trainers, anticipate or have experienced clinician turnover, and/or plan to expand their MDFT services into new regions, arenas, or for more youth and families than they currently serve.


Cost: $15,000 plus travel to train 1 trainer who must be a certified MDFT supervisor prior to trainer training.

Trainer Certification

  • Observe and give feedback on MDFT Introduction
  • Observe and give feedback on weekly Case Consultation Calls
  • Review and give feedback on Case Reviews and Video reviews
  • Observe and give feedback on Intensive Onsite Training
  • Review and give feedback on Weekly Case and Therapist Development Plans
  • Review and give feedback on Written Assessments 1 & 2

Herschell, A.D., Kolko, D.J., Baumann, B.L., Davis, A.C. (2010). The role of therapist training in the implementation of psychosocial treatment: A review and critique with recommendations. Clinical Psychology Review, 30, 448-466.