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Theoretischer Hintergrund: Einflüsse von therapeutenorientiertem Kompetenz-Feedback in der Psychotherapieausbildung wurden bislang wenig untersucht.
Fragestellung: Wie gehen Ausbildungstherapeuten mit Feedback um? Welchen Einfluss hat ein regelmäßiges Kompetenz-Feedback auf die Qualität psychotherapeutischer Behandlungen (insbesondere Therapiesitzungen, therapeutische Beziehung, Person des Therapeuten, Supervision)?
Methode: Elf Therapeuten wurden mithilfe eines halbstrukturierten Interviewleitfadens befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015).
Ergebnisse: Das auf Basis der Interviews erstellte Kategoriensystem umfasste die Kategorien „Erwartungen an das Feedback“, „Wahrnehmung des Feedbacks“, „Verarbeitung von und Umgang mit Feedback“, „Folgen, Auswirkungen und Veränderungen durch Feedback“ sowie „Verbesserungswünsche“.
Schlussfolgerungen: Therapeuten streben eine Umsetzung des Feedbacks an, welches sich auf die Behandlung, die Supervision, die eigene Person und die therapeutische Beziehung auswirkt.
Theoretischer Hintergrund: Einflüsse von therapeutenorientiertem Kompetenz-Feedback in der Psychotherapieausbildung wurden bislang wenig untersucht.
Fragestellung: Wie gehen Ausbildungstherapeuten mit Feedback um? Welchen Einfluss hat ein regelmäßiges Kompetenz-Feedback auf die Qualität psychotherapeutischer Behandlungen (insbesondere Therapiesitzungen, therapeutische Beziehung, Person des Therapeuten, Supervision)?
Methode: Elf Therapeuten wurden mithilfe eines halbstrukturierten Interviewleitfadens befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015).
Ergebnisse: Das auf Basis der Interviews erstellte Kategoriensystem umfasste die Kategorien „Erwartungen an das Feedback“, „Wahrnehmung des Feedbacks“, „Verarbeitung von und Umgang mit Feedback“, „Folgen, Auswirkungen und Veränderungen durch Feedback“ sowie „Verbesserungswünsche“.
Schlussfolgerungen: Therapeuten streben eine Umsetzung des Feedbacks an, welches sich auf die Behandlung, die Supervision, die eigene Person und die therapeutische Beziehung auswirkt.
Theoretischer Hintergrund:
Selbsterfahrung ist zentraler Bestandteil der Psychotherapieausbildung. Gleichzeitig wurde Selbsterfahrung selten empirisch untersucht.
Fragestellung:
Ziel unserer Studie war es, Bedingungen und Effekte hilfreicher Selbsterfahrung zu explorieren.
Methode:
Vierzehn verhaltenstherapeutische Ausbildungskandidat_innen wurden anhand halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015).
Ergebnisse:
Verschiedene Bedingungen wurden mit hilfreich erlebter Selbsterfahrung in Zusammenhang gebracht: Merkmale der Selbsterfahrungsleitung (u. a. Durchführungskompetenz), der Organisation, der Teilnehmer_innen (Lernbereitschaft), die behandelten Themen und die eingesetzten Techniken, sowie eine tragfähige Arbeitsbeziehung. Berichtete positive Effekte waren u. a. die Förderung interpersoneller Kompetenzen. Zudem wurden Nebenwirkungen und negative Effekte formuliert (u. a. Erschöpfung).
Schlussfolgerungen:
Bedingungen zur Durchführung von als hilfreich erlebter Selbsterfahrung und Effekte von Selbsterfahrung wurden aus Sicht der Teilnehmer_innen extrahiert.
Aim
Although research and clinical definitions of psychotherapeutic competence have been proposed, less is known about the layperson perspective. The aim was to explore the views of individuals with different levels of psychotherapy experience regarding what-in their views-constitutes a competent therapist.
Method
In an online survey, 375 persons (64% female, mean age 33.24 years) with no experience, with professional experience, or with personal pre-experience with psychotherapy participated. To provide low-threshold questions, we first presented two qualitative items (i.e. "In your opinion, what makes a good/competent psychotherapist?"; "How do you recognize that a psychotherapist is not competent?") and analysed them using inductive content analysis techniques (Mayring, 2014). Then, we gave participants a 16-item questionnaire including items from previous surveys and from the literature and analysed them descriptively.
Results
Work-relatedprinciples, professionalism, personalitycharacteristics, caringcommunication, empathy and understandingwere important categories of competence. Concerning the quantitative questions, most participants agreed with items indicating that a therapist should be open, listen well, show empathy and behave responsibly.
Conclusion
Investigating layperson perspectives suggested that effective and professional interpersonal behaviour of therapists plays a central role in the public's perception of psychotherapy.
Aim
Although research and clinical definitions of psychotherapeutic competence have been proposed, less is known about the layperson perspective. The aim was to explore the views of individuals with different levels of psychotherapy experience regarding what-in their views-constitutes a competent therapist.
Method
In an online survey, 375 persons (64% female, mean age 33.24 years) with no experience, with professional experience, or with personal pre-experience with psychotherapy participated. To provide low-threshold questions, we first presented two qualitative items (i.e. "In your opinion, what makes a good/competent psychotherapist?"; "How do you recognize that a psychotherapist is not competent?") and analysed them using inductive content analysis techniques (Mayring, 2014). Then, we gave participants a 16-item questionnaire including items from previous surveys and from the literature and analysed them descriptively.
Results
Work-relatedprinciples, professionalism, personalitycharacteristics, caringcommunication, empathy and understandingwere important categories of competence. Concerning the quantitative questions, most participants agreed with items indicating that a therapist should be open, listen well, show empathy and behave responsibly.
Conclusion
Investigating layperson perspectives suggested that effective and professional interpersonal behaviour of therapists plays a central role in the public's perception of psychotherapy.
Clinical supervision is regarded as one of the most important components of psychotherapy training. In clinical practice, it has been found that the implementation of clinical supervision varies substantially and often differs from the recommendations made in the literature. The objective of the current study was to investigate the frequency of topics (e.g. ethical issues) and techniques (e.g. role play) in the clinical supervision of psychotherapy trainees in Germany. To this end, we considered supervisions in cognitive behavioural therapy (CBT) and psychodynamic therapy (PT). A total of 791 psychotherapy trainees (533 CBT and 242 PT) were asked via the internet to provide information about their current supervision sessions. We found that clinical supervision in psychotherapy training addressed topics that are central for the effective treatment of supervised patients (i.e. therapeutic interventions, therapeutic alliance, maintaining factors, and therapeutic goals). However, the most frequently used intervention in clinical supervision in psychotherapy training was case discussion. Rarely were techniques used that allowed the supervisor to give the supervisee feedback based on the supervisee's demonstrated competencies. For example, 46% of the supervisors never used audiotapes or videotapes in the supervision. Differences between CBT and PT were rather small. Current practice regarding the techniques used in clinical supervision for psychotherapy trainees contradicts recommendations for active and feedback-oriented clinical supervision. Thus the potential of clinical supervision might not be fully used in clinical practice.
Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients’ interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists’ adherence (r = 0.54) and therapeutic alliance (r = 0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients’ interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r = 0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG.
Objective
There is a very limited amount of research on the relationship between therapist and patient in‐session behavior and treatment outcome in cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/AG). Additionally, the findings tend to be inconclusive. This study investigates the association between therapist competence, adherence, patient interpersonal behavior, and therapeutic alliance and outcome in a low‐control CBT setting by using comprehensive measures.
Methods
Twenty‐six patients with PD/AG received 12 sessions of exposure‐based CBT. With regard to the outcome, treatments were classified either as problematic or nonproblematic by means of distinct criteria. Two raters evaluated the in‐session behavior.
Results
Patient interpersonal behavior was significantly associated with outcome at follow‐up (r = 0.49). At posttreatment, the correlation did not reach significance ( r = 0.34). Competence, adherence, and alliance were not outcome associated.
Conclusion
The findings emphasize the need for therapists to pay particular attention to patients’ interpersonal behavior during treatment.
Although effective treatments exist, obsessive-compulsive disorder (OCD) is, according to the views of patients and experts, still associated with chronicity, a term with no clear and consistent definition. To improve patient care and to foster research, a clear distinction between the various concepts of chronicity cited in the literature is crucial. The aim was thus to explicate central concepts related to courses and trajectories in OCD based on an explorative, scoping search of the existing literature. Our review revealed a considerable lack in content validity, as the concepts were operationalized inconsistently. Concepts related to symptom improvement were (complete) recovery, partial/full remission and partial/full response. Terms used in relation with symptom stability or worsening were chronic/continuous, intermittent and episodic course, waxing and waning, relapse, recurrence, deterioration and treatment-refractoriness. All concepts are explained and visualized as a result of the review. Further, based on authors' remarks, we present recommendations on how to enhance care for chronic OCD patients, namely training psychotherapists to apply CBT as intended, managing patient beliefs about disease and treatment, and adapting psychotherapy to OCD subtypes. Finally, we then propose a literature-based definition of treatment-refractory OCD.
Objective: There is a lack of brief rating scales for the reliable assessment of psychotherapeutic skills, which do not require intensive rater training and/or a high level of expertise. Thus, the objective is to validate a 14-item version of the Clinical Communication Skills Scale (CCSS-S).
Methods: Using a sample of N = 690 video-based ratings of role-plays with simulated patients, we calculated a confirmatory factor analysis and an exploratory structural equation modeling (ESEM), assessed convergent validities, determined inter-rater reliabilities and compared these with those who were either psychology students, advanced psychotherapy trainees, or experts.
Results: Correlations with other competence rating scales were high (rs > 0.86–0.89). The intraclass correlations ranged between moderate and good [ICC(2,2) = 0.65–0.80], with student raters yielding the lowest scores. The one-factor model only marginally replicated the data, but the internal consistencies were excellent (α = 0.91–95). The ESEM yielded a two-factor solution (Collaboration and Structuring and Exploration Skills).
Conclusion: The CCSS-S is a brief and valid rating scale that reliably assesses basic communication skills, which is particularly useful for psychotherapy training using standardized role-plays. To ensure good inter-rater reliabilities, it is still advisable to employ raters with at least some clinical experience. Future studies should further investigate the one- or two-factor structure of the instrument.