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Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life-long practice, structured instruments are used only occasionally. In the current study, an observation-based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists-in-training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one-factorial structure of the instrument was found. By providing multiple opportunities for feedback, self-reflection, and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly support competence-based training and supervision.
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.
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.
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.
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.