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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.
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.
Theoretischer Hintergrund:Supervision spielt eine zentrale Rolle zum Wissens- und Kompetenzerwerb sowie in der Qualitätssicherung.
Fragestellung:Ziel war es, den aktuellen Forschungsstand zur Supervision im Rahmen der kognitiven Verhaltenstherapie abzubilden, um daraus Schlussfolgerungen für die zukünftige Forschung abzuleiten.
Methode:Zur Evidenzsynthese wurde ein Scoping Review durchgeführt, das die Darstellung zentraler Konzepte, aktueller Evidenz und möglicher Forschungsbedarfe ermöglichte. Neben einer systematischen Literaturrecherche wurden Vorwärts- und Rückwärtssuchstrategien eingesetzt.
Ergebnisse:Eingeschlossen wurden zwölf Publikationen basierend auf zehn empirischen Studien. Alle Studien beschrieben Ausbildungssettings, aber nur wenige untersuchten übende Interventionen (z. B. Rollenspiele). Häufig wurden Effekte subjektiv erfasst, die methodische Qualität der Begleitstudien variierte.
Schlussfolgerungen:Notwendig sind weitere methodisch hochwertige Studien, experimentell orientiert oder in der klinischen Praxis, die die Supervisionsforschung bereichern können.
Background
Psychotherapy is highly effective and widely acknowledged for treating various mental disorders. Nevertheless, in terms of methods for teaching effective psychotherapeutic approaches and competencies, there has been a lack of investigation. Training and supervision are the main strategies for teaching therapist competencies, and standardized role-plays with simulated patients (i.e., trained individuals playing someone with a mental disorder) seem useful for evaluating training approaches. In medical education, this procedure is now internationally established. However, so far, little use has been made of standardized role-playing to evaluate training and supervision in the area of clinical psychology and psychotherapy.
Methods
In this study, standardized role-plays are used to evaluate methods for training and supervision. Central cognitive behavioral approaches for treating depression are taught in the training. The first experiment compares an active training approach (i.e., model learning) with a passive one (i.e., reading manual-based instructions). The second experiment compares a direct supervision technique (i.e., supervision based on video analysis) with an indirect one (i.e., supervision based on verbal reporting). In each experiment, 68 bachelor’s and master’s students of psychology will be randomly assigned to the experimental and control groups. Each student takes part in three role-plays (baseline, post and 3-month follow-up), which are all videotaped. Two independent raters assess therapist competencies in each role-play on the basis of a standardized competence scale.
Discussion
The research project aims to contribute to the development of specific training and supervision methods in order to improve psychotherapy training and patient care.
Objectives: The use of simulated and standardized patients (SP) is widely accepted in the medical field and, from there, is beginning to disseminate into clinical psychology and psychotherapy. The purpose of this study was therefore to systematically review barriers and facilitators that should be considered in the implementation of SP interventions specific to clinical psychology and psychotherapy. Methods: Following current guidelines, a scoping review was conducted. The literature search focused on the MEDLINE,PsycINFO and Web of Science databases, including Dissertation Abstracts International. After screening for titles and abstracts,full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, a pre-defined form was piloted and used. Units of meaning with respect to barriers and facilitators were extracted and categorized inductively using content-analysis techniques. From the results, a matrix of interconnections and a network graph were compiled. Results: The 41 included publications were mainly in the fields of psychiatry and mental health nursing, as well as in training and education. The detailed category system contrasts four supercategories, i.e., which organizational and economic aspects to consider, which persons to include as eligible SPs, how to develop adequate scenarios, and how to authentically and consistently portray mental health patients.Conclusions: Publications focused especially on the interrelation between authenticity and consistency of portrayals, on how to evoke empathy in learners, and on economic and training aspects. A variety of recommendations for implementing SP programs,from planning to training, monitoring, and debriefing, is provided, for example, ethical screening of and ongoing support for SPs.
Background
Despite the prevalence of obsessive-compulsive disorder (OCD), its precise identification remains challenging. With the Zohar-Fineberg Obsessive-Compulsive Screen (ZF-OCS; 5 or 6 items), a brief instrument is widely available mainly in English. As there is a lack of empirical studies on the ZF-OCS, the aim of the present study was to translate the items into German and investigate the instrument in a nonclinical sample.
Methods
In two consecutive online surveys, n = 304 and n = 51 students participated. Besides the ZF-OCS, they answered established measures on OCD, depression, health anxiety, general anxiety and health-related well-being.
Results
Whereas internal consistency was low (α = .53–.72; ω = .55–.69), retest reliability (rt1,t2 = .89) at two weeks was high. As expected, we found high correlations with other OCD instruments (r > .61; convergent validity), and significantly weaker correlations with measures of depression (r = .39), health anxiety (r = .29), and health-related well-being (r = −.28, divergent validity). Nonetheless, the correlations with general anxiety were somewhere in between (r = .52).
Conclusions
Due to heterogeneous OCD subtypes, the ZF-OCS asks diverse questions which probably resulted in the present internal consistency. Nevertheless, the results on retest reliability and validity were promising. As for other OCD instruments, divergent validity regarding general anxiety seems problematic to establish. Even so, the ZF-OCS seems valuable for screening purposes, as it is short and easy to administer, and may facilitate initiating subsequent clinical assessment. Further studies should determine the instrument’s diagnostic accuracy.
Purpose: Although subjective knowledge about the prognosis of an advanced disease is extremely important for coping and treatment planning, the concept of prognostic awareness (PA) remains inconsistently defined. The aims of the scoping review were to synthesize a definition of PA from the most recent literature, describe preconditions, correlates and consequences, and suggest a conceptual model.
Methods: By using scoping review methodology, we searched the Web of Science and PubMed databases, and included publications, reviews, meta-analyses or guidelines on all physical diagnoses, as well as publications offering a conceptual or an operational definition of PA. The data were analyzed by means of content analysis techniques.
Results: Of the 24 included publications, 21 referred exclusively to cancer, one to patients with hip fractures and two to palliative care in general. The deduced definition of PA comprised the following facets: adequate estimation of chances for recovery, knowledge of limited time to live, adequate estimation of life expectancy, knowledge of therapy goals, and knowledge of the course of the disease. Further content analysis results were mapped graphically and in a detailed table.
Conclusion: There appears to be a lack of theoretical embedding of PA that in turn influences the methods used for empirical investigation. Drawing on a clear conceptual definition, longitudinal or experimental studies would be desirable.
Background: Although clinical supervision is considered to be a major component of the development and maintenance of psychotherapeutic competencies, and despite an increase in supervision research, the empirical evidence on the topic remains sparse.
Methods: Because most previous reviews lack methodological rigor, we aimed to review the status and quality of the empirical literature on clinical supervision, and to provide suggestions for future research. MEDLINE, PsycInfo and the Web of Science Core Collection were searched and the review was conducted according to current guidelines. From the review results, we derived suggestions for future research on clinical supervision.
Results: The systematic literature search identified 19 publications from 15 empirical studies. Taking into account the review results, the following suggestions for further research emerged: Supervision research would benefit from proper descriptions of how studies are conducted according to current guidelines, more methodologically rigorous empirical studies, the investigation of active supervision interventions, from taking diverse outcome domains into account, and from investigating supervision from a meta-theoretical perspective.
Conclusions: In all, the systematic review supported the notion that supervision research often lags behind psychotherapy research in general. Still, the results offer detailed starting points for further supervision research.
Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood.
Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines.
Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives.
Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications.
Background
Communicating a diagnosis is highly important, yet complex, especially in the context of cancer and mental disorders. The aim was to explore the communication style of an oncologist vs. psychotherapist in an online study.
Methods
Patients (N = 136: 65 cancer, 71 depression) were randomly assigned to watch a standardized video vignette with one of two communication styles (empathic vs. unempathic). Outcome measures of affectivity, information recall, communication skills, empathy and trust were applied.
Results
Regardless of diagnosis, empathic communication was associated with the perception of a significantly more empathic (p < 0.001, η2partial = 0.08) and trustworthy practitioner (p = 0.014, η2partial = 0.04) with better communication skills (p = 0.013, η2partial = 0.05). Cancer patients reported a larger decrease in positive affect (p < 0.001, η2partial = 0.15) and a larger increase in negative affect (p < 0.001, η2partial = 0.14) from pre- to post-video than depressive patients. Highly relevant information was recalled better in both groups (p < 0.001, d = 0.61–1.06).
Conclusions
The results highlight the importance of empathy while communicating both a diagnosis of cancer and a mental disorder. Further research should focus on the communication of a mental disorder in association with cancer.