Exposure therapy tailored to inhibitory learning principles in a naturalistic setting: an open pilot trial in obsessive-compulsive outpatient care.

Inhibitory learning (IL) theory offers promising therapeutic strategies. However, more evidence is needed, especially regarding OCD treatment in routine care. The present pilot study investigated the positive and negative effects of IL-focused cognitive-behavioral therapy (CBT) in a university outpatient setting. A total of N = 21 patients (57.14% male, mean age 31.14, SD = 12.39 years) passed through manualized therapy delivered by licensed psychotherapists. Between the first and 20th IL-focused CBT session, obsessive-compulsive symptoms (Obsessive Compulsive Inventory-Revised, d = 3.71), obsessive beliefs (Obsessive-Beliefs Questionnaire, d = 1.17), depressive symptoms (Beck Depression Inventory, d = 3.49), and overall psychological distress (Global Severity Index, d = 3.40) decreased significantly (all ps < 0.01). However, individual patients reported some negative effects of therapy. The results underline the value of thorough investigations of novel therapeutic interventions in naturalistic settings.

Differences in psychotherapy preferences between psychotherapy trainees and laypeople.

Despite increasing research on psychotherapy preferences, the preferences of psychotherapy trainees are largely unknown. Moreover, differences in preferences between trainees and their patients could (a) hinder symptom improvement and therapy success for patients and (b) represent significant obstacles in the early career and development of future therapists.We compared the preferences of n = 466 psychotherapy trainees to those of n = 969 laypersons using the Cooper-Norcross Inventory of Preferences. Moreover, we compared preferences between trainees in cognitive-behavioural therapy (CBT) and psychodynamic trainees.We found significant differences between both samples in 13 of 18 items, and three of four subscales. Psychotherapy trainees preferred less therapist directiveness (d = 0.58), more emotional intensity (d = 0.74), as well as more focused challenge (d = 0.35) than laypeople. CBT trainees preferred more therapist directiveness (d = 2.00), less emotional intensity (d = 0.51), more present orientation (d = 0.76) and more focused challenge (d = 0.33) than trainees in psychodynamic/psychoanalytic therapy.Overall, the results underline the importance of implementing preference assessment and discussion during psychotherapy training. Moreover, therapists of different orientations seem to cover a large range of preferences for patients, in order to choose the right fit.

Modeling in psychotherapy training: A randomized controlled proof-of-concept trial.

OBJECTIVE: Despite the importance of modeling for learning, it has only so far been investigated in a few controlled studies in psychotherapy training. We, therefore, investigated, across several study outcomes, whether modeling outperformed a control group. METHOD: Sixty-nine trainees (i.e., psychology students; mean age 25.58 years, 81.2% women and 81.2% Caucasian) were randomly assigned to the intervention group (IG, manual reading plus modeling) or control group (CG, manual reading). After manual reading, IG participants watched a video of a skillfully conducted therapy session, whereas CG participants watched an unspecific tutorial (e.g., solving a Rubik's Cube). Trainees then demonstrated cognitive behavioral interventions in videotaped role-plays with (SPs). Psychotherapeutic competences and counseling skills were rated by two independent raters, on the Cognitive Therapy Scale (CTS) and the Clinical Communication Skills Scale-Short Form (CCSS-S). In addition, raters, trainees, and SPs assessed empathy (Empathy Scale [ES]) and alliance (Helping Alliance Questionnaire [HAQ]). RESULTS: Multilevel modeling revealed Significant Time × Group Effects, that is, psychotherapy competences (CTS, ß = .26, p = .026) and counseling skills (CCSS-S, ß = .31, p = .004) to increase more pre-post in the IG than in the CG (rater perspective). The same applied to the alliance (HAQ) from the external rater and SP perspectives. Trainees evaluated the alliance as improving in both groups from pre to post training (main effect). CONCLUSIONS: The results provide initial support for modeling as important for fostering psychotherapy skills. Future studies should focus on more complex training and real patient encounters. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The concise measurement of clinical communication skills: Validation of a short scale.

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.

Corrigendum: Assessing Patient Preferences: Examination of the German Cooper-Norcross Inventory of Preferences.

[This corrects the article on p. 795776 in vol. 12, PMID: 35095681.].

Assessing Patient Preferences: Examination of the German Cooper-Norcross Inventory of Preferences.

Despite the positive effects of including patients' preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP.

Standardized patients in psychotherapy training and clinical supervision: study protocol for a randomized controlled trial.

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. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN19173895. Registered on 10 December 2019.