The impact of alliance-focused and facilitative interpersonal relationship training on therapist skills: An RCT of brief training.

Research on standard methods of therapist training has found mixed evidence to as to whether standard training methods are effective. This study investigated the impact of a novel, research-informed training protocol that integrated elements of alliance-focused training (AFT) and facilitative interpersonal skills (FIS). Beyond traditional training techniques of didactics and lecture, the AFT/FIS intervention incorporated empirically supported video simulations of therapy, which were reinforced by role plays and deliberate practice on key therapeutic interpersonal skills. Fifty-eight graduate-level therapy trainees and professional therapists from various helping fields were randomized to one of two brief trainings in a multi-site RCT: (i) the AFT/FIS workshop or (ii) a more traditional demonstration training (DT) workshop. Participants were assessed on critical, relational therapeutic skills before and after the training. After controlling for relevant covariates, participants in the AFT/FIS training saw a marginally higher post-intervention level of overall therapeutic skills. Subsequent exploratory analyses revealed AFT/FIS participants also had significantly higher levels of specifically targeted post-training therapist skills (i.e., empathy, alliance bond capacity, and alliance rupture-repair responsiveness) compared to participants in DT. Implications for future empirical investigations and training initiatives are discussed.

Modeling therapist responses with structured practice enhances facilitative interpersonal skills.

OBJECTIVE: Facilitative interpersonal skills (FIS) video stimuli were used to develop and test a brief training component of observational modeling with repeated practice. Specifically, this study hypothesized that a brief training of video modeling therapeutic use of interpersonal skills, combined with repeated practice, would result in improved FIS responses (relative to control). METHOD: Undergraduates (n = 101) with expressed interest in the helping professions were randomly assigned to Modeled Practice or Control conditions. After a baseline, participants in Modeled Practice observed model responses and then repeatedly practiced different responses, while those in the Control group observed videos comparable in format, but nontherapeutic in content. Participants then gave responses to different simulated clients, which were used to assess hypotheses. RESULTS: FIS for Modeled Practice was significantly higher than controls in postpractice. CONCLUSIONS: Result provides empirical support for training in practice strategy components and has implications for therapeutic deliberate practice training.

Enhancing psychotherapy process with common factors feedback: A randomized, clinical trial.

In this study, we developed and tested a common factors feedback (CFF) system. The CFF system was designed to provide ongoing feedback to clients and therapists about client ratings of three common factors: (a) outcome expectations, (b) empathy, and (c) the therapeutic alliance. We evaluated the CFF system using randomized, clinical trial (RCT) methodology. PARTICIPANTS: Clients were 79 undergraduates who reported mild, moderate, or severe depressive symptoms at screening and pretreatment assessments. These clients were randomized to either: (a) treatment as usual (TAU) or (b) treatment as usual plus the CFF system (TAU + CFF). Both conditions entailed 5 weekly sessions of evidence-based therapy delivered by doctoral students in clinical psychology. Clients completed measures of common factors (i.e., outcome expectations, empathy, therapeutic alliance) and outcome at each session. Clients and therapists in TAU + CFF received feedback on client ratings of common factors at the beginning of Sessions 2 through 5. When surveyed, clients and therapists indicated that that they were satisfied with the CFF system and found it useful. Multilevel modeling revealed that TAU + CFF clients reported larger gains in perceived empathy and alliance over the course of treatment compared with TAU clients. No between-groups effects were found for outcome expectations or treatment outcome. These results imply that our CFF system was well received and has the potential to improve therapy process for clients with depressive symptoms. (PsycINFO Database Record