Systematic Evaluation of Psychotherapy Training: Supervision, Student Learning, and Patient Outcomes

Official title

Systematic Evaluation of Psychotherapy Training: Impact of Supervision and Training on Student Learning and Patient Outcomes

Overview

The project is a longitudinal observation study that aims to systematically evaluate selected parts of the material collected within the framework of the psychotherapy training conducted at the Center of Psychotherapy Education and Research unit at Karolinska Institutet and Region Stockholm, Sweden. Students at the unit, patients being administered psychotherapy by the students, and supervisors will participate in the study. The aim of the present study is to investigate the associations between (1) content and quality of psychotherapy supervision, (2) student therapists' competence, and (3) patient outcomes following student-led psychotherapy.

Detailed description

The project is a longitudinal observation study that aims to systematically evaluate selected parts of the material collected within the framework of the psychotherapy training conducted at the Center of Psychotherapy Education and Research unit at Karolinska Institutet and Region Stockholm, Sweden, from 2023 - 2028. The courses/programs that will be included in the project are the psychotherapist program (six semesters), the specialist training for psychologists in adult psychiatry (six semesters), the basic training in evidence-based psychotherapeutic methods (three semesters), and the basic training in psychotherapy for residents in child, adolescent, and adult psychiatry (two semesters). The element of the programs that will be evaluated is student-led psychotherapy, in which students conduct psychotherapy with patients in the public health care system.

The study's research subjects are supervisors, students, and their patients from the unit's student-led psychotherapies. Data consists of material that the supervisors and students have collected within the framework of the educational setting; the data are placed and stored on a secure digital platform (BASS). For objective estimates, the project also intends to code selected audio-recorded psychotherapy and supervision sessions.

The primary research questions are:

1. Do psychotherapy students' general and specific psychotherapy competence increase over time during training? 2. Can statistically significant and/or clinically meaningful patient improvements be observed after student-led psychotherapy? 3. Is students' psychotherapy competence significantly associated with patient outcomes? 4. Are aspects (content and quality) of the psychotherapy supervision setting significantly related to improved student therapists' competence?

The project also aims to psychometrically evaluate (validity and reliability) some of the included instruments.

Interventions

• Behavioral Psychotherapy education
  Psychotherapy education, including supervision, lectures, and workshops

Primary outcome measures

• The Generalized Anxiety Disorder Assessment 7 (GAD-7) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Patient Health Questionnaire-9 (PHQ-9) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The WHO Disability Assessment Schedule (WHODAS 2.0) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Alcohol Use Disorders Identification Test (AUDIT) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy for those patients scoring above the cut-off at pre-treatment]
• The Sleep Condition Indicator (SCI) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Liebowitz Social Anxiety Scale, self-report (LSAS-SR) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Panic Disorder Severity Scale - Self-rated (PDSS-SR) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Penn State Worry Questionnaire (PSWQ) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Posttraumatic Stress Disorder Checklist, version 5 (PCL-5) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]
• The Obsessive Compulsive Inventory-Revised (OCI-R) [Time frame: Change from pre-treatment to immediately after the end of psychotherapy]

Eligibility criteria

Inclusion criteria

• Students at one of the following courses/programs: Primary training in evidence-based psychotherapeutic methods (three semesters) and specialty trainee (ST) for doctors in child, adolescent, and adult psychiatry (two semesters), the postgraduate psychotherapist program (six semesters), and the specialist training program for clinical psychologists (six semesters).
• Clinical supervisors for the students in the abovementioned courses/programs.
• Patients in psychotherapy with students in the abovementioned courses/programs as therapists. The patients are regular patients at public health care facilities in psychiatry and primary care.
• Students, supervisors, and patients must consent to inclusion.

Exclusion criteria

• No exclusion criteria are applied.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Cohort

Study locations

Sweden · 1 center

• Center for Psychiatry Research — Stockholm

Identifiers

NCT: NCT06105502 · 2023-03668-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗