Plain English Summary
Background and study aims
Psychotherapy is highly effective and widely acknowledged for treating various mental disorders. 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. Standardized role plays with simulated patients (trained persons playing someone with a mental disorder) are useful for evaluating training approaches. In medical education, this procedure is now internationally established. However, little use has been made so far of standardized role playing to evaluate training and supervision in the area of clinical psychology and psychotherapy. Yet, this approach has a considerable potential for systemizing research. During the first phase of the research project, standardized role playing will be adapted to assess therapist competencies in clinical-psychological practice. In the second phase, standardized role plays are used to evaluate methods for training and supervision. In two experiments, central approaches for treating depression are trained (cognitive restructuring and behavioral activation). The first experiment compares an active training approach (model learning) with a passive one (reading the manual). The second experiment compares two methods of supervision (verbal report vs video analysis).
Who can participate?
What does the study involve?
In each experiment, students are randomly allocated to the experimental and control groups, and to the order of the training topics (behavioral activation and cognitive strategies or vice versa). Training: In the experimental group, participants watch a video of an experienced psychotherapist who skillfully demonstrates behavioral activation (Video 1) and cognitive strategies (Video 2) with an SP demonstrating a depressive disorder. In the control group, participants watch two unspecific learning tutorials.
Supervision: In the experimental group, participants show their video on behavioral activation (Video 1) and on cognitive techniques (Video 2) of an interaction with an SP demonstrating a depressive disorder to a supervisor (behaviorally-based). In the control group, participants report their experiences with the role plays to a supervisor (verbally-based supervision).
Each student takes part in three role plays (before, after and three-month follow-up) which are all videotaped. Two independent raters assess the therapist competence of each role play on the basis of an established competence scale.
What are the possible benefits and risks of participating?
Participants will contribute to the further development of training and supervision methods. Participation may be associated with anxiety during the video recordings.
Where is the study run from?
University of Potsdam (Germany)
When is the study starting and how long is it expected to run for?
June 2019 to June 2022
Who is funding the study?
German Research Foundation
Who is the main contact?
Dr Franziska Kühne
WE 4654/10-1; KU 3790/2-1
Simulated patients in training and supervision for the evaluation of therapeutic competencies
Post-training, psychology students randomized to the intervention group (i.e., modeling) will display more therapeutic competencies than students in the control group (i.e., reading written instructions; hypothesis 1).
These differences will persist until 3-month follow-up (hypothesis 2).
Post-supervision, psychology students randomized to the intervention group (i.e., supervision based on video sessions) will display more therapeutic competencies than students in the control group (i.e., supervision based on verbal reporting; hypothesis 3).
These differences will persist until 3-month follow-up (hypothesis 4).
Approved 23/05/2018 by the University of Potsdam ethics review committee (Universität Potsdam, Ethikkommission des Senats, Gremienverwaltung, Nadine Mohaupt, Am Neuen Palais 10, 14469 Potsdam, Germany; Tel: +49 (0)331 977 1791; Email: firstname.lastname@example.org), ref: 9/2018
Single-center randomized-controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Participants (i.e., bachelor and master students included either as trainees or supervisees) will conduct therapy sessions with standardized patients. They will be randomized in a 1:1 manner by computer-generated numbers and allocated to the experimental or control groups, and to the order of the training topics (behavioral activation and cognitive strategies or vice versa). The allocation will be implemented by a researcher independent of the role plays.
Training (modeling vs written instructions)
Supervision (based on video sessions vs based on verbal reporting)
Training: In the experimental group, participants will watch a video of an experienced psychotherapist who skillfully demonstrates behavioral activation (Video 1) and cognitive strategies (Video 2) with an SP demonstrating a depressive disorder. In the control group, participants will watch two unspecific learning tutorials.
Supervision: In the experimental group, participants will show their video on behavioral activation (Video 1) and on cognitive techniques (Video 2) of an interaction with an SP demonstrating a depressive disorder to a supervisor (behaviorally-based). In the control group, participants will report their experiences with the role plays to a supervisor (verbally-based supervision).
Total duration of the first appointment: 3.5 hours, and of the follow-up appointment: 1.5 hours.
Primary outcome measure
Measured at pre, post- and 3-month follow-up:
1. Psychotherapeutic competencies measured via the Cognitive Therapy Scale (CTS)
2. Therapeutic techniques measured using a self-developed checklist
Secondary outcome measures
Measured at pre, post- and 3-month follow-up unless otherwise specified:
1. Therapeutic alliance measured using the Helping Alliance questionnaire (HAQ)
2. Empathy measured via the Empathy Scale
3. Therapeutic adherence measured using the Cognitive-Behavioral Therapy Adherence Scale (CBT-AS)
4. Therapeutic knowledge evaluated by multiple choice questions and case vignettes
5. Anxiety measured by the state-trait-anxiety (STAI)
6. Authenticity measured by the Authenticity of Patient Demonstrations (APD) scale
7. Counseling skills measured using the Helping Skills Measure
8. Negative therapist effects measured using self-developed questionnaire
9. Personality measured by the Big Five Inventory (BFI-K) at post-measurement
10. Allegiance effects measured using self-developed questionnaire at pre-measurement
11. The individual perception of the study measured using a self-developed questionnaire at post- measurement and 3-month follow-up
12. Demographic data measured using a self-developed questionnaire at pre-measurement and 3-month follow-up
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Psychology students
2. Informed consent (i.e., agreement to the video recordings)
Target number of participants
Participant exclusion criteria
1. Currently in psychotherapeutic treatment
2. Insufficient German language skills
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
University of Potsdam
German Research Association, DFG
Funding Body Type
private sector organisation
Funding Body Subtype
Trusts, charities, foundations (both public and private)
Results and Publications
Publication and dissemination plan
Planned protocol publication in a peer-reviewed journal. Planned publication of the study results in a high-impact peer-reviewed journal.
IPD sharing statement
The datasets generated during and/or analysed during the current study are not expected to be made available. Since making the individual participant data publicly available was not covered by the ethics vote, they will be held on a password-protected computer at the researchers' department until deletion (after 10 years) is prescribed.
Intention to publish date
Participant level data
Not expected to be available
Basic results (scientific)
2020 protocol in https://www.ncbi.nlm.nih.gov/pubmed/32183859 (added 19/03/2020)