Clinical trial NCT06105502: 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
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Student Education
Keywords: psychotherapy
supervision
student learning
patient outcomes
Lead sponsor: Region Stockholm
Sponsor class: OTHER_GOV
Collaborators: name: Karolinska Institutet
First posted: 2023-10-27
Enrollment: 417
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Psychotherapy students at the Center for Psychotherapy Education and Research, Karolinska Institutet and Region Stockholm, Sweden

Brief summary: 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.

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.

Primary outcomes:
measure: The Generalized Anxiety Disorder Assessment 7 (GAD-7)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Patient Health Questionnaire-9 (PHQ-9)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The WHO Disability Assessment Schedule (WHODAS 2.0)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Alcohol Use Disorders Identification Test (AUDIT)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy for those patients scoring above the cut-off at pre-treatment
measure: The Sleep Condition Indicator (SCI)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Liebowitz Social Anxiety Scale, self-report (LSAS-SR)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Panic Disorder Severity Scale - Self-rated (PDSS-SR)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Penn State Worry Questionnaire (PSWQ)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Posttraumatic Stress Disorder Checklist, version 5 (PCL-5)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Obsessive Compulsive Inventory-Revised (OCI-R)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Perceived Stress Scale-10 (PSS-10)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Short Health Anxiety Inventory-14 (SHAI-14)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Eating Disorder Examination Questionnaire (EDE-Q)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
measure: The Drug Use Disorders Identification Test (DUDIT)
timeFrame: Change from pre-treatment to immediately after the end of psychotherapy
Secondary outcomes:
Other outcomes:
measure: Psychotherapy summary
timeFrame: Student and patient data immediately after the end of psychotherapy
measure: Cognitive Therapy Scale-Revised (CTS-R)
timeFrame: At first session, first treatment session, fifth treatment session, and last treatment session
measure: Supervision Adherence and Guidance Evaluation (Short-SAGE)
timeFrame: At first session, first treatment session, fifth treatment session, and last treatment session
measure: Evaluation of Supervisory Skills and Adherence, 2019 (ESSA-19)
timeFrame: At first session, first treatment session, fifth treatment session, and last treatment session
measure: Supervision evaluation
timeFrame: At the middle of the student term (week 10 out of 20)
Locations:
city: Stockholm
country: Sweden
facility: Center for Psychiatry Research
Study officials:
affiliation: Center for Psychiatry Research, Karolinska Institutet and Region Stockholm
name: Maria Beckman, PhD
role: PRINCIPAL_INVESTIGATOR
References: