Background: Psychology students at universities in Denmark and worldwide only receive little
clinical training, even though such training is crucial to psychologists' job performance
after graduation. Training non-specific psychotherapeutic skills, such as being empathic and
facilitating the therapeutic alliance, is critical since these skills are related to
psychotherapy outcomes. In this study, a deliberate practice approach to training will be
compared to theoretical teaching.
Hypothesis: The first and main hypothesis is that the students' observer-rated Facilitative
Interpersonal Skills (FIS) will improve significantly more after deliberate practice training
compared to theoretical teaching. The second hypothesis is that students' self-reported
Facilitative Interpersonal Skills (FIS-SR), self-efficacy, and empathy will increase
significantly more after training compared to theoretical teaching. The third hypothesis is
that students reporting higher baseline levels of self-affiliation, attachment security,
external feedback propensity, and self-efficacy will have a larger increase in FIS after the
training program. The fourth hypothesis is that the amount of deliberate practice will
predict improvement in FIS at post-training, whereas the students' sociodemographic
characteristics, previous experience with psychotherapy, and preferred psychotherapy approach
will not be associated with improvement in FIS.
Methods: One hundred ninety-eight graduate students from the Universities of Copenhagen and
Aalborg University will be randomized into two groups, a) deliberate practice training of
non-specific skills using role-play and Theravue, or b) theoretical teaching. Group a will
first receive the experimental condition (deliberate practice), followed by the control
condition, while group b will receive the conditions in reverse order. Each condition
consists of 15 hours of classroom participation and homework. The primary outcome is
Facilitative Interpersonal Skills - Observer. Secondary outcomes include the Facilitative
Interpersonal Skills-Self-Report, the Counselor Activity Self-Efficacy Scales, and the
Interpersonal Reactivity Index. Outcomes will be measured at baseline (week 0), after the
first condition (week 5; before the crossover, reflecting true randomization), and after both
conditions (week 10). Main outcome analyses will be performed at week 5.
To test deliberate practice as a predictor of FIS improvement, the amount of deliberate
practice activity is measured on a self-report questionnaire developed for this study and
tracked on Theravue as a) the total time spent on watching and responding to therapy videos
and b) the average number of attempts to improve the response to each therapy video. The
Structural Analysis of Social Behavior Intrex questionnaire (SASB; Benjamin, 2000), the
Social Skills Inventory (SSI; Riggio, 1989), the Experiences in Close Relationships Scale
(ECR; Brennan et al., 1998), and the Internal and External Feedback Propensity Scales (IEFPS;
Herold et al., 1996) will be measured at week 0 and explored as possible between-condition
moderators of the outcome. The Group Climate Questionnaire-Short Form (GCQ-S; MacKenzie,
1983) will be used to measure the collaboration in the student groups, where approximately
five students work together throughout the study period, performing role-plays and giving
peer feedback in the experimental condition, and discussing theory in the control condition.
The observer-rated DP Coach Competency Scale (DPCCS; Rousmaniere, 2020) will be used to
evaluate adherence and quality of the deliberate practice training. Stig Bernt Poulsen,
University of Copenhagen, and Ole Karkov Østergård, Aalborg University, are co-principal
investigators.
Discussion: The study can potentially transform the training of psychotherapy, not only for
psychology students but also for psychologists in general. Furthermore, the results of the
study can be transferred to the training of other clinical skills.
Ethics: Ethical approval has been obtained from the Institutional Ethical Review Board,
Department of Psychology, University of Copenhagen, and Aalborg University. Before signing up
for the course, the students will be informed about the course and the research embedded
herein. Informed consent will be obtained from students agreeing to participate in the study.
Course participants can decline to participate in the study without negative consequences for
their course participation.