Lagerberg Håkan, Boswell James F, Constantino Michael J, Andersson Gerhard, Carlbring Per
Department of Psychology, Stockholm University, Stockholm, Sweden.
Department of Psychology, University at Albany, State University of New York, Albany, NY, USA.
Clin Psychol Eur. 2024 Sep 30;6(3):e12353. doi: 10.32872/cpe.12353. eCollection 2024 Sep.
Deliberate Practice (DP), which underscores the importance of expert mentorship, personalized learning objectives, feedback, and repetition, has been suggested as a method to enhance the effectiveness of therapists.
The study tested the efficacy of an eight-week, structured, group-based online course, enriched with peer feedback, for 37 Cognitive Behavioral Therapists. The goal was to assess whether this intervention could boost the quality of therapist-patient alliances, as compared to a control group. To measure this, therapists had their patients anonymously fill out the Session Alliance Inventory both before and after the course. The trial encompassed 120 patient alliance ratings at baseline and 64 at the post-course measurement. The DP course was comprised of a 75-minute remote video workshop each week for eight weeks, supplemented by related study materials. Each workshop focused on a specific skill, such as responding to client resistance, and included 55 minutes of concentrated role-play activities, providing ample opportunities for repetition and feedback.
Using a linear mixed model we did not find an effect on patient alliance ratings. However, we observed a trend ( = .054) indicating that the DP group decreased their alliance ratings (Cohen's = -0.40), while the control group demonstrated an increase in their scores ( = 0.49).
This pilot study did not find support for DP leading to better patient-rated alliance compared to a waitlist control. However, the study had several methodological limitations. Further and more rigorous investigation of the effects of DP on patient outcomes is recommended.
刻意练习（DP）强调专家指导、个性化学习目标、反馈和重复的重要性，已被提议作为提高治疗师效能的一种方法。
该研究测试了一个为期八周、结构化、基于小组的在线课程对37名认知行为治疗师的疗效，该课程富含同伴反馈。目标是评估与对照组相比，这种干预措施是否能提高治疗师-患者联盟的质量。为了衡量这一点，治疗师让他们的患者在课程前后匿名填写《治疗联盟量表》。该试验在基线时涵盖了120份患者联盟评分，在课程结束后测量时涵盖了64份。DP课程包括每周一次75分钟的远程视频研讨会，为期八周，并辅以相关学习材料。每个研讨会都聚焦于一项特定技能，如应对来访者的阻抗，其中包括55分钟的集中角色扮演活动，提供了大量重复和反馈的机会。
使用线性混合模型，我们未发现对患者联盟评分有影响。然而，我们观察到一种趋势（p = 0.054），表明DP组的联盟评分下降（科恩d = -0.40），而对照组的评分有所提高（d = 0.49）。
这项初步研究未发现与等待名单对照组相比，刻意练习能带来更好的患者评定联盟的证据。然而，该研究存在几个方法学上的局限性。建议对刻意练习对患者治疗结果的影响进行进一步且更严格的调查。
