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

The GAD-7 is originally a measure for generalized anxiety disorder, but it is also frequently used to assess general anxiety. The form consists of seven items with a four-point scale. The range is 0-21 points. An eight item describes how disruptive the anxiety is from not at all to very significant, which is not included in the total score. The GAD-7 has been translated into Swedish and has shown good psychometric properties in terms of both reliability and validity.

The PHQ-9 is a well-established depression questionnaire consisting of nine items that correspond to the diagnostic criteria for a major depressive episode according to the DMS-5. How often the symptoms have bothered the patient in the past two weeks is rated by the patient, at the start and end of treatment, on a four-point scale. The range is 0-27 points. The PHQ-9 has been translated into Swedish and has good internal consistency and test-retest reliability.

The WHODAS 2.0 is a widely used generic assessment instrument that provides a standardized method for measuring health and disability across cultures. The form is based on a set of questions from the International Classification of Functioning, Disability, and Health (ICF) that are sufficiently reliable and sensitive to measure changes after interventions. The form is available in seven different versions with 36 questions, 12 questions, and 12+24 questions as interview-administered, self-administered, and proxy-administered, respectively. In the project, the self-administered 12-question form is used.

The AUDIT is a widely used instrument for identifying hazardous and harmful alcohol consumption. The instrument was initially developed by the WHO and consists of a ten-item questionnaire designed to measure three domains: consumption, dependence, and alcohol-related harm. The project uses a cut-off point of 5 points as an indication of mild alcohol use disorder. The project uses the AUDIT-C, which includes the first three questions of the AUDIT.

The SCI will be used to measure sleep disorders. The SCI contains eight questions regarding nocturnal symptoms, function, performance, duration, frequency, and severity. The form is translated into Swedish, and the psychometric properties have been shown in studies to be acceptable to good.

The LSAS-SR is only used for patients with social anxiety disorder or similar.

The PDSS-SR is only used for patients with panic disorder or similar.

The PSWQ is only used for patients with generalized anxiety disorder or similar.

The PCL-5 is only used for patients with posttraumatic stress disorder or similar.

The OCI-R is only used for patients with obsessive-compulsive disorder or similar.

The PSS-10 is only used for patients with stress or burnout problems or similar.

The SHAI-14 is only used for patients with health anxiety problems or similar.

The EDE-Q is only used for patients with eating disorders or similar.

The DUDIT is only used for patients with drug problems or similar.

At the end of each treatment, all students write a summary of the treatment consisting of questions about the student (socio-demographic and contextual), the patient (socio-demographic and clinical), and the treatment (e.g., content, duration, and compliance). The summary concludes by summarizing the results of the patient's pre- and post-measurements, which are guided by the patient's problem domain.

The CTS-R is a standard instrument for assessing CBT competence that measures both general psychotherapy aspects and specific CBT aspects. The instrument contains twelve items, which are rated on a scale from 0 to 6 points corresponding to six different categories of therapist competence (incompetent, novice, advanced, beginner, competent, knowledgeable, and expert). The CTS-R has been translated into Swedish and has shown acceptable psychometric properties in several studies.

The Short-SAGE is an observational tool to evaluate supervisors' skills and adherence to CBT supervision. Short-SAGE describes 14 behaviors (competencies of the supervisor and supervisee), grouped on two main factors: the Supervisor's set (specific behaviors of the supervisor that are believed to facilitate optimal learning through experience) and the Supervisee's set (specific learning competencies that can be observed in the supervisee). The assessor observes a tutoring session and rates the competencies observed on a 7-point scale. For training purposes, a simpler 3-point scale is used. The instrument is available in Swedish and English, is fairly new, and has only undergone preliminary psychometric evaluations.

The ESSA-19 is a behavioral coding system to evaluate supervisors' skills and adherence to MI supervision. ESSA has been developed to be used as a tool for structured feedback to MI supervisors and as a measure of supervisory integrity in clinical trials. The manual has been developed at the unit 2019. The instrument is relatively new and has only undergone preliminary psychometric evaluations.

A unit-developed set of 10 questions focusing on how the students perceive the supervisor and the supervision setting, e.g., regarding feedback, skills training, and activity.