The University Clinic as a setting for research in psychotherapy and supervision

Background and aims: Since 2000, the University Clinic (UC) at the Department of Communication and Psychology, Aalborg University, has trained approximately 350 psychology students, treating their first two patients in psychodynamic psychotherapy. The overall purpose of the UC is to create a learning environment where it is possible to integrate theory, practice, and research in clinical psychology. A training clinic, such as the UC, is first and foremost an education clinic for Master’s students. However, it can also be a place to research novice therapists' education, processes, and outcome in psychotherapy. In 2019, the students started to collect self-report data on patient characteristics, symptoms, psychotherapy outcomes, the therapeutic alliance, and significant events during each session. Moreover, all therapy sessions are still video recorded. The aims of the research are twofold. Firstly, to engage the students in a scientific endeavor according to the scientific-practitioner model and provide them with data they can use in scientific assignments and as feedback on their practice. Secondly, the research can be used in scientific publications, specifically on the education and supervision of novice therapists, and on processes and outcomes of psychotherapy. The UC is highly structured, and both the students and the clients are motivated to collect the data. Therefore, they provide data of high quality, although the training setting limits the opportunity to generalize to more experienced psychotherapists.
Method: The UC is psychodynamic-oriented and based on the assumption that there must be a coherence between the theoretical understanding, the treatment model, interventions delivered to the patient, supervision, and the research. The UC uses both qualitative and quantitative methods. Both client outcomes and psychotherapeutic processes (i.e., the therapeutic alliance and significant events) are measured at each session and at post treatment from three perspectives: the client, the therapist, and an external observer based on video recordings. The supervision is also recorded on video and both supervisor and supervisee fill in questions about the alliance and significant events in the supervision.
Planned publications and perspectives: The first publication investigates whether the student psychotherapists were able to detect negative and positive client changes from session to session and after treatment. The title is: “Do psychotherapists know when their clients get worse – an investigation of the agreement between therapists and a questionnaire assessment of client change during and after therapy”. The second publication uses mixed methods. Firstly, multilevel modeling will test whether between-client or within-client changes in the therapeutic alliance can predict client outcomes. The hypothesis is that within-client change in the alliance predict client outcome in the following session and at post treatment. Secondly, qualitative data will be used to explore what happened during deteriorations in the therapeutic alliance. A third paper will test whether the development in the supervision alliance will be more positive in the group where the supervisor gets feedback on the supervision alliance compared to the non-feedback group.