The effect of behavioral rehearsal in the training of clinical psychology students in cognitive therapy for social anxiety disorder: A randomized controlled trial.

OBJECTIVE: The present study investigated the effects of including behavioural rehearsal (i.e., expert demonstration followed by role-playing treatment components) in the training of clinical psychology students in cognitive therapy for social anxiety disorder. METHOD: A randomized controlled design was used where fifth year clinical psychology students (N = 94, M age = 26.2 years, SD = 3.81) were randomized to behavioural rehearsal or a bona fide control training condition (expert demonstration and discussions), as part of a 16-h training course in cognitive therapy for social anxiety disorders. Videotapes (N = 94) of participants role-playing therapists after training were rated for therapist competence (primary outcome measured by three competence variables) by raters who were unaware of the training condition allocation. Secondary outcomes (therapists' self-efficacy, therapist worry levels and satisfaction with training) were collected by self-report at post-training and at 6-month follow-up. RESULTS: Participants in the behavioural rehearsal condition achieved higher competence scores compared to the control condition. Differences between groups were found for all three competence variables, with large effect sizes (d = 1.23-1.40, 95 % CI [.78, 1.85]). Large between-group effect sizes were also found for all individual items of competence (d = .80-1.22, 95 % CI [.38, 1.66]). No effects were found for secondary outcomes. CONCLUSIONS: The results suggest that inclusion of behavioural rehearsal in training leads to higher competence among clinical psychology students when delivering cognitive therapy for social anxiety disorder. Training providers should consider incorporating behavioural rehearsal in cognitive therapy training.