Clinical Psychology Trainees Research Articles

What happens to University of Hertfordshire DClinPsy research? A survey exploring community dissemination & barriers that prevent this

Historically, the dissemination of research findings across many disciplines has been limited to peer reviewed journals. More recently, dissemination practices are broadening to include sharing with wider audiences, such as the community being researched. At the University of Hertfordshire some doctoral clinical psychology trainees disseminate more widely than others. Research has not yet asked what helps support trainees on the programme to disseminate their work beyond scientific publication, or what barriers disrupt this. This programme-related project utilised a mixed methods survey which aimed to gain an understanding of barriers to community dissemination practices and how these could be overcome. Results indicated that, although participants strongly agreed that findings should be shared with communities researched, barriers to delivering this exist. The identified barriers to community dissemination included time and limited awareness of community dissemination practices. Further support from supervisors and teaching on wider dissemination practices may help trainees to disseminate more widely. This is important as it could move dissemination outside of the academic community where findings could reach those who could benefit most from them.

Learning Climate, Intrinsic Motivation and Psychological Wellbeing among Clinical Psychology Trainees in Pakistan

Self-determination theory proposes that satisfaction of the basic human needs for autonomy, competence, and relatedness are essential for people to perform at their best across cultures. The study aimed to investigate self-determination theory in a collectivistic culture using the relationship between learning climate, intrinsic motivation, psychological wellbeing and academic performance. Students doing postgraduate degree in Clinical Psychology program (n= 150) with (females = 130, males = 12) were recruited from universities of Lahore, Pakistan. Path analysis was conducted. Path model I showed the weak correlation of learning climate with intrinsic motivation. Subscales of Intrinsic Motivation Inventory (IMI) (interest/enjoyment, competence, perceived choice) showed indirect effect with psychological wellbeing whereas subscale of IMI (pressure/tension) shared direct effect as pressure among students in collectivistic culture was found to be affecting their psychological wellbeing. In Path model II, learning climate and intrinsic motivation showed indirect effects on CGPA. Learning climate of Eastern countries is more controlling so learning climate and pressure/tension directly and indirectly affected psychological wellbeing. The findings highlighted that students in Pakistan are not practicing intrinsic motivation to achieve academic performance. Therefore, needs of self-determination theory are not satisfied in academic performance of students in collectivistic culture.

Development and evaluation of a national careers in aging webinar series for psychology trainees

ABSTRACT Trainees may be interested in careers in aging but unfamiliar with career options, leading to a shortage in the geriatric workforce. In response to needs identified at a national geropsychology training conference, a multisite faculty group developed a six-session webinar series about careers in geropsychology, detailing career options in six unique settings. Each webinar session featured a moderated discussion with a panel of four professionals currently employed in the career of interest. The webinar was advertised to clinical and counseling psychology trainees with a potential interest in age-related careers, with evaluation of the series primarily including trainees from graduate programs, clinical internships, and postdoctoral fellowships. Participants rated their attitudes and beliefs about each career option at pre- and post-discussion. On average, each webinar session was attended by 48 individuals (SD = 12, range = 33–60). At baseline, attendees reported significantly more interest in careers in clinical practice compared to other careers, and interest in university settings increased from pre- to post-discussion. Across all six sessions, participants reported increased understanding of training experiences that would be helpful in pursuing that specific career. Findings point to the feasibility and utility of webinars for enhancing interest and confidence in pursuing careers in aging.

Therapist and client perceptions of empathy in simulated teletherapy sessions

ABSTRACT Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of ‘therapist’ or ‘client’, forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy.

Towards implementation of context-specific integrated district mental healthcare plans: A situation analysis of mental health services in five districts in Ghana.

Access to quality mental health services in Ghana remains poor, yet little is known about the extent of the access gaps and provision of mental health services at the district level in Ghana. We aimed to conduct an analysis of mental health infrastructure and service provision in five districts in Ghana. A cross-sectional situation analysis was conducted using a standardised tool to collect secondary healthcare data, supplemented by interviews with key informants, across five purposively selected districts in Ghana. The Programme for Improving Mental Health Care (PRIME) situation analysis tool was adapted to the Ghanaian context and used for data collection. The districts are predominantly rural (>60%). There were severe challenges with the provision of mental healthcare: there were no mental healthcare plans, supervision of the few mental health professionals was weak and unstructured, access to regular supplies of psychotropic medications was a major challenge, and psychological treatments were extremely limited given the lack of trained clinical psychologists. There were no available data on treatment coverage, but we estimate this to be <1% for depression, schizophrenia, and epilepsy across districts. Opportunities for mental health systems strengthening include: the commitment and willingness of leadership, the existence of the District Health Information Management System, a well-established network of community volunteers, and some collaboration with traditional and faith-based mental health service providers. There is poor mental health infrastructure across the five selected districts of Ghana. There are opportunities for strengthening mental health systems through interventions at the district healthcare organisation, health facility, and community levels. A standardised situation analysis tool is useful for informing district-level mental healthcare planning in low-resource settings in Ghana and potentially other sub-Saharan African countries.

Clinical psychologists’ experience of cultivating reflective practice in trainee clinical psychologists during supervision: a qualitative study

ABSTRACT Reflective practice is regarded as an essential competency to maintain high clinical standards by various professional bodies and is therefore emphasised within healthcare training programmes including Clinical Psychology. Clinical supervision is seen as the most common and useful way to encourage reflective practice in healthcare professionals but there is limited evidence on effective strategies for its development. Given this, this research aims to investigate the experience of clinical psychologist supervisors’ in developing reflective skills in trainee clinical psychologists. Six themes have been derived by using thematic analysis and the findings are discussed along with implications and future research directions.

EMPOWERING TEACHERS AND STUDENTS TO COPE WITH THE STRESS OF ONLINE TEACHING AND LEARNING: FINDINGS FROM A PILOT PROJECT ON PSYCHOSOCIAL SUPPORT IN THE LANGUAGE AND TRANSLATION CLASSROOM

In times of crisis, emergency education makes significant contributions to individuals and societies by providing a sense of normality (Johannes 2012). As teachers facilitate the learning process and are expected to support students emotionally, Muldong, Garcia &amp; Gozum (2021) suggest that work-from-home teachers should be provided with psychosocial support to address the mental and emotional stress caused by the Covid-19 pandemic. El-Monshed, El-Adl, Ali and Loutfy (2021) and Carreon &amp; Manansala (2021) suggest that educational institutions should also take measures to improve students’ mental health and academic performance and make it a priority in the current context.This paper reports the findings of a project on psychosocial support at Blaze Koneski Faculty in Skopje from March to June 2021 involving 15 language and translation teachers and 121 students. The teachers attended a series of workshops guided by a trained clinical psychologist. The workshops aimed at providing immediate psychosocial assistance to teachers to cope with the stress of the pandemic, to sensitise teachers to the students’ needs in an emerging crisis and to empower them to employ new ways of student engagement in the online classroom. The training concept was based on the assumption that one’s self-care and well-being are prerequisites for one to be able to care about others (in this context the students).The teachers tested various methods at two levels of classroom communication. They engaged in informal communication and introduced well-being techniques to create a relaxing class atmosphere and to facilitate the learning process. They also involved students in participative activities to help them take hold of their learning. Teacher and student feedback has been positive and points to the encouraging effect of this approach in the online environment and beyond it. It shows that the modern translation classroom, be it physical or virtual, requires giving students an active voice and a sense of control over their learning. It also shows that moving away from adhering to technical material to enrich the curriculum with topics and methods that address well-being and mental health is beneficial.

Interrogation in clinical supervision sessions: Exploring the construction of clinical psychology trainees’ professional identities

BackgroundProfessional socialisation is a complex process through which learners become healthcare professionals. This process occurs in relational spaces: learners are exposed to norms and expectations of them in interactions during formal and informal learning activities. Research exploring socialisation into the healthcare professions is extensive yet inadequately captures details of the actual processes of socialisation and forming of professional identity. Our study offers a moment-by-moment examination of clinical psychology trainee supervision to provide a deeper exploration of novice healthcare professionals’ identity development within formal educational interactions. AimsWe sought to explore how, and in what ways, supervision interactions impact clinical psychology trainees’ professional identity development. MethodOur data comprises 12 audio recordings of supervisor-trainee interactions in a clinical psychology training clinic. Initial data engagement identified 20 instances of interrogation instigated by supervisors (i.e., repetitive questioning, enquiry) as being key events in which identities are contested and re-negotiated. These sections were transcribed verbatim. Drawing on positioning, framing and impression management theories, we explored identity construction in interrogations using discourse analysis. ResultsSupervisors approached interrogations of trainees from either a quality control or a reflective frame focusing on the client or trainee respectively. These frames influenced the positions being made available to trainees. Reflective frame interrogations often defaulted back to quality control. Trainees employed impression management tactics to manage perceived face-threat. DiscussionFindings highlight challenges with maintaining a reflective space in supervision during interrogations. Supervisors had authority to initiate interrogations that could be taken up, negotiated or resisted by trainees, ultimately maintaining certain professional knowledge and truths. We illuminate the ways in which socialisation processes at the interactional level during formal learning activities ultimately make available (and restrict) certain ways for trainees to think, feel and be.

OUTCOME OF DEVELOPMENTAL THERAPY IN CHILDREN WITH CEREBRAL PALSY CHILDREN: A PROSPECTIVE COHORT

Introduction: Cerebral palsy (CP) is the non-progressive disorder of motor and posture with associated delayed development in areas of cognition, perception, behavior and sensation, due to insult to immature brain. Improvement in all developmental domains of CP patients depends upon early institution of rehabilitation programs involving all multidisciplinary approach. The portage early education program (PEEP) is a worldwide, effective and early interventional method, for developmentally delayed children. Objective: To determine the outcome of developmental therapy in children with CP by using PEEP. Study Design: Experimental research design (within group) Settings: The children hospital and the institute of child health Multan. Methodology: 156 patients of 2 to 10 years of age, both gender from January 2020 to December 2020, diagnosed as CP were enrolled for this study. All children were assessed by using PEEP and GMFM (Gross Motor Function Measure) twice 6 months apart. A trained clinical psychologist administered PEEP to all the children. All the Patients were advised regular weekly sessions at hospital by multidisciplinary team and at least 2 hours per day for continuation of these therapies at home. At the end of 6 months we found that all families had not followed this. The patient who visited &gt;2times/month were considered compliant and those visited &lt;2times/month were considered non-compliant. Data was analyzed by using SSPS version 16. Paired t test was used to compare the developmental outcome of compliant and non-compliant groups. Results: Out of 156 participants, 58(37%) were in compliant and 98(63%) non-compliant. Male subjects were prominent 42(72.41%) and 67(68.37%) respectively. Most of the participants belonged to 3-6 years of age in both groups28(48.29%) and 51(52.04%) respectively. Spastic quadriplegia (26(44.83%), 57 (58.16%)), and level 5 on GMFM 24(42.86) and 52(53.06%) respectively was commonly presents in both patient groups. The mean comparison of DQ of Compliant CP Children at initial stage and after six months in areas of GM, C, SH, S, L and GMFM was found statistically significant. Conclusion: CP children should be on regular follow up for developmental therapy for long time for better outcome. PEEP is an excellent system for the assessment, training and rehabilitation of children with delayed development.

Climate for evidence-based mental health care implementation in Germany: psychometric investigation of the Implementation Climate Scale (ICS)

Organizational implementation climate is an important construct in implementation research to describe to what extent implementation is expected, supported, and rewarded. Efforts in bridging the research-practice gap by implementing evidence-based practice (EBP) can benefit from consideration of implementation climate. The Implementation Climate Scale (ICS) is a psychometrically strong measure assessing employees’ perceptions of the implementation climate. The present cross-sectional study aimed at providing a German translation and investigating its psychometric properties. The translation followed standard procedures for adapting psychometric instruments. German psychotherapists (N = 425) recruited online completed the ICS, the Evidence Based Practice Attitudes Scale (EBPAS-36D) and the Intention Scale for Providers (ISP). We conducted standard item and reliability analyses. Factorial validity was assessed by comparing an independent cluster model of Confirmatory Factorial Analysis (ICM-CFA), a Bifactor CFA, a Second-order CFA and an (Bifactor) Exploratory Structural Equation Model (ESEM). Measurement invariance was tested using multiple-group CFA and ESEM, convergent validity with correlation analysis between the ICS and the ISP subjective norms subscale (ISP-D-SN). The mean item difficulty was pi = .47, mean inter-item correlation r = .34, and mean item-total correlation ritc = .55. The total scale (ω = 0.91) and the subscales (ω = .79–.92) showed acceptable to high internal consistencies. The model fit indices were comparable and acceptable (Second-order CFA: RMSEA [90% CI] = .077 [.069; .085], SRMR = .078, CFI = .93). Multiple-group CFA and ESEM indicated scalar measurement invariance across gender and presence of a psychotherapy license. Psychotherapists in training reported higher educational support for EBP than licensed psychotherapists (T = 2.09, p = .037, d = 0.25). The expected high correlation between the ICS and the ISP-D-SN was found (r = .59, p < .001). Results for the German ICS confirm good psychometric properties including validity.

Relationship between Family Functioning, Personality Traits, and Psychological Health in Clinical Psychology Trainees

This research was intended to explore in what way family functioning and personality traits predicts psychological health in clinical psychology trainees. These three variables were never studied together in Pakistan, and it provided the clarity about the impact of both individual and collectivistic variables on psychological health. This study aimed to determine the extent to which family functioning and personality traits predict psychological health in clinical psychology trainees. The study comprised of 135 clinical psychology trainees (30 males, 105 females). Snowball sampling was used to collect the data through online questionnaire. The data were collected from seven major cities of Pakistan like Lahore, Karachi, Islamabad, Hyderabad, Faisalabad, Multan, and Peshawar. Hierarchical Linear Model was used to analyze the data and the major finding indicated that neuroticism was the predictor of higher psychological health in clinical psychology trainees whereas agreeableness, conscientiousness, extraversion, and openness did not predict psychological health of clinical psychology trainees. Family functioning did not play significant role in predicting psychological health of clinical psychology trainees. However, this study was significant as the psychological health of the clinical psychology trainees is important because they treat people with psychological illnesses. If trainees would not be psychologically well, they would not be able to treat their clients well.

Mindfulness skills in trainee child and adolescent psychotherapists: Exploring the effects of mindfulness‐based workshops in a mixed‐methods study

AbstractObjectivesMindfulness may be a helpful tool to enhance psychotherapists' self‐care and intrapersonal skills. To gain deeper knowledge about how to improve mindfulness skills in child and adolescent psychotherapists, we investigated the impact of two mindfulness‐based workshops and a self‐experience interval (individual homework practice of mindfulness exercises) on quantitative and qualitative measures in a nonrandomised study.MethodsThirty‐six trainee psychotherapists took part in the 6‐week workshop‐based mindfulness intervention (experimental group, EG). Twenty‐one trainee psychotherapists served as a comparison group (CG). All participants completed the Kentucky Inventory of Mindfulness Skills (KIMS‐D), the Self‐Compassion Scale (SCS‐D) and the Empathy Scale for Social Workers (ESSW) at pre, post and 6‐month follow‐up. Benefits of the regular use of mindfulness practice of 10 trainee psychotherapists in the EG were analysed using qualitative content analysis at the 6‐month follow‐up.ResultsThe quantitative analyses revealed a significant increase over time on the KIMS‐D subscale “acting with awareness” in both groups and a significant increase over time on the KIMS‐D subscale “accepting without judgment” in the EG in contrast to the CG. The qualitative analyses indicated good acceptance of the mindfulness‐based workshop intervention. Qualitative changes referred to the achievement of knowledge in theory and practice concerning mindfulness and the integration of mindfulness‐based interventions in everyday life.ConclusionThe mindfulness intervention appeared to produce quantitative long‐term changes concerning mindfulness aspects and qualitative changes. Future research should elaborate conditions (i.e., intervention length, intensity and setting) that may influence the manifestation of quantitative and/or qualitative changes in mindfulness‐based workshop interventions in professionals.

Trainee clinical psychologists’ experiences of the therapeutic alliance while pregnant

SummaryThe present study examined trainee clinical psychologists’ experiences of the therapeutic alliance while pregnant.There is a dearth of literature that has explored trainee clinical psychologists’ lived experiences of the therapeutic alliance while pregnant. To address this gap in the literature, the present study explored trainee clinical psychologists’ experiences of the therapeutic alliance while pregnant. Using a qualitative design, 11 trainee clinical psychologists from clinical doctorate programmes in Ireland and the United Kingdom were invited to take part in a semi-structured interview about their experiences. From the analysis, three superordinate themes emerged: a) disclosure of the pregnancy; b) perception of the alliance and c) changes within the therapeutic interaction. The findings suggest that trainees may experience changes in their relationships with clients during their pregnancy. Recommendations from this study include the development of specific guidelines for responding to these relational changes that may emerge within the therapeutic space, in response to their pregnancy. Directions for future studies are discussed.

Trainee clinical psychologists’ views on the facilitators and barriers to cognitive behavioural practice: A thematic exploration

This evaluation aims to provide insight into trainees’ experience of delivering cognitive behavioural therapy (CBT) whilst on placement. Thematic analysis was employed to analyse data from a focus group consisting of trainees on a selected clinical doctorate programme. Results highlighted the importance of supervisors’ CBT background, teaching focused on the structure and the providing of materials, and trainees’ reactions to CBT. Future directions were suggested for enhancing CBT training and further evaluation.

The Diabetes Tune-Up Group: A Multidisciplinary Approach to Improve Diabetes Distress and A1C Among Adults With Type 1 and Type 2 Diabetes.

The purpose of this study was to assess the feasibility of delivering the Diabetes Tune-Up Group (DTU), a cognitive-behavioral-therapy-based (CBT) multidisciplinary intervention for adults with diabetes distress and elevated A1C using a group in-person delivery format. The DTU intervention consisted of 6 weekly group sessions (90 minutes in duration per session). The groups were cofacilitated by a diabetes care and education specialist (DCES) and a master's-level clinical psychology trainee. The intervention integrated CBT with patient-centered diabetes education. Using a pre/post study design, participants completed assessments at baseline, post-intervention, and 3 months following the intervention. The sample consisted of 29 adults with type 1 diabetes (N = 8) or type 2 diabetes (N = 21) who were predominantly female (79%), White (59%), and educated (56% with a college degree or greater). Participants attended 131 total sessions out of 174 possible sessions, for an overall attendance rate of 75.3%. At 3-month follow-up, significant improvements were observed in A1C values (mean decrease = 0.39%). Diabetes distress improved significantly from baseline (mean = 3.44, SD = 0.68) to post-intervention (mean = 2.94, SD = 0.68), and 3-month follow-up (mean = 2.55, SD = 0.75). Significant improvements were also observed in diabetes self-efficacy from baseline to post-intervention and at 3-month follow-up. This group-based, multidisciplinary intervention resulted in improvements in A1C, diabetes distress, and patient self-efficacy in caring for diabetes. Future studies to validate this intervention approach across settings and delivery platforms are needed.

Psychedelic-supportive psychotherapy: A psychotherapeutic model for, before and beyond the medicine experience

AbstractA renaissance is underway as research studies are substantiating psychotherapeutic and physiological benefits of psychedelic medicines, along with advancements towards legalization, expansion of professional training programs and a renewed cultural recognition of the healing qualities of the medicines. Pending legislation, a cadre of trained psychotherapists are poised to apply their expertise for those who might benefit however, they are currently largely blocked from doing so. There are also ranks of competent psychedelically informed psychotherapists who might provide support to clients engaging with the medicines but are lacking guidelines to do so.‘Psychedelic-Supportive Psychotherapy’ is a proposed model which might be immediately implemented by qualified practitioners for working with clients adjacent to but not during a medicine experience without compromising ethical or legal risk. This model aimed at psychotherapists who are increasingly challenged to help clients already engaging with or considering psychedelics, draws from the current field of knowledge to respond to a moral imperative for practitioners to act in the service of client's best interests and expand access for diverse communities. It balances psychedelic harm reduction perspectives with support for the emotional, psychological, and spiritual gains to be had when clients use psychedelics outside of therapy and can process the experience within their therapy. The model of psychedelic-supportive psychotherapy,’ is transtheoretical, its core premise being centrality of the therapeutic relationship as a change agent even as the therapist is not physically present in the client's medicine journey. Here a foundational structure is presented along with criteria, parameters, and recommendations for practitioners in its application.

Atypical jobs in psychology: Interview of Dr. Karen DuBois-Walton.

This article provides a look into the career of Dr. Karen DuBois-Walton, the president of Elm City Communities in New Haven, Connecticut. As an African American woman and a trained clinical psychologist, Dr. DuBois-Walton has utilized her knowledge of psychology to guide her career in serving marginalized communities. Fueled by her interest in community building and her willingness to challenge the status quo, Dr. DuBois-Walton has helped to transform the policy and infrastructure that underlie the historic marginalization of those across the New Haven community. This interview outlines her career trajectory and how her work has helped impact families on both an individual and systemic levels. Dr. DuBois-Walton provides commentary on how her training as a psychologist has fundamentally shaped her approach to serve families and how through her role, she strives to set in place programming and policy that moves away from how our nation has historically treated low-income families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinical and counseling psychology doctoral trainees’ attitudes toward and interest in working with older adult clients

ABSTRACT The small percentage of psychologists specializing in geropsychology will be increasingly insufficient to meet projected mental health needs of the growing older adult population in the United States. The current study examined contact with older adults, empathy, and multicultural competence as predictors of counseling and clinical psychology doctoral trainees’ attitudes toward and interest in working with older adults. A sample of 311 doctoral trainees in clinical (n = 234) and counseling (n = 78) psychology were surveyed online. A structural equation model testing hypothesized interrelationships between study variables showed good fit. Greater contact with older adults was significantly related to less ageist attitudes, greater interest in work with older adults, and more empathy. Less ageist attitudes were significantly related to greater interest in clinical work with older adults. Greater empathy was significantly related to less ageist attitudes and greater multicultural competence, but to less interest in working with older adults. Empathy mediated the relation of contact to attitudes. Increasing positive contact with older adults as part of doctoral training in counseling and clinical psychology may enhance trainees’ empathy, attitudes toward older adults, and interest in work with older adults.

Trainee clinical, and sport and exercise psychologists’ experiences of professional development: A longitudinal study

The aim of this study was to examine longitudinal professional development in distinct types of UK psychologists. We interviewed 9 trainee clinical psychologists (TCPs), and 9 sport and exercise psychologists’ (TSEPs) 3 times at a minimum of yearly intervals during their 3-year (TCP) or 2-year (TSEP) training programme. Participants were registered on either the British Psychological Society (BPS) Qualification in Sport and Exercise Psychology (QSEP; Stage 2), or a doctorate in clinical psychology. We applied a reflexive thematic analysis to transcripts based on a counsellor development framework. Our findings indicate that diverse types of trainee psychologists experience similar patterns of development. Participants: (a) were developing their practice consistent with their personality; (b) experienced changes in emotions and presence during training; and (c) internal developmental processes were influenced by external sources (supervisors, and peers). Findings may help us to understand how trainees fuse their personal and professional selves during training.

The effectiveness of cognitive behavioural therapy for social anxiety disorder in routine clinical practice.

Numerous randomized controlled trials have shown cognitive behaviour therapy (CBT) to be effective in treating social anxiety disorder (SAD). Yet, less is known about the effectiveness of CBT for SAD conducted by psychotherapists in training in routine clinical practice. In this study, 231 patients with SAD were treated with CBT under routine conditions and were examined at pre- and post-treatment as well as at 6 and 12 months follow-up. We applied self-reports to assess symptoms of SAD (defined as primary outcome), depression and psychological distress (defined as secondary outcome). We conducted both completer and intent-to-treat analyses and also assessed the reliability of change with the reliable change index. Results revealed significant reductions in symptoms of SAD between pre- and post-assessments, with effect sizes ranging from d = 0.9 to 1.2. Depending on the SAD specific questionnaire applied, 47.8% to 73.5% of the sample showed a reliable positive change, whereas 1.9% to 3.8% showed a reliable negative change. Depressive symptoms and psychological distress also decreased significantly from pre- to post-assessment, with large effect sizes. Significant treatment gains regarding both primary and secondary outcomes were further observed at 6 and 12 months follow-up. The current findings based on a large sample of patients suggest that psychotherapists in CBT training working under routine conditions can effectively treat symptoms of SAD, depression and psychological distress.