Training of Cross-cultural Competencies in Psychotherapists

Evaluation of an Internet-based Training Program to Improve Cross-cultural Competencies in Psychotherapists

The purpose of this study is to determine whether a web-based training program with text-based information as well as practical exercises can improve cross-cultural competencies in therapists.

Study Overview

• Status: Completed
• Conditions: Healthy Volunteers
• Intervention / Treatment: Behavioral: Training; Behavioral: Education only

Detailed Description

As the number of patients from diverse cultures increases in psychotherapeutic care, cross-cultural competencies of therapists become increasingly important. In particular, mental health care of patients with immigration background needs to be improved as studies show that these patients drop out of treatment more often and benefit less from therapy. In addition, patients with immigration background and refugees show higher prevalences in mental illnesses. Nevertheless, evaluated training programs to improve cross-cultural competencies in psychotherapists are lacking. In particular, web-based training programs, which allow therapists to work time-flexible and at their own pace on a training, are, to date, missing completely.

For the current study, a web-based training program to improve therapists' cross-cultural competencies was developed. It is based on existing conceptions of cross-cultural competencies. The developed program consists of six modules with the following contents: definitions and conceptions of culture, the role of cross-cultural competencies in psychotherapy, the influence of prejudices and discrimination as well as the role of migration and acculturation, and culturally sensitive diagnostics. The modules contain PDF-files with text-based information, video files, case studies with associated questions as well as practical exercises. The main focus of the training is the participants' self-reflection concerning their conceptions of (their own) culture and their beliefs about culturally diverse patients. The training group will be compared to two other groups, i.e. an education only and a waitlist control group. Whereas the waitlist control group will not receive any training materials, the education only group will receive a slimmed down version of the training consisting only of text-based information files.

• Study Type: Interventional
• Enrollment (Actual): 173
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Hessen
    • Marburg, Hessen, Germany, 35037
      • Philipps University Marburg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• current psychotherapeutic work
• Internet access
• sufficient German language skills
• ongoing or completed training in Psychotherapy

Exclusion Criteria:

• too much previous knowledge about cross-cultural competencies (> 10h training)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Training; In the training group, participants work six weeks on the training program, one module per week. The modules contain PDF-files with text-based information, video files, case studies with associated questions as well as practical exercises that participants perform independently. The main purpose of this intervention is the improvement of cross-cultural competencies in psychotherapists	Behavioral: Training; Six modules containing PDF-files with text-based information, video files, case studies with associated questions and practical exercises. Participants can download the modules and associated materials from an online platform they need to register for. They receive access to modules and associated exercises once a week. After six weeks the training is completed.
Active Comparator: Education only; In the education only group, participants work six weeks on a slimmed down version of the training program. The modules only contain text-based information without any exercises. After completion, participants receive access to the practical exercises, case studies and video files as well. Main purpose of the education only group is to determine whether the practical part of the training program can offer additional benefit.	Behavioral: Education only; Six modules containing only PDF-files with text-based information. Participants can download the modules and associated materials from an online platform they need to register for. They receive access to modules once a week. After six weeks the education is completed.
No Intervention: Waiting control; Initially, participants do not receive any training contents. After a six week waiting period, they can participate in the training program as well. Modules are equivalent to those of the training group. Purpose of this group is to determine whether the training program is effective.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Transcultural Competencies of Psychotherapists Questionnaire (TKKP; Reichardt et. al., in prep.)	Change in cross-cultural psychotherapeutic competencies	pre-training, post-training (6 weeks after the start of the training); follow up (6 month after training completion)
Multicultural Counseling Inventory (MCI; Sodowsky, 1994)	Change in cross-cultural psychotherapeutic competencies	pre-training, post-training (6 weeks after the start of the training); follow-up (6 month after training completion)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cultural sensitivity in actual psychotherapeutic work I	Percentage of culturally diverse patients currently in treatment in own actual psychotherapeutic work	pre-training, post-training (6 weeks after the start of the training), follow-up (6 month after training completion)
Cultural sensitivity in actual psychotherapeutic work II	Willingness to treat culturally diverse patients in own actual psychotherapeutic work (rating scale)	pre-training, post-training (6 weeks after the start of the training), follow-up (6 month after training completion)
Cultural sensitivity in actual psychotherapeutic work III	Satisfaction with cross-cultural therapies provided in actual psychotherapeutic work (rating scale)	pre-training, post-training (6 weeks after the start of the training), follow-up (6 month after training completion)
Cultural sensitivity in actual psychotherapeutic work IV	Perceived competence in the currently provided cross-cultural therapies (rating scale)	pre-training, post-training (6 weeks after the start of the training), follow-up (6 month after training completion)
Knowledge regarding the provision of cross-cultural psychotherapy	Test of specific knowledge gained during the training (knowledge test in multiple choice answer format)	post-training (6 weeks after the start of the training)
Training satisfaction scale	Satisfaction with the training (rating scale; items assessing satisfaction with contents and structure of the developed training)	post-training (6 weeks after the start of the training); follow-up (6 month after training completion)
Learning success scale	Rating of competencies achieved through the training for the treatment of culturally diverse patients (rating scale, rating of the degree to which certain competencies have been achieved)	post-training (6 weeks after the start of the training); follow-up (6 month after training completion)
Cultural sensitivity in psychotherapeutic work (Behavioural change measure)	Rating of different case examples with focus on expected difficulty and effectiveness of psychotherapy (given different cases with different disorders, severity levels, and cultural backgrounds)	post-training (6 weeks after the start of the training), 2 months after training completion; follow-up (6 month after training completion)

Collaborators and Investigators

• Sponsor: Philipps University Marburg Medical Center
• Collaborators: Humboldt-Universität zu Berlin
• Investigators: Principal Investigator: Cornelia Weise, PhD, Department of Clinical Psychology and Psychotherapy, Philipps University Marburg; Study Chair: Winfried Rief, PhD, Department of Clinical Psychology and Psychotherapy, Philipps University Marburg; Study Chair: Ulrike von Lersner, PhD, Department of Transcultural Psychology, Humboldt University Berlin; Study Chair: Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University

Publications and helpful links

General Publications

• Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005 Apr 9-15;365(9467):1309-14. doi: 10.1016/S0140-6736(05)61027-6.
• Gaitanides, S. (2001). Zugangsbarrieren von Migrant (inn) en zu den sozialen und psychosozialen Diensten und Strategien interkultureller Öffnung. In G. Auernheimer (Hrsg.), Migration als Herausforderung für pädagogische Institutionen (pp. 181-194). Wiesbaden: Springer Fachmedien.
• Mösko, M., Baschin, K., Längst, G., & von Lersner, U. (2012). Interkulturelle Trainings für die psychosoziale Versorgung. Psychotherapeut, 57(1), 15-21.
• Mosko MO, Pradel S, Schulz H. [The care of people with a migration background in psychosomatic rehabilitation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011 Apr;54(4):465-74. doi: 10.1007/s00103-011-1245-x. German.
• Reichardt, J., von Lersner, U., Rief, W., & Weise, C. (in Vorb.). Entwicklung und Validierung des Inventars zur Erfassung transkultureller Kompetenzen bei Psychotherapeuten (TKKP).
• Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the Multicultural Counseling Inventory: A Self-Report Measure of Multicultural Competencies. Journal of Counseling Psychology, 41(2), 137-148.
• Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70(4), 477-486.
• Reichardt, J., von Lersner, U., Rief, W., & Weise, C. (2017). Wie lassen sich transkulturelle Kompetenzen bei Psychotherapeuten steigern? Vorstellung eines webbasierten Trainingsprogramms [How to improve cross-cultural competencies in psychotherapists? Introduction of a web-based training program]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 65(3), 155-165. doi:10.1024/1661-4747/a000316

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2020
• Primary Completion (Actual): December 31, 2021
• Study Completion (Actual): August 31, 2022

Study Registration Dates

• First Submitted: January 17, 2017
• First Submitted That Met QC Criteria: January 27, 2017
• First Posted (Estimate): January 31, 2017

Study Record Updates

• Last Update Posted (Actual): November 8, 2022
• Last Update Submitted That Met QC Criteria: November 6, 2022
• Last Verified: November 1, 2022

More Information

Terms related to this study

• Keywords: cross-cultural competencies; internet-based training; cognitive-behavioural therapy (CBT); psychotherapy training; competence training
• Other Study ID Numbers: Cross-cultural psychotherapy

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No