Practice of therapeutic skills with memory versus video-based self-reflection: a mixed-method randomized controlled trial

Self-reflection is central to the development of psychotherapeutic competence. Given the positive reports of video analysis use in psychotherapy training, we suggest that self-reflection based on video analysis may be particularly effective. The aim of this study was to test whether video-based structured self-reflection (VSR) is superior to memory-based structured self-reflection (MSR) in terms of its effect on students’ psychotherapeutic competence and the therapeutic alliance. As part of a university seminar within a Master’s program, N =34 psychology students ( M =25 years; n =32 identifying as female) were randomly assigned to 4 weeks of practice with either VSR ( n =16) or MSR ( n =18). Independent raters assessed students’ psychotherapeutic competence and the alliance before and after the practice phase (pre- and post-assessment). Students additionally rated their own competence during the practice phase. The written self-reflections were analysed using qualitative content analysis and frequency analysis. A repeated measures MANOVA revealed no significant differences between the study groups in the development of externally rated psychotherapeutic competencies from pre- to post-assessment. An analysis of students’ self-reported competencies during the practice phase revealed a significant time effect (η 2 G =0.12). Analysis of the written self-reflections showed that students focused mainly on the positive aspects of their behavior. The assumption that VSR is particularly beneficial was not confirmed. It seems that self-reflection requires additional guidance, feedback, and a sufficient time frame to effectively improve trainee skills. Key learning aims (1) To find out whether video-based structured self-reflection is an effective means of developing students’ psychotherapeutic skills and the therapeutic alliance. (2) To identify the main characteristics of students’ self-reflections and the benefits and challenges they perceive during the self-reflection process. (3) To draw methodologically valid conclusions for the implementation of self-reflection in the university context.