THE USE OF SIMULATED PATIENTS IN THE TRAINING OF EMPATHY AND RESPECT IN PSYCHOTHERAPISTS.

Abstract

This study examined the use of a simulated patient, or programmed patient, to train clinical psychology graduate students to be empathic and respectful in the psychotherapeutic relationship. Twenty-five subjects were given a 50-minute training session with a simulated patient, an alternate training which consisted of viewing a video tape or were no-attention control subjects. The video tape used for the alternate training consisted of the section of "Three Approaches to Psychotherapy" in which Carl Rogers interviews the client, Gloria, followed by a discussion of empathy and respect. Training with the simulated client consisted of interviewing the "client" and receiving feedback from her. Pre-post empathy and respect skills were evaluated with Carkhuff's 5-point scales. Subjects' responses to recorded client statements were judged by two trained raters. Interjudge agreement ranged from .66 to .74. Analysis of variance revealed no significant difference between increases in empathy and respect for the three experimental groups. Subjects with more than one year of graduate clinical training profited significantly more (p = .05) from both training experiences than did subjects with less than one year of training. There was also a significant interaction between experimental training received and level of clinical experience, inexperienced subjects scoring higher with the simulated patient than with the video tape training. More advanced subjects scored higher with the video training than with the simulated patient training. Interview data indicated that the training with the simulated patient was perceived as useful and, in the case of more-experienced subjects, as being superior to the training with the video tape. Possible difficulties with the measurement of empathy and respect are discussed. The use of simulated patients is reviewed and the selection and training of simulated patients discussed in some depth.