Third-Party Observation in Psychotherapy: Playing to the Audience.

Area of Science:

• Psychotherapy research
• Clinical psychology
• Medical education

Background:

• Third-party observation of psychotherapy sessions is common for training and quality assessment.
• Observation can influence therapist and patient behavior, potentially altering therapeutic processes.
• Understanding these behavioral shifts is vital for effective clinical practice and supervision.

Approach:

• A selective narrative literature review was conducted.
• Searches were performed in PubMed and PsycInfo databases.
• The review synthesized findings on therapist performance during observed psychotherapy.

Key Points:

• Therapists, including trainees and instructors, tend to skew psychotherapy performance when observed.
• This skewing occurs irrespective of observation method (in vivo, remote, synchronous, asynchronous).
• Both conscious and unconscious factors contribute to therapist and patient behavioral changes during observation.

Conclusions:

• Third-party observation offers significant benefits for psychotherapy training and quality assurance.
• Therapists must be aware of how observation can adversely affect themselves and patients.
• Implementing mitigation strategies can address potential negative consequences of observed psychotherapy.