[The implementation of clinical micro-skills by therapists during clinical training].

Abstract

Clinical micro-skills, such as empathic communication, are essential in every therapeutic session, regardless of theoretical orientation or patient diagnosis. These skills should be fostered from the outset of clinical training. This study explores various facets of clinical micro-skills and their development throughout training.The sample included 59 future therapists, comprising master's students and psychotherapists at early and advanced stages of training. Clinical micro-skills were assessed using the Clinical Micro-Skill Training Scale (CMST) by two independent raters, based on reaction videos to scripted patient statements. Skill facets and their progression were analyzed using an Aligned Rank Transform (ART) ANOVA followed by post-hoc tests.The ART ANOVA revealed significant main effects for skill facets (F(2,11)=42.58, p<0,001, ηp²=0,43) and training level (F(2,56)=7,18, p=0,002, ηp²=0,20). Communicative skills were the most developed across all training levels, while interpersonal skills were the least developed. Marked inter-individual differences were observed: some participants excelled across all skill facets, others in only one or two, and some struggled in all three. Differences between training levels were most pronounced in interpersonal skills.The significant differences in clinical micro-skill facets suggest that therapeutic competence should be measured in a differentiated way rather than as a global value. Future research should longitudinally explore how personal strengths and weaknesses can be systematically addressed.