E-learning in psychotherapy training: a systematic review of learning outcomes and comparison to conventional training methods (Preprint)

Abstract

Mental disorders posit a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming and dependent on a small number of top-level professionals as trainers. E-learning have been proposed to enhance psychotherapy training accessibility, quality, and scalability.

This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition and application of trained content in daily practice. Furthermore, the equivalence of online training and conventional training methods is evaluated.

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid Medline, PsycINFO, and SCOPUS databases between 2008 and June 2022. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and non-randomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated.

The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes are generally comparable between e-learning and conventional training methods. The current literature displays a high level of heterogeneity in e-learning solutions and assessment methods.

E-learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in hybrid settings supported by active learning practices are presented. However, due to the heterogeneity and limitations in the existing literature, more research is warranted to further replicate the results and establish international standards for e-learning and assessment in psychotherapy training. Research is especially needed on optimal ways to combine e-learning and conventional training methods in blended learning settings.