The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. As described in the Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences.

Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

×

Objective:

The aim of this report is to describe how trainees and instructors skew their performance of psychotherapies when sessions are observed by third parties and to discuss approaches to mitigate potentially adverse consequences.

Methods:

To supplement clinical observations, a selective narrative literature review was conducted by searching PubMed and PsycInfo.

Results:

When third-party observers were involved, therapists were likely to skew how they conducted psychotherapy. Skewing occurred regardless of whether the third parties observed in vivo or remotely, observed synchronously or asynchronously, or were instructors or trainees. Such skewing may have resulted from conscious, preconscious, or unconscious decisions by therapists as well as by patients. Despite the benefits of observed psychotherapy for therapists and patients, deleterious consequences have sometimes emerged.

Conclusions:

Benefits of third-party observation of psychotherapy are substantial. Nevertheless, therapists must recognize how being observed may adversely affect themselves and their patients. Mitigation strategies are available to address potential harms.

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.