Effects of a Simulation-Based Recertification for Licensed Psychotherapists on Patient Outcomes: A Cluster-Randomized Controlled Trial

This study investigates whether a simulation-based recertification procedure for licensed psychotherapists leads to improved patient-related outcomes compared to the existing continuing education credit system. The study is designed as a pragmatic cluster-randomized controlled trial in outpatient psychotherapy settings. Psychotherapists are randomized to either a simulation-based recertification including structured feedback or to the standard continuing education system. Patient outcomes, including symptom severity, therapy dropout, and therapeutic working alliance, are assessed longitudinally. The study aims to evaluate whether structured competence assessment improves treatment quality in routine care.