USE OF SIMULATED CLIENTS IN MARRIAGE AND FAMILY THERAPY EDUCATION Jennifer L. Hodgson and Angela L. Lamson East Carolina University Elizabeth B. Feldhousen Syracuse University Knowledge of how one should manage suicidal, homicidal, child maltreatment, and domes- tic violence situations is paramount in the training of marriage and family therapists (MFTs). Simulated patient modules were created to help clinical faculty address these crisis situations in a protected learning environment. The modules were implemented by the MFT faculty in collaboration with the Office of Clinical Skills Assessment and Edu- cation at East Carolina University’s Brody School of Medicine. Qualitative data over the course of 2 years revealed six thematic domains regarding therapists’ performance, thera- pists’ emotions, the simulation experiences, and lessons learned. Educational, clinical, and research recommendations include tools to implement simulation exercises into marriage and family therapy programs as well as suggestions to assess for teaching effectiveness. In the medical field, a form of instruction that has become increasingly more common in the training of physicians is the use of standardized or simulated patient (SP) scenarios. Typic- ally, an SP scenario involves any ‘‘medical encounter conducted purely for educational purpo- ses’’ (Adamo, 2003, p. 262), in which ‘‘participants have the opportunity to interact with patients in a controlled learning environment’’ (Donovan, Hutchison, & Kelly, 2003, p. 125). The most common terms for these scenarios are standardized or simulated, and these terms will be used in this article interchangeably. Standardized patient encounters allow faculty to assess their students’ clinical skills in a safe environment with no chance of harming an actual patient and provide students with an opportunity to transition to working with real patients (Barrows, 1993). Moreover, investiga- tors (Colliver & Williams, 1993) suggested that the use of SPs was ‘‘as good or better an assess- ment of clinical performance than conventional methods,’’ such as the use of ‘‘physician observers’’ (p. 455), or ‘‘paper and pencil examinations’’ (p. 457) that measure knowledge of clinical skills. As a result of the success and effectiveness of the medical community’s use of SPs, investi- gators and educators have begun to incorporate standardized patients or clients in other fields as well (Larson et al., 1999). However, the use of standardized clients outside of the medical Jennifer L. Hodgson, PhD, and Angela L. Lamson, PhD, Department of Child Development and Family Relations, East Carolina University; Elizabeth B. Feldhousen, MS, Department of Marriage and Family Therapy, Syracuse University. Elizabeth B. Feldhousen, MS, was a master’s student in the Department of Child Development and Family Relations, East Carolina University, at the time of this data collection and analysis. The authors would like to give special recognition to Christy Pipho, MS, and Judy Cole, MS, for their contributions to the data analyses. We would also like to thank East Carolina University for internally funding the first year of this project and Heidi Lane at the Office of Clinical Skills Assessment and Education for training the actors and actresses for all four simulations. Portions of this article were presented at the Collaborative Family Healthcare Association Conference, Seattle, WA, and the American Association for Marriage and Family Therapy’s 61st Annual Conference in Long Beach, CA. Address correspondence to Jennifer L. Hodgson, Department of Child Development and Family Relations, East Carolina University, 150 Rivers Building, Greenville, North Carolina 27858-4353; E-mail: hodgsonj@ecu.edu Journal of Marital and Family Therapy January 2007, Vol. 33, No. 1, 35–50 January 2007 JOURNAL OF MARITAL AND FAMILY THERAPY 35