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Alva MH, Antony SP, Kataria K. Exploring the Use of the Therapist's Self in Therapy: A Systematic Review. Indian J Psychol Med 2025; 47:17-24. [PMID: 39564272 PMCID: PMC11572587 DOI: 10.1177/02537176241252363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2024] Open
Abstract
Purpose This systematic qualitative review explored how psychotherapists use their self in therapy within the psychotherapy literature. It sought to examine the key documented ways through which the therapist's self is intentionally used in therapy and the process of using the therapist's self. Methods Following PRISMA guidelines, databases including PubMed, ProQuest, APA PsycArticles, and APA PsycINFO were searched. The review question "How do therapists use their self in therapy?" guided the search using derivative keywords. Of the 149 screened articles, 20 underwent full-text review, and only four studies met inclusion criteria. Findings All studies that met the inclusion criteria were from the West. Therapeutic self-disclosure (TSD) emerged as the primary way through which therapists used their self in therapy-notably, the only way documented in the studies reviewed. Studies discussed the nature, rationale, influencing factors, and effectiveness of TSD. This article elaborates upon the themes from the reviewed studies. It critically examines existing literature, lists avenues for future research, and discusses implications for psychotherapy practice. Conclusions The review underscores a significant gap in empirical qualitative research regarding therapists' use of their self beyond TSD in therapy. There is an urgent need for further exploration in this domain.
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Affiliation(s)
- Meera H. Alva
- Dept. of Psychology, Christ University, Bangalore, Karnataka, India
| | - Sherin P. Antony
- Dept. of Psychology, Christ University, Bangalore, Karnataka, India
| | - Kanak Kataria
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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Mösler T, Poppek S, Leonhard C, Collet W. Reflective Skills, Empathy, Wellbeing, and Resilience in Cognitive-Behavior Therapy Trainees Participating in Mindfulness-Based Self-Practice/Self-Reflection. Psychol Rep 2023; 126:2648-2668. [PMID: 35499138 PMCID: PMC10652655 DOI: 10.1177/00332941221094482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Self-Practice/Self-Reflection (SP/SR) is an aspect of therapist training and professional development aimed at enhancing therapy skills, empathy, wellbeing, and resilience in the ultimate furtherance of client outcomes. For many decades, intensive SP/SR has been a required part of therapist training in many countries but relatively little is known about the effect of SP/SR. Studies have found cognitive-behavior therapy (CBT) therapists trained under a Beckian CBT paradigm benefitted from more time limited Beckian SP/SR. Mindfulness-based CBT is a more recent third-wave CBT paradigm with psychological process aims similar to those of SP/SR. While training in mindfulness-based CBT often has prominent SP/SR aspects, and mindfulness practice has been shown to benefit health care providers personally and professionally, to date no evaluations have been reported specifically of effects of participation of CBT trainees in stand-alone mindfulness-based SP/SR that meets regulatory requirements for more intensive SP/SR. A study on SP/SR training meeting German requirements is reported here. Post-graduate CBT trainees (N = 95) were assigned to delayed or immediate SP/SR with those in the delayed SP/SR condition crossing-over into SP/SR training after two baseline evaluations on a variety of reflective skill, wellbeing, and resilience measures spaced six to 9 months apart before participating in 120-150 hours of stand-alone mindfulness-based SP/SR followed by a third reevaluation on all study measures. Participants assigned to the immediate SP/SR condition underwent identical SP/SR training with pre/post assessments. Results indicate participation in intensive stand-alone mindfulness-based SP/SR resulted in favorable changes in measures operationalizing all variables. Findings are discussed in terms of their implications for training and professional development of CBT therapists.
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Affiliation(s)
- Thomas Mösler
- Institut für Verhaltenstherapie, Verhaltensmedizin und Sexuologie, Nuremberg/Fuerth, Germany
| | - Sandra Poppek
- Institut für Verhaltenstherapie, Verhaltensmedizin und Sexuologie, Nuremberg/Fuerth, Germany
| | - Christoph Leonhard
- Institut für Verhaltenstherapie, Verhaltensmedizin und Sexuologie, Nuremberg/Fuerth, Germany
- The Chicago School of Professional Psychology, Xavier University of Louisiana, New Orleans, LA, USA
| | - Wilfried Collet
- Institut für Verhaltenstherapie, Verhaltensmedizin und Sexuologie, Nuremberg/Fuerth, Germany
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Nakashima M, Matsunaga M, Otani M, Kuga H, Fujisawa D. Development and preliminary validation of the Group Cognitive Therapy Scale. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e128. [PMID: 38867831 PMCID: PMC11114285 DOI: 10.1002/pcn5.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 06/14/2024]
Abstract
Aim The aim of this research was to create a scale to assess the competency of therapists who conduct group cognitive behavioral therapy (G-CBT). The scale is intended to serve as a tool to aid the training of therapists. Methods Three stepped studies were conducted. Process 1: Through literature review and experts' consensus process, essential skills for G-CBT were articulated and categorized according to the criteria of the Cognitive Therapy Scale, a well-established rating scale for evaluating clinicians' skills in individual cognitive behavioral therapy. The list of those skills was organized into a rating scale. Process 2: Behavioral anchors were added to each skill and were classified by the levels of difficulty (beginner, intermediate, and advanced levels), based on the rating by G-CBT experts. Process 3: Inter-rater reliability and validity of the rating scale were examined in a sample of 41 videotaped G-CBT sessions of actual clinical sessions and educational role-plays. Results The 12-item Group Cognitive Therapy Scale (G-CTS) was developed. It consists of 11 items that are adapted from the original Cognitive Therapy Scale, and a new 12th item called "Intervention using relationships with other participants," which describes therapists' skills to address group dynamics. The G-CTS showed excellent internal consistency (Cronbach's α: 0.95), satisfactory inter-rater reliability (interclass correlation coefficients: 0.65-0.88), and high predictive validity. Conclusion A novel rating scale to evaluate therapists' competency in G-CBT was developed and successfully validated. The G-CTS behavioral checklist created in this study provides concrete guidelines that can be used by therapists to hone their skills in G-CBT.
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Affiliation(s)
- Misuzu Nakashima
- Division of Clinical ResearchNational Hospital Organization Hizen Psychiatric CenterKanzakiSaga PrefectureJapan
| | - Miki Matsunaga
- Department of PsychologyRikkyo UniversityNiizaSaitama PrefectureJapan
| | - Makoto Otani
- Department of Psychosomatic MedicineNTT Medical Center TokyoTokyoJapan
| | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | - Daisuke Fujisawa
- Division of Patient SafetyKeio University School of MedicineTokyoJapan
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
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What characterizes helpful personal practice in psychotherapy training? Results of an online survey. Behav Cogn Psychother 2023; 51:74-86. [PMID: 36281883 DOI: 10.1017/s1352465822000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Personal practice (PP) is often considered as a central component in psychotherapy training aiming to promote personal and therapeutic competences. However, its implementation varies considerably in practice. AIMS The purpose of this exploratory study was to examine the current practice of PP regarding the frequency/occurrence and perceived usefulness/impairment of topics, techniques and effects, as well as its helpful characteristics in psychotherapy training. METHOD 407 German psychotherapy trainees (214 cognitive behavioural therapy; 178 psychodynamic therapy) were surveyed online as to their current practice of PP. RESULTS For trainees, personal and therapeutic related topics were discussed. Reflection techniques and self-experiential practice were among the most frequently reported strategies, while the fostering of personal and interpersonal competences was among the effects with the strongest occurrence. However, negative PP effects were recorded as well. Differences in PP practice emerged between therapeutic orientations. CONCLUSIONS As certain techniques which are central to PP (e.g. self-experience) were also rarely or not used, and negative effects reported, its potential might not be fully utilized.
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Pilkington PD, Spicer L, Wilson M. Schema therapists' perceptions of the influence of their early maladaptive schemas on therapy. Psychother Res 2022; 32:833-846. [PMID: 35179087 DOI: 10.1080/10503307.2022.2038804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Objective: This qualitative survey aimed to explore schema therapists' perceptions of how their early maladaptive schemas are activated in their therapeutic work, and how they manage their reactions.Method: An online qualitative survey was conducted with 22 schema therapists. Following brief demographic questions, participants were asked three open-ended questions about their schema activation and associated reactions. An inductive-deductive hybrid thematic analysis of the qualitative responses identified four superordinate themes and 12 subthemes.Results: Participants described several negative impacts on their therapeutic work, including avoiding limit setting, becoming argumentative or aggressive, detaching or avoiding, and over-functioning. An array of strategies for managing schema and countertransference reactions were identified, including refocusing on the client's vulnerability, caring for one's own vulnerability and connecting with one's healthy adult self, and engaging in supervision, training, personal therapy, and self-care. Notably, several participants described how their internal reactions can be used advantageously to conceptualize and support clients, and to facilitate therapists' personal development.Conclusion: The findings highlighted that although schema and associated countertransference experiences can be challenging, awareness and effective management of therapists' reactions can benefit treatment and promote personal growth.
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Affiliation(s)
- Pamela D Pilkington
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Liam Spicer
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Meghan Wilson
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
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The why, what, when, who and how of assessing CBT competence to support lifelong learning. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Abstract
Assessment of cognitive behaviour therapy (CBT) competence is a critical component in ensuring optimal clinical care, supporting therapists’ skill acquisition, and facilitating continuing professional development. This article provides a framework to support trainers, assessors, supervisors and therapists when making decisions about selecting and implementing effective strategies for assessing CBT competence. The framework draws on the existing evidence base to address five central questions: Why assess CBT competence?; What is CBT competence?; When should CBT competence be assessed?; Who is best placed to assess CBT competence?; and How should CBT competence be assessed? Various methods of assessing CBT competence are explored and the potential benefits and challenges are outlined. Recommendations are made about which approach to use across different contexts and how to use these effectively to facilitate the acquisition, enhancement and evaluation of CBT knowledge and skills.
Key learning aims
After reading this article you will be able to:
(1)
Identify key issues about why, what, when, who and how to assess CBT competence and use this framework to guide decisions about the best strategy to use.
(2)
Be aware of the range of methods for assessing CBT competence and consider the main benefits and potential challenges of these.
(3)
Consider the most effective ways to implement CBT competence assessment strategies as a tool for evaluation and learning.
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Amouroux R, Gerber L, Aronov M. Putting psychotherapy in its place: The regionalization of behavior therapy in France, Switzerland, and Belgium, 1960s-1990s. JOURNAL OF THE HISTORY OF THE BEHAVIORAL SCIENCES 2022; 58:5-23. [PMID: 34599839 PMCID: PMC9292482 DOI: 10.1002/jhbs.22142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/16/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
This article traces the history of the behavior therapy movement in French-speaking Europe between the 1960s and the 1990s, focusing on its geographically located development, whether on a national, sub- or supra-national scale. By examining the trajectories of the three main behavioral therapy associations in France, Switzerland, and Belgium, we show that it is not possible to subsume them under a common intellectual history. Despite the importance of theoretical debates in the emergence of this brand of psychotherapy in English-speaking countries, adherence to this type of explanation falls short of accounting for the differential reception of behavioral therapies in these countries. We argue that the later development of behavioral therapy in France, Belgium, and Switzerland was shaped more by professional agendas, local definitions, and regulations of psychotherapy than by "pure" theoretical commitments and conflicts between schools of thought. From a historiographical perspective, exploring the regionalization of psychotherapeutic styles thus involves contesting the idea that different therapies are mainly characterized by adherence to psychological theories and embedded ontologies of the self that are radically opposed (i.e., humanism vs. naturalism, psychoanalysis vs. behavior therapy). Localizing psychotherapies and paying attention to the varying circumstances and traditions in which they have evolved allows us to go beyond this dichotomous vision and to access a multiplicity of nondogmatic and intermediate positions that would otherwise be invisible.
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Affiliation(s)
- Rémy Amouroux
- Institute of Psychology, FADOUniversity of LausanneLausanneSwitzerland
| | - Lucie Gerber
- Institute of Psychology, FADOUniversity of LausanneLausanneSwitzerland
| | - Milana Aronov
- Institute of Psychology, FADOUniversity of LausanneLausanneSwitzerland
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Group cohesion in group-based personal practice. Behav Cogn Psychother 2021; 50:28-39. [PMID: 34569462 DOI: 10.1017/s1352465821000369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Personal practice (PP) is an integral component of many psychotherapy training programmes. It aims to promote personal and professional growth and is often conducted in a group format (g-PP). Group cohesion is one of the most researched mechanisms in group psychotherapy, but has rarely been studied in the context of g-PP. AIMS AND METHOD This exploratory study examines the associations between cohesion, satisfaction with g-PP, its impact on personal and professional development, and theoretical orientation in a sample of n = 329 German psychotherapy trainees. Cohesion was assessed with the group questionnaire (GQ-D; Positive Bonding, Positive Working, Negative Relationship). RESULTS Overall, participants reported high levels of all outcome variables. Positive Bonding was the strongest predictor of satisfaction with g-PP (β = 0.46, p<.001). While trainees in cognitive behaviour therapy reported significantly better cohesion scores (d≥0.31), trainees in psychodynamic therapy reported significantly higher satisfaction with g-PP and its impact on their developments (d≥0.30). CONCLUSIONS Group cohesion appears to be an important factor in g-PP that should be actively promoted by group leaders. However, longitudinal study designs are needed to better understand the emergence of cohesion in g-PP as well as potential moderating factors.
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Laing T, Sheen J, Nicola-Richmond K, Pépin G, O’Shea M. The utility of threshold concepts for clinical psychology education programmes. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2021.1949244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tara Laing
- Faculty of Health, Deakin University, Melbourne, Australia
| | - Jade Sheen
- Faculty of Health, Deakin University, Melbourne, Australia
| | | | | | - Melissa O’Shea
- Faculty of Health, Deakin University, Melbourne, Australia
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10
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Strauß B, Taeger D. [Effects of Personal Therapy during psychotherapy training - A Systematic Review]. Psychother Psychosom Med Psychol 2021; 71:489-498. [PMID: 34255330 DOI: 10.1055/a-1499-8115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Self-experiential work/personal therapy as part of psychotherapeutic training is often under critical discussion. In the German system, self-experiential work will remain an established part of training in psychosocial medical specialties and will continue to be part of the future curriculum in psychotherapy and in practical training subsequent to the study. OBJECTIVES Identification of different impacts of self-experiential work on psychotherapy trainees. MATERIAL AND METHOD Systematic literature review of studies between 2005 and 2020. Literature search via electronic databases, prior literature search and searches through reference lists of previous research. Selection via previously determined inclusion and exclusion criteria. RESULTS Thirteen studies were selected for this review. Results were summarised related to 7 outcome variables which mostly displayed positive impacts of self experience related to interpersonal skills, self-perception, knowledge and understanding of therapeutic work, well-being and relief. Satisfaction and the acceptance of the subjective importance of personal therapy for increasing competence were more common than reports about intensive emotions and stress. CONCLUSION Self-experiential work is highly valued by psychotherapy trainees and is therefore correctly considered as an obligatory part of training. Nonetheless, it should be evaluated regularly. For further research, self-reports, the most commonly used method, should be combined with objective measures, representativeness of samples should be enhanced and long-term effects should be investigated.
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Hahn D, Weck F, Witthöft M, Maiwald LM, Foral A, Kühne UF. Wie erleben Psychotherapeut_innen in Ausbildung ihre Selbsterfahrung? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Selbsterfahrung ist zentraler Bestandteil der Psychotherapieausbildung. Gleichzeitig wurde Selbsterfahrung selten empirisch untersucht. Fragestellung: Ziel unserer Studie war es, Bedingungen und Effekte hilfreicher Selbsterfahrung zu explorieren. Methode: Vierzehn verhaltenstherapeutische Ausbildungskandidat_innen wurden anhand halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015 ). Ergebnisse: Verschiedene Bedingungen wurden mit hilfreich erlebter Selbsterfahrung in Zusammenhang gebracht: Merkmale der Selbsterfahrungsleitung (u. a. Durchführungskompetenz), der Organisation, der Teilnehmer_innen (Lernbereitschaft), die behandelten Themen und die eingesetzten Techniken, sowie eine tragfähige Arbeitsbeziehung. Berichtete positive Effekte waren u. a. die Förderung interpersoneller Kompetenzen. Zudem wurden Nebenwirkungen und negative Effekte formuliert (u. a. Erschöpfung). Schlussfolgerungen: Bedingungen zur Durchführung von als hilfreich erlebter Selbsterfahrung und Effekte von Selbsterfahrung wurden aus Sicht der Teilnehmer_innen extrahiert.
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Affiliation(s)
- Daniela Hahn
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Florian Weck
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam
| | - Michael Witthöft
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Lisa Marie Maiwald
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Annika Foral
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
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Measuring therapist cognitions contributing to therapist drift: a qualitative study. COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x21000039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Therapist beliefs have been identified as a contributing factor to ‘therapist drift’ in cognitive behavioural therapy (CBT). Scales have been developed to measure therapist beliefs, but none explicitly measure ‘therapy-interfering cognitions’, and there is no research on their usage. The aim of this study was to explore how best to conceptualise such a scale’s content and usage, based on clinicians’ perceptions and experiences of current scales. Three focus groups were conducted, involving 12 participants who were either qualified or trainee CBT therapists. Transcripts were analysed using thematic analysis. Four main themes were generated: (1) The Awareness and Importance of Cognitions, (2) Factors Fuelling Therapist Cognitions, (3) Addressing Therapist Cognitions, and (4) Using the Scale. Participants thought it important to be aware of and address therapist cognitions (not underlying beliefs). Participants emphasised that therapist cognitions are not just products of the individual, but are influenced by external factors. A scale could enable therapists to do better work through reflective practice, as long as it was used not just to identify cognitions but also to support changes in therapist behaviour. A scale could also meet a perceived need for making this part of routine practice. However, participants discussed how therapists might have reservations about disclosing cognitions in this way. Recommendations for current practice, and future research developing such a scale, are made.
Key learning aims
(1)
To describe the phenomenon of therapist drift, and the contributions of therapist beliefs to this.
(2)
To explore the usage of current scales for measuring therapist beliefs.
(3)
To understand, based on therapist experience, how to address therapist beliefs in current practice using scales.
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Spafford S, Haarhoff B. What Are the Conditions Needed to Facilitate Online Self‐Reflection for Cognitive Behaviour Therapy Trainees? AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Writing the ‘self’ into self-practice/self-reflection (SP/SR) in CBT: learning from autoethnography. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x19000217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Self-practice/self-reflection (SP/SR) allows cognitive behavioural therapists (CBT) to self-experience the techniques they use clinically. However, it is difficult to find published first-hand accounts of CBT therapists’ SP/SR experiences. This may be because CBT research is primarily positivist and objective, while SP/SR is intrinsically subjective. Borrowing from the principles of autoethnography may offer a subjectivist qualitative methodology, allowing CBT therapists to write up their SP/SR experiences as rich, first-hand research material, potentially impacting theory and practice. This novel personal case study of SP/SR borrows from autoethnography, adapting it to analyse the self-practice of the CBT model of worry, in order to understand my own experience of worry as well as the model itself.
Key learning aims
(1)
To develop an approach to the research that is applicable to first-hand SP/SR material.
(2)
To demonstrate how therapists can continue SP/SR practice post-CBT training.
(3)
To illustrate how, with the aid of autoethnographic principles, SP/SR practice can influence not only the practitioner’s personal and therapist-self, but also theory development.
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Chigwedere C, Thwaites R, Fitzmaurice B, Donohoe G. Self-practice/self-reflection as an alternative to personal training-therapy in cognitive behavioural therapy training: A qualitative analysis. Clin Psychol Psychother 2018; 26:74-83. [DOI: 10.1002/cpp.2331] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/05/2018] [Accepted: 09/04/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Craig Chigwedere
- Department of Psychiatry, School of Medicine, Trinity College Dublin; University of Dublin; Dublin Ireland
| | | | - Brian Fitzmaurice
- Department of Psychiatry, School of Medicine, Trinity College Dublin; University of Dublin; Dublin Ireland
| | - Gary Donohoe
- Department of Psychology; National University of Ireland; Galway Ireland
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How beginning cognitive behavioural therapists develop professional confidence. COGNITIVE BEHAVIOUR THERAPIST 2018. [DOI: 10.1017/s1754470x1800003x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractEvidence exists that the effectiveness of psychotherapy depends more on therapists’ variables than on their theoretical orientation or the techniques they use. Nevertheless, relatively little is known regarding the process of cognitive behavioural psychotherapists’ development. The purpose of the study was to explore how beginning cognitive behavioural therapy (CBT) practitioners develop, considering various professional and personal influences. Eight in-depth interviews with beginning therapists were conducted, and the Grounded Theory Method was used for data analysis. The developmental process was conceptualized as Gaining Professional Confidence, and three phases of this process were identified: (1) Externally Based Confidence in CBT Methods, (2) Internalized Confidence in CBT Methods, and (3) Therapists’ Self-Confidence. The results indicate that trainees’ self-reflection on their personal qualities, values, attitudes and preferences should be given more attention in CBT training, as this plays a crucial role in their overall professional development.
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Bennett-Levy J, Finlay-Jones A. The role of personal practice in therapist skill development: a model to guide therapists, educators, supervisors and researchers. Cogn Behav Ther 2018; 47:185-205. [DOI: 10.1080/16506073.2018.1434678] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- James Bennett-Levy
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Amy Finlay-Jones
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Friedberg RD. Best practices in supervising cognitive behavioral therapy with youth. World J Clin Pediatr 2018; 7:1-8. [PMID: 29456927 PMCID: PMC5803561 DOI: 10.5409/wjcp.v7.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/16/2017] [Accepted: 01/07/2018] [Indexed: 02/06/2023] Open
Abstract
Clinical supervision of cognitive behavioral therapy (CBT) with youth ensures better patient care and fosters trainees' professional development. However, often insufficient attention is directed toward disseminating best practices in supervision of CBT with youth. This Therapeutic Advances contribution aims to communicate the core content of supervision. Additionally, the key supervisory practices associated with CBT with youth are described. Supervisory outcomes are summarized and recommendations for supervisory practices are made.
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Affiliation(s)
- Robert D Friedberg
- Center for the Study and Treatment of Anxious Youth, Palo Alto University, Palo Alto, CA 94304, United States
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Muse K, McManus F. Expert Insight into the Assessment of Competence in Cognitive-Behavioural Therapy: A Qualitative Exploration of Experts' Experiences, Opinions and Recommendations. Clin Psychol Psychother 2015; 23:246-59. [PMID: 25864586 DOI: 10.1002/cpp.1952] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 01/16/2015] [Accepted: 02/28/2015] [Indexed: 11/08/2022]
Abstract
UNLABELLED To offer insight into how cognitive-behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts' (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants' experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE A qualitative exploration of experts' experiences, opinions and recommendations for assessing the competence of CBT therapists. Semi-structured interviews were conducted and analysed using interpretive phenomenological analysis. Themes identified shed light on (i) what to assess; (ii) how to assess; (iii) who is best placed to assess; and (iv) common pitfalls. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.
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Affiliation(s)
- Kate Muse
- Psychology, Institute of Health and Society, University of Worcester, Worcester, UK
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Knowing our ‘ABCs’: self-reflection using cognitive-behavioural formulation of client–therapist interaction in work with a survivor of torture. COGNITIVE BEHAVIOUR THERAPIST 2015. [DOI: 10.1017/s1754470x15000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractSelf-reflection can aid therapist development, particularly interpersonal skills. It can be achieved through using cognitive-behavioural therapy techniques, for example, formulations of the therapist's cognitions and behaviours have been used to aid self-reflection. As interpersonal skills may be an area that benefits from self-reflection, an approach to formulating the interaction between client and therapist may be beneficial. This study reports the use of simple ‘antecedent-belief-consequence’ (ABC) formulations for the client and therapist to conceptualize their interaction. This description of a treatment failure focuses on cross-cultural work with a survivor of torture, where self-reflection may be particularly indicated to promote cultural competence and address the impact of the content on the therapist. ABC formulations for the client and therapist were completed and through this structured self-reflection, the therapist was able to identify the impact of her own beliefs on the process of therapy. This method identified areas for further development and generated hypotheses for how to continue therapy with this client. Using ABC formulations then may provide a useful and structured way to conduct self-reflection with explicit focus on the interaction between client and therapist.
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Gale C, Schröder T. Experiences of self-practice/self-reflection in cognitive behavioural therapy: a meta-synthesis of qualitative studies. Psychol Psychother 2014; 87:373-92. [PMID: 24677534 DOI: 10.1111/papt.12026] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/17/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND Self-practice/self-reflection is a valuable training strategy which involves therapists applying therapeutic techniques to themselves, and reflecting on the process. PURPOSE To undertake a meta-synthesis of qualitative studies exploring therapists' experiences of self-practice/self-reflection in cognitive behavioural therapy (CBT). This would integrate, and interpret, the current literature in order to develop a new understanding, and contribute to the development of CBT training programmes. METHODS The meta-synthesis encompassed three distinct phases: undertaking a comprehensive and systematic literature search; critically appraising the papers; and synthesising the data using the meta-ethnographic method. RESULTS The literature search identified 378 papers, ten met the criteria for inclusion. After critical appraisal, all were included in the synthesis. The synthesis identified 14 constructs, which fell into three broad categories: 'experience of self-practice/self-reflection'; 'outcomes of self-practice/self-reflection'; and 'implications for training'. This synthesis found that self-practice allows therapists to put themselves into their clients' shoes, experiencing the benefits that therapy can bring but also the problems that clients can run in to. This experience increases therapists' empathy for their clients, allowing them to draw on their own experiences in therapy. As a result, therapists tend to feel both more confident in themselves and more competent as a therapist. The self-practice/self-reflection process was facilitated by reflective writing and working with others, particularly peers. CONCLUSIONS Self-practice/self-reflection is a valuable training strategy in CBT, which has a range of beneficial outcomes. It can also be used as a means of continuing personal and professional development. PRACTITIONER POINTS Self-practice of CBT techniques, and reflecting on the process, can be a useful training strategy and helpful for ongoing development Therapists could consider developing a 'self-case' study, rather than using the exercises as one-off techniques, recording reflections in writing, and sharing reflections with peers. Self-practice/self-reflection can be particularly helpful for increasing empathy for clients, highlighting the difficulties they may encounter.
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Affiliation(s)
- Corinne Gale
- Division of Psychiatry and Applied Psychology, University of Nottingham, UK; Derbyshire Healthcare NHS Foundation Trust, Derbyshire, UK
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Davis ML, Thwaites R, Freeston MH, Bennett-Levy J. A measurable impact of a self-practice/self-reflection programme on the therapeutic skills of experienced cognitive-behavioural therapists. Clin Psychol Psychother 2014; 22:176-84. [PMID: 24464966 DOI: 10.1002/cpp.1884] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/29/2013] [Accepted: 12/05/2013] [Indexed: 11/06/2022]
Abstract
The need for effective training methods for enhancing cognitive-behavioural therapist competency is not only relevant to new therapists but also to experienced therapists looking to retain and further enhance their skills. Self-practice/self-reflection (SP/SR) is a self-experiential cognitive-behavioural therapy (CBT) training programme, which combines the experience of practicing CBT methods on oneself with structured reflection on the implications of the experience for clinical practice. In order to build on previous qualitative studies of SP/SR, which have mainly focused on trainee CBT therapists, the aim of the current study was to quantify the impact of SP/SR on the therapeutic skills of an experienced cohort of CBT therapists. Fourteen CBT therapists were recruited to participate in an SP/SR programme specifically adapted for experienced therapists. In the context of a quasi-experimental design including multiple baselines within a single-case methodology, therapists provided self-ratings of technical cognitive therapy skill and interpersonal empathic skill at four critical time points: baseline, pre-SP/SR and post-SP/SR and follow-up. Analysis of programme completers (n = 7) indicated that SP/SR enhances both technical skill and interpersonal therapeutic skill. Further intention-to-treat group (n = 14) analyses including both those who left the programme early (n = 3) and those who partially completed the programme (n = 4) added to the robustness of findings with respect to technical cognitive therapy skills but not interpersonal empathic skills. It was concluded that SP/SR, as a training and development programme, could offer an avenue to further therapeutic skill enhancement in already experienced CBT therapists.
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Affiliation(s)
- Melanie L Davis
- Pain Management Unit, University Hospital of North Durham, County Durham and Darlington NHS Foundation Trust, Durham, UK
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McMahon A, Errity D. From new vistas to life lines: psychologists' satisfaction with supervision and confidence in supervising. Clin Psychol Psychother 2013; 21:264-75. [PMID: 23355350 DOI: 10.1002/cpp.1835] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 12/13/2012] [Accepted: 12/14/2012] [Indexed: 11/07/2022]
Abstract
UNLABELLED This study aimed to provide the first detailed survey of Irish psychologists' supervision practices as well as to identify what is related to satisfaction with supervisory support and to confidence in providing supervision. An online survey was distributed nationwide to Irish psychologists. Participants were mostly clinical and counselling psychologists. Three-quarters of the participants constituted 51% of the total population of Irish health service psychologists, the remainder working in various non-health service settings. The results showed that most Irish psychologists attend supervision but at a low frequency, typically once monthly. One-third were dissatisfied with their supervision, greater satisfaction being related to having more frequent clinical supervision and having external individual clinical supervision. Having a safe and trustworthy relationship with supervisors was a dominant issue, and two-thirds of psychologists wanted separation of their clinical and line management supervision. Although 70% were supervisors, only 40% were confident in their supervisory skills and just 16% had formal supervisor training. Independent predictors of supervisory confidence were experience as a psychologist, having formal supervisor training, experience as a supervisor and confidence as a therapist. A novel finding was that longer experience of personal therapy was related to greater confidence as a supervisor. This study indicates the need for access to more frequent clinical supervision to be facilitated for psychologists and for there to be clear separation of line management and clinical supervision. It is also essential that more resources are put into training supervisors. KEY PRACTITIONER MESSAGE While most psychologists are engaged in supervision, frequency of attendance is low, with more satisfied psychologists having more frequent supervision. Most psychologists want separation of their clinical and line management supervision and have a preference for external supervision, safe and trustworthy relationships with supervisors being their primary concern. Only 16% of psychologists had formal training in supervision but having such training significantly contributed to greater confidence as a supervisor, indicating an urgent need to provide more supervisor training for psychologists.
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Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit? Behav Cogn Psychother 2012; 42:48-64. [PMID: 23116565 DOI: 10.1017/s1352465812000781] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent. AIMS This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training. METHOD The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data. RESULTS A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR. CONCLUSIONS A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.
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Self-case study as a catalyst for personal development in cognitive therapy training. COGNITIVE BEHAVIOUR THERAPIST 2010. [DOI: 10.1017/s1754470x10000097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPersonal development is a vital requirement of counsellor development, and educators need to consider how best to promote and support students’ personal development throughout training. ‘Self-case study’ can provide both learning and personal development opportunities for counselling students. This qualitative narrative study explores seven students’ perspectives about their experiences of completing a self-case study as a learning requirement for a compulsory introductory course in cognitive therapy at undergraduate level. Unstructured individual interviews were used for data collection. Data analysis involved identifying themes and analysing the narrative structure of stories. The findings emphasized the view that self-case study provides useful learning opportunities in the areas of theory, practice and personal development. Most participants described transformational life changes resulting from completing a self-case study. This paper presents selected findings. The ethical issues and limitations of this study are discussed. Self-case study is recommended as a potentially effective education strategy.
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Abstract
Background: The widening scope of cognitive therapy models and strategies poses a challenge for designing cognitive therapy training. What are the core skills to be learned? What do learners view as important to learn and what are the skills and knowledge they focus on? Aims: The present study describes the perceptions of CT trainees of both what is important and what is difficult to learn. We also analyse what the trainees focus on when evaluating their professional learning. In addition, we report on changes in self-assessed skills during the training. Method: Quantitative and qualitative data were collected after 2 years of training (n = 39) in three programmes and after the entire 4-year training in four programmes (n = 53). Results: Significant progress was reported in all domains of therapist skills, most clearly in cognitive and constructivist strategies. The trainees practised most those skills they considered important to be learned and, consequently, they also attained a higher level of mastery in these skills. The trainees’ learning orientation and foci of self-reflections remained relatively unchanged. They focused on technical and conceptual skills and knowledge, whereas interpersonal skills were peripheral in their self-reflection. Conclusions: Pedagogical and theoretical implications of the findings are discussed.
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Sheikh AI, Milne DL, MacGregor BV. A model of personal professional development in the systematic training of clinical psychologists. Clin Psychol Psychother 2007. [DOI: 10.1002/cpp.540] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lucock MP, Hall P, Noble R. A survey of influences on the practice of psychotherapists and clinical psychologists in training in the UK. Clin Psychol Psychother 2006. [DOI: 10.1002/cpp.483] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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