Marital counselling: Teaching an eclectic approach

Limited opportunities for training combined with misperceptions about the nature of marital counselling lead to many professionals conducting consultations with couples without training. Where training exists, generally a specific ‘pure’ approach, or a definite brand of eclecticism is taught. The Sheffield Marital and Sexual Difficulties Clinic training course currently aims to give trainees the building blocks for evolving their own brand of eclecticism, or the opportunity to follow a particular approach. Psychodynamic, behavioural and systems theories are highlighted, and the various ways to which these (and other theories) can be used together are examined.     

Stresses reported by UK trainee counselling psychologists

This study examined stressors and psychological distress in 109 UK counselling psychology trainees. The research focus was two-fold. What is the profile of stressors that counselling psychology trainees report about the components of training? What relationship is there between this profile, and other characteristics of trainees, including their level of current psychological distress? Data from a stress survey and from the General Health Questionnaire were examined. High stress scores were found on three aspects of the stress survey (‘academic’, ‘placements’, ‘personal and professional development’), but not–surprisingly–on the aspect, ‘lack of support systems’. Significant stress differences were reported for gender and age of participants, and highly significant positive relationships were found between General Health Questionnaire and stress scores. Overall, the results suggest actions to be taken. Further research is needed to clarify unavoidable and avoidable stressors in training, and the reduction of trainees’ experience of training stress to the necessary minimum needs to be adopted as an active target by programmes.     

The challenge of becoming an integrative counsellor: The trainee's perspective

Aim: Integrative therapeutic practice is commonplace within the UK. Counsellors and psychotherapists increasingly report working in this way and numerous training courses have developed which advocate such practice. Despite its popularity, researchers have paid little attention to the impact that such training has upon students. This study therefore explores newly qualified counsellors' reflections of undertaking professional training in integrative counselling. Design: Newly qualified counsellors were invited to take part in a focus group to discuss their training experiences. Two groups were held involving a total of seven people. The data generated was analysed using Grounded Theory. Findings: The core-category ‘The challenge of becoming an integrative counsellor’ was identified. Embedded within this were four sub-categories: (1) ‘training issues’, (2) ‘applied issues’, (3) ‘the development of an integrative theory and identity’, and (4) ‘the impact of integrative training post qualification’. Key findings include the willingness of trainees to tolerate theoretical ambiguity and the discomfort that surrounded not belonging to a pure paradigm community. Discussion: Recommendations are made that trainers and practice supervisors are mindful of the distinct struggles that integrative trainees encounter. Additionally, in response to the isolation that some trainees report, greater use of peer support networks is encouraged.     

The crisis of psychoanalysis and psychoanalytical training: The suffering of the candidate on the long road towards qualifi cation1

The author assesses the impact of the so‐called ‘crisis of psychoanalysis’ on the training of candidates, and on those who accompany them through the course. Different causes of the most relevant symptom of the crisis, i.e. the diffi culty of fi nding patients for a four‐sessions‐weekly analysis, are considered. According to the author, analysts themselves must bear some of the responsibility for it. She draws attention to a number of interrelated phenomena, such as: trainees' tension in their encounters with potential analysands, due to awareness of their own needs as trainees; the necessity to accept very disturbed patients whose selection might arouse criticism from the training committee; analyses in which trainees seem to become patients' hostages because of ever‐present fears of interruption; the diffi cult construction of a psychoanalytic identity in trainees who also are in full‐time psychiatric practice; trainees' profound uncertainty about the future both of psychoanalysis in general and their own careers in particular. In agreement with Kernberg, the author stresses the importance of considering the ‘crisis of psychoanalysis’ as a phenomenon whose development may be infl uenced by the analysts themselves.     

How do trainees choose their first psychotherapy training? The case of training in psychotherapy integration

Future trainees go through difficult decision-making processes when starting their first psychotherapy training. The choice of training in psychotherapy integration is a specific type of this process. In this study, qualitative data were obtained from the motivational letters, in-depth semi-structured interviews and e-mail questionnaires of 26 future trainees to answer the research question, ‘How do trainees choose their first psychotherapy training?’ We primarily employed the grounded theory approach as well as consensual qualitative research to shed light on the central category of Gaining Certainty to enter the training. This category was elaborated into a four-phase model, specifically comprised of the: (1) Critical Comparison, (2) Identification, (3) Self-Confirmation and (4) Waiting phases. The model was then discussed in connection with relevant concepts, such as the degree of complexity and flexibility within the epistemological development of trainees [Vasco, A. B., &; Dryden, W. (1994). The development of psychotherapists’ theoretical orientation and clinical practice. British Journal of Guidance &; Counselling, 22(3), 327–341].     

Understanding black issues in postgraduate counsellor training

This paper presents a brief account of a qualitative multicultural study and heuristic exploration of how trainee counsellors understand black issues in their training and in their therapeutic work with clients. This initiative is supported by a previous survey of black clients and therapists who suggest that changes are needed in training. It presents current legislation and need for equalities in Higher Education and counsellor training, by challenging the dominance of Eurocentric approaches. A pluralistic, flexible Action Research methodology will be outlined. The theory and context of previous studies are presented. Phases of the process are described to show how this study was approached. Phase one describes how interviews with a variety of experienced practitioners confirmed the need for the study. Using examples of trainees’ narratives, phase two describes how the phenomenon of black issues was integrated into training and the process of generating data. The paper shows how the explication process reveals elements of fear, history, guilt and racism, present in the dynamic of black issues. The paper highlights how racism features highly in trainees’ concerns and influences their ability to share and understand. A snapshot of emerging concepts such as ‘finding a voice’ and ‘recognition trauma’ which are developed to assist the reflexive process is featured. The role of the researcher and black trainees as ‘black expert’ is discussed. In the context of ethical concerns and working through the researcher's counter transference as a black female tutor researcher, the process of modelling within a participatory role is described. An excerpt from a discussion with colleagues gives an essence of the outcome. The outcome is summarised in the conclusion:'A bridge from fear to transformation’. The study enabled both trainees and staff as collaborators to shift from a position of fear and not knowing to engaging in active dialogue about black issues on a personal and professional basis.     

Outsider Witness Groups as a Means of Professional Growth in Family Therapy Training: An Exploratory Qualitative Study

This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees’ participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees’ experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees’ development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.     

Dialogical construction of the selves of trainees as competent researchers

There is a widespread perception among family therapy trainees and practitioners of research as an alien activity. This perception is both damaging and unnecessary. Exercises to enhance the relationship of trainees to research were conducted in stages. Concepts of dialogically constructed selves were introduced, and exercises explored the trainees' construction of ‘self as a systemic therapist’. The idea of an extensive repertoire of selves was proposed. During subsequent research training the fact that all trainees had successfully completed a collaborative research project was exploited. Pairs successfully conducted a dialogue in which they actively and imaginatively constructed their selves as researchers.     

The path towards a professional identity: An IPA study of Greek family therapy trainees

Objective: Contemporary psychotherapy research has focused mainly on practitioners' training and education. The impact of training on professional development and the application of therapeutic skills have been the primary foci of the empirical literature. The aim of this paper is to present the experiences of seven family therapy trainees regarding their personal paths toward the development of professional identity as they underwent training in systemic psychotherapy. Method: In‐depth interviews were conducted and analysed using Interpretative Phenomenological Analysis. Results & Conclusions: Seven themes were identified: The Quest, Developing by Relating, Learnings, Personification of Training, Use of Self, Self‐Care and Empowerment, and Reflecting on the Role of the Therapist. The findings are discussed with regard to the development of the ‘therapist as a person’, gaining acknowledgement and autonomy, and the development of a community of therapeutic practice.     

Therapeutic attitudes and practice patterns among psychotherapy trainees in Germany

Aim: This study aims to explore if and how values and attitudes from trainees of different psychotherapeutic schools vary during training. Another aim has been to evaluate the extent of their therapeutic self-confidence during training. Methods: In a cross-sectional study, 171 trainees in German institutes with different theoretical orientations (Psychoanalysis – PA, Psychodynamic Therapy – PT and Cognitive Behavioral Therapy – CBT) participated. Results are reported for two questionnaires: Therapeutic-Attitudes-Candidate-Version (ThAT-CV) and Work-Involvement-Scales (WIS). Results: Therapeutic attitudes showed significant differences between trainees with different theoretical orientations but no significant difference between different levels of training within the same school. Whereas the PA and CBT trainees endorsed contrasting attitude profiles, the PT group displayed less differentiated attitudes in between those contrasts. Most trainees experienced their psychotherapeutic practice as challenging, and Stressful Involvement in therapy sessions was lower with more years in training. Female trainees reported more Healing Involvement and felt more competent in general than their male colleagues. Self-reported competence was higher the more congruent the trainees’ attitudes with their school's theoretical orientation. Conclusions: The ThAT-CV discriminates significantly between trainees of different therapeutic schools. Our sample demonstrates high identification with attitudes belonging to their theoretical orientation. This may account for high ratings of self-reported therapeutic competence. Attitudes seem to be formed before training and change little thereafter. Less differentiated attitudes may explain PT-trainees’ higher levels of Stressful Involvement.     

Using the internet to extend training in team problem solving

A hybrid training approach, composed of both computer-mediated communication on the Internet and face-to-face meetings, was implemented. The goals were to examine whether such an approach (1) could be used to extend traditional, short-term training, and (2) would be perceived as useful by the trainees. A central element of the approach was thelinchpin expert, a trainer who served as a communication bridge on the Internet between a team of trainers and a team of trainees. A coding system was developed to analyze the content of the Internet messages. Logistic regression analysis revealed that two types of content were related to the trainees’ perceptions that the messages enhanced their expertise in team problem solving: (1) outcome feedback given to a trainee about a specific activity, and (2) the sharing of conceptual information. The trainees perceived face-to-face and computer-mediated communications with the linchpin expert as being important to their development of expertise.     

Inside it was orange squash concentrate: trainees’ experiences of reflective practice groups within clinical psychology training

Despite many clinical psychology training programmes utilising reflective practice groups (RPGs) to develop reflective practice (RP) skills, there remains little research examining how trainees experience these groups. This study uses interpretative phenomenological analysis (IPA) to explore the experiences of eight qualified clinical psychologists who attended RPGs on one United Kingdom (UK) clinical psychology training programme. A purposive sample was recruited for single, semi-structured interviews. Five superordinate themes were identified: ‘The process: there were so many layers’; ‘The impact: an ongoing process’; ‘Commitment: I hated it, but I still went’; ‘The facilitator: a presence who was not always present’; and ‘Getting through it: finding ways to cope’. The findings illustrate the varied and complex experiences of the participants. Whilst the experience was often difficult, the participants were committed to attending and sought out ways to navigate it. The results are conceptualised in terms of existing psychological theory and literature. A critique of the research and suggestions for future studies are offered, including exploring the views of group facilitators and comparing how groups are utilised within different training programmes. Recommendations are made on the development of future RPGs, which include consideration of the facilitation style and the groups’ frequency and size.     

‘A baptism of fire’: A qualitative investigation of a trainee counsellor's experience at the start of training

Background: Belief in the effectiveness of professional counselling and psychotherapy training is widespread and generally unquestioned. Few studies have attempted to understand the changes experienced by trainees, or identified which aspects of professional training programmes assist them in the process of becoming therapists. Aims: to investigate how a trainee counsellor changes at the start of training, and to identify which aspects of a professional counsellor training programme were helpful in instigating and supporting change. Method: the experience of one trainee counsellor, Margaret, was captured through three semi-structured interviews conducted at the beginning, middle and end of her first term. The data were subjected to systematic qualitative analysis. Findings: Margaret experienced significant change during her first term. Each interview revealed a different phase of her development. The core categories were: becoming something new (week 3); growth in therapeutic confidence (week 6); surviving ‘stressful involvement’ through supervision (week 11). Experiential learning, in particular group supervision, was helpful throughout. The presence of real clients was identified as the main driver for change. Conclusion: The findings were found to be consistent with a number of other studies, which suggest that training is potentially painful because of the emotional demands it places on trainees, particularly at the start of practice. Consequently trainees require opportunities for experiential learning, peer support and supportive supervision to assist them in their development, but most importantly, given that supportive supervision can only minimise the harm of stressful involvement (Orlinsky & Ronnestad, 2005), they need early positive experiences with clients.     

Cognitive-Behavioral Processes Based on Using the ABC Analysis by Trainees’ for Their Personal Development

As cognitive-behavior therapy (CBT) has proven to be an evidence-based intervention for many mental health problems, the requirement for training programs has increased. Although there is promising data on the skills outcomes of such programs, trainees’ affective/behavioral changes mechanisms and in their faulty thinking patterns during the personal development of such training are unknown. The aim of this study is to investigate which are the most common irrational/dysfunctional beliefs of trainees during a cognitive-behavioral intervention training and their maladaptive consequences, as well as the methods of restructuring that they prefer to change these beliefs into rational/functional ones and achieve more adaptive consequences. 94 participants in a cognitive-behavioral interventions training program filled out 340 ABC, forms related to negative events at work and in personal life, as part of the personal development component in the training program. The obtained qualitative data was coded by three trained ratters in accordance to the current cognitive model of CBT. Contingencies analysis showed that demandingness, awfulizing and global evaluation (GE) are most frequently associated with anxiety, while low frustration tolerance is associated with anger. Comfort, affiliation, achievement themes were most frequently associated with anxiety, while fairness was most frequently associated with anger. Pragmatic cognitive restructuring was the most frequently used by trainees. We found evidence that confirmed many of the theoretical predictions form the cognitive model of CBT in respect to the associations between irrational/dysfunctional cognitions and dysfunctional emotions as well as some particularities for this specific population.     

Military police investigator perspectives of a new self-reflective approach to strengthening resilience: A qualitative study

In this study, we explored participants’ experiences of a unique form of resilience training. The aims of this study were to obtain rich information about the participants’ experience of the resilience intervention based on adaptive self-reflection, their ability to report the private stress experience and coping efforts when faced with a stressor, their perceptions of training applicability to other contexts, and whether the training was able to encourage the reappraisal of stressors as growth opportunities. A qualitative design was employed with a sample of 21 investigator trainees from the Australian Defence Force School of Policing. Following implementation of the program, trainees provided written responses to seven open ended questions and participated in one focus group designed to embellish understanding of the survey answers. The analysis identified both strengths and limitations in the way respondents were able to recall and report on their private stress experience and coping efforts and several domains where the resilience training seemed to have its effects. Moreover, the respondents reported increased confidence in their ability to manage stressors in the future, recognition of stress in others and the potential to assist them, and a changed view of stress as an opportunity for personal development. Based on these findings, potential improvements in the training materials are recommended. Moreover, the findings suggest coping and emotion regulatory self-reflection may encourage the application of useful strategies and reinforce personal resilient capacities and coping self-efficacy.     

Feminist identity and program characteristics in the development of trainees’ social advocacy

Feminism, multiculturalism, and social justice (SJ) are closely related constructs, with an important shared emphasis on societal barriers and client empowerment. Yet, research on the relationships between the three variables in their links to counselor advocacy remains scarce. Employing the Input–Environment–Outcome framework, this study examined the unique contributions of 235 female trainees’ feminist identity, training environment SJ supports, and training multicultural focus in explaining trainees’ advocacy using a three-step hierarchical MMLR model. Findings revealed that all three factors were important to trainees’ advocacy. However, the extent to which each factor influenced advocacy varied. For instance, the more strongly identified trainees were with the Feminist Identity Active Commitment stage, the more likely they were to engage at all four levels of advocacy. Conversely, the more aligned trainees were with Passive Acceptance, the less likely they were to empower clients. Moreover, although both training environment SJ support and multicultural focus were influential, SJ training environment was a better predictor of trainee’s advocacy than multicultural training environment. These findings not only highlight the distinctions between SJ and multiculturalism, but also argue for the importance of SJ training in addition to multicultural training. Implications for theories, training, and practice are discussed.     

Learning and difficult experiences in graduate training in clinical psychology: A qualitative study of Japanese trainees’ retrospective accounts

This study examined the experiences of Japanese clinical psychology trainees in their graduate school with the aim of identifying factors that might enhance or hinder their learning and professional development. We analyzed the interview data obtained from 17 clinical psychologists using grounded theory approach. Two major category groups were generated: Developing as a Clinician and Difficulties. The primary positive learning experiences in Developing as a Clinician were labeled “Hot Learning,” in which trainees acquired professional knowledge and skills through close interpersonal engagement with clients, peers, faculty, and supervisors. In contrast, Difficulties involved trainees’ negative experiences resulting in feelings of self-doubt and incompetence. These experiences occurred in close but sometimes conflicted interpersonal contexts, where trainees felt evaluated in a manner incommensurate with the support they received. We found that the quality of interpersonal relationships, which provided the context for optimal learning for trainees, was paramount to the definition of positive versus difficult learning experiences. Implications for therapist training, professional development and future research are discussed.     

‘You have to treat the person,not the mouth only’: UK dentists’ perceptions of communication in patient consultations

Effective communication between patients and health professionals is a key component of patient-centred care. Although there is a large body of literature focusing on doctor-patient communication, there has been limited research related to dentist-patient communication, especially presented from the dentists’ perspective. The aim of our study was to explore UK dentists’ perceptions of communication in their consultations, and the factors they perceive may influence this. We conducted semi-structured interviews with eight dentists in UK dental NHS practices. Thematic analysis revealed three themes (‘Treating the whole person’, ‘Barriers to patient-centred communication’ and ‘Mutuality of communication’), which reflected the dentists’ perceptions of their own communication during consultations, the patients’ interaction skills, attitudes (and characteristics that may affect them), and external factors, such as time constraints, that can influence dentist-patients’ encounters. These in-depth accounts are valuable, in that we see what dentists perceive is important, obstructive and facilitative. They report using a patient-centred approach in their everyday dental practice; however this is often difficult due to factors such as time constraints. Although they emphasized that the patient has an active role to play in the communication process, it may be the case that they also need to play their part in facilitating this.     

Interprofessional Education: Psychology Trainee Experiences and Perspectives on Team Skills

Interprofessional education (IPE) is defined as educational activities involving trainees from two or more professions learning about, from, and with each other with the goal of building team-based collaboration skills. The degree to which psychology trainees are involved in IPE is unknown. A national survey was distributed to gather information regarding the nature and prevalence of IPE experiences and psychology trainees’ perceived competence in collaboration skills. Participant responses (n?=?143) are presented overall and by training level. Some respondents reported no IPE activities in their training, especially trainees earlier in their training. Highest rated competencies were in acting with honesty and integrity and developing/maintaining mutual respect and trust of other professions. Lowest rated were in giving feedback to others and managing differences in opinion. More research related to the nature and impact of IPE on psychology trainees is critical.

     

Intergroup relations in action: Questions asked about lesbian,gay and bisexual issues in diversity training

This paper focuses on the questions which heterosexual trainees ask about lesbian, gay and bisexual (LGB) experience within diversity training about LGB issues. Drawing on a data corpus of 162 questions asked by trainees in 13 tape‐recorded training sessions, questions were coded into six categories: (1) general ‘understanding’ questions; (2) questions about the trainer's life, experience and practices; (3) professional practice questions; (4) questions about lesbian and gay related legislation, policies and procedures; (5) questions about specific people and projects and (6) questions about the meanings, derivations and correct use of terms and symbols. ‘Real’ questions are compared with the decontexualized questions (and answers to them) that are provided in training manuals and it is demonstrated that these questions differ markedly from how questions actually get asked and how they actually get answered. Recommendations are provided for improving training and the argument made for turning towards analyses of the real world in action, especially when considering intergroup relations. Copyright © 2008 John Wiley & Sons, Ltd.