Online Cognitive Behavioural Therapy Training for Therapists: Outcomes,Acceptability, and Impact of Support

The objectives of the present study were to assess the effects of online cognitive behavioural therapy (CBT) training for therapists on measures of CBT knowledge, skills, confidence, and utilisation; to determine what differences might exist between a group supported by regular telephone contact and an independent group who undertook online training without additional support; and to determine the acceptability of CBT online training among rural and remote mental health professionals. Mental health practitioners were randomly allocated to a supported training group (six sessions of 15‐min support) or an independent group. They undertook a 12‐week online CBT training program. The two groups showed similar gains on an objective test of knowledge of CBT, and on self‐report measures of knowledge, skills, confidence levels, and utilisation of skills. However, the supported training group had a significantly higher program completion rate than the independent group. Participants evaluated the program favourably. The results suggest that online CBT training represents a promising and cost‐effective approach to training the mental health workforce, and may be particularly attractive for those who live in regional, rural, and remote communities. A challenge is to determine the most cost‐effective ways to enhance program completion rates and trainee skills.     

A Developmental Approach to the Supervision of Therapists in Training

Supervision is considered essential to therapeutic effectiveness yet trainees frequently report negative supervisory experiences. Although such experiences may be due to inadequate or poor supervision, more often they result from differing needs or expectations among trainees. Thus, supervisors must struggle to determine how to best conduct supervision. We propose that many negative experiences result from a supervisors inattention to the trainees development as a mature individual. By examining the cognitive and emotional development of trainees supervisors are offered a framework from which to select interventions and strategies that encourage rather than discourage trainees.     

A Narrative Approach to Child and Family Therapy in Africa*

Professional family therapy in Africa is heavily influenced by theories and principles of Western family practice. Its practice structure and philosophies are however grounded on African family values and the principles and orientations of traditional African psychology. This paper presents a clinical report that illustrates adaptations we make to incorporate compatible aspects of narrative family practice in African and Western cultures. A summary of African family values and child psychology intended as a background perspective is provided. The paper is significant against the background of the current need for forging multiculturally relevant healing methods that fit well with the globalized nature of the contemporary world. Augustine Nwoye, PhD, is Associate Professor and Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya (amnwoye@avu.org). Professor. Nwoye has developed an African paradigm for mental health and, in particular, for family and couple therapy. He also has experience in dealing with stress and multiple losses, especially surrounding HIV/AIDS within an African context. *An earlier version of the paper was presented to the members of staff and students of the Faculty of Education, University of Cambridge, England, UK, and the initial version was presented to the members of the Family Therapy Program of the Faculty of Medicine of the University of Calgary, Calgary, Canada. I wish to thank Dr. Colleen McLaughlin (University of Cambridge) and Professor Karl Tomm (University of Calgary) for their invitation, assistance, time, attention, and suggestions.     

The Management of Personal and Professional Boundaries in Marriage and Family Therapy Training Programs

The authors review the function of boundaries within teaching and supervisory relationships and identify patterns that create vulnerability to boundary infringement. Boundary violations are conceptualized as a process that that is more likely to develop when teachers and supervisors are isolated and under stress. Suggestions are made for a personal check up that focus on self-care, student care, and care of the professional group.     

On the Right Track: Client Experience of Narrative Therapy

This article presents an ethnographic research on eight families' experience of narrative therapy and discusses six major themes found in the interviews including externalizing conversation, developing the alternate story, personal agency, reflecting/consulting teams, building a wider audience, and the helpful and unhelpful aspects of the therapy. The findings and the notation that families found the therapy to be very effective are also included.     

Using the Michigan State University Family Therapy Questionnaire for Training

The development of the Michigan State University Family Therapy Questionnaire (MSU/FTQ) is described and a case example given of its use as a training tool. The MSU/FTQ is a relatively exhaustive list of 74 generic, structural, strategic, brief, and trans-generational family therapy interventions culled from the literature and translated into layperson's language. The marital and family therapy client uses it to provide feedback about the effectiveness of therapy by assessing those things theorists consider important about behavior maintenance and systemic change, indicating whether or not specific interventions occurred and their importance.     

A Sensemaking Approach to Ethics Training for Scientists: Preliminary Evidence of Training Effectiveness

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed.     

Hegemonic Masculinity and the Experience of Prostate Cancer: A Narrative Approach

Prostate cancer is a major health problem—one that inevitably challenges men's notions about themselves and their expressions of masculinity. As part of a larger study investigating linkages between masculinity and prostate cancer, this article focuses on the narratives of three men with prostate cancer—all of whom shed light on contemporary forms of hegemonic masculinity. Multiple interviews were conducted with study participants, capturing experiencesboth prior to and following cancer diagnosis. Analysis of individual narratives showed how social factors such as work and family influenced (and were influenced by) men's experiences with illness. All three men were forced to renegotiate their performances of masculinity—with this renegotiation mostly occurring within the parameters of performance consistent with hegemonic masculinity. However, there was also some evidence of shifts into new socialterritory and new expressions of masculinity. In contrast to more traditional, trait-based approaches to studying men's experiences, a narrative approach allows social scientists to do justice to the temporal realities and contextual complexities of men's lives. Men will be better understood as more attention is paid to the actual shape of individual lives.     

Narrative Therapy Using a Reflecting Team: An Ethnographic Study of Therapists' Experiences

Narrative therapy in the last 15 years has been utilized by many clinicians and yet there is a lack of research on therapists' experience of this approach. This ethnographic research explores the views and perceptions of eight narrative therapists who belonged to a narrative team in an outpatient clinic. These therapists were observed and interviewed. Five themes emerge from the data. The themes include a sense of success in reducing the clients' problems as well as some limitations of narrative therapy. Two recommendations for research and practice involve the use of narrative therapy without a team and the use of narrative therapy in addressing issues of family violence.     

Mirrors, Clocks, Maps, and Music: A South African Response to Family Therapy Supervision/Training

Once upon a time a training unit embarked upon a Journey. The Journey was to encompass a year's training and supervision in family therapy. Bags were packed to the brim with theory and training methods. One day the Unit left the bags behind to see what would happen if they travelled light and let the students bring their own luggage to the examination. Students were expected to describe their relationships with the interviewed families, and their training through a story. The great exam day came. Inspired students used innovative ideas and metaphors to describe the Journey. This article tells the story about these stories and the Unit's learning from them.     

Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.     

Spirituality in MFT Training: Development of the Spiritual Issues in Supervision Scale

As spirituality moves increasingly to the forefront of the body of marriage and family therapy (MFT) literature, many clinicians still find it uncomfortable or difficult to address spirituality in therapy. This study presents a new measure—the Spiritual Issues in Supervision Scale (SISS)—that examines supervisees' perceptions of the degree to which spirituality is addressed in supervision. Researchers distributed the SISS to mental health professionals around the United States who either were receiving supervision currently or had received supervision recently from professionals in their fields or programs. Results indicated that the new instrument has evidence of reliability and validity.     

Narrative Process Coding System in Marital and Family Therapy: An Intensive Case Analysis of the Formation of a Therapeutic System

The aim of this study is to investigate whether the method (Narrative Processes Coding System) for studying the narrative sequences of individual psychotherapy developed by Angus and Hardtke (1994) can be applied in a family therapeutic process. According to the results narrative process coding system adds new dimensions and gives new depth in the narrative understanding of family therapeutic process. In micro-analytic interactional level it shows the complicated interactions between narration, plot, and narrative process type.     

Immigration as a Dynamic Experience: Personal Narratives and Clinical Implications for Family Therapists

This is a reflective account of the experiences of the authors who immigrated to the United States from India at different developmental, historical, political, and social stages. Although their culture-of-origin was the same, the meaning and experience of immigration was different for each author. The narratives show a natural continuum of experiences based on their developmental stage during immigration, reasons for immigration, and the historical context of both India and the US at the time of immigration. A common theme is the ambivalence experienced by them in their process of creating a physical and psychological home in a different culture.     

The Sense of Agency and the Search for a Narrative in Acute Psychosis

The search for a narrative in acute psychosis exists but the result of this search can be insufficient because the stories available do not sufficiently capture the pre-narrative quality of personal experience, and hence the sense of agency may be diminished. The context of reflexivity is lost when a subjugating story blocks an individual off from making a choice from among a multiplicity of stories. Psychosis can also be an escape in order to maintain a sense of agency. When the patient has trouble in creating meaning through narrative action, the aim of therapy and treatment is to open a channel through which the pre-narrative quality of life can become narrated, to create a multiplicity of stories, and so offer the possibility of choice in the construction of a narrative identity.     

Personal Therapy and Self-Care in the Making of Psychologists

Abstract

Psychologists are skilled in assessing, researching, and treating patients’ distress, but frequently experience difficulty in applying these talents to themselves. The authors offer 13 research-supported and theoretically neutral self-care strategies catered to psychologists and those in training: valuing the person of the psychologist, refocusing on the rewards, recognizing the hazards, minding the body, nurturing relationships, setting boundaries, restructuring cognitions, sustaining healthy escapes, maintaining mindfulness, creating a flourishing environment, cultivating spirituality and mission, fostering creativity and growth, and profiting from personal therapy. The latter deserves special emphasis in the making of health care psychologists. These strategies are recommended both during training and throughout the career span. Recommendations are offered for enhancing and publicizing systems of self-care throughout the profession.     

Brief Report: Assessment of Training and Supervision Needs Among Registered Behavior Technicians

We assessed the self-perceived training needs of Registered Behavior Technicians (RBTs) to inform the content and direction of supervision provided by Board Certified Behavior Analysts (BCaBAs). The RBTs identified several training priorities that would improve their delivery of applied behavior analysis (ABA) services. Self-assessment by RBTs combined with direct observation allows supervisors to develop individualized training plans with these paraprofessional providers.