Psychodynamic therapists' dilemmas in providing personal therapy to therapists in training: An exploratory study

Aim: This study explores dilemmas facing psychodynamic therapists who provide personal therapy to therapists in training. Method: Eight experienced psychodynamic psychotherapists were interviewed using a semi‐structured interview format during which they were asked about the importance of personal therapy, if they encountered any dilemmas and, if so, how they resolved those dilemmas. Their responses were analysed using a qualitative form of content analysis. Findings: Two categories of dilemma emerged: clinical and personal. Clinical dilemmas arose out of the mandatory requirement for therapy, boundaries, fitness to practice and the suitability of trainees. Personal dilemmas included pressure to model, sense of responsibility, therapeutic narcissism, countertransference reactions, over‐use of self and stressful involvement. The therapists' strategies for resolving the dilemmas are described. Conclusion: The results show participants considered personal therapy to be essential for trainees and thought it should be mandatory even though it led to difficulties in the therapy. Questions arose about the suitability of some trainees, the person of the therapist and stressful involvement. Further research into these important areas is recommended.     

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.     

Conflicting internalizations: Effect on development of trainees' professional role

Training in psychoanalytic psychotherapy stimulates both trainee regression and development-enhancing intemalization of supervisors. The internalization processes of introjection, identification and ego-integration influence both trainees' personal development and development of a professional role. Since both supervisors and the personal therapist are introjected and identified with, the possibility of trainee-perceived conflict arises. Where the identifications seem incompatible, trainees will tend to reject the supervision if it is overly dogmatic. If their personal therapy is conflictual, trainees will apply ego-ideal and superego structures to their personal therapy experience and reject their personal therapist. The reasons for this choice suggest the possible value of supervisor-personal therapist collaboration and a supervisory stance of identification with the learning process itself.     

“Being human”: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective

Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses.

Methods

In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods.

Results

Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop.

Conclusions

The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions.     

Better Preparing Sports Psychologists for the Demands of Applied Practice: The Emotional Labor Training Gap

The aim of this article was to investigate the emotional educational–training–practice gap in the professional formation of sport and exercise psychologists in the United Kingdom through the theoretical lens of emotional labor. Twenty semistructured interviews were conducted with 4 participant groups: master’s students (n?=?5), trainees (n?=?5), neophytes (n?=?5), and experienced sport and exercise psychologists (n?=?5). Adopting an interpretive epistemology, an abductive thematic analysis was conducted in relation to the participant groups recruited. Several overarching themes were identified in each participant group: (a) master’s students (emotional labor as theory, practice), (b) trainees (emotional labor to survive, a professional development tool), (c) neophytes (emotional labor as a new professional, self-care), and (d) experienced sport and exercise psychologists (emotional labor as a professional resource, lifelong learning). A synthesized list of applied recommendations to improve the professional formation of sport and exercise psychologists was developed based on the analysis. The themes extend sport and exercise psychology professional development literature, and we make recommendations for educators, professional associations, and regulatory bodies with regard to (a) bridging the emotional labor and experiential gap when transitioning between development phases via collaborative and innovative educational provision, (b) supporting the development of skills relating to the enactment of emotional labor, and (c) considering support mechanisms for student/trainee/neophyte safeguarding and welfare issues as a result of the emotion-laden transactions in professional practice. The implications for future pedagogy, andragogy, and research are discussed.

Lay Summary

Sports psychologists need to manage their emotions when working with athletes and coaches, but this is not often taught during education or training. This study aimed to understand whether sports psychologists were aware of or prepared to manage their emotions and to identify activities that could develop education and training courses.     

Women counsellors' experiences of personal therapy: A thematic analysis

Background: Following recent moves to relax the requirements for clinical mental health trainees to undergo personal therapy, this qualitative project explored the effects of personal therapy on volunteer counsellors. Method: Interviews were conducted with 19 volunteer counsellors at a women's community centre, and the data were analysed using thematic analysis. Findings: Emerging themes included the importance of personal therapy for trainee development, key elements of personal therapy and the idea that personal therapy is ‘a double‐edged sword’. Discussion: Allowing for evident methodological difficulties in evaluating the impact of personal therapy on trainees, this study suggests that close consideration should be given to the potentially adverse effects of reducing requirements for personal therapy in clinical trainings.     

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.     

Exploring Our “Deltas”: A Training Tool for Conceptualizing Systemic Theory of Change

Systematically utilizing theory to guide clinical practice is integral to developing and maintaining therapist competency. However, helping Marriage and Family therapist trainees develop their own theory of change can be a challenging training component and more educational guides are needed to help facilitate the learning process. This paper introduces the Delta Model for conceptualizing systemic change as such a tool. The proposed Delta Model is introduced and guidelines for specifically teaching trainees at each level of the Delta are provided. The proposed model will be applied to a case vignette and discussion of additional considerations for applying the Delta Model beyond clinical practice will be reviewed.

     

Implicit Theories About Willpower Predict Subjective Well‐Being

Lay theories about willpower—the belief that willpower is a limited versus nonlimited resource—affect self‐control and goal striving in everyday life (Job, Dweck, & Walton, 2010). Three studies examined whether willpower theories also relate to people's subjective well‐being by shaping the progress they make toward their personal goals. A cross‐sectional (Study 1) and two longitudinal studies (Studies 2 and 3) measured individuals’ willpower theories and different indicators of subjective well‐being. Additionally, Study 3 measured goal striving and personal goal progress. A limited theory about willpower was associated with lower subjective well‐being in a sample of working adults (Study 1, N = 258). Further, a limited theory predicted lower levels of well‐being at a time when students faced high self‐regulatory demands (Study 2, N = 196). Study 3 (N = 157) replicated the finding that students with a limited theory experienced lower well‐being in phases of high self‐regulatory demands and found that personal goal progress mediated this relationship. Results suggest that the belief that willpower is based on a limited resource has negative implications not only for self‐control but also for personal goal striving and subjective well‐being.     

‘My language thing … is like a big shadow always behind me’: International counselling trainees' challenges in beginning clinical practice

Background: While counsellor education becomes increasingly culturally diverse, little is known about international trainees' experiences of training. Objective: The present study explores one aspect of training, namely clinical practice from the perspective of international, non‐native speaking trainees. In particular, this paper focuses on the challenges this group encounters when practicing in a second language. Methodology: Semi‐structured interviews with four non‐native English‐speaking trainees were conducted and analysed following the principles of interpretative phenomenological analysis (IPA). Results: Findings suggest that participants encounter practical difficulties related to their non‐native/foreign identity in practice, such as problems with articulate self‐expression and understanding the client's speech. These difficulties generate anxiety and impact on the trainees' confidence. Conclusions and implications for counsellor training: This study elucidates language as a fundamental aspect of culture, and identifies second language use as a significant source of difference in counselling practice. This paper highlights the need for attention to linguistic diversity and for appropriate support during counsellor education. This will improve international trainees' experiences of training, but also enhance all trainees' understanding of difference, resulting in better service provision for the community.     

Trainee nondisclosure in supervision: What are they not telling you?

Aims: The purposes of this study were to examine: (1) the content of and reasons for trainee nondisclosure in supervision, and (2) the influence of trainee anxiety and perception of the supervisory working alliance on amount of nondisclosure and willingness to disclose. Method: As the focus of the study was a single supervision session, qualitative and quantitative data were collected from 204 trainees about their most recent supervision session. Results: Within the single supervision session on which they reported, 84.3% of trainees withheld information from their supervisors. Trainees reported an average of 2.68 nondisclosures occurring in the session, with the most common nondisclosure involving a negative supervision experience. Trainee perception of a better supervisory working alliance was related to less nondisclosure and greater overall willingness to disclose in supervision. Higher trainee anxiety was related to greater nondisclosure and lower overall willingness to disclose in supervision. Implications: The implications of the findings for the practice of supervision are discussed and areas for further research are suggested.     

What Front-Line CBO Staff Can Tell Us About Culturally Anchored Theories of Behavior Change in HIV Prevention for Asian/Pacific Islanders

Few rigorously tested primary prevention programs have been developed to prevent HIV infection among immigrant communities in the United States. This is in part because of the lack of culturally specific behavioral theories that can inform HIV prevention for immigrant communities in the United States. This article aims to develop such theories for a population—Asian/Pacific Islanders (A/PIs) immigrant communities—who have been overlooked in theory development and program evaluation. Frontline community-based organization (CBO) peer educators, an underutilized source of expertise regarding cultural factors specific to HIV infection among A/PI communities, are the sample of study Asian/Pacific Islander peer educators working at an urban AIDS service organization devoted to health promotion for this population; (N=35). They were interviewed to examine (1) detailed narratives describing instances of behavior change and (2) culturally anchored theories of behavior change which the narratives imply. Theories of the influence of positive cultural symbols on the taboo of HIV/AIDS, moderators of the effectiveness of social network influences on behavior change, and setting- and community-level processes predicting HIV risk behavior were implicit in the peer educators' narratives. Implications for future research, methodology and prevention practice are discussed.     

Coaches Who Care: Moral Exemplars in Collegiate Athletics

This study examines moral exemplar coaches to better understand how they are able to maintain integrity in the high-stakes environment of NCAA Division-I college sport. In-depth interviews based on moral exemplar and moral identity development theories were conducted with peer-nominated, “moral exemplar” Division-I collegiate head coaches (n?=?12). Interviews elicited themes of moral exemplarity, including, for example, having an internalized moral compass and engaging in ongoing personal and professional growth. Illuminating themes and mechanisms by which these coaches develop and sustain moral identity can inform applied work with coach education efforts for current and future members of the profession.

Lay Summary:

This study looks at coaches who are known by their peers and athletic directors as having strong morals and integrity despite the challenges they face balancing the competing values of fostering athlete well-being with winning while working in the highly competitive environment of National Collegiate Athletic Association Division I athletics.     

The Nonhuman Environment in Normal Development and in Schizophrenia by Harold F. Searles

Abstract

Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist’s embodied attunement are explored.     

A Constructivist Approach to Defining Human Emotion: From George Kelly to Rue Cromwell

In Being Human: Human Being, Rue Cromwell proposed that scientific knowledge does not need to converge in order to progress and that embracing diversity of knowledge domains benefits researchers more than the quest for unification. Principles from Kelly's personal construct theory and Cromwell's book are used to suggest a more meta-theoretical approach to emotion research, as well as defining emotion, by explaining how (a) various theories of emotion are not necessarily in competition with one another, as one can view various theories of emotion as simply being different (and perhaps not similar enough to one another to be compared in a clear-cut fashion); and (b) one cannot definitively claim that one theory of emotion is the correct or best account of all of emotional life, without simultaneously ignoring the difficulties that arise when considering multiple theories (or alternative constructions) that rely on different fundamental assumptions. This second point draws on Cromwell's discussion of how “unity of knowledge” is an oxymoronic concept.     

Experiences in Groups by W. R. Bion

This article discusses self psychology as a theory of personality development and conceptual framework for diagnosing psychopathology. It seeks to show how specific components of this theory, including selfobjects, bipolar self, mirroring, tension arc, and nuclear self, can be compared with the “curative factors” of group psychotherapy as presented by Yalom (1975). These include altruism, group cohesiveness, universality, interpersonal learning, guidance, and family reenactment. Existing literature is used to explain both theories and develop their synthesis.     

The sociocultural movement in psychology,the role of theories in sociocultural inquiries,and the theory of sociocultural models

This special issue presents the theory of sociocultural models (TSCM) and its applications in diverse areas of psychology, including education, health care, clinical practice, gender relations, and general research. As many theories already exist in the social sciences, some readers may ask: “Why do cross‐cultural, cultural, and indigenous psychologists need another theory?” This question is comprised of two aspects: culture/cultural and theory/theoretical. Therefore, to answer it, it is important to clarify both issues. The first relates to cultural and its relation to psychological. The second, theory, considers its relation to cultural and psychological. These issues have long‐range implications for all culture and psychology disciplines as they pose many questions: What role does culture play in the mental functioning of people? How is culture constituted? Is cultural related to social? Does people’s mental functioning exert reciprocal influences on their cultural and social functioning? While working toward answering these questions, researchers quickly determine that more questions arise: What role should theories play in answering these questions? What constitutes theory in culture and psychology disciplines? How should such a theory (or such theories) address the triad of cultural, social, and mental? Consequently, in an effort to provide an overview of the TSCM and to begin to answer these questions, this introduction consists of two parts. The first part addresses the sociocultural turn in modern psychology; this part discusses its implications for research in culture and psychology disciplines. The second segment examines the topic of the theoretical backgrounds of cultural and cross‐cultural research and connects the philosophical paradigms of interpretivism and realism with the theory of sociocultural models. This introduction concludes with a brief overview of the articles included in this issue.     

Reconciling Counselors’ Christian Beliefs and Lesbian,Gay, Bisexual,and Transgender Affirmation: A Grounded Theory

The purpose of this qualitative grounded theory study was to learn how 15 Christian heterosexual counselors successfully reconciled a perceived conflict between lesbian, gay, bisexual, and transgender (LGBT) affirmation and their religious beliefs. Obstacles to reconciliation, helpful factors, states, and participant characteristics were integrated into a grounded theory (the Relational Equilibrium Model) of religious‐based value conflict reconciliation to guide counselor educators and supervisors working with nonaffirming or conflicted Christian trainees to develop LGBT‐affirming dispositions and practices.     

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.