Experiences of Countertransference: Reports of Clinical Psychology Students

While historically linked with psychoanalysis, countertransference is recognised as an important component of the experience of therapists, regardless of the therapeutic modality. This study considers the implications of this for the training of psychologists. Fifty‐five clinical psychology trainees from four university training programmes completed an anonymous questionnaire that collected written reports of countertransference experiences, ratings of confidence in managing these responses, and supervision in this regard. The reports were analysed using a process of thematic analysis. Several themes emerged including a desire to protect or rescue clients, feeling criticised or controlled by clients, feeling helpless, and feeling disengaged. Trainees varied in their reports of awareness of countertransference and the regularity of supervision in this regard. The majority reported a lack of confidence in managing their responses, and all reported interest in learning about countertransference. The implications for reflective practice in postgraduate psychology training are discussed.     

Child Protection and Psychology Education in Australian Universities

Child maltreatment is a significant problem in Australia. Psychologists in a wide range of occupations play an important role in the identification and prevention of child abuse and neglect, the provision of interventions to children and families, and the development and conduct of research in related areas. Psychology graduates must be adequately prepared to work in this field; however, little is known about the extent to which child abuse and neglect related contents are taught in current university curricula. A purpose‐developed curriculum‐mapping survey was used to examine Australian undergraduate, fourth year, and postgraduate Australian Psychology Accreditation Council‐accredited programmes available in 2008. Results showed that students in the majority of programmes were exposed to child protection‐related content; however, the extent of exposure was limited. Three postgraduate units specifically addressed the prevention, identification, and response to child abuse and neglect. Course coordinators reported that child maltreatment content was mostly integrated into general units throughout the programme, typically within developmental psychology units in the undergraduate curriculum and in ethics, research, or professional issues units in the fourth year and postgraduate programmes. Results suggest the need for child protection content to be included in minimum national standards and accreditation guidelines for universities.     

University psychology clinics in Australia: Their place in professional training

Abstract: There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real‐world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and high‐quality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low‐cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.     

Mental health teaching to UK psychology undergraduates: report of a survey

One of the limitations on developing more progressive applied psychology training is the teaching received by students at undergraduate level. In this study, we focus on the provision of teaching about mental health or its equivalents (e.g. abnormal psychology and clinical psychology) on UK undergraduate psychology programmes. Most students who go on to train as clinical psychologists will have received teaching on modules like these. A survey questionnaire was sent to 109 university departments which might offer a module in mental health mental health module and 348 individuals who might be involved in such modules. The majority of programmes responding offered a mental health module, which was available each year as an optional subject. A number of findings on the content and delivery of the modules are reported and a number of recommendations are made including more involvement from practitioners and service users. Copyright © 2007 John Wiley & Sons, Ltd.     

Tele‐web Psychology in Rural South Australia: The Logistics of Setting Up a Remote University Clinic Staffed by Clinical Psychologists in Training

There is a significant shortage of clinical psychology services in rural and remote Australia. It is proposed that tele‐web psychology may provide one potential solution to this inequity in health provision. A tele‐web psychology project was developed through a partnership between a university and country health service setting in rural South Australia. Tele‐web psychology was conducted by Provisional Psychologists on their first clinical placement, with patients attending sessions in a community mental health team hub in a regional centre north of Adelaide. This article describes the logistics of setting up a collaborative tele‐web psychology service and makes recommendations on how to expedite the success of this type of venture.     

Clinical Psychology Students’ Experiences of a Pilot Objective Structured Clinical Examination

There is a need to improve methods used to assess students’ clinical skills in postgraduate clinical psychology training, but research into the use of new competency‐based assessments are sparse. The current study examines the potential application of the objective structured clinical examination (OSCE) to clinical psychology training. Commonly used in medical training, the OSCE requires students to demonstrate clinical skills across a number of standardised stations with trained actors playing the part of patients. A pilot OSCE was conducted with nine students from a psychology doctoral program. Participants completed a brief student feedback questionnaire and attended a focus group after the OSCE. They also completed the State–Trait Anxiety Inventory before and after the OSCE. The results showed that students viewed the OSCE as a valid, realistic, and fair assessment method. They reported high levels of anxiety during the OSCE but noted that the OSCE was a positive learning experience. These results suggest that OSCEs should be considered in clinical psychology training programs for the assessment of clinical competence. Further evaluations of the validity and reliability of the clinical psychology OSCE using a larger sample size are required. Other limitations and implications of the study are discussed.     

The Australian Psychology Workforce 2: A national profile of psychologists' education,training, specialist qualifications and continuous professional development

Objective data on the training profiles of Australian psychologists is scarce, despite important reforms across the higher education sector. This study aimed to profile Australian psychological training leading to registration. Universities, Registration Boards and registrants were profiled during 2008. Results revealed that there were 1063 postgraduate places a year across 34 university postgraduate training programs, with two thirds of places in clinical psychology. However, half of psychologists do not undertake postgraduate training, but undertake four years of university psychology followed by a 2 year internship (4+2) to make up the minimum standard for registration of 6 years training. Those with over 6 years of university training tended to work more in clinical, university or specialised areas of practice, whereas those with 4+2 were more likely to work in schools and general counselling. One quarter of psychologists are College members and 13% have doctoral qualifications. Analysis revealed a workforce that is actively engaged in ongoing professional development, supervision and further training. The profession has grown steadily in size by 6.24% per annum over the past 8 years and this presents a challenge for increasing the supply of postgraduate training places.     

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.     

Delivery of Psychological Interventions by Clinical Neuropsychologists: Current Practice in Australia and Implications for Training

Clinical neuropsychologists are increasingly involved in delivering psychological interventions to people with neurological conditions. This is a key competency for accredited Australian postgraduate neuropsychology courses; however it is not clear how effective courses are in preparing neuropsychologists to deliver interventions. The study aims were to (a) determine the frequency and confidence with which particular types of interventions are delivered by Australian neuropsychologists, (b) examine the availability of opportunities to deliver interventions on clinical placements, (c) identify barriers to delivering interventions in current workplaces; and (d) determine which factors influence the frequency and confidence with which neuropsychologists deliver interventions. An online survey was completed by 114 participants who had graduated from a postgraduate neuropsychology program. Results indicated that respondents delivered different intervention types with varying frequency. They reported limited opportunities to practice these interventions on placements. The majority wanted to be doing more interventions, with lack of time, resources, and adequate training being the major barriers. There were several significant relationships between the frequency and confidence with which respondents delivered interventions and the perceived quality of their postgraduate training. These results highlight the need to consider appropriate postgraduate training options in delivery of interventions, including increasing opportunities to practice interventions on placements.     

Counselling Older Adults Living in Residential Aged Care Settings: Four Illustrative Case Studies

The role of psychologists and other mental health professionals in long‐term care settings is undefined in Australia. Graduate psychology students receive little training in clinical geropsychology, and residential aged care providers do not routinely employ psychologists within such settings. Further, despite high rates of depression, neurocognitive problems, and other mental health problems, residents are rarely referred for evidence‐based psychological treatment. This article presents four case studies showing how psychology services may be employed in such settings within the context of a postgraduate psychology placement programme. These case studies emphasise the importance of engagement, the use of flexible and individualised treatment approaches, and the involvement of family and professional carers in the provision of psychological services. Psychology services in residential settings can have a positive impact on the care of older adults and their families.     

Career Development for Psychology Students through an Inpatient Mental Health Volunteer Programme

We report on a volunteer programme for undergraduate psychology students, as a prospective career pathway into the inpatient mental health context. Data on motives for joining the programme, as well as their expectations and career plans were collected from 56 students (mainly under 25 years of age; approximately 80% females) in a volunteer placement within an inpatient mental health setting. About 89.3% of the volunteers reported being on the programme to enhance their applications for postgraduate training prospects in the same field. Only 10.7% were motivated primarily by the desire to help mentally ill patients. Over three-quarters planned to pursue postgraduate training in clinical psychology.     

Exploring the perceptions of Greek counsellors’ and counselling psychologists’ professional identity and training experience,through the lens of the first alumni graduates of a Greek state University

The field of Counselling as a profession and that of Counselling Psychology is a relatively new and developing discipline in Greece. As in other European countries, it is only in recent years that this postgraduate training started to be delivered by a state/national University Institution in Greece. The present study focused on attempting to capture the qualitative experience of the first two cohorts of graduates from the first postgraduate programme in Counselling and Counselling Psychology delivered by the National and Kapodistrian University of Athens in collaboration with the Democritus University of Thrace. This data was collected via two focused group interviews using a thematic analysis approach which facilitated the immersion of the following main themes: motivating factors (for choosing such discipline), reflections on placements, the role of personal development, the evolving professional identity, issues of professional recognition, opportunities for employment, vision for the future. In conclusion, the participants expressed the opinion that the provision of such a postgraduate programme by a Greek University was delivered in a rigorous way with high standards and has equipped them with the reflexivity and critical thinking required to build their professional identity and influence the developments still to come.     

Assessing the Clinical Competence of Psychology Students Through Objective Structured Clinical Examinations (OSCEs): Student and Staff Views

Objective Structured Clinical Examinations (OSCEs) are a well‐known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open‐ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector.     

Examining the role and functions of self-development in healthcare therapy trainings: A review of the literature with a modest proposal for the use of learning agreements

Many healthcare trainings with a psychodynamic orientation encourage or require students to commit to a process of personal development, such as provided through attending individual psychotherapy and/or an experiential ‘as if therapy’ group. This paper reviews recent literature about training in psychodynamically oriented practices within counselling psychotherapy, psychiatry, the creative arts therapies and clinical psychology. The results indicate that the mandatory personal development dimension of therapy training needs urgent reassessment. Results of studies consistently call for further research about the direct benefits of personal development on students’ development of skills for therapy practice. There is minimal evidence to indicate what self-development through individual psychotherapy can specifically deliver in terms of eventual professional competence. To address some aspects of the current lacuna, this paper summarises the recommendations for training programmes available from the current research, and makes a modest proposal for the use of learning agreements, rather than only mandated hurdle requirements, to ensure that the incremental steps by which the student attains expected requirements is negotiated and agreed within regularised, and widely accepted university course procedures.     

研究生临床技能测试制度与临床决策能力培养

医学研究生的生源不同、学制不同和培养方式等的差异,导致医学研究生毕业时的临床技能和临床决策能力参差不齐。建立医学毕业研究生临床技能测试制度,合理地评价医学研究生毕业时的实际临床能力,从而制定针对个体的临床技能培养方案,为快速培养和提高青年研究生的临床决策能力提供有力的措施。     

Professional Training in Applied Psychology: Towards a Signature Pedagogy for Forensic Psychology Training

Forensic Psychology is a recognised and important sub‐specialty of the Psychology discipline. However, after an expansion in the number of training places that were offered when programmes were first developed, recent years have seen these diminish in response to changes in university policies, resulting from reformulated Federal government funding models. In this article, we argue that it is important for the future of specialist areas of professional psychology to not only articulate the core skills and competencies that are associated with specialist practice but also to develop unique and distinctive approaches to teaching and learning signature pedagogies. Based on the premise that forensic psychological practice is, indeed, a distinctive activity that requires different skills and, importantly, different ways of thinking about the work from other areas of professional psychology, it is suggested that professional training in this area should aim to develop a signature pedagogy which combines methods of teaching and learning that have been developed in legal training programmes with principles of problem‐based learning.     

“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.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

Evidence-Based Practice in Psychology: An Ethical Framework for Graduate Education,Clinical Training,and Maintaining Professional Competence

Evidence-based practice is often acknowledged as the future state of psychology, yet those graduate students who will soon be applying such practices tend to hold several misconceptions about the major components within this framework. This review highlights implications for graduate education, clinical training, and professional competence in light of the movement toward evidence-based practice in psychology. These implications are discussed in relation to the close parallel between the major components of the evidence-based framework and the current Ethical Principles of Psychologists and Code of Conduct. The evidence-based framework is discussed as an ideology that promotes lifelong learning and best prepares graduate students for ethical clinical practice throughout their careers as psychologists.