“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.     

Globalising counselling: humanistic counselling in Kenya

This paper explores the application of a Western, psychologically-based model of counselling and counselling training in contexts where the social and cultural conditions differ from mainstream Western societies. A group of Kenyan trainee counsellors following such a course are interviewed about their experience of training. The interview data are analysed to provide a tentative answer to the question of the appropriateness in a Kenyan cultural milieu of a humanistic counselling training model developed in the UK. It is concluded that such application is possible and desirable, if it is undertaken as shared and respectful learning between trainers and trainees.     

Effects of level of academic training on client-perceived rapport and use of verbal response modes in counselling dyads

The Standardized Client procedure was used with 22 fifth-year counselling psychology trainees in 1 -hour interviews to assess the impact of counsellor verbal response modes upon client-perceived rapport in 1-minute segments collected during the entire interviews. In addition, the effects of level of academic training on client-perceived rapport and verbal response mode usage were investigated via comparisons with previous data collected from 10 fourth-year counselling psychology trainees. Data indicated that the higher level trainees produced higher mean levels of client-perceived rapport per minute than the lower level trainees, and that there were also different distributions of verbal response mode usage across rapport ratings for the two trainee groups. Implications for training programmes are discussed.     

What makes a good counsellor? An analysis of ways in which counsellor trainers construe good and bad counselling trainees

As part of an investigation into criteria used by counsellor trainers to distinguish between good and bad students of counselling, experienced counsellor trainers were asked to complete a repertory grid. Each trainer was asked to list five good counsellor trainees and five not so good or bad counselling trainees they had worked with, as elements for the grid. Repertory grid forms were provided by the researcher with spaces for ten constructs which were elicited from the trainers in the standard triadic manner. For each elicited construct subjects were asked to rate each trainee on a five point scale. Twenty-seven correctly completed grids were collected. The 262 constructs elicited were conflated into 22 semantically similar categories by the researcher and independent raters. The data was subjected to statistical analysis using the Statistical Package for the Social Services (SPSS). Overall the constructs that were most frequently used in describing trainees were open-closed, personable/aloof, secure-insecure, professionally skilled-unskilled. The mean differences for scores of good and bad trainees for each of the 22 conflated constructs were calculated. The greatest mean difference related to professional competence. The 22 conflated constructs were subsumed into three categories, and the mean of the difference between ratings for good and bad trainees within each category was calculated. Counselling related competence showed the greatest mean difference. Implications for counselling course curricula and the selection and assessment of counsellor trainees are discussed.     

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.     

Tutors’ stories of personal development training – attempting to maximize the learning potential

This paper uses a narrative approach to examine some of the dilemmas that counselling trainers face when designing and running personal development activities as part of a Diploma in Counselling training programme. The research emerges from a focus group discussion by the tutors involved in piloting and evaluating an experimental personal development training programme. The themes examined include: the strengths and weaknesses of unstructured group work; whether structured activities helped quieter members to participate and learn more; how trainers can evaluate and assess students learning in relation to personal development in order to maximize student learning potential. The aim is to invite debate and further re‐tellings from other counselling trainers and practitioners in the field.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.     

Financial and practical implications of counselling psychology training: A student survey

It is common knowledge that students make considerable sacrifices in order to pursue a course of study, and there is no reason to belive that counselling psychology trainees are any differnt in this regrd. The results are presented of a survey of 56 postgraduate students in the greater London area which addressed some of the practical and financial implications of counselling psychology training. While none of the respondents was registered on a BPS recognised course, the majority intended to become Chartered Counselling Psychologists. Many t rainees had considerable debts as a consequence of having to pay tution fees, for personal psychological counselling and in some cases to for the supervision of their practical work with clients. Most trainees found that they had to set up their own practice placements, which were unpaid, and had difficulty doing so. The majority of respondents devoted, on average, 30 hours per week to their studies while nearly 60% had a paid job (not related to counselling) to help them cover their expenses. Inplications are discussed for conunselling psychology training in the 1990's and beyond.     

On the experience of shame in multicultural counselling: implications for white counsellors-in-training

During the process of developing multicultural competencies, counsellors-in-training experience a wide array of emotional reactions. Through extensive instruction, observation, personal communications and training exercises, the authors have noted the commonality of shame among many white trainees participating in multicultural coursework.The experience of shame in white counsellorsin-training tends to increase as their white identity development evolves and as an awareness of racial differences, stereotypes, and prejudices becomes evident.The emotion of shame can then lead to defensive responses that can hinder empathic understanding and thus forestall the development of true multicultural competencies. Therefore, it is vital that white counsellors-in-training increase selfawareness of, monitor, and actively work through shame related to multicultural issues while undergoing the training process. This article differentiates shame from guilt, describes the link between shame and white identity development, and outlines how experiences of shame in white counselling trainees may limit their professional growth if not addressed by trainers. Steps for assessing, actively processing and following up with these experiences during training situations are summarised.     

Trainer–Trainee Bullying

This paper considers the abuse of the trainer–trainee relationship by the trainer. Such abuse occurs in the context of power and gender imbalances and is afforded little attention by professional organizations. A specific example of inappropriate behaviour between trainers and trainees, that of sexual contact, is discussed in detail. Research on positive and negative supervision is considered in terms of a model of objectionable supervisory styles, and it is suggested that trainer–trainee bullying is an area which requires further research attention. © 1997 John Wiley & Sons, Ltd.     

The stresses of learning counselling: Six recent graduates comment on their personal experience of learning counselling and what can be done to reduce associated harm

This paper presents research that examines the negative and stressful aspects of learning counselling and methods for harm reduction. Using an in-depth semi-structured interviewing approach, six people who recently graduated from a UK university counselling programme have commented on their negative experiences of learning counselling and what helped or would have helped to reduce the harmful effects. This research has produced information which indicates that counselling trainees experience significant disruptions in their relationships with their family and friends; that a sizeable number of trainees report feelings of depression and or stress; and that counselling trainers have not addressed these issues effectively. The study concludes with a suggestion that an extra training component could be built into existing training frameworks that focus on the process of 'becoming a counsellor'.     

The role of personal development groups in counsellor training: understanding factors contributing to self-awareness in the personal development group

Personal development groups (PD groups) are widely employed in counsellor training with the aim of developing the self-awareness of trainee counsellors, and the intention of this paper is to open a discussion forum of the use of these groups and understand their use more fully. A quantitative and qualitative approach was employed in this study, using focus groups with a cross section of 88 trainees of counselling, at different points in their training, to establish those factors that were felt to contribute to developing self-awareness in the group. A questionnaire was used to measure both trainees' perceptions of their own self-awareness and the extent to which the contributory factors were felt to be both present and helpful in their current PD group (this is referred to as the 'comfort fit'). Statistical findings, from the full cohort of 88 trainees, indicated that they were more comfortable in the PD group at the start of their training and less comfortable at the end, although there was no clear relationship between there being a better 'comfort fit' and increased self-awareness. These findings are discussed in relation to alternative methods of facilitating the self-awareness of trainees of counselling (such as mandatory personal therapy) alongside the associated complexities of undertaking research of this kind.     

Vocational counselling of mentally retarded young adults

Vocational counselling was given to a sample of mentally retarded young adults attending an Adult Training Centre. Counselling proved effective in the following areas: the dissemination of occupational information to the trainees; the development of trainees' vocational interests; the encouragement of trainees to express personal preoccupations; and the contribution to trainees' comprehension of the vocational and social aspects of their lives in the training centre. Counselling was too short to succeed in effecting a basic change of attitudes towards work. It is recommended that vocational counselling should be an integral part of any rehabilitation programme for retarded adults.     

‘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.     

THE USE OF IMPOSED AND SELF-SELECTED TRAINING PACKAGES TO ESTABLISH CLASSROOM TEACHING SKILLS1

Although much is known about techniques for teaching elementary pupils in the classroom, no procedures have been consistently effective in training teachers to use these techniques. In the present study, six teacher trainees were observed individually and trained sequentially to use a variety of teaching skills: praise for academic responses, praise for appropriate classroom behavior, correction procedures for incorrect academic responses, and token fines. These skills were examined under four conditions: (1) baseline sessions were taught by the trainees before any instructions on the use of the teaching skills. (2) Instruction sessions were taught by the trainees after they were given instructions describing the use of several teaching skills. (3) During each Imposed-Package session, the trainees received modelling, verbal feedback, graphic feedback, and grade and quiz contingencies on their use of a particular teaching skill. (4) During each Self-Selected Package session, a grade contingency was in effect with the trainees choosing the components (modelling, verbal feedback, graphic feedback, quiz contingency) they wanted included in their training package for a particular skill. The effects of instructions were quite varied. Large increases on three of the four skills occurred with one trainee; almost no changes occurred with another trainee; and changes with the remaining four trainees fell within these extremes. The Imposed and Self-Selected Packages reliably increased the use of teaching skills, including those skills for which instructions had not been effective. The Self-Selected Package was considered to be as effective as the Imposed Package, since the time required for training a teaching skill varied from two to nine sessions with both packages. Under the Self-Selected Package, the trainees chose from modelling, verbal feedback, and graphic feedback, but none chose the quiz contingency. Questionnaire data collected after training showed that all six trainees preferred the Self-Selected Package to the Imposed Package. The effectiveness of the Self-Selected Package, together with the trainees' preference for it, suggests that it may be desirable for teacher training programs to specify the teaching skills, arrange a contingency for performance, and allow trainees to choose which additional components are to be used in each training session.     

A qualitative study into the experience of mandatory personal therapy during training

A small scale qualitative study was carried out to investigate the experiences of attendees of a Masters Degree in counselling. The study used an in depth semi‐structured group interview and analysed the data using a form of grounded theory. The key findings suggest that personal therapy for trainees can be a positive experience and can enhance the process of becoming a professional counsellor. The findings are put forward in terms of a model illustrating how therapy can be of use to trainees. This involves the trainee experiencing the emergence of four key processes: reflexivity, growth, authenticity and prolongation.     

“Out on the edge of my comfort”: Trainee counsellor/psychotherapists' experiences of spirituality in therapy—A qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered.     

Die Psychotherapieausbildung aus Sicht der Lehrkräfte

Background

A survey was carried out to ask the trainers and supervisors about their appraisal of the quality of the psychotherapy training and about ways to improve it 10 years after the inception of the “German psychotherapy law”.

Methods

Training institutes provided e-mail addresses and other contact information from over 5,000 trainers. The questioning was carried out mainly by on-line questionnaires and 2,196 data sets were used for analysis.

Results

Trainers showed overall satisfaction with the components of psychotherapy training and the skills of the training candidates. More knowledge transfer in the fields of therapy techniques and case studies and more cooperation with other professional groups were suggested. Trainers acknowledged redundancies between professional training and university studies and observed a heterogeneity of trainees, however, these were mostly considered helpful. Only half of the trainers were subject to evaluation of their work.

Conclusions

The quality of psychotherapy training could be improved by stronger emphasis on practical knowledge. Structural changes should be made to take the problem of redundancies and heterogeneities into account. Regular and continuous evaluation of the training should become an integral part of professional training and the results should have consequences.     

Trainee social justice advocacy: investigating the roles of training factors and multicultural competence

Theoretical research asserts that social justice advocacy (SJA) represents an extension of multicultural competence (MC). However, limited empirical literature examines if and how SJA manifests and is developed as an aspect of trainee MC. The current study used path modeling to examine direct and indirect links between aspects of training environment and trainee MC and SJA for a sample of 197 trainees embedded in counseling-oriented training programs. MC demonstrated the strongest positive association with SJA. In addition, multicultural training environment, but not social justice training environment, influenced SJA indirectly through MC. Results are encouraging of a differentiation between multicultural and social justice training emphases, with practical implications for training programs seeking to enhance and foster both MC and SJA among their trainees.