Trainee perspectives on their family therapy training

Although research into family therapy training is increasing it has so far mostly focused on the process of the teaching and acquisition of certain concepts and skills. In contrast, the experience of training as family therapists has rarely been investigated. This paper reports on the impact of family therapy training at one training institution in the UK on the personal, relational and professional identities of trainees. Six family therapy trainees were interviewed using semi‐structured interviews at regular intervals over a period of approximately twenty months. Interpretive phenomenological analysis (IPA) was employed to analyse the interviews. The results suggest that participants often found the experience of training as a family therapist overwhelming and de‐skilling, but that it nevertheless provoked a re‐evaluation of some of their established personal, relational and professional identities. In many cases these re‐evaluations seemed to have preceded a process of individuation, of assuming a different or more complex identity.     

Patterns of learning in family therapy training

This study presents the results of an evaluation of two cohorts of trainees who had completed a 2-year training program in family therapy. The 15 trainees were assessed in the areas of perceptual/conceptual, intervention/executive skills and personal development both pre- and post-training. Although the group results showed skill acquisition in all areas assessed, the individual results revealed a complexity in performance glossed over by the group analysis. Trainees' learning commenced from different baselines, advanced at different rates, and there was a marked discrepancy between self-reports of improvements (or otherwise) and the results of the observer-rated measures. We recommend that increasing attention be paid to individual differences in learning styles in training and in evaluation.     

Training in family therapy: perceptual, conceptual and executive skills.

This paper presents a comprehensive and detailed outline of family therapy skills to aid in providing a more precise focus in the training of clinicians in family therapy. The skills are based on an integrated treatment model within a systems framework. Four major functions performed by a family therapist are separated and are further differentiated into general therapeutic competencies. Specific perceptual, conceptual, and executive skills are described in the form of instructional objectives and are listed under each competency. Occasional clarifying notes or examples are cited along with particular skills. Clinicians and trainees should find this outline a useful guide in skill development.     

The skeleton in the cupboard: experiential geneogram work for family therapy trainees

This paper outlines the experiences of five family therapy trainees, relating to seminars which involved visual geneogram analysis and research into their extended families of origin. Changes induced by the seminars and their impact on the trainees' personal lives and clinical performance will be examined. These findings are discussed in the light of some of the literature dealing with the relevance, for the family therapy trainee, of an appropriate family-oriented experiential training.     

Multiple theoretical approaches to supervision: choices in family therapy training

The supervision techniques used in structural, strategic, family-of-origin, and experiential family therapy training are discussed and compared, with emphasis on the isomorphism between supervision and therapy in each school. The usefulness of each supervisory model is related to supervisees' needs at different levels of training. Recommendations are made about the sequence of family therapy training, including the utility of eclectic versus purist family therapy training programs for trainees at different levels of experience.     

Evaluation of family therapy trainees: acquisition of cognitive and therapeutic behavior skills

In this study, which describes the evaluation of a structural family therapy training program, we developed an evaluation procedure that can be used with other similar training programs. Trainees were evaluated before and after training as to their improvement in cognitive, case-planning and in-therapy intervention skills. Results suggest a progression of skill learning, beginning with cognitive understanding, followed by case planning, and then intervention skills. Though trainees made significant progress in cognitive and planning skills, this was not the case with intervention skills. Trainees' self-evaluations were similar to their results on other measures.     

Bringing the self into family therapy training: personal and professional consultations with trainee families

The qualifying level of training in family therapy at Bristol University requires trainees to attend three ‘therapeutic consultations’ with their families with a recognized systemic practitioner, to consider issues pertinent to their development as therapists. This innovation is synchronic with the course philosophy which foregrounds the training in the development of ‘self’. Survey results on the consultations suggest that trainees report significant ‘news of difference’ and all recommend it as a mechanism for other trainees. The consultants also affirmed the value of the sessions they have facilitated. The paper describes the practicalities of how the consultations are organized.     

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.     

Do Better Trainees Make Worse Family Therapists? A Followup Study of Client Families

This study was designed to evaluate the effects of training on family therapy outcome and to validate measures of cognitive/perceptual and executive skills. Followup data on family satisfaction were obtained from 176 individuals (73 families) treated by 12 trainee family therapists in their first or second year of training. The prediction that clients' scores on a scale of family satisfaction with therapy (FSS) would increase with training was not confirmed. Instead, there was a tendency for FSS scores to decrease with training. However, trainees' ratings of outcome did increase significantly as training progressed. Cognitive/perceptual and executive skill measures were not validated by the FSS, but negative associations indicated a tendency for trainees with high course-skills to receive poor FSS scores. The results suggest that trainees became more confident as they acquired technical skills, but that they put aside their nonspecific therapist skills as training progressed, to the dissatisfaction of families.     

Training family therapy students in conceptual and observation skills relating to the therapeutic alliance: an evaluation

This paper describes a training intervention to develop students' conceptual and observation skills relating to the therapeutic alliance (TA) in family therapy. An evaluation methodology was developed and piloted. The knowledge and observation skills of family therapy students pre‐ and post‐training were assessed in comparison to a non‐intervention group of experienced clinicians. Students' mean scores on the knowledge measure improved significantly from 43 per cent to 74 per cent (p<0.001) and on the observation test from 43 per cent to 65 per cent, although this failed to reach statistical significance (p=0.08). There were no significant changes in the clinicians' scores over the same period. The clinicians' knowledge was higher initially, but the students had caught up after six months. In conclusion, training students in conceptual and observational skills relating to the therapeutic alliance may have a measurable effect. A ‘stepwise’ methodology for demonstrating the relationship between training in TA and outcomes for families is proposed.     

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.     

An evaluation of the effectiveness of Diploma-level training in cognitive behaviour therapy

Background

As part of the UK government’s initiative to Increase Access to Psychological Therapies (see http://www.iapt.nhs.uk/for full details of the IAPT programme) there has been an expansion in the provision of post-graduate Diploma training in cognitive behaviour therapy (CBT). Previous evaluations of such training programmes have yielded mixed results but have been limited by small sample sizes and/or limited assessment measures.

Aims

To evaluate the impact of a long-standing Diploma in CBT training programme on a variety of measures of CBT competence.

Method

Trainees’ levels of CBT skill are compared at the beginning and end of CBT training. The effect of therapist factors such as age, professional background and gender on the development of CBT competence is also examined.

Results

Results show that trainees demonstrate higher levels of CBT skills after completing the training than they did before, with the majority achieving pre-determined criteria for competence. Trainees’ gender was not related to their performance but trainees’ age showed a negative association with CBT skill (older trainees performed worse). Trainees’ professional background also had an impact on their level of CBT competence, with trainees who were clinical psychologists demonstrating the highest levels of competence across a range of measures.

Conclusions

CBT Diploma training leads to increases in the level of trainees’ CBT competence, with the majority achieving the levels demonstrated in research trials by the end of training. Thus, this training is likely to lead to improved outcomes for patients. Further research is needed to determine the most efficient ways of enhancing CBT skills.     

AIDS/HIV in the work of family therapy trainees

A group of family therapy trainees were asked about their experience at work and knowledge of AIDS/HIV. The majority had already encountered AIDS-related issues in the context of their work. On the whole, they were well informed about AIDS/HIV, although specific gaps in their knowledge were identified. It is recommended that provision be made for the training of family therapists in this area.     

Psychopolitics

Neophyte group therapy trainees often encounter significant difficulties in their initial experiences as group therapists. In this article, we report and discuss the results of a semistructured interview conducted with each of 16 neophyte group therapy trainees in an academic training program. The interview focused on the trainees' subjective experiences related to their initial training and group therapy clinical practice, with particular emphasis on their satisfaction with their training and the role and impact of supervision. All trainees reported strong emotional reactions to their group experience and numerous technical concerns. However, trainees reported a broad range of degrees of satisfaction with their training. Overall satisfaction with training strongly paralleled satisfaction with supervision and the supervisory relationship. Recommendations for improving the group therapy training experience that emerge from the evaluation of the trainees' subjective experiences are suggested.     

Live supervision/consultation: conceptual and pragmatic guidelines for family therapy trainers

This paper addresses a conceptual and pragmatic gap in the area of family therapy training and supervision. It details an evolving stage-specific set of skills for the conduct of live supervision/consultation, using the previously developed conception of the isomorphic nature of training and therapy as a theoretical backdrop.     

No question has a single answer: Integrating discrepant models in family therapy training

Todd and Greenberg use a co-supervisory model with predoctoral psychology family therapy interns, but with Todd using a structural/strategic model and Greenberg a symbolic-experiential model. They focus on the isomorph of cotherapist trainees replaying family problems and the traineers replaying trainee problems. Their model involves using the trainee's creative confusion/tension to help each of them to integrate individually appropriate configurations as their training continues over a year.The authors wish to acknowledge the editorial comments and helpful advice of Carl A. Whitaker, MD, and Milton L. Greenberg, MFT, in the development of this paper from earlier drafts. They would also like to acknowledge significant contributions from Drs. Glenn Bronley, Paul Coleman, Chad Glang, Beverly Keith, Tracy Lewis, Charles Lock-wood, Wesley Matsui, Rita McKenzie, Timothy Weber, Ms. Holly DeVore, Lee Ann Lockwood, and Misty Weber. Christopher Weber made a special contribution as the program's first child therapist.     

Sexual counseling and therapy

Abstract

This article is an edited version of four interviews conducted with Dr. Ivan Boszormenyi-Nagy in the Spring of 1980. The interviews ranged in content from Dr. Nagy's early training and influences to the theoretical and clinical foundations of contextual family therapy. This article focuses on the major constructs of contextual family therapy. Since this approach is often viewed as highly theoretical and conceptual in nature, it may be helpful to the practitioner to see how Dr. Nagy uses these constructs in a clinical situation. As a practitioner, I have found his theory extremely useful in conceptualizing the family system, and also in developing a treatment strategy. Hopefully, the questions asked of Dr. Nagy in these interviews will be of interest to other family therapists who are concerned with the clinical aspects of family therapy theories.     

Process variables mediating change in intensive group therapy training

This investigation is based on over 400 American Group Psychotherapy Association members involved in 41 intensive, two-day training experiences for mental health professionals. The participants completed a questionnaire immediately after their group sessions to evaluate the process and leadership variables that contributed to a constructive learning experience. A similar questionnaire was mailed to participants three to four months later to explore the impact of training on group interventions within their clinical practices. One third of the trainees responded to the follow-up survey. Overall, the findings suggest that successful outcomes are related to a range of group processes, such as self-disclosure, feedback, and interpersonal support, as well as personal qualities and technical expertise modeled by the leaders of the training groups. Both the immediate and delayed assessments demonstrate that the groups were regarded as highly valuable learning opportunities.     

The state of the art of training in systemic family therapy in Switzerland

This article presents a training program in systemic therapy with families and couples. Our training institute was founded by an interdisciplinary group of psychologists, psychiatrists, sociologists, and social workers in 1987 in Meilen (Zürich), Switzerland, and has from the beginning been connected to the field of family therapy in Europe and the United States. The specific organization of our institute, our training program, and the theoretical base of the training concept are highlighted. Our multidimensional treatment and training model is grounded in a variety of conceptual frameworks and inspired by the tradition of Enlightenment in European philosophy. We pay special attention to the personal and professional development of the emerging family therapist.