To fail psychotherapy training: Students’ and supervisors’ perspectives on the supervisory relationship

Previous research showed that supervision during psychotherapy training sometimes includes negative alliance and harmful events. The aim of this study was to investigate how such events were related to failing psychotherapy training. Interviews were made with informants from two separate samples: psychotherapy students who had failed training (n = 6) and supervisors with experience from failing students (n = 6). The interviews were analyzed separately for the two samples with inductive thematic analysis and then compared. The core category for students (‘Paradoxical response’) indicated that they experienced their supervisors as either demanding too much or nothing at all. The core category for supervisors (‘Balancing contradictory demands’) indicated that they wanted to fail students who did not live up to expectations but were pressured by training institutes to let them pass. Both students and supervisors experienced distress but it seemed that they were not fully aware of each other’s vulnerability. The results suggest that a weak supervisory alliance and harmful events may contribute to student failures, independently of students’ actual suitability for psychotherapy.     

Professional values and their development among trainees in psychoanalytic psychotherapy1

Forty-six psychotherapy students in three groups at one training institute for psychoanalytic psychotherapy in Sweden were asked to fill out a questionnaire about important influences on their professional development during their three-year training and afterwards. The questionnaire was distributed on three occasions during the training program and on one later occasion. Twenty-one students responded to the questionnaire on all four occasions. Working with patients in therapy, getting supervision, and participating in personal psychotherapy were viewed as the three most important influences on the students. The importance attributed to specialist literature and technical skills seemed to increase over time during the training, while the influences of experiences in personal life and personal qualities decreased. These changes in reported views were reversed in the initial years after graduation. Concerning assets, the students valued the ability to be containing and emphatic as the most important, but in their first years as licensed psychotherapists assigned more importance to the ability to create contact. The training program led to a change over time in a higher rating for the importance of technical and methodological attributes and less emphasis on personal characteristics and experiences. Most of the changes reported during training tended to be reversed afterwards.     

The development of therapeutic attitudes during and after psychotherapy training

The aim of this study was to explore changes in psychotherapeutic attitudes of students during training in psychodynamic psychotherapy and the first few years after it. Forty-six students were asked to answer a therapeutic identity questionnaire at three times during training and at one time after it. Twenty-one students completed the questionnaire on all four occasions. The questionnaire assessed attitudes on nine scales relating to beliefs about curative elements in psychotherapy, therapeutic style, and basic assumptions about psychotherapy and human nature. At the beginning of training, students had a clear psychoanalytical orientation, similar to that of their supervisors. From the last year of training, after supervision had ended, and continuing during the post-training period, students distanced themselves from the psychoanalytical orientation and their supervisors toward a more eclectic position. This development may reflect the formation of an autonomous therapeutic identity.     

Novice therapist,the client and therapy: Integrating the triad

Therapy process research focuses on understanding how therapy is conducted by professionals in the field. It is a nascent field of psychotherapy enquiry in India. This paper explores how novice therapists in India perceive their clients, and how this influences the process of therapy. In depth interviews were conducted with ten novice therapists, with less than six years of practice experience, from Mumbai, India. The data was thematically analysed. The data revealed that therapists' perceptions of their clients were defined by socio-demographic features of age and gender, along with presenting complaints and personal attributes. Participants had defined beliefs about good clients as contrasted with difficult ones. Distinct preferences for particular client types were identified. The antecedents to these beliefs were attributed to the therapist's worldview, their training and the supervision received. These views, and the conceptualisation of the client, influenced the choice of client, the process of therapy and how they proceeded with sessions, and their methods of referral. The data from the study has implications for therapist training, supervision and further research.     

The current status of psychological assessment training in graduate and professional schools.

Test-based psychological assessment is threatened by the policies of managed care organizations; however, research has demonstrated that test-based psychological assessment is quite valuable and economically justified when conducted by well-trained psychologists. This surfaces the question of the current status of graduate training in test-based psychological assessment. Results of this study indicate that clinical and counseling students currently receive almost equivalent training in test-based assessment. However, in a larger context, results indicate a lack of sound preparation in test-based assessment training for a large proportion of clinical and counseling students. These findings are discussed in terms of their implications for the field and, more specifically, for graduate and internship training.     

汉语母语儿童和成人视听双通道英语语音知觉的训练研究

本研究通过前测-训练-后测的实验程序,对22名五年级小学生和29名大学一年级学生在不同测查条件下知觉英语辅音/s/和/θ/的可塑性情况进行了考察和比较。两个年龄阶段被试在前后测中均接受纯听、视听一致、视听不一致和纯视条件下的测查,训练时两个年龄阶段被试中分别有一半接受纯听训练,另一半接受视听训练,训练时间历时10天,每天30分钟左右。对训练效果的分析发现:(1)接受纯听和视听训练的五年级学生在纯视测查条件下知觉英语辅音/s/和/θ/的提高率有显著差异,视听训练被试显著高于纯听训练被试,在其他条件下没有显著差异;(2)接受两种训练的大学生在所有条件下知觉英语辅音/s/和/θ/的提高率都没有显著差异。说明儿童表现出了更强的视听双通道语音知觉的可塑性。     

团体箱庭疗法干预初中生考试焦虑的效果

以19名考试焦虑初中生为被试,运用等组前后测实验方法,考察团体箱庭疗法干预考试焦虑的效果,并与放松训练进行比较。结果表明：团体箱庭疗法与放松训练一样能够有效地干预初中生的考试焦虑情绪,团体箱庭疗法干预效果的保持性优于放松训练。     

Increasing Anger Log Use During School Among Middle School Students with Emotional/Behavioral Disorders

ABSTRACT

Although anger management programs often promote the use of anger logs as an alternative to aggressive behavior, researchers have not studied whether or not these programs actually increase anger log use. Thus, this study examines the impact of In Control, a classroom-based curriculum with 10 weekly 30-minute sessions, on the frequency of anger log use between sessions. Study participants were all of the students attending a middle school for emotional/behavioral disorders. Twenty-seven students received the In Control program, and 19 equivalent students did not. While anger logs were visibly available in all of the classrooms, the students who received the In Control program completed significantly more logs between sessions than did the nonprogram students. During a 4-month follow-up, the 19 program students who received monthly booster sessions continued to fill out significantly more logs than did the nonprogram students. These findings suggest that In Control can increase the use of a log to record anger-provoking episodes by middle school students with serious emotional/behavioral disorders, both in between training sessions and during follow-up, if booster sessions are provided.     

Developing clinical effectiveness in psychotherapy training: Action research

This study is an evaluation of a new approach to clinical training in Transactional Analysis using the methodology of action research. The evaluation focuses on the second year of training and placement‐based clinical practice at the Metanoia Institute, UK. The design of the training year was research‐based and used the concept of an ‘internship’ year. The design aimed to close the gaps between clinical practice, supervision and formal training; facilitate translation of theory into practice; and integrate findings from the ‘common factors’ research into effectiveness of psychotherapy. Training and supervision methods were linked and focused on emerging issues in clinical practice and the development of students’ capacity for critical reflection and a research attitude to practice. The evaluation was a naturalistic study which used quantitative and qualitative methodology within the action research framework to reflect on the impact of the training on the participants, the organisation and the clinical practice. The quantitative outcomes show that the project developed the effectiveness of students’ clinical practice and reflexivity. Qualitative analysis gives insight into the experiences of the participants and the emotional impact of the research process.     

中小学生生活满意度的调查与分析*

为了解中小学生的生活满意度状况,课题组用中小学生的愉快心境来定义生活满意度,对我国10249名中小学生进行了调查。结果表明:85%的中小学生生活得很愉快或比较愉快,72.3%的中小学生有烦恼,经检验存在明显的年级、性别及城乡差异;中小学生最烦恼问题排在前三位的分别是学习紧张、父母期望值高、同学中没友谊;中小学生最烦恼问题与愉快心境相关的排序依次是:父母期望值高、学习紧张、家庭气氛紧张和同学中没友谊。     

German students’ current choice of profession in the field of psychotherapy

The psychoanalytic societies in Germany as in many other countries are concerned by a decline in the number of candidates for full psychoanalytic training. While this situation is partly attributable to changes both in society and in educational and healthcare systems, it is questionable whether psychoanalytic training institutions have yet found adequate responses to it. Under the banner of ‘evidence‐based treatment’, behaviour therapy has come to be widely disseminated, with major implications for the teaching of different psychotherapy paradigms at universities. To investigate the determinants of this trend in the specific German situation, a large‐scale, multi‐method exploratory study supported by IPA's DPPT programme was undertaken, focusing on the reasons given by a population (N = 679) of German psychology, medical, and education students for embarking on training in psychoanalysis or behaviour therapy. The results suggest that behaviour therapy is more compatible with the prevailing scientific understanding and with current societal and cultural trends, owing in part to inadequacies or bias in university teaching of the various paradigms of psychotherapy. While most of the psychology students expressed a preference for behavioural training, the psychotherapy option proved less attractive for their counterparts in the fields of medicine and education. Semi‐standardized qualitative interviews were used to gain a deeper understanding of the students’ decisions for or against training in a specific paradigm, and led to the identification of seven decision‐making prototypes. Possible reasons for the students’ decisions are discussed, and concrete proposals and recommendations are presented.     

“Part of me feels like there must be something missing”: a phenomenological exploration of practising psychotherapy as a clinical psychologist

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: “Feeling there’s something missing”, “Being able to get in there emotionally” and “Needing somewhere to go for support”. This study suggests that training for psychotherapy work can be experienced as piecemeal and fragmented, contributing to professional self-doubt, with clinical psychologists seeking more structured, cohesive training in this area. It also suggests that engagement in personal therapy can contribute to greater emotional capacity as a psychotherapy practitioner, although clinical psychologists can fear engaging in something that is unfamiliar. In addition, the psychologists highlighted the felt necessity of safe and satisfying supervision for resilient practice.     

A Common Factors Approach to Psychotherapy Training

This article addresses training in psychotherapy integration from the perspective of common factors. Problems related to this training perspective are first reviewed. As an attempt to deal with such problems, current teaching and supervision efforts by the author are briefly described. Based on a developmental model of clinical learning, a sketch of a more comprehensive program of integrative psychotherapy training is advanced.     

Supervising Integrative Psychotherapy in the 21st Century: Pressing Needs,Impressing Possibilities

Supervisors and teachers who are interested in advancing integrative psychotherapy in the 21st century have the dual task of surveying the range of treatment approaches that have been developed and distilling these approaches down to a manageable number of influences that have been found to have the greatest impact on clinical practice over time. It has been proposed that there are four bona fide schools of psychotherapy that would be most useful for comprehensive training and supervision that would contribute to either (a) case conceptualization or (b) the process of clinical interviewing: psychodynamic psychotherapy; cognitive-behavioral psychotherapy; family systems therapy; and, humanistic/client-centered therapy. The goal for such broadly based clinical instruction would be for students, trainees, and interns to have an ability to provide a multi-level case conceptualization for any of the psychotherapy cases for which they are providing treatment. Thorough instruction in clinical reasoning and decision-making in this type of multi-level case formulation can provide some of the most valuable tools for novice and experienced clinicians alike.     

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.     

箱庭疗法缓解初中生考试焦虑的有效性

以18名考试焦虑初中生为被试,采用等组前后测设计,以考察箱庭疗法缓解考试焦虑的效果,并与放松训练进行比较。结果表明:箱庭疗法与放松训练一样能够有效地缓解初中生的考试焦虑情绪,但其干预效果的保持性要优于放松训练。     

The embodied analyst: from Freud and Reich to relationality

This paper presents the impact of clinical supervision on once-weekly psychoanalytically-informed training psychotherapy. The development of Oedipus complex theory is presented, culminating in Britton's work on the triangular space that opens up by working through the complex. The geometry of psychic space is described to highlight the importance of supervision, especially when training in therapy. The theme of spiders and cobwebs emerging from the clinical material provides a powerful metaphor for the tensions in psychic space. In the course of this training, the trainee therapist was at times less able to benefit fully from supervision, and thus the third position partially collapsed. Vignettes from anonymised clinical work are presented in the three ‘phases’ of this therapeutic process, illustrating the impact of the presence – and relative absence – of supervision.     

Reinforcers and vocational maturity in occupational aspiration,expectation, and goal deflection

When vocational aspirations and expectations are not the same, this difference is termed occupational goal deflection. The present study was designed to investigate the notion that such aspirations, expectations, and goal deflection are related to an individual's vocational maturity, education, and job reinforcers. The subjects were 149 vocational rehabilitation clients and 51 graduate students. Analyses of variance yielded findings that more vocationally mature individuals tend to display greater vocational aspiration, greater vocational expectation, and less goal deflection. Similarily, subjects who value such job characteristics as “getting a feeling of accomplishment, fair company policies, trying out their own ideas, doing work without feeling it is morally wrong, making their own decisions, (and) planning work with little supervision” tend to have higher aspirations and expectations, but lower goal deflection.     

Modern Advances in Genetic Testing: Ethical Challenges and Training Implications for Current and Future Psychologists

The ethical implications for psychological practice of genetic testing are largely unexplored. Predictive testing can have a significant impact on health and well-being, and increasing numbers of individuals with knowledge of their risk for various disorders are likely to present for psychotherapy. In addition, more people will struggle with the decision of whether to obtain information regarding their genetic material. Psychologists will need to have the appropriate knowledge and clinical skills to effectively counsel this population. This article highlights the relevant ethical issues surrounding psychological treatment of individuals pursuing or considering undergoing genetic testing. These issues are extended to psychologists working in research, education, and policy domains. Recommendations for graduate training programs to facilitate current and future practitioner competence are also discussed.     

Von den Schwierigkeiten, Analytiker zu werden

The results of a study concerning the social situation of students in psychoanalytic training in DPG institutes are presented. The study based on a questionnaire worked out at the meetings of the spokesmen of DPG candidates as a reaction to the changing external conditions. The Psychotherapist Act, the introduction of a new medical specialization and the planning of demand have put a considerable strain on the training conditions and have led to reduced numbers of applicants also because more and more competing, low cost training courses for psychotherapy have come onto the market. Data are presented concerning age, gender, marital status of students, beginning and termination of training, original profession of students, means of funding, frequency and costs of training analysis and supervision, as well as monthly income and expenses. The findings show for example that students nowadays are considerably older than they used to be (see Pohl 1974 and Pollmann 1985), the number of men in training decreased as well as the number of physicians while the number of women and psychologists increased. The frequency and the expenses for training analysis strongly increased while the income decreased. Many students therefore can no longer fund their training by their current income. In addition the assumption is confirmed that psychoanalytic training takes considerably longer than required by the law. As a consequence it seems necessary to reduce costs and duration of training in order to keep psychoanalytic training competitive and practicable for applicants. Therefore it is proposed by the authors to give credit for theory acquired elsewhere, to start treating patients at earlier stages of training, to allow group supervision on a larger scale and to bring the costs for training analysis and supervision in line with the rates paid by the health insurance companies in order to keep costs manageable. Other means of support, such as scholarships or reasonable loans are discussed. It is proposed to promote and further use the innovative and creative potential of candidates at an early stage to prompt research and development of psychoanalysis. It is imperative to promote psychoanalysis in the public so that it can defend its place in society and make its contribution to public health.