Therapist self-awareness and perception of actual performance: the effects of listening to one recorded session

Research in psychotherapy has emphasized the relevance of the therapist's role, particularly the impact of deliberate practice and self-awareness (SA). This study aims to explore how SA is presented in the accounts of psychotherapists and assess the impact of attending to actual performance. Twenty cognitive behavioral therapy psychotherapists in training were interviewed before and after listening to their session recordings. The interview was based on five domains of self-awareness: recognition of emotional experience, assessment of personal skills, recognition of prejudices and implicit biases, and awareness of personal values. Results show that SA is frequently attained in skills identification and emotional experience. Recognizing the influence of personal values and bias, and emotional regulation was less frequently identified. There were minor differences before and after listening to the recording. There is an increase of SA in identifying the therapist's personal skills, and aspects such as our prejudices and biases are more internalized and difficult to change. This article suggests the importance of deliberate practice strategies to promote SA and increase the effectiveness of psychotherapy.

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

OBJECTIVE

Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.

METHODS

The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles.

RESULTS

A total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.

CONCLUSION

The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socio-economic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.

How beginning cognitive behavioural therapists develop professional confidence

Evidence exists that the effectiveness of psychotherapy depends more on therapists’ variables than on their theoretical orientation or the techniques they use. Nevertheless, relatively little is known regarding the process of cognitive behavioural psychotherapists’ development. The purpose of the study was to explore how beginning cognitive behavioural therapy (CBT) practitioners develop, considering various professional and personal influences. Eight in-depth interviews with beginning therapists were conducted, and the Grounded Theory Method was used for data analysis. The developmental process was conceptualized as Gaining Professional Confidence, and three phases of this process were identified: (1) Externally Based Confidence in CBT Methods, (2) Internalized Confidence in CBT Methods, and (3) Therapists’ Self-Confidence. The results indicate that trainees’ self-reflection on their personal qualities, values, attitudes and preferences should be given more attention in CBT training, as this plays a crucial role in their overall professional development.

Trainee difficulties with therapeutic engagement: a qualitative study of in-session critical incidents

Trainee therapists or psychologists starting to practice psychotherapy are met with a number of inherent difficulties in engaging their clients in the treatment process. Using interpersonal process recall and interpretive phenomenological analysis, 18 counselling/clinical psychology trainees were interviewed about core difficulties they faced in engaging their clients in a therapeutic process. Interviews look place after 10 weeks of training and trainees were asked to self-select a single video-taped session for the interview. The analysis uncovered seven main themes: (1) difficulties with ‘personal material’; (2) difficulties with certainty, control, and idealized intentions; (3) frustrations with the client’s presentation; (4) difficulty in becoming the focus of attention; (5) reactions triggered by perceived exclusion; (6) anxieties about difference; and (7) interpersonal strategies to manage intense emotions. Findings are understood to be organized around the trainee’s struggle for self-definition and agency at the expense of empathic relating.

The applicability of a seminal professional development theory to creative arts therapies students

The purpose of this mixed-methods study was to test the extent to which a seminal theory of the professional development of counsellors and therapists is applicable to the particular experiences of creative arts therapies graduate students who learn how to use the arts in psychotherapy. Nevertheless, readers may consider the results of the present study transferable to other healthcare disciplines. Questionnaires for each developmental phase were used for data collection, and analysis included data quantification, assessment of inter-rater agreement and theory derivation procedure. Results indicate that creative arts therapies students were concerned about translating theory into practice, learning how experienced therapists concretely function in practice, and reducing cognitive dissonance upon realization that their pre-training lay conceptions of helping were no longer valid. Stress and anxiety drove students to adopt easily mastered techniques that were implemented creatively in practicum. The results confirm that students who were older and had undergraduate human-service education and/or considerable life experience were less concerned about their suitability to the profession, were more acquainted with a professional working style and searched for their individual way of becoming therapists. Finally, recommendations for future research are suggested, and implications for practice are offered.

The impact of providing therapy on the therapist: a student's reflection

Providing psychotherapy changes the therapist in a variety of ways. This article discusses one doctoral student's perceptions of these changes, such as increasing her patience, gratitude, and reliance on faith; stretching her ability to tolerate ambiguity; and influencing her interpersonal relationships.

The daily events and emotions of master's-level family therapy trainees in off-campus practicum settings

The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers-in-training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a student's practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training.