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Westin F, Rozental A. Informing patients about possible negative effects of psychological treatment: A survey of Swedish clinical psychologists' attitudes and practices. Psychother Res 2024; 34:709-721. [PMID: 37757474 DOI: 10.1080/10503307.2023.2259064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE The present study explored Swedish clinical psychologists' attitudes and practices of informing patients about possible negative effects of psychological treatment. METHOD An anonymous online survey with closed and open-ended questions was distributed via Facebook and two mailing lists. In total, 320 clinical psychologists (age M = 38.6, SD = 10.3; 76% women; 77.3% Cognitive Behavior Therapy) completed the survey. Responses were analyzed using χ2, binominal regression analysis, and thematic analysis. RESULTS No significant associations were identified between demographic variables selected a priori and informing patients about possible negative effects, i.e., years in practice, therapeutic orientation, age, and male gender. The thematic analysis resulted in several positive (e.g., creating realistic expectations of treatment and increasing resilience) and negative attitudes (e.g., causing excessive worry) of sharing patients with information about possible negative effects. It also revealed various factors that prevent an open discussion on the topic, despite being seen as important. CONCLUSION The need to offer patients information about possible negative effects should be included in ethical guidelines, codes of conduct, and taught during clinical training. Lack of knowledge, fear, lack of time, and patient characteristics however seem to prevent therapists from discussing the issue during the informed consent procedure.
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Affiliation(s)
- Fanny Westin
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Alexander Rozental
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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Chigwedere C, Fitzmaurice B, Thwaites R. Reliability of the Reflective Essay Marking Scale (REMS): a scale for marking of students’ reflective essays. COGNITIVE BEHAVIOUR THERAPIST 2023. [DOI: 10.1017/s1754470x22000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Abstract
Personal practice (PP) is widely practised and a requirement across major psychology and psychotherapy organizations and modalities. However, one of the challenges for training institutions is how to assess the quality of such PP. The Reflective Essay Marking Scale (REMS) was developed to improve standardization of marking reflective essays in cognitive behavioural psychotherapy (CBT) training. A small sample of 16 expert CBT participants recruited by email used the REMS to rate two mock reflective essays in a within-subjects design. The internal consistency of REMS was acceptable (Cronbach’s α=.73) with excellent inter-rater reliability. Across the raters, it sufficiently differentiated quality (t12=4.91; p<.0001). Although these are the results of a preliminary and very small study with a small sample using mock essays, the REMS may be a useful scale, allowing CBT courses to account for students’ reflective work in a standardized way. A larger validation study is required in the future.
Key learning aims
(1)
To improve the thinking about what raters should focus on when rating the reflective essays of trainee therapists.
(2)
To describe the development of the scale and how its reliability was tested.
(3)
To improve the transparency and objectivity in assessing and rating reflective practice.
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What characterizes helpful personal practice in psychotherapy training? Results of an online survey. Behav Cogn Psychother 2023; 51:74-86. [PMID: 36281883 DOI: 10.1017/s1352465822000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Personal practice (PP) is often considered as a central component in psychotherapy training aiming to promote personal and therapeutic competences. However, its implementation varies considerably in practice. AIMS The purpose of this exploratory study was to examine the current practice of PP regarding the frequency/occurrence and perceived usefulness/impairment of topics, techniques and effects, as well as its helpful characteristics in psychotherapy training. METHOD 407 German psychotherapy trainees (214 cognitive behavioural therapy; 178 psychodynamic therapy) were surveyed online as to their current practice of PP. RESULTS For trainees, personal and therapeutic related topics were discussed. Reflection techniques and self-experiential practice were among the most frequently reported strategies, while the fostering of personal and interpersonal competences was among the effects with the strongest occurrence. However, negative PP effects were recorded as well. Differences in PP practice emerged between therapeutic orientations. CONCLUSIONS As certain techniques which are central to PP (e.g. self-experience) were also rarely or not used, and negative effects reported, its potential might not be fully utilized.
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Prasko J, Krone I, Burkauskas J, Vanek J, Abeltina M, Juskiene A, Sollar T, Bite I, Slepecky M, Ociskova M. Homework in Cognitive Behavioral Supervision: Theoretical Background and Clinical Application. Psychol Res Behav Manag 2022; 15:3809-3824. [PMID: 36578283 PMCID: PMC9792257 DOI: 10.2147/prbm.s382246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
The homework aims to generalize the patient's knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient's lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice - first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.
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Affiliation(s)
- Jan Prasko
- Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic,Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic,Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic,Jessenia Inc. - Rehabilitation Hospital Beroun, Akeso Holding, Beroun, The Czech Republic,Correspondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, Olomouc, 77520, The Czech Republic, Tel +420 603 414 930, Email
| | | | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jakub Vanek
- Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic
| | - Marija Abeltina
- University of Latvia, Latvian Association of CBT, Riga, Latvia
| | - Alicja Juskiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tomas Sollar
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Ieva Bite
- University of Latvia, Latvian Association of CBT, Riga, Latvia
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Marie Ociskova
- Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic,Jessenia Inc. - Rehabilitation Hospital Beroun, Akeso Holding, Beroun, The Czech Republic
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Farrell D, Fadeeva A, Zat Z, Knibbs L, Miller P, Barron I, Matthess H, Matthess C, Gazit N, Kiernan MD. A Stage 1 Pilot Cohort Exploring the Use of EMDR Therapy as a Videoconference Psychotherapy During COVID-19 With Frontline Mental Health Workers: A Proof of Concept Study Utilising a Virtual Blind 2 Therapist Protocol. Front Psychol 2022; 13:901855. [PMID: 35874361 PMCID: PMC9298740 DOI: 10.3389/fpsyg.2022.901855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
Objective The COVID-19 pandemic has had a major impact on the delivery of psychological treatment. Due to social distancing requirements, the provision moved to videoconferencing psychotherapy (VCP). There is a paucity of empirical data supporting the efficacy of EMDR therapy as a VCP. This stage 1 pilot study tested an EMDR therapy scripted protocol, such as Virtual Blind 2 Therapist (VB2Tr), on frontline mental health workers as a VCP regarding fitness for purpose, distinctiveness, relevance, and efficiency. Methods A total of 24 participants were recruited for the study. The design included a one-session treatment intervention with pre, post, 1-month, and 6-month follow-up (FU) measurements. This treatment session used a “Blind 2 Therapist” EMDR therapy scripted protocol as videoconference psychotherapy that involves non-disclosure of traumatic memory. The research explored the treatment effect on the core characteristics of trauma memory, including subjective disturbance, belief systems, memory intensity (MI), vividness, and levels of emotionality. Additionally, the research explored participants’ experiences of adverse and benevolent childhood experiences (ACEs/BCEs) during their childhood. Results Regarding the four tests, namely, fitness for purpose, distinctiveness, relevance, and efficiency, results are favourably suggesting potential clinical benefits of using EMDR as videoconference psychotherapy. Although this is a proof-of-concept study showing positive results, no clinical population or control group was used. The purpose of the study is to explore the potential for scalability toward a larger clinical trial. The treatment intervention was achieved irrespective of either ACEs/BCEs during childhood. Conclusion The research tentatively supports the case for EMDR therapy as a credible treatment when used as video conference psychotherapy and in using the Blind 2 Therapist protocol. However, more research is needed to scale toward a clinical trial. Clinical Trial Registration Clinical Trial Registration:https://www.isrctn.com/ISRCTN12099530, identifier ISRCTN12099530.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Anastasia Fadeeva
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul Miller
- Mirabilis Health Institute, Newtownabbey, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Helga Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Cordula Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | | | - Matthew D Kiernan
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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Linden M, Strauß B. Selbsterfahrung in der Weiterbildung zum Arzt für Psychiatrie und Psychotherapie. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-022-00595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Exploring CBT therapists’ experience of feeling of safety within self-practice/self-reflection: an interpretative phenomenological analysis. COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x21000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Self-practice/self-reflection (SP/SR) is an experiential training strategy implemented to develop the skills of CBT therapists through the self-application of CBT techniques and subsequent reflection on the experience in relation to clinical practice. Outcome studies report significant personal and professional benefits from SP/SR but engagement studies suggest that CBT therapists’ experience is mixed. In order to inform the design and implementation of SP/SR within CBT, this study aims to explore CBT therapists’ experience of feeling of safety (FOS) within SP/SR. FOS has been identified as an important engagement factor. Three CBT therapists were interviewed using semi-structured interviews. The data, which took the form of verbatim transcripts, were subjected to interpretative phenomenological analysis. Four superordinate themes relating to participants’ experience of FOS within SP/SR emerged: FOS and its absence as embodied and non-verbal, role of the instructor, awareness of others and venturing beyond safety. Ensuing recommendations for instructors include proactive use of interventions within SP/SR which directly impact embodied FOS, monitoring the wellbeing and engagement of participants through awareness of physical cues and employment of measures designed to promote a sense of equality among group members. Areas of future research include exploration of factors which influence FOS, investigation of the effect on FOS of pre-existing relationships within the SP/SR group and review of interventions which are currently used by SP/SR instructors to promote FOS.
Key learning aims
(1)
To explore the lived experience of FOS within SP/SR as experienced by CBT therapists.
(2)
To identify factors which influence CBT therapists’ experience of FOS within SP/SR.
(3)
To identify practical recommendations for use in SP/SR instruction which will promote participants’ FOS.
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