https://doi.org/10.4081/ripppo.2024.799
Shaping psychotherapy trainees’ potential: insights from training program directors
Submitted: May 20, 2024
Accepted: July 29, 2024
Published: August 27, 2024
Accepted: July 29, 2024
Abstract Views: 1418
PDF: 287
HTML: 27
HTML: 27
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The role of the therapist has received growing attention in psychotherapy research, suggesting that training effectiveness may also depend on the person of the trainees, with relevant implications in terms of candidate selection or tailoring training to the person. In the present study, we focused on how and how much psychotherapy training can be effective in fostering trainees’ characteristics associated with successful therapists and contrast trainees’ characteristics that could represent limitations as therapists. The aim was to explore training program directors’ perspectives on individual trainees’ limitations and strengths, and on the effectiveness of training in shaping successful therapists. To this aim, we interviewed 14 training program directors with different psychotherapy approaches. Audio recordings of these semi-structured interviews were transcribed verbatim and analysed using NVivo software. According to our findings, transversally to different psychotherapy approaches, trainees’ self-awareness and the ability to embrace uncertainty were recognized as the main characteristics of good trainees. Four training elements were fre- quently mentioned by directors as effective in shaping trainees’ development: experiential learning, the use of paradigm that pri- oritizes self-awareness (instead of technique-focused approaches), the centrality of supervision and inter-vision, the trainer-trainee relationship. These insights highlight the importance of trainees’ self-awareness and the ability to embrace uncertainty as potential personal variables that may influence the effectiveness of future psychotherapists and suggest giving attention to experiential learning and training relationships as crucial elements of psychotherapists’ development during the training.
Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23(1), 1-33.
DOI: https://doi.org/10.1016/S0272-7358(02)00146-0
Barnett, M. (2007). What brings you here? An exploration of the unconscious motivations of those who choose to train and work as psychotherapists and counsellors. Psychodynamic Practice, 13(3), 257-274.
DOI: https://doi.org/10.1080/14753630701455796
Bordin, E. S. (1979) The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3),252-260.
DOI: https://doi.org/10.1037/h0085885
Delgadillo, J., Saxon, D., & Barkham, M. (2019). Associations between therapists' occupational burnout and their patients' depression and anxiety treatment outcomes. Depression and Anxiety, 35(9)
DOI: https://doi.org/10.1002/da.22766
Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399.
DOI: https://doi.org/10.1037/pst0000175
Farber, B. A., Manevich, I., Metzger, J., & Saypol, E. (2005). Choosing Psychotherapy as a Career: Why Did We Cross That Road? Journal of Clinical Psychology, 61(8), 1009-1031.
DOI: https://doi.org/10.1002/jclp.20174
Fauth, J., & Williams, E. N. (2005). The in-session self-awareness of therapist-trainees: Hindering or helpful?. Journal of Counseling Psychology, 52(3), 443.
DOI: https://doi.org/10.1037/0022-0167.52.3.443
Fereday, J., Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Research, 5, 80-92.
DOI: https://doi.org/10.1177/160940690600500107
Fussell, F. W., & Bonney, W. C. (1990). A comparative study of childhood experiences of psychotherapists and physicists: Implications for clinical practice. Psychotherapy: Theory, Research, Practice, Training, 27(4), 505.
DOI: https://doi.org/10.1037/0033-3204.27.4.505
Gioia, D. A., Corley, K. G., & Hamilton, A. L. (2013). Seeking qualitative rigor in inductive research: Notes on the Gioia methodology. Organizational Research Methods, 16(1), 15-31.
DOI: https://doi.org/10.1177/1094428112452151
Heinonen, E., & Orlinsky, D. E. (2013). Psychotherapists' personal identities, theoretical orientations, and professional relationships: Elective affinity and role adjustment as modes of congruence. Psychotherapy Research, 23(6), 718-731.
DOI: https://doi.org/10.1080/10503307.2013.814926
Hennink, M., Hutter, H., & Rechsteiner, L. (2017). Qualitative research methods. Oxford University Press.
Hennink, M., & Kaiser, B. N. (2022). Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Social Science & Medicine, 292, 114523
DOI: https://doi.org/10.1016/j.socscimed.2021.114523
Hiebler‐Ragger, M., Nausner, L., Blaha, A., Grimmer, K., Korlath, S., Mernyi, M., & Unterrainer, H. F. (2021). The supervisory relationship from an attachment perspective: Connections to burnout and sense of coherence in health professionals. Clinical Psychology & Psychotherapy, 28(1), 124-136.
DOI: https://doi.org/10.1002/cpp.2494
Hill, C. E., Thompson, B., & Williams, E. N. (2014). Methods for assessing sample adequacy in qualitative research. Nursing Research, 63(4), 260-266.
Hill, C. E., Baumann, E., Shafran, N., Gupta, S., Morrison, A., Rojas, A. E. P., ... & Gelso, C. J. (2015). Is training effective? A study of counseling psychology doctoral trainees in a psychodynamic/interpersonal training clinic. Journal of Counseling Psychology, 62(2), 184.
DOI: https://doi.org/10.1037/cou0000053
Johns, R. J., Barkham, M., Kellett, S., & Saxon, D. (2019). A systematic review of therapist effects: A critical narrative update and refinement to review. Clinical Psychology Review, 67, 78-93.
DOI: https://doi.org/10.1016/j.cpr.2018.08.004
Jorissen, A., van de Kant, K., Ikiz, H., van den Eertwegh, V., van Mook, W., & de Rijk, A. (2024). The importance of creating the right conditions for group intervision sessions among medical residents–a qualitative study. BMC Medical Education, 24(1), 375.
DOI: https://doi.org/10.1186/s12909-024-05342-0
Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Self-awareness questions for effective psychotherapists: Helping good psychotherapists become even better. Practice Innovations, 2(4), 163.
DOI: https://doi.org/10.1037/pri0000051
Ladany, N., Ellis, M. V., & Friedlander, M. L. (1999). The supervisory working alliance, trainee self‐efficacy, and satisfaction. Journal of Counseling & Development, 77(4), 447-455.
DOI: https://doi.org/10.1002/j.1556-6676.1999.tb02472.x
Lohani, G., & Sharma, P. (2023). Effect of clinical supervision on self-awareness and self-efficacy of psychotherapists and counselors: A systematic review. Psychological services, 20(2), 291.
DOI: https://doi.org/10.1037/ser0000693
Mammen, M. A. (2020). Attachment dynamics in the supervisory relationship: Becoming your own good supervisor. Journal of Psychotherapy Integration, 30(1), 93.
DOI: https://doi.org/10.1037/int0000164
Messina, I., Gelo, O. C., Gullo, S., Sambin, M., Mosconi, A., Fenelli, A., ... & Orlinsky, D. (2018). Personal background, motivation and interpersonal style of psychotherapy trainees having different theoretical orientations: An Italian contribution to an international collaborative study on psychotherapy training. Counselling and Psychotherapy Research, 18(3), 299-307.
DOI: https://doi.org/10.1002/capr.12176
Messina, I., Gullo, S., Gelo, O. C. G., Giordano, C., & Salcuni, S. (2019). An overview of the Italian contribution to the international multisite SPRISTAD study on psychotherapy training. Research in Psychotherapy: Psychopathology, Process, and Outcome, 22(3).
DOI: https://doi.org/10.4081/ripppo.2019.418
Nikčević, A. V., Kramolisova-Advani, J., & Spada, M. M. (2007). Early childhood experiences and current emotional distress: What do they tell us about aspiring psychologists?. The Journal of Psychology, 141(1), 25-34.
DOI: https://doi.org/10.3200/JRLP.141.1.25-34
Nissen-Lie, H. A., Goldberg, S. B., Hoyt, W. T., Falkenström, F., Holmqvist, R., Nielsen, S. L., & Wampold, B. E. (2016). Are therapists uniformly effective across patient outcome domains? A study on therapist effectiveness in two different treatment contexts. Journal of Counseling Psychology, 63(4), 367–378.
DOI: https://doi.org/10.1037/cou0000151
Nissen-Lie, H. A., Monsen, J. T., & Rønnestad, M. H. (2010). Therapist predictors of early patient-rated working alliance: A multilevel approach. Psychotherapy research, 20(6), 627-646.
DOI: https://doi.org/10.1080/10503307.2010.497633
Norcross, A. E. (2002), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. Oxford University Press.
Norcross, A. E. (2009). The challenge of uncertainty in psychotherapy: Depth psychological voices from the field. Pacifica Graduate Institute.
Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 5(4), 303-315.
DOI: https://doi.org/10.1037/pst0000193
Nutt, W. E. (2008). A psychotherapy researcher's perspective on therapist self-awareness and self-focused attention after a decade of research. Psychotherapy Research, 18(2), 139-146.
DOI: https://doi.org/10.1080/10503300701691656
Orlinsky, D.E., Messina, I., Hartmann, A., Willutzki, U., Heinonen, E., Rønnestad, M. H., Löffler-Stastka, H., & Schröder, T. (2024). Ninety psychotherapy training programmes across the globe: Variations and commonalities in an international context. Counselling and Psychotherapy Research, 24, 558–571.
DOI: https://doi.org/10.1002/capr.12690
Orlinsky, D. E., Strauss, B., Rønnestad, M. H., Hill, C., Castonguay, L., Willutzki, U., & Carlsson, J. (2015). A collaborative study of development in psychotherapy trainees. Psychotherapy Bulletin, 50(4), 21-25.
Pieterse, A. L., Lee, M., Ritmeester, A., & Collins, N. M. (2013). Towards a model of self-awareness development for counselling and psychotherapy training. Counselling Psychology Quarterly, 26(2), 190-207.
DOI: https://doi.org/10.1080/09515070.2013.793451
Ramos-Sánchez, L., Esnil, E., Goodwin, A., Riggs, S., Touster, L. O., Wright, L. K., ... & Rodolfa, E. (2002). Negative supervisory events: Effects on supervision and supervisory alliance. Professional Psychology: Research and Practice, 33(2), 197.
DOI: https://doi.org/10.1037//0735-7028.33.2.197
Roeske, D. (2014). From self-doubt to uncertainty in the analytic act: A narrative study of therapist maturation. California Institute of Integral Studies.
Rønnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist: Research findings and perspectives on professional development. Journal of Career Development, 30, 5-44.
DOI: https://doi.org/10.1177/089484530303000102
Schumann, N. R., Farmer, N. M., Shreve, M. M., & Corley, A. M. (2020). Structured peer group supervision: A safe space to grow. Journal of Psychotherapy Integration, 30(1), 108.
DOI: https://doi.org/10.1037/int0000180
Schöttke, H., Flückiger, C., Goldberg, S. B., Eversmann, J., & Lange, J. (2017). Predicting psychotherapy outcome based on therapist interpersonal skills: A five-year longitudinal study of a therapist assessment protocol. Psychotherapy Research, 27(6), 642-652.
DOI: https://doi.org/10.1080/10503307.2015.1125546
Schröder, T. (2022). Self-acknowledged limitations of therapists in the early stages of professional training. Book of Abstracts 9th EU-SPR Chapter Meeting Rome.
Saxon, D., & Barkham, M. (2012). Patterns of therapist variability: therapist effects and the contribution of patient severity and risk. Journal of Consulting and Clinical Psychology, 80(4), 535.
DOI: https://doi.org/10.1037/a0028898
Silva, S., & Sousa, D. (2022). Existential psychotherapy supervision: The supervisor’s perspective. Journal of Humanistic Psychology, 62(3), 397-417.
DOI: https://doi.org/10.1177/0022167818802905
Staempfli, A., & Fairtlough, A. (2019). Intervision and professional development: An exploration of a peer-group reflection method in social work education. The British Journal of Social Work, 49(5), 1254-1273.
DOI: https://doi.org/10.1093/bjsw/bcy096
Wampold, B. E., & Owen, J. (2021). Therapist effects: History, methods, magnitude, and characteristics of effective therapists. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield's handbook of psychotherapy and behavior change: 50th anniversary edition (7th ed., pp. 297–326). John Wiley & Sons, Inc..
Watkins Jr, C. E. (2014). The supervisory alliance: A half century of theory, practice, and research in critical perspective. American Journal of Psychotherapy, 68(1), 19-55.
DOI: https://doi.org/10.1176/appi.psychotherapy.2014.68.1.19
Williams, E. N. (2003). The relationship between momentary states of therapist self-awareness and perceptions of the counseling process. Journal of Contemporary Psychotherapy, 33, 177-186.
DOI: https://doi.org/10.1023/A:1023969502532
Williams, E. N., Hayes, J. A., Fauth, J. A. M. E. S., Brown, S., & Lent, R. (2008). Therapist self-awareness: Interdisciplinary connections and future directions. Handbook of Counseling Psychology, 303-319.
How to Cite
Messina, I., & Trimoldi, G. (2024). Shaping psychotherapy trainees’ potential: insights from training program directors. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(2). https://doi.org/10.4081/ripppo.2024.799
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Victoria Klimkowski, Sofia McRae, Alexia Blick, Laurence Beaulieu, J. Reese S. Handley, Anara A. Hopley, Caroline A. Hyde, Devika M. Jain, Sylvia Kolodziejczyk, Josiane Laliberté, Alexa Lévesque, Lara M. Masri, Anya M. Monet, Reagan S. Nediu, Rachel Valihrach, Giorgio Tasca, Models of practice and training in psychotherapy: cross-national perspectives from Italy and Canada , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 1 (2024)
- Ying Zhang, Lili Shi, Jing Wei, Armin Hartmann , Rainer Leonhart, Markus Bassler, Kurt Fritzsche, Perceived professional development of Chinese psychotherapy trainees: a pilot study , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 25 No. 2 (2022)
- Hubert de Condé, Emmanuelle Zech, Jochem Willemsen, The person behind the therapist: a recall study on significant events that contribute to therapists’ personal and professional development , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
- Vasiliki Yotsidi, Theodora Anastasiou, Konstantinos Doulgeris, Panagiota Theodosiou, Clive Richardson, Trauma focused-cognitive behavioral therapy training effectiveness in promoting professional development of psychotherapists working with unaccompanied minors in Greece: a non-blinded randomized control trial , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
- Gaia Albano, Arianna Teti, Arianna Scrò, Rubinia Celeste Bonfanti, Lucia Fortunato, Gianluca Lo Coco, A systematic review on the role of therapist characteristics in the treatment of eating disorders , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
- Nina Jakhelln Laugen, Torun Grøtte, Truls Ryum, Patrick A. Vogel, Heidi Brattland, Katrine Høyer Holgersen, Something has sort of opened up for me: psychology students’ reflections after participating in an apprenticeship training model , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
- Lucia Nuñez, Sofía Fernández, Nicolle Alamo, Nick Midgley, Claudia Capella, Mariane Krause, The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 25 No. 1 (2022)
- Jordan Bate, Angelica Tsakas, Facilitative interpersonal skills are relevant in child therapy too, so why don’t we measure them? , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 25 No. 1 (2022)
- Meltem Yilmaz, Kutlu Kağan Türkarslan, Ludovica Zanini, Dilara Hasdemir, Grazia Fernanda Spitoni, Vittorio Lingiardi, Transference interpretation and psychotherapy outcome: a systematic review of a no-consensus relationship , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 1 (2024)
- Ana Nunes da Silva, Antònio Branco Vasco, Jeanne C. Watson, Alexithymia and emotional processing: a longitudinal mixed methods research , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 21 No. 1 (2018)
You may also start an advanced similarity search for this article.
