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How beginning cognitive behavioural therapists develop professional confidence

Published online by Cambridge University Press:  06 June 2018

Lenka Maruniakova  and
Tomas Rihacek
Lenka Maruniakova*
Affiliation:
Department of Psychology, Masaryk University, Brno, Czech Republic
Tomas Rihacek
Affiliation:
Department of Psychology, Masaryk University, Brno, Czech Republic
*
*Author for correspondence: Lenka Maruniakova, Department of Psychology, Faculty of Social Studies, Masaryk University, Jostova 10, 602 00 Brno, Czech Republic (email: maruniakova.lenka@gmail.com)
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Abstract

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.

Keywords

cognitive behavioural therapy trainingprofessional and personal sources in therapist developmenttherapist confidenceprofessional identitygrounded theory method
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 11 , 2018 , e5
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Further reading

Bennett-Levy, J, Lee, NK, Travers, K, Pohlman, S, Hamernik, E (2003). Cognitive therapy from the inside: enhancing therapist skills through practicing what we preach. Behavioural and Cognitive Psychotherapy 31, 143–158. doi: 10.1017/S1352465803002029Google Scholar
Bennett-Levy, J, Thwaites, R, Haarhoff, B, Perry, H (2015). Experiencing CBT from the inside out: a self-practice/self-reflection workbook for therapists. New York: The Guilford Press.Google Scholar
Bischoff, RJ (1997). Themes in therapist development during the first three months of clinical experience. Contemporary Family Therapy 19, 563–580. doi: 10.1023/A:1026139206638CrossRefGoogle Scholar
Wolff, S, Auckenthaler, A (2014). Processes of theoretical orientation development in CBT trainees: what internal processes do psychotherapists in training undergo as they ‘integrate’? Journal of Psychotherapy Integration 24, 223–237. doi: 10.1037/a0037514CrossRefGoogle Scholar

References

Auxier, CR, Hughes, FR, Kline, WB (2003). Identity development in counselors-in-training. Counselor Education and Supervision 43, 25–38. doi: 10.1002/j.1556-6978.2003.tb01827.xCrossRefGoogle Scholar
Baldwin, SA, Imel, ZE (2013). Therapist effects: findings and methods. In Lambert, MJ (ed), Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (6th edn, pp. 258–297). Hoboken, NJ: John Wiley and Sons.Google Scholar
Barnfield, TV, Mathieson, FM, Beaumont, GR (2007). Assessing the development of competence during postgraduate cognitive-behavioral therapy training. Journal of Cognitive Psychotherapy: An International Quarterly 21, 140–147. doi: 10.1891/088983907780851586.CrossRefGoogle Scholar
Beidas, RS, Kendall, PC (2010). Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clinical Psychology 17, 1–30. doi: 10.1111/j.1468-2850.2009.01187.xGoogle Scholar
Bennett-Levy, J (2006). Therapist skills: a cognitive model of their acquisition and refinement. Behavioural and Cognitive Psychotherapy 34, 57–78. doi: 10.1017/s1352465805002420Google Scholar
Bennett-Levy, J, Beedie, A (2007). The ups and downs of cognitive therapy training: what happens to trainees perception of their competence during a cognitive therapy training course? Behavioural and Cognitive Psychotherapy 35, 61–75. doi: 10.1017/s1352465806003110Google Scholar
Bennett-Levy, J, Lee, NK (2014). Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees’ engagement and experience of benefit? Behavioral and Cognitive Psychotherapy 42, 48–64. doi: 10.1017/S1352465812000781Google Scholar
Bennett-Levy, J, McManus, F, Westling, BE, Fennell, M (2009a). Acquiring and refining CBT skills and competencies: which training methods are perceived to be most effective? Behavioral and Cognitive Psychotherapy 37, 571–583. doi: 10.1017/S1352465809990270Google Scholar
Bennett-Levy, J, Lee, NK, Travers, K, Pohlman, S, Hamernik, E (2003). Cognitive therapy from the inside: enhancing therapist skills through practicing what we preach. Behavioural and Cognitive Psychotherapy 31, 143–158. doi: 10.1017/S1352465803002029Google Scholar
Bennett-Levy, J, Thwaites, R, Chaddock, A, Davis, M (2009b). Reflective practice in cognitive behavioural therapy: the engine of lifelong learning. In Stedmon, J and Dallos, R (eds), Reflective Practice in Psychotherapy and Counselling (pp. 115–135). Maidenhead: McGraw-Hill/Open University Press.Google Scholar
Bennett-Levy, J, Turner, F, Beaty, T, Smith, M, Paterson, B, Farmer, S (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy 29, 203–220.CrossRefGoogle Scholar
Bischoff, RJ (1997). Themes in therapist development during the first three months of clinical experience. Contemporary Family Therapy 19, 563–580. doi: 10.1023/A:1026139206638Google Scholar
Bischoff, RJ, Barton, M, Thober, J, Hawley, R (2002). Events and experiences impacting the development of clinical self-confidence: a study of the first year of client contact. Journal of Marital and Family Therapy 28, 371–382. doi: 10.1111/j.1752-0606.2002.tb01193.xGoogle Scholar
Boswell, JF, Castonguay, LG, Pincus, AL (2009). Trainee theoretical orientation: profiles and potential predictors. Journal of Psychotherapy Integration 19, 291–312. doi: 10.1037/a0017068Google Scholar
Carlsson, J, Norberg, J, Sandell, R, Schubert, J (2011). Searching for recognition: the professional development of psychodynamic psychotherapists during training and the first few years after it. Psychotherapy Research 21, 141–153. doi: 10.1080/10503307.2010.506894Google Scholar
Charmaz, K (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. London: Sage Publications.Google Scholar
Farrand, P, Perry, J, Linsley, S (2010). Enhancing Self-Practice/Self-Reflection (SP/SR) approach to cognitive behaviour training through use of reflective blogs. Behavioural and Cognitive Psychotherapy 38, 473–477. doi: 10.1017/S1352465810000238CrossRefGoogle ScholarPubMed
Fitzpatrick, MR, Kovalak, AL, Weaver, A (2010). How trainees develop an initial theory of practice: a process model of tentative identifications. Counselling and Psychotherapy Research 10, 93–102. doi: 10.1080/14733141003773790Google Scholar
Freiheit, SR, Overholser, JC (1997). Training issues in cognitive behavioural psychotherapy. Journal of Behaviour Therapy and Experimental Psychiatry 28, 79–86. doi: 10.1016/S0005-7916(97)00001-3Google Scholar
Glaser, BG (1978). Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. Mill Valley, CA: Sociology Press.Google Scholar
Glaser, BG, Strauss, AL (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine.Google Scholar
Haarhoff, B, Gibson, K, Flett, R (2011). Improving the quality of cognitive behaviour therapy case conceptualization: the role of Self-Practice/Self-Reflection. Behavioural and Cognitive Psychotherapy 39, 323–339. doi: 10.1017/S1352465810000871Google Scholar
Hatcher, RL, Lassiter, KD (2007). Initial training in professional psychology: the practicum competencies outline. Training and Education in Professional Psychology 1, 49–63. doi: 10.1037/1931-3918.1.1.49CrossRefGoogle Scholar
Hill, CE, Charles, C, Reed, KG (1981). A longitudinal analysis of changes in counseling skills during doctoral training in counseling psychology. Journal of Counseling Psychology 28, 428–436. doi: 10.1037//0022-0167.28.5.428Google Scholar
Hill, CE, Sullivan, C, Knox, S, Schlosser, LZ (2007). Becoming psychotherapists experiences of novice trainees in a beginning graduate class. Psychotherapy Theory, Research, Practice, Training 44, 1–27. doi: 10.1037/0033-3204.44.4.434Google Scholar
Howard, EE, Inman, AG, Altman, AN (2006). Critical incidents among novice counselor trainees. Counselor Education and Supervision 46, 88–102. doi: 10.1002/j.1556-6978.2006.tb00015.xCrossRefGoogle Scholar
James, IA, Blackburn, I-M, Milne, DL, Reichfelt, FK (2001). Moderators of trainee therapists’ competence in cognitive therapy. British Journal of Clinical Psychology 40, 131–141. doi: 10.1348/014466501163580Google Scholar
Laireiter, A-R, Willutzki, U (2003). Self-Reflection and Self-Practice in training of cognitive behaviour therapy: an overview. Clinical Psychology and Psychotherapy 10, 19–30. doi: 10.1002/cpp.348Google Scholar
Leahy, RL (2008). The therapeutic relationship in cognitive-behavioral therapy. Behavioural and Cognitive Psychotherapy 36, 769–777. doi: 10.1017/s1352465808004852Google Scholar
Lucock, MP, Hall, P, Noble, R (2006). A survey of influences on the practice of psychotherapists and clinical psychologists in training in the UK. Clinical Psychology and Psychotherapy 13, 123–130. doi: 10.1002/cpp.483.Google Scholar
Maruniakova, L, Rihacek, T, Roubal, J (2016). How beginning counselors learn: the interaction of personal and professional experiences in counselors with an experiential orientation. Counselling Psychology Quarterly [online]. doi: 10.1080/09515070.2016.1148013Google Scholar
McManus, F, Westbrook, D, Vazquez-Montes, M, Fennell, M, Kennerley, H (2010). An evaluation of the effectiveness of Diploma-level training in cognitive behaviour therapy. Behaviour Research and Therapy 48, 1123–1132. doi: 10.1016/j.brat.2010.08.002.Google Scholar
Milne, DL, Baker, C, Blackburn, I-M, James, I, Reichelt, FK (1999). Effectiveness of cognitive therapy training. Journal of Behaviour Therapy and Experimental Psychiatry 30, 81–92. doi: 10.1016/S0005-7916(99)00011-7Google Scholar
Muse, K, McManus, F (2013). A systematic review of methods for assessing competence in cognitive behavioural therapy. Clinical Psychology 33, 484–499. doi: https://dx.doi.org/10.1016/j.cpr.2013.01.010Google Scholar
Myles, PJ, Milne, DL (2004). Outcome evaluation of a brief shared learning programmes in cognitive behavioural therapy. Behavioural and Cognitive Psychotherapy 32, 177–188. doi: https://doi.org/10.1017/S1352465804001183Google Scholar
Najavits, LM (1997). Psychotherapists’ implicit theories of therapy. Journal of Psychotherapy Integration 7, 1–16. doi: 10.1037/h0101137Google Scholar
Rakovshik, S, McManus, F (2010). Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clinical Psychology Review 30, 496–516. doi: 10.1016/j.cpr.2010.03.004Google Scholar
Reiser, RP, Milne, D (2012). Supervising cognitive-behavioral psychotherapy: pressing needs, impressing possibilities. Journal of Contemporary Psychotherapy 42, 161–171. doi: 10.1007/s10879-011-9200-6Google Scholar
Rihacek, T, Roubal, J (2017). Personal therapeutic approach: concept and implications. Journal of Psychotherapy Integration 27, 548–560. doi: 10.1037/int0000082Google Scholar
Rønnestad, MH, Skovholt, TM (2003). The journey of the counselor and therapist: research findings and perspectives on professional development. Journal of Career and Development 30, 5–44. doi: 10.1177/089484530303000102Google Scholar
Schwing, AE, LaFollette, JR, Steinfeldt, JA, Wong, YJ (2011). Novice counselors conceptualizations and experiences of therapeutic relationships. International Journal for the Advancement of Counselling 33, 51–63. doi: 10.1007/s10447-010-9112-2Google Scholar
Sharpless, BA, Barber, JP (2009). A conceptual and empirical review of the meaning, measurement, development, and teaching of intervention competence in clinical psychology. Clinical Psychology Review 29, 47–56. doi: 10.1016/j.cpr.2008.09.008Google Scholar
Skovholt, TM, Rønnestad, MH (1992). The Evolving Professional Self: Stages and Themes in Therapist and Counselor Development. Chichester: John Wiley and Sons.Google Scholar
Spruill, DA, Benshoff, JM (2000). Helping beginning counselors develop a personal theory of counseling. Counselor Education and Supervision 40, 70–80. doi: 10.1002/j.1556-6978.2000.tb01800.xGoogle Scholar
Sudak, D (2009). Training in cognitive behavioral therapy in psychiatry residency: an overview for educators. Behavior Modification 33, 124–137. doi: 10.1177/1059601108322626Google Scholar
Taubner, S, Kächele, H, Visbeck, A, Rapp, A, Sandell, R (2010). Therapeutic attitudes and practice patterns among psychotherapy trainees in Germany. European Journal of Psychotherapy and Counselling 12, 361–381. doi: 10.1080/13642537.2010.530085CrossRefGoogle Scholar
Wampold, BE, Imel, ZE (2015). The Great Psychotherapy Debate: The Evidence for what makes Psychotherapy work (2nd edn). New York, NY: Routledge.Google Scholar
Wolff, S, Auckenthaler, A (2014). Processes of theoretical orientation development in CBT trainees: what internal processes do psychotherapists in training undergo as they ‘integrate’? Journal of Psychotherapy Integration 24, 223–237. doi: 10.1037/a0037514CrossRefGoogle Scholar
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