Pub Date : 2022-01-06DOI: 10.1080/09515070.2021.2023098
Angie Chircop Coleiro, M. Creaner, L. Timulak
ABSTRACT . With qualitative studies increasingly published on different aspects of supervision, this qualitative meta-analysis synthesized existing qualitative research and explored what aspects therapy trainees find helpful and unhelpful in individual supervision. A sample of 29 studies (755 participants) was selected by conducting a systematic literature search and a critical appraisal process to ensure a suitable level of methodological rigor. Data analysis followed a descriptive and interpretative framework. Results yielded 6 main meta-categories: three in the helpful aspects domain (i) Supervisor establishes a secure learning environment, (ii) Supervisor demonstrates ability to facilitate learning, and (iii) Supervisor demonstrates willingness and ability to acknowledge and negotiate differences; and three in the unhelpful aspects domain (i) Supervisor demonstrates behaviour that lacks sensitivity, accountability, and ethical consideration, (ii) Supervisor fails to create a safe and supportive environment, and (iii) Supervisor demonstrates limitations in the appropriate maintenance and sharing of knowledge and skills. Influenced by the quality of the supervisory alliance, supervision can be helpful, but it may also be experienced as unhelpful and potentially harmful. Issues of power and diversity need to be negotiated in a manner that maintains ethical and professional standards of practice and care. Implications for supervision training, practice, and research are discussed.
{"title":"The good, the bad, and the less than ideal in clinical supervision: a qualitative meta-analysis of supervisee experiences","authors":"Angie Chircop Coleiro, M. Creaner, L. Timulak","doi":"10.1080/09515070.2021.2023098","DOIUrl":"https://doi.org/10.1080/09515070.2021.2023098","url":null,"abstract":"ABSTRACT . With qualitative studies increasingly published on different aspects of supervision, this qualitative meta-analysis synthesized existing qualitative research and explored what aspects therapy trainees find helpful and unhelpful in individual supervision. A sample of 29 studies (755 participants) was selected by conducting a systematic literature search and a critical appraisal process to ensure a suitable level of methodological rigor. Data analysis followed a descriptive and interpretative framework. Results yielded 6 main meta-categories: three in the helpful aspects domain (i) Supervisor establishes a secure learning environment, (ii) Supervisor demonstrates ability to facilitate learning, and (iii) Supervisor demonstrates willingness and ability to acknowledge and negotiate differences; and three in the unhelpful aspects domain (i) Supervisor demonstrates behaviour that lacks sensitivity, accountability, and ethical consideration, (ii) Supervisor fails to create a safe and supportive environment, and (iii) Supervisor demonstrates limitations in the appropriate maintenance and sharing of knowledge and skills. Influenced by the quality of the supervisory alliance, supervision can be helpful, but it may also be experienced as unhelpful and potentially harmful. Issues of power and diversity need to be negotiated in a manner that maintains ethical and professional standards of practice and care. Implications for supervision training, practice, and research are discussed.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"36 1","pages":"189 - 210"},"PeriodicalIF":3.0,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47339122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-04DOI: 10.1080/09515070.2021.2013162
Anna Mylona, Evrinomy Avdi, Evangelos Paraskevopoulos
ABSTRACT This exploratory single session-study presents a multimodal, mixed-method description of a session of psychoanalytic psychotherapy and illustrates an in-session “failure”, defined in terms of rupture in the therapeutic alliance and the process of its repair. It aims to enhance our understanding of the mechanisms implicated in therapeutic change. The research materialcomprises session’s video-recording, transcript, and measurements of participants’physiological arousal, as reflected in their heart rate in the session. The analysis consisted of an iterative, multi-layered process that combines observations from verbal and nonverbal modalities of interaction for the identification of significant in-session moments. We applied quantitative descriptive analysis on participants’ physiological arousal and synchronization, qualitative analysis of the clinical dialogue, and coded the in-session fluctuations in the therapeutic alliance,using the Rupture Resolution Rating System. The detailed analysis of specific interactive events in the session illustrates the shift from a “failure” in therapeutic collaboration to gradual repair; this shift entailed increased relatedness and physiological synchronization, and on a semantic level, co-created, reflective meanings in the here-and-now of the therapeutic interaction. The findings highlight ruptures as important in-session events and suggest that the therapist’s empathic oscillation between interpretative and metacommunication strategies can be mutative during moments of relational rupture. Practical Implications Negotiation and resolution of in-session therapeutic ruptures may provide opportunities for therapeutic growth in terms of increased relatedness and reflectiveness. The therapist’s flexible shifts between using interpretative interventions and immediate collaborative explorations in the here-and-now, in the form of metacommunication, seem to facilitate the repair of alliance rupture. Multimodal methodologies and multi-layered analyses, integrating verbal and nonverbal, physiological data in the study of therapeutic interaction can shed light on significant in-session events and mechanisms of the change process.
{"title":"Alliance rupture and repair processes in psychoanalytic psychotherapy: multimodal in-session shifts from momentary failure to repair","authors":"Anna Mylona, Evrinomy Avdi, Evangelos Paraskevopoulos","doi":"10.1080/09515070.2021.2013162","DOIUrl":"https://doi.org/10.1080/09515070.2021.2013162","url":null,"abstract":"ABSTRACT This exploratory single session-study presents a multimodal, mixed-method description of a session of psychoanalytic psychotherapy and illustrates an in-session “failure”, defined in terms of rupture in the therapeutic alliance and the process of its repair. It aims to enhance our understanding of the mechanisms implicated in therapeutic change. The research materialcomprises session’s video-recording, transcript, and measurements of participants’physiological arousal, as reflected in their heart rate in the session. The analysis consisted of an iterative, multi-layered process that combines observations from verbal and nonverbal modalities of interaction for the identification of significant in-session moments. We applied quantitative descriptive analysis on participants’ physiological arousal and synchronization, qualitative analysis of the clinical dialogue, and coded the in-session fluctuations in the therapeutic alliance,using the Rupture Resolution Rating System. The detailed analysis of specific interactive events in the session illustrates the shift from a “failure” in therapeutic collaboration to gradual repair; this shift entailed increased relatedness and physiological synchronization, and on a semantic level, co-created, reflective meanings in the here-and-now of the therapeutic interaction. The findings highlight ruptures as important in-session events and suggest that the therapist’s empathic oscillation between interpretative and metacommunication strategies can be mutative during moments of relational rupture. Practical Implications Negotiation and resolution of in-session therapeutic ruptures may provide opportunities for therapeutic growth in terms of increased relatedness and reflectiveness. The therapist’s flexible shifts between using interpretative interventions and immediate collaborative explorations in the here-and-now, in the form of metacommunication, seem to facilitate the repair of alliance rupture. Multimodal methodologies and multi-layered analyses, integrating verbal and nonverbal, physiological data in the study of therapeutic interaction can shed light on significant in-session events and mechanisms of the change process.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 1","pages":"814 - 841"},"PeriodicalIF":3.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48657114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2021-11-11DOI: 10.1080/09515070.2021.1997916
Adelya A Urmanche, Lauren M Lipner, Sarah Bloch-Elkouby, Elaine Hunter, Jerzy Kaufmann, Jonathan T Warren, Gregory T Weil, Catherine F Eubanks, J Christopher Muran
About one in five clients drops out of treatment prematurely. Premature termination has been found to correlate with patient, therapist, and treatment factors, as well as complex interpersonal processes, including ruptures in the therapeutic alliance. This study examines the therapeutic alliance using a qualitative approach to patient-, therapist-, and observer-based data. The sample includes five trainee therapists, each of whom worked with one patient who terminated after the first or second session, and one who completed a cognitive-behavioral therapy protocol. The session(s) preceding premature termination in the drop case and the corresponding session(s) in the completer case were examined. Rupture resolution process was prevalent in both groups, though confrontation ruptures seemed more prevalent with completers and withdrawal ruptures were more clinically impactful with dropouts. Therapist awareness of process and responsiveness or contribution to rupture were identified as potential factors contributing to patient retention.
{"title":"The beginning of the end: A comparison of treatment completers and early dropouts in trainee-provided time-limited Cognitive Behavioral Therapy.","authors":"Adelya A Urmanche, Lauren M Lipner, Sarah Bloch-Elkouby, Elaine Hunter, Jerzy Kaufmann, Jonathan T Warren, Gregory T Weil, Catherine F Eubanks, J Christopher Muran","doi":"10.1080/09515070.2021.1997916","DOIUrl":"10.1080/09515070.2021.1997916","url":null,"abstract":"<p><p>About one in five clients drops out of treatment prematurely. Premature termination has been found to correlate with patient, therapist, and treatment factors, as well as complex interpersonal processes, including ruptures in the therapeutic alliance. This study examines the therapeutic alliance using a qualitative approach to patient-, therapist-, and observer-based data. The sample includes five trainee therapists, each of whom worked with one patient who terminated after the first or second session, and one who completed a cognitive-behavioral therapy protocol. The session(s) preceding premature termination in the drop case and the corresponding session(s) in the completer case were examined. Rupture resolution process was prevalent in both groups, though confrontation ruptures seemed more prevalent with completers and withdrawal ruptures were more clinically impactful with dropouts. Therapist awareness of process and responsiveness or contribution to rupture were identified as potential factors contributing to patient retention.</p>","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 4","pages":"763-788"},"PeriodicalIF":3.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9856216/pdf/nihms-1766986.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/09515070.2021.1895724
Carly A Hunt, Rachael D Goodman, Alexander J Hilert, Wilson Hurley, Clara E Hill
We investigated the impact of a 1.5 hr workshop based on mindfulness-based compassion practices (MBCP) for 6 doctoral student therapists, followed by these therapists engaging in pre-session preparation for each of their clients in one of 3 randomly assigned conditions (MBCP, self-supervision, preparation-as-usual) over a 1-month period. State mindfulness and meditation self-efficacy increased following the workshop. Therapist ratings of session effectiveness were higher following pre-session meditation relative to preparation-as-usual, although there were no client-rated differences in session outcome. In a focus group, therapists reported that the workshop was generally helpful, and noted that pre-session MBCP led to a positive state of being and increased selfcare. However, they felt rushed to fit in the exercises and some doubted their meditation self-efficacy. They suggested that longer, at-home practice might be more beneficial than pre-session exercises. We encourage replication in larger samples varying the amount and format of meditation training for improving outcomes.
{"title":"A Mindfulness-Based Compassion Workshop and Pre-Session Preparation to Enhance Therapist Effectiveness in Psychotherapy: A Pilot Study.","authors":"Carly A Hunt, Rachael D Goodman, Alexander J Hilert, Wilson Hurley, Clara E Hill","doi":"10.1080/09515070.2021.1895724","DOIUrl":"https://doi.org/10.1080/09515070.2021.1895724","url":null,"abstract":"<p><p>We investigated the impact of a 1.5 hr workshop based on mindfulness-based compassion practices (MBCP) for 6 doctoral student therapists, followed by these therapists engaging in pre-session preparation for each of their clients in one of 3 randomly assigned conditions (MBCP, self-supervision, preparation-as-usual) over a 1-month period. State mindfulness and meditation self-efficacy increased following the workshop. Therapist ratings of session effectiveness were higher following pre-session meditation relative to preparation-as-usual, although there were no client-rated differences in session outcome. In a focus group, therapists reported that the workshop was generally helpful, and noted that pre-session MBCP led to a positive state of being and increased selfcare. However, they felt rushed to fit in the exercises and some doubted their meditation self-efficacy. They suggested that longer, at-home practice might be more beneficial than pre-session exercises. We encourage replication in larger samples varying the amount and format of meditation training for improving outcomes.</p>","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 3","pages":"546-561"},"PeriodicalIF":3.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/09515070.2021.1895724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.1080/09515070.2021.2014401
M. Brodt
ABSTRACT The COVID pandemic has allowed transformative change that has otherwise faced resistance, and counseling psychology can use the pandemic as a time of reflection and change. Counseling psychology needs to incorporate insights from the disability justice community to create a more liberated world. The manuscript begins with a brief overview of disability justice principles and the relative lack of attention to disability in counseling psychology. An overview of three areas for change is presented: 1) expanding pathways to connection and recognizing humanity’s interdependence, 2) redefining resilience and ensuring that we add ongoing transformative justice to our resilience practice, and 3) persistent access. Finally, the manuscript ends with a conclusion that discusses the importance of fully practicing disability justice, which includes understanding that it will be messy, imperfect, and takes practice. This manuscript is a roadmap to create a more just set of practitioners, teachers, researchers, and social justice advocates, among the many other roles that counseling psychologists take on.
{"title":"Cyborg oracles: insights for counseling psychology from the disability justice movement post COVID","authors":"M. Brodt","doi":"10.1080/09515070.2021.2014401","DOIUrl":"https://doi.org/10.1080/09515070.2021.2014401","url":null,"abstract":"ABSTRACT The COVID pandemic has allowed transformative change that has otherwise faced resistance, and counseling psychology can use the pandemic as a time of reflection and change. Counseling psychology needs to incorporate insights from the disability justice community to create a more liberated world. The manuscript begins with a brief overview of disability justice principles and the relative lack of attention to disability in counseling psychology. An overview of three areas for change is presented: 1) expanding pathways to connection and recognizing humanity’s interdependence, 2) redefining resilience and ensuring that we add ongoing transformative justice to our resilience practice, and 3) persistent access. Finally, the manuscript ends with a conclusion that discusses the importance of fully practicing disability justice, which includes understanding that it will be messy, imperfect, and takes practice. This manuscript is a roadmap to create a more just set of practitioners, teachers, researchers, and social justice advocates, among the many other roles that counseling psychologists take on.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"36 1","pages":"169 - 188"},"PeriodicalIF":3.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48286227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.1080/09515070.2022.2130175
B. Rijn, James N. Agar, Charlotte Sills, W. Stiles
ABSTRACT In transactional analysis theory, life script themes are archaic patterns of experience and interaction, which can emerge during clinical work and impact practice. This study examined whether a newly qualified therapist’s problematic life script themes were detectable in supervision, how they were addressed, and whether addressing them led to assimilation of these themes. Seven consecutive supervision sessions with a recently-qualified male therapist (pseudonym Adam) were transcribed and analyzed using a qualitative theory-building approach. The assimilation of problematic experiences sequence (APES) was used to track changes in Adam’s life script themes. Life script themes were evident in all seven supervision sessions. They centered on two interconnected themes of abuse and rejection. Discussions of these themes in supervision focused on over-identification, protectiveness, and self-disclosure. The supervisor’s interventions included didactic work appropriate for a beginning clinician and facilitative work in supporting development of assimilation of problematic themes. Reflective supervision including exploration of the therapist’s personal process when it is triggered can enhance practice development, and be an important part of the supervision process, providing it respect teach/treat boundary. Comparisons with previous research suggested that script themes emerged differently in supervision of relatively inexperienced supervisees as opposed to experienced ones.
{"title":"Assimilating problematic life script themes in clinical supervision: The case of Adam","authors":"B. Rijn, James N. Agar, Charlotte Sills, W. Stiles","doi":"10.1080/09515070.2022.2130175","DOIUrl":"https://doi.org/10.1080/09515070.2022.2130175","url":null,"abstract":"ABSTRACT In transactional analysis theory, life script themes are archaic patterns of experience and interaction, which can emerge during clinical work and impact practice. This study examined whether a newly qualified therapist’s problematic life script themes were detectable in supervision, how they were addressed, and whether addressing them led to assimilation of these themes. Seven consecutive supervision sessions with a recently-qualified male therapist (pseudonym Adam) were transcribed and analyzed using a qualitative theory-building approach. The assimilation of problematic experiences sequence (APES) was used to track changes in Adam’s life script themes. Life script themes were evident in all seven supervision sessions. They centered on two interconnected themes of abuse and rejection. Discussions of these themes in supervision focused on over-identification, protectiveness, and self-disclosure. The supervisor’s interventions included didactic work appropriate for a beginning clinician and facilitative work in supporting development of assimilation of problematic themes. Reflective supervision including exploration of the therapist’s personal process when it is triggered can enhance practice development, and be an important part of the supervision process, providing it respect teach/treat boundary. Comparisons with previous research suggested that script themes emerged differently in supervision of relatively inexperienced supervisees as opposed to experienced ones.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"36 1","pages":"525 - 548"},"PeriodicalIF":3.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43970307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-23DOI: 10.1080/09515070.2021.2001312
J. Tomlinson, Steven J. Sandage, Peter J. Jankowski, Laura E. Captari
ABSTRACT Positive psychology, as a subdiscipline oriented to promoting human well-being, has grown significantly as a field over the past thirty years. To date, clinical applications in positive psychology have tended to advance more generalized, universal understandings of what constitutes well-being. We assert in this article that greater attention ought to be paid to more particular understandings of well-being, especially those emerging from religious traditions. We summarize visions of well-being from four different religious traditions, while highlighting possibilities for integrating understandings of these with clinical approaches in psychotherapeutic contexts. For each religious tradition, we also describe case examples to elucidate therapeutic possibilities when working with clients from diverse religious contexts. The article concludes with an extended discussion concerning points of divergence among religious traditions’ conceptions of well-being, along with commentary on the merits and practical demands of integrating universal and particular understandings of well-being in positive psychology interventions.
{"title":"Religious diversity and well-being in positive psychology: implications for clinical practice","authors":"J. Tomlinson, Steven J. Sandage, Peter J. Jankowski, Laura E. Captari","doi":"10.1080/09515070.2021.2001312","DOIUrl":"https://doi.org/10.1080/09515070.2021.2001312","url":null,"abstract":"ABSTRACT Positive psychology, as a subdiscipline oriented to promoting human well-being, has grown significantly as a field over the past thirty years. To date, clinical applications in positive psychology have tended to advance more generalized, universal understandings of what constitutes well-being. We assert in this article that greater attention ought to be paid to more particular understandings of well-being, especially those emerging from religious traditions. We summarize visions of well-being from four different religious traditions, while highlighting possibilities for integrating understandings of these with clinical approaches in psychotherapeutic contexts. For each religious tradition, we also describe case examples to elucidate therapeutic possibilities when working with clients from diverse religious contexts. The article concludes with an extended discussion concerning points of divergence among religious traditions’ conceptions of well-being, along with commentary on the merits and practical demands of integrating universal and particular understandings of well-being in positive psychology interventions.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 1","pages":"959 - 979"},"PeriodicalIF":3.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43528865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-17DOI: 10.1080/09515070.2021.1997918
Elly Quinlan, F. Deane, S. Schilder, Ellen Read
ABSTRACT The role of a practicing psychologist often involves uncertainty and ambiguity, and individuals differ in their ability to manage or “tolerate” this uncertainty. This study investigated the relationship between tolerance of uncertainty, pluralism and confidence in case formulation in a sample of Australian psychologists. The sample consisted of 190 Australian psychologists, aged between 22 and 69 years (M = 30.48, SD = 8.04) and comprising mostly females (77.9%). This study had a cross-sectional survey design in which participants completed measures of uncertainty tolerance, pluralism and confidence in case formulation. Hierarchical multiple regression was used to predict tolerance to uncertainty. The final regression model was significant and explained 39.1% of the variance in tolerance of uncertainty. The predictor variables that contributed significantly to the model were therapeutic orientation, age, pluralistic practice and confidence in case formulation. Stage of career and pluralistic philosophy did not contribute significantly to the model. Higher pluralistic practice and confidence in case formulation skills are related to higher tolerance of uncertainty. Training in pluralistic models of therapy and the hypothesis generation approach to case formulation may offer the potential to increase uncertainty tolerance in practicing psychologists.
{"title":"Confidence in case formulation and pluralism as predictors of psychologists’ tolerance of uncertainty","authors":"Elly Quinlan, F. Deane, S. Schilder, Ellen Read","doi":"10.1080/09515070.2021.1997918","DOIUrl":"https://doi.org/10.1080/09515070.2021.1997918","url":null,"abstract":"ABSTRACT The role of a practicing psychologist often involves uncertainty and ambiguity, and individuals differ in their ability to manage or “tolerate” this uncertainty. This study investigated the relationship between tolerance of uncertainty, pluralism and confidence in case formulation in a sample of Australian psychologists. The sample consisted of 190 Australian psychologists, aged between 22 and 69 years (M = 30.48, SD = 8.04) and comprising mostly females (77.9%). This study had a cross-sectional survey design in which participants completed measures of uncertainty tolerance, pluralism and confidence in case formulation. Hierarchical multiple regression was used to predict tolerance to uncertainty. The final regression model was significant and explained 39.1% of the variance in tolerance of uncertainty. The predictor variables that contributed significantly to the model were therapeutic orientation, age, pluralistic practice and confidence in case formulation. Stage of career and pluralistic philosophy did not contribute significantly to the model. Higher pluralistic practice and confidence in case formulation skills are related to higher tolerance of uncertainty. Training in pluralistic models of therapy and the hypothesis generation approach to case formulation may offer the potential to increase uncertainty tolerance in practicing psychologists.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 1","pages":"943 - 958"},"PeriodicalIF":3.0,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44060746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Despite research demonstrating the poor mental health outcomes of transgender young people within the secondary school environment, little is known about the experiences of psychologists working in school counselling with this population. To address this gap, the current study explored the experiences of psychologists working with transgender young people in a school counselling context. Seven psychologists in Australia completed individual semi-structured interviews and the data were analysed using Interpretative Phenomenological Analysis (IPA). Four superordinate themes were identified: affirming agency within transgender young people, perceived competency and transgender knowledge, expectations and surprises, and challenges during counselling. The findings demonstrated the importance of school psychologists promoting and celebrating the positioning of transgender young people within society, adopting a queer lens in their work with this population, being informed and knowledgeable regarding transgender issues, and managing the various challenges associated with this work. Practical implications for school psychologists include the need to engage with transgender training and education, helping transgender young people link-in with trans-inclusive services, as well as “queering” both the counselling space and the school environment . Future researchers should further explore the experiences of school psychologists and mental health professionals across different contexts, settings, and levels of practical experience.
{"title":"The experiences of psychologists working with transgender young people in school counselling: an Australian sample","authors":"Grace Mackie, Karen Lambert, Lefteris Patlamazoglou","doi":"10.1080/09515070.2021.2001313","DOIUrl":"https://doi.org/10.1080/09515070.2021.2001313","url":null,"abstract":"ABSTRACT Despite research demonstrating the poor mental health outcomes of transgender young people within the secondary school environment, little is known about the experiences of psychologists working in school counselling with this population. To address this gap, the current study explored the experiences of psychologists working with transgender young people in a school counselling context. Seven psychologists in Australia completed individual semi-structured interviews and the data were analysed using Interpretative Phenomenological Analysis (IPA). Four superordinate themes were identified: affirming agency within transgender young people, perceived competency and transgender knowledge, expectations and surprises, and challenges during counselling. The findings demonstrated the importance of school psychologists promoting and celebrating the positioning of transgender young people within society, adopting a queer lens in their work with this population, being informed and knowledgeable regarding transgender issues, and managing the various challenges associated with this work. Practical implications for school psychologists include the need to engage with transgender training and education, helping transgender young people link-in with trans-inclusive services, as well as “queering” both the counselling space and the school environment . Future researchers should further explore the experiences of school psychologists and mental health professionals across different contexts, settings, and levels of practical experience.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"36 1","pages":"1 - 24"},"PeriodicalIF":3.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47467556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-11DOI: 10.1080/09515070.2021.2000941
D. Kealy, James C. McCollum, J. Curtis, G. Silberschatz, K. Aafjes-van Doorn, Xiaochen Luo
ABSTRACT One factor that may help avoid treatment failure by premature termination is the therapist’s responsiveness to the patient’s coaching. Coaching refers to the patient’s efforts to inform and guide the therapist about the kinds of therapist behaviors, attitudes, and interventions that would advance the therapy. The case of Barb, from a naturalistic study of time-limited psychotherapy, was examined as a failed treatment due to premature termination. Using a case study approach, descriptive analysis of the therapy process, along with quantitative ratings of coaching and responsiveness, was employed to examine instances of patient coaching with corresponding therapist responsiveness. Analysis indicated that the patient attempted to coach the therapist throughout each session about her plan for treatment and the responses she sought from the therapist. The therapist’s responses were only partially aligned––and in some instances not at all aligned––with the patient’s coaching. The disparity between the patient’s coaching and the therapist’s responsiveness was widest in the two sessions immediately prior to termination. This case study indicates that patients may coach therapists in order to avoid treatment failure. Therapists who attend to patient coaching and modify their responsiveness may be better able to sustain treatment and help patients achieve therapeutic goals.
{"title":"Failure to respond to the patient’s coaching: a case study of premature termination in psychodynamic psychotherapy","authors":"D. Kealy, James C. McCollum, J. Curtis, G. Silberschatz, K. Aafjes-van Doorn, Xiaochen Luo","doi":"10.1080/09515070.2021.2000941","DOIUrl":"https://doi.org/10.1080/09515070.2021.2000941","url":null,"abstract":"ABSTRACT One factor that may help avoid treatment failure by premature termination is the therapist’s responsiveness to the patient’s coaching. Coaching refers to the patient’s efforts to inform and guide the therapist about the kinds of therapist behaviors, attitudes, and interventions that would advance the therapy. The case of Barb, from a naturalistic study of time-limited psychotherapy, was examined as a failed treatment due to premature termination. Using a case study approach, descriptive analysis of the therapy process, along with quantitative ratings of coaching and responsiveness, was employed to examine instances of patient coaching with corresponding therapist responsiveness. Analysis indicated that the patient attempted to coach the therapist throughout each session about her plan for treatment and the responses she sought from the therapist. The therapist’s responses were only partially aligned––and in some instances not at all aligned––with the patient’s coaching. The disparity between the patient’s coaching and the therapist’s responsiveness was widest in the two sessions immediately prior to termination. This case study indicates that patients may coach therapists in order to avoid treatment failure. Therapists who attend to patient coaching and modify their responsiveness may be better able to sustain treatment and help patients achieve therapeutic goals.","PeriodicalId":51653,"journal":{"name":"Counselling Psychology Quarterly","volume":"35 1","pages":"789 - 813"},"PeriodicalIF":3.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44487221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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