Competency in integrative psychotherapy: Perspectives on training and supervision.

Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training issues in psychotherapy integration: A commentary.

This article is a commentary on A. J. Consoli and C. M. Jester's (see record 2006-01691-002) and J. Gold's (see record 2006-01691-003) eloquent and stimulating reflections on training in psychotherapy integration. Three issues are addressed: (a) the timing of an integrative perspective in training, (b) the potential merits of "hero worshiping" at an early phase of training, and (c) some misconceptions about training in "pure-form" psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Existential applications to practice: Can existentialism integrate psychotherapy?

Reviews the book, The psychology of existence: An integrative, clinical perspective by Kirk Schneider and Rollo May (see record 1994-98741-000). In light of what they see as a growing interest in existential psychology among training clinicians and researchers, Schneider and May have authored a text which introduces the existential movement and outlines clinical applications of existentialism in psychotherapy. The text's most significant contribution is the latter—the presentation of a guiding clinical framework for conducting the "existential- integrative approach" in psychotherapy. While many personality and psychotherapy texts include introductory chapters about existentialism, few discuss how therapy cases are conceptualized and conducted from an existential therapeutic orientation. This text is an important contribution to the clinical psychology training literature. In traditional clinical training programs, existential approaches to psychotherapy are often overlooked, because such approaches are viewed as purely philosophical rather than clinically applicable. Schneider and May challenge this view. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy integration in internships and counseling psychology doctoral programs.

Training directors from APA-accredited internships and counseling psychology doctoral programs reported on the status of doctoral training in psychotherapy integration. A mail survey was used to assess several areas related to psychotherapy integration, such as didactic and clinical training, faculty/staff theoretical orientation and hiring practices, student competency and evaluation, directors' beliefs about integrative/eclectic training, and internship admissions. Overall results show a positive attitude toward psychotherapy integration in predoctoral training and suggest that the foundations for further student development in psychotherapy integration exist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decision making and psychotherapy integration: Theoretical considerations, preliminary data, and implications for future research.

In recent years, a number of publications have called for investigation of how psychotherapists make treatment decisions in clinical practice. This recommendation is particularly salient for psychotherapy integration, as studies have consistently shown that a plurality of American clinicians consider themselves to be either "eclectic" or "integrative" in theoretical orientation. Yet, the research on clinician decision making in psychotherapy is in its infancy. This article examines the need for decision-making research in psychotherapy integration, as well as aspects of psychotherapy integration that are targets for research and possible theoretical frameworks for understanding decision-making processes of integrative psychotherapists. A preliminary study provides data from practicing psychotherapists to illustrate these points. Finally, implications and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empathic relational bonds and personal agency in psychotherapy: Implications for psychotherapy supervision, practice, and research.

Although psychotherapy researchers have become increasingly interested in identifying common factors that contribute to effective therapeutic practices, across psycho-diagnostic categories and treatment approaches, relatively little attention to date has been focused on the impact of these research findings for psychotherapy supervision and training programs. To address this gap, in this article we describe key components of an integrative psychotherapy supervision and training program that focuses on the development of a strong therapeutic alliance as an empirically supported, common principle of change in psychotherapy. We review empirical research evidence that addresses the contributions of therapist empathic engagement for the development of secure, relational bonds, heightened client agency, and the development of strong therapeutic alliances, and we discuss the implications of these findings for therapy practice and supervision training. We conclude with specific recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning psychotherapy in the digital age.

There is substantial literature documenting the process factors that lead to effective psychotherapy. Similarly, there is now a wealth of data attesting to the effectiveness of several psychotherapy brands. Little is known about the elements that facilitate learning how to be an effective clinician. One important step, after reading about a treatment model and seeing techniques demonstrated, is having the chance to practice the approach and receiving feedback and coaching from an experienced, knowledgeable supervisor. To accomplish this efficiently, most programs rely not only on trainee accounts of what went on in their therapy sessions, but also on recordings and videos of therapeutic encounters. This article describes our experience over a 5-year period in developing the use of Webcams for training psychology interns and psychiatric residents in the delivery of psychotherapy services. Pragmatic and technical details are given about how we went about establishing a recording system that is easy to use and provides secure, confidential storage of information at a reasonable cost. Discussion addresses both the weighing of choices that need to be made and overcoming the hesitation of trainees to reveal their work during treatment sessions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychotherapy training: Suggestions for core ingredients and future research.

Despite our considerable depth and breadth of empirical knowledge on psychotherapy process and outcome, research on psychotherapy training is somewhat lacking. We would argue, however, that the scientist-practitioner model should not only guide practice, but also the way our field approaches training. In this paper we outline our perspective on the crucial elements of psychotherapy training based on available evidence, theory, and clinical experience, focusing specifically on the structure, key components, and important skills to be learned in a successful training program. In addition, we derive specific research directions based on the crucial elements of our proposed training perspective, and offer general considerations for research on training, including method and measurement issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The next generation of SEPI: Integrationists from the "get go."

A generation of integrative therapists developed inside the Society for the Exploration of Psychotherapy Integration (SEPI) and the psychotherapy integration movement emerged the last couple of decades. These integrationists from the "get go" represent a new model of integrative development, which comes to complement the traditional route of "single theorist gradually turns integrationist." This series of articles presents the developmental journeys, future plans, and views about psychotherapy integration of four such integrative scientist-practitioners, in an effort to inspire the next generation of SEPI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Test of the phase model of psychotherapy in a training clinic.

Recent publications suggest that psychotherapy models generated in outpatient settings do not fully generalize to the training clinic. A possible explanation for these findings is that the nature in which change occurs during psychotherapy may actually differ according to setting. To examine this possibility, the phase model of psychotherapy was tested in an outpatient training clinic. Results partially support the phase model, suggesting that the nature of change during effective psychotherapy within the training clinic setting does not differ from that in other outpatient settings. That is, clients who completed effective courses of treatment in the training clinic environment generally experience an improvement in subjective well-being before evidencing a reduction in symptom distress. Obtaining success in role performances (i.e., work or school) appears to emerge last. Practitioners may enhance treatment outcomes by targeting interventions that are congruent with the phase of the individual client presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal pathways in psychotherapy integration.

This article traces the pathways that led the author to his current integrative perspective on psychotherapy. Such perspective is described as an attempt to cope with repeated confrontations with the complexity of human functioning, as revealed by the seductiveness of major intellectual traditions, the untamable nature of clinical reality, and the challenge of unexpected empirical findings. The article also outlines the author's current and future integrative efforts, both in terms of training and research. Recommendations for the future of the integration movement, as well as the Society for the Exploration of Psychotherapy Integrations, are also suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models of Psychotherapy Outcome: Are They Applicable in Training Clinics?

To explore whether psychotherapy models are applicable in the training clinic setting, the dose-effect model of psychotherapy outcome was tested in the outpatient clinic of an American Psychological Association-approved doctoral training program in clinical psychology. Outcome data, using the Outcome Questionnaire 45.2, were gathered immediately prior to each psychotherapy session during the course of treatment (mean total number of sessions: 14.81). Sixty-one clients, treated by 21 trainee clinicians, participated. Although a similar pattern emerged, response to treatment was not as rapid as the dose-effect model would predict. Ideas for future research are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Education for Research.

Notes that after reading about a third of the article "Education for Research in Psychology" (Amer. Psychologist, 1959, 14, 167-179; see record 1960-03707-001), I found myself playing a little game (an idiosyncrasy of mine to encourage the reading of psychological journals). Every time the article mentioned education for research, I substituted education for psychotherapy. Once seen in this way, it seemed to me that the implications for training graduate students in research are also quite applicable in training graduate students in psychotherapy or in counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Riposte.

This refers to comments by Bergin et al. (American Psychologist, 1964, Vol. 19:845-846) criticizing the author's study, "Education for Psychotherapy," (1962) in which they impugn the accuracy of the data and the methodology. They argue that since, in their opinion, the data about Teachers College are inaccurate, all of the data must therefore be inaccurate. The author's survey compared training in psychotherapy in academic and nonacademic programs and under medical and nonmedical auspices. All of the data were derived from material sent by the training facility itself. Bergin et al. do make one valid point, and that is that a more comprehensive (and now more up-to-date) survey is now indicated, with the purpose of improving the quality of nonmedical training in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of psychotherapy training and intervention use on session outcome.

Objective: This study was an investigation of the relationships among therapist training variables, psychotherapy process, and session outcome in a psychotherapy training clinic. The aims were to assess the relationship between “training as usual” and intervention use in individual psychotherapy, to investigate the relationship between therapist intervention use and session outcome, and to test whether training variables moderate this relationship. Method: Graduate student therapists (n = 19; mean age = 27 years; 79% women; 84% White) provided information about their training and completed a measure of intervention use (Multitheoretical List of Therapeutic Interventions; McCarthy & Barber, 2009) and clients (n = 42; mean age = 33 years; 64% women; 95% White) completed a measure of session outcome (Session Progress Scale; Kolden, 1991) after each session of individual psychotherapy. Results: With regard to intervention use and session outcome, no main effects were found for the training variables. Consequently, tests of moderation were not performed. The final model for intervention use and session outcome yielded main effects for time-varying interpersonal therapy and time-varying common factor use, and a 3-way interaction among time-varying cognitive–behavioral (CBT) intervention use, between-patient common factor use, and between-therapist common factor use. Patients who received more common factor interventions on average rated sessions as less helpful when more CBT interventions were employed; this finding was stronger for patients who were being treated by therapists with higher average levels of common factor use. Conclusions: Implications for training are discussed, with particular attention paid to the importance of clinical decision making and the complex interaction between common and unique technical factors in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Humanistic–existential psychotherapy competencies and the supervisory process.

There has been an increasing focus in recent years on articulating foundational and functional competencies for practice in professional psychology and how a competency-based approach might inform psychology training. With the aim of contributing to the dialogue in this area, the discussion herein explores psychotherapy competencies through the lens of a humanistic–existential perspective and describes implications for psychotherapy training and supervision. Specifically, competencies pertaining to facilitating the client’s experiential awareness and use of the psychotherapy relationship to engender client change are described. Next, the foundational and functional competencies within professional psychology that are particularly salient to a humanistic–existential psychotherapy framework are discussed. Finally, the ways in which a humanistic–existential supervision framework contributes to the development of psychotherapy competencies in trainees is considered. A brief vignette is presented to illustrate the supervision process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative psychotherapy: From Chile with love.

Psychotherapy today is facing a challenge of growing within a new framework. Outcomes are becoming critical and integrative psychotherapy should provide good results. Chilean experience--with integrative psychotherapy--is described. The Chilean approach involves a theoretical background (an integrative model) and a clinical branch (integrative psychotherapy). This article shows how Chilean experience looks healthy today, and why it is too soon to say victory has arrived. So, a new approach involves a new reading of the existing data, giving a new framework to these data and having a self-critical attitude in terms of the new developments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Right View of Your Patient: A Computer-Assisted, Individualized Module for Psychotherapy Training.

Because there is no uniform treatment, it is obvious that everything psychotherapists say and do depends on their view of a patient. The ability to develop a working model of patients' problems is generally not as good as desired. Even experienced therapists often have difficulty developing sufficiently complete and useful case conceptualizations. It is argued that this is partly due to traditional psychotherapy training models, which are considered insufficient. In accordance with research on expertise, the authors favor an individualized training procedure with concise and intensive feedback. A computer-supported approach makes such training affordable. An evaluation of the program completed by psychotherapy trainees shows good acceptance and a clear improvement in the ability to cover the relevant aspects of a case conceptualization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)