Training in experiential therapy.

Literature on training in the core facilitative conditions is reviewed to highlight issues that have emerged from this research tradition. A reconceptualization of the way in which empathic responding is conceptualized is called for, and suggestions are made about features that need to be addressed in empathy training. Four methods of training therapists (didactic, skill training, experiential, and personal growth) are examined, and a combination of these methods is proposed as the best means of training experiential therapists. Current developments in manualization and adherence measurement in experiential approaches are reviewed. The advantages of context-sensitive, process diagnostic manuals are discussed. These manuals specify not only what the therapist does but also when and in what sequence interventions are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A national survey of practicing psychologists' attitudes toward psychotherapy treatment manuals.

There has been considerable debate and little empirical data on the role of psychotherapy treatment manuals in clinical practice. Attitudes toward treatment manuals are a potentially important determinant of how likely practitioners are to use manual-based treatments in clinical practice. A total of 891 practicing psychologists nationwide were surveyed about their attitudes toward treatment manuals and their ideas about the content of manuals. Practitioners held widely varying attitudes toward treatment manuals, and ideas about what constitutes a manual were associated with attitudes in a predictable way. Recommendations are made for how to gather more useful information about practitioners' attitudes toward the many changes affecting current models of clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a Cognitive Adjunct Procedure Within a Microtraining Situation.

The present study examined the generalization effects of three methods of counselor training: cognitive-behavioral (CB), behavioral (B), and programmed learning (PL). Each of 45 low-scoring females, prescreened on empathic communication, was randomly assigned to one of these groups. The CB and B groups received training via manuals, videotapes, and individual supervision, whereas the PL group received programmed manuals only. The CB group was exposed to cognitive strategies in addition to the skill acquisition content of the B and PL groups. Each trainee completed an interview before, after, and 4 weeks after training. The effects of training on different communication skills were examined and assessed by interview, written, and self-report measures. Findings indicated that the CB group was more empathic at posttraining and demonstrated better communication skills than the PL group at follow-up. The B group generally fell in the intermediate position between the CB and PL groups. These findings are discussed in terms of different cognitive strategies and the benefits of programmed manuals within microtraining. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meditation, biofeedback, and the relaxation controversy: A cognitive-behavioral perspective.

Summarizes data from 2 clinical manuals by the present author (1985, in press) to illustrate that D. S. Holmes's (see PA, Vol 71:25288; see also 1985) conclusion that there is little evidence that meditation reduces somatic arousal and A. H. Roberts's (see record 1986-11198-001) questioning of the effectiveness of biofeedback in treating a variety of somatic conditions are based on outdated assumptions about the nature of relaxation and relaxation training. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of manual-based training on treatment fidelity and outcome: A review of the literature on adult individual psychotherapy.

The authors examine training issues related to the use of treatment manuals in psychotherapy outcome research. In particular, they examine methodological considerations such as the operationalization of manual-based training, trainer effects, therapist variables that mediate training, issues related to experimental design, and the choice and definition of appropriate dependent variables. The research literature indicates that manual-based training can produce technical adherence. Improvements in treatment competence were seen within, as opposed to across, cases. Researchers have been unable to draw strong links between treatment fidelity and patient outcomes. The review concludes that the limited focus on training studies in the manual-based treatment field compromises conclusions drawn from psychotherapy outcome research that relies on manuals to ensure a uniform delivery of the experimental variable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conjoint Consultation Using Self-Administered Manual and Videotape Parent-Teacher Training: Effects on Children's Behavioral Difficulties.

This research involved comparing the effectiveness of two different approaches of conjoint consultation using a manual versus a videotape series as the main components of joint training parents and teachers to treat children's behavioral difficulties. Children exhibiting externalizing or internalizing behavioral problems who attended Head Start Programs were targeted for this intervention. During the first 2 years of the project, a manual-based program was conducted. The last 3 years of the project involved delivery of the parent-teacher training program through a series of videotapes and accompanying manuals. Children were randomly assigned to either an experimental or no treatment control group. The effectiveness of the intervention within the experimental group was assessed primarily through a pretest-posttest, experimental-control, group repeated-measures design. Direct behavioral observations did not indicate clinically relevant improvements in behavior; however, parents' and teachers' goal attainment reports characterized students as meeting their overall behavior goals. Parents and teachers also reported high rates of treatment acceptability and satisfaction with the manual and videotape treatment programs... (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Behavioral bibliotherapy: A review of self-help behavior therapy manuals.

Reviews the current status of self-help behavioral treatment manuals. Organizing concepts and strategies for the development and evaluation of such programs are described. Programs that have been published or empirically tested for the treatment of phobias, smoking, obesity, sexual dysfunctions, assertiveness, child behavior problems, study skills, and physical fitness, as well as general instructional texts, are reviewed. It is concluded that the validation of available self-help behavior therapy manuals is extremely variable at the present time. It is suggested that future research evaluate manuals under conditions of intended usage, recruit clinically relevant Ss, employ follow-through and cost-effectiveness indices, include appropriate controls and follow-up assessments, and attempt to identify S or other clinical predictors of treatment outcome. The clinical and ethical issues raised by self-help programs are also briefly considered. (5 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics and perceptions of beginning doctoral students in school psychology.

A national sample of 251 1st- and 2nd-yr doctoral students in school psychology responded to a questionnaire measuring demographic characteristics, preferences among applied specialties in professional psychology, graduate program applications, anticipated internship setting, preferred client population, personal interests, professional goals, and satisfaction with current training. Survey responses showed a clear preference for working directly with children and adolescents following graduation, a high degree of correspondence between training program emphases and student interests and goals, and a moderate degree of student satisfaction with training experiences. Results are interpreted with respect to training trends and standards in school psychology, the relationship between school and clinical psychology, satisfaction of students in clinical and counseling psychology programs, and methodology limitations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of manual-guided training in the conduct and efficacy of interpersonal psychotherapy for depression.

This article reviews findings from manual-guided training programs in short-term interpersonal psychotherapy (IPT) for depression, an exploratory treatment that focuses on symptom reduction and improvement of social functioning. The literature revealed (a) that experienced, dynamically trained therapists were able to achieve a high level of competence in IPT after comparatively brief training and were able to maintain adherence to the manual over a lengthy study; (b) that general dimensions of the psychotherapy process, including therapist warmth and patient difficulty, were highly correlated with ratings of therapist competence in the performance of IPT; and (c) that therapists judged as performing IPT more competently tended to be more effective. Although definitive evidence on the effectiveness of manual-guided training is lacking, the use of manuals and systematic therapist training appear to be useful for the conduct of psychotherapy efficacy research. Findings showing that manual adherence is related to therapist efficacy suggest a role for these procedures in clinical training and competency determination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Demise of the 3rd-year internship: The changing role of the internship in graduate training.

Current training in PhD clinical psychology stems from the 1949 Boulder conference on graduate education in clinical psychology. Among the detailed recommendations made by that committee were specific guidelines and goals for a clinical internship that was deeply embedded within the graduate training experience. Since that time, the academic and practical training of PhD clinical psychologists has become increasingly separated, to the point at which the clinical internship year almost universally occurs after the completion of graduate training. In this article the development of the current-day internship and the probable factors involved in the demise of the original 3rd-year model are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Being bolder with the Boulder model: The challenge of education and training in empirically supported treatments.

A number of factors interfere with the realization of the scientist–practitioner model of training in applied psychology. Resistance to empirically supported treatments (ESTs) may arise from both academic faculty and internship supervisors who have an investment in approaches of longer standing but with less empirical justification. A possible problem with ESTs, however, is that they typically derive from studies that use treatment manuals, which, originally developed to define the independent variables in psychotherapy research, have become central in graduate training. Because manuals can constrain clinician behavior and because they are almost always associated with categorically defined diagnostic categories, one can lose sight of the idiographic analysis of single cases. Reliance on manualized treatment can discourage functional analysis of the complexities of individual cases. Achieving some synthesis of this dialectic poses a significant challenge to the continuing development of the science and profession of applied psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supervision: Its contributions to treatment efficacy.

The efficacy of supervision in training of psychotherapists is discussed in relation to (a) trainees' attitudes, beliefs, and skills, (b) trainee's performance in the therapist role, (c) interactional process events in supervision and psychotherapy, and, (d) client change. Although investigations to date suggest the potential of supervision for teaching advanced skills of psychotherapy, few studies exist that examine directly the relation of therapist performance and client change to supervision. There are virtually no studies that compare the efficacy of supervision to other training methods. If supervision is to remain an integral part of training, then standardized training manuals, analogous to those in psychotherapy, need to be developed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward evidence-based interventions for diverse populations: The San Francisco General Hospital prevention and treatment manuals.

Clinical trials have seldom included adequate samples of people of color. Therefore, practitioners serving ethnic minorities often do not have access to readily available evidence-based interventions. This article summarizes the development and empirical evaluation of prevention and treatment manuals designed for low-income ethnic minority populations at San Francisco General Hospital. The manuals were often designed by people of color familiar with the communities for which they were developed. Independent research teams in multi-site national and international clinical trials have evaluated many of these manuals with encouraging results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Historically grounding the practice of psychology: Implications for professional training.

The author explores 3 ways the history of psychology can be made relevant to professional training in clinical psychology. Focusing on the practitioner-scholar model of clinical professional training, he argues that 3 central facets of historical understanding can be wedded to existing goals of professional training: (a) providing an interdisciplinary context for psychology, (b) addressing concerns about humans in the field, and (c) mediating theory-practice tensions that often exist in professional training. Suggestions are also made for encouraging historical understanding as essential to fostering critical self-reflection among students preparing for careers in professional psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of clonidine on the pituitary hormonal response to pelvic surgery

In view of the fact that the sources of information (text-books, manuals, monographs) used in higher medical institutions lack a clear-cut system of directing the learning activities of those being thought, we have devised a variant of a manual that stipulates that a goal be defined, the content of pharmacotherapy of urgent states chosen, teaching material organized, a system of individual tasks set, results of learning controlled, auto-education and self-control exercised. The above type manuals are supposed to be a means of directing the activity aimed at learning to apprehend and must be a mainstay in the realization of the programme-deliberate management of quality of training a specialist.     

Introduction to the special series.

Provides an introduction to the special series on research in utilizing competency-based criteria for training psychotherapeutic skills. The introduction of manuals for practicing psychotherapy reactivates an old debate about the value of competency-based education for the mental health disciplines. In a general way, this special series approaches and explores this debate. The articles included are of two types: (a) those that address general issues of criteria-based training and (b) those that explore standards for training in specific approaches. Altogether, the articles cover a variety of therapeutic approaches, including most of those that are applied by contemporary mental health practitioners. Moreover, the articles address the problems of negative effects, common versus specific variables, and the roles of cognitive and experiential learning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a more clinically valid approach to therapy research.

Despite the advances in psychotherapy outcome research, findings are limited because they do not fully generalize to the way therapy is conducted in the real world. Research's clinical validity has been compromised by the medicalization of outcome research, use of random assignment of clients without regard to appropriateness of treatment, fixed number of therapy sessions, nature of the therapy manuals, and use of theoretically pure therapies. The field needs to foster a more productive collaboration between clinician and researcher; study theoretically integrated interventions; use process research findings to improve therapy manuals; make greater use of replicated clinical case studies; focus on less heterogeneous, dimensionalized clinical problems; and find a better way of disseminating research findings to the practicing clinician. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research and the supervisory process.

Reviews current research on the psychotherapy supervisory process that addresses the effects of supervision on therapist attitudes toward patients and various methods of training and acquiring specific intervention strategies. Emphasis is placed on the importance of relationship skills for psychotherapy outcome, and the methodological problems that are encountered in the study of the process of building these skills in the supervisory setting are noted. An important area for further research is the acquisition of intervention skills that lie outside the area of relationship enhancement. The continued growth in number of treatment manuals is mentioned as a positive current development in the training of experienced therapists and as a promising research tool for future psychotherapy outcome studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)