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)     

Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Internet and video technology in psychotherapy supervision and training.

The seven articles in this special section on the use of Internet and video technology represent the latest growth on one branch of the increasingly prolific and differentiated work in the technology of psychotherapy. In addition to the work presented here on video and the Internet applications to supervision and training, information technology is changing the field of psychotherapy through computer assisted therapies and virtual reality interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Advances in psychotherapy supervision: Introduction.

Psychologists tend to take psychotherapy supervision for granted. This is especially puzzling when they discover that 55% of academic clinicians spent between 10% and 29% of their time in supervision and another 7% claim to spend over 30% of their time so engaged. As recently as 10 years ago, few and scattered materials existed in the literature to guide the conscientious supervisor, but more materials have recently become available, including books, a journal devoted to supervision, and workshops offered at regional and national conventions. Given these developments, it is fitting that psychologists take stock of the field of psychotherapy supervision. Toward this end, several people who have worked in a particular area were asked to prepare either a review of the area or a seminal treatment of a topic in the area. The articles that follow are the result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The experience of shame in psychotherapy supervision.

Notes that shame is a complex and powerful experience that is difficult for therapists to address. The purpose of this article is to help therapists on both sides of the supervision dyad have a better understanding of shame and its defenses. In order to elucidate the inevitable shame that arises in supervision, this article first describes the nature of shame, beginning with its early manifestations in interpersonal relationships with primary caregivers. It also includes a short section on the adaptive nature of shame. Because individuals develop characteristic ways of coping with it, it is suggested that shame may be concealed from oneself and others through withdrawal, avoidance, attack on self, and attack on others. These characteristic reactions to shame are discussed in detail because they influence how shame is manifested. Four vignettes illustrate how each defensive reaction may be manifested in supervision, and suggestions for minimizing the adverse impact of shame are proffered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does psychotherapy training matter? Maybe not.

Four articles address aspects of psychotherapy training and the ways in which training can enhance psychotherapist development. In this article, the author reviews the suppositions and contentions made by these authors, identifies common themes, offers critical comment, and provides perspectives, albeit personally biased, on these articles. In addition, propositions regarding the effectiveness and ineffectiveness of psychotherapy training are offered as well as future directions in examining the adequacy of psychotherapy training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using client feedback in psychotherapy training: An analysis of its influence on supervision and counselor self-efficacy.

Tracking client outcome and the therapeutic relationship across treatment (i.e., client feedback) has become a recommended practice for clinicians. This study investigated whether the utility of this practice would extend to trainees if the data gained from clients was provided to their supervisor for use within supervision. Trainees (N = 28) were assigned to a continuous feedback condition or no-feedback condition for 1 academic year. Results indicated that trainees in both conditions demonstrated better client outcomes at the end of their practicum training than at the beginning, but those in the feedback condition improved more. However, those in the feedback condition did not rate the supervisory alliance or satisfaction with the supervision process differently. The relationship between counselor self-efficacy and outcome was stronger for trainees in the feedback condition than for those in the no-feedback condition, perhaps indicating that feedback may facilitate a more accurate assessment of one’s skills. Implications of how counseling self-efficacy, the supervisory alliance, and satisfaction with supervision are related to effective supervision are addressed. (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)     

The impact of psychotherapy supervision on client outcome: A critical examination of 2 decades of research.

The supervision of counselors-in-training has become an important area of psychotherapy research. Through supervision, one expects that trainees will gain the knowledge and clinical skills needed to work effectively with clients. Much research has been dedicated to understanding trainee skill development through supervision, but relatively few studies in the literature have addressed whether clinical supervision leads to improved client outcome. The current article presents a review of 2 decades of research into the question of whether clinical supervision improves client outcome. Ten studies conducted between 1981 and 1997 are reviewed in detail. Caveats and criticisms, as well as suggested directions for future research, are discussed. (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)     

A contextual behavioral approach to the role of emotion in psychotherapy supervision.

As behavior therapy expands to address problems related to private events, appropriate methods of supervision must be developed to train individuals to work with the full range of human experience, using a behavioral model. The authors suggest that therapists’ in-session emotions are an important source of information about the impact of clients’ behavior on others. Contextual behavior therapists may enhance their effectiveness in meeting clients’ needs by attending to the therapist’s own emotional responses. This paper provides a contextual behavioral rationale for including a focus on emotion in supervision, with a four-phase model for shaping early trainees’ ability to use their emotional reactions to facilitate therapy in a coherent manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The supervisory encounter: A guide for teachers of psychodynamic psychotherapy and psychoanalysis.

Review of book: The Supervisory Encounter: A Guide for Teachers of Psychodynamic Psychotherapy and Psychoanalysis by Daniel Jacobs, Paul David and Donald J. Meyer, New Haven, CT: Yale University Press, 1985, 285 pp. Reviewed by Alan Z. Skolnikoff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Big ideas for psychotherapy training.

Research indicates that traditional psychotherapy training practices are ineffective in durably improving the effectiveness of psychotherapists. In addition, the quantity and quality of psychotherapy training research has also been limited in several ways. Thus, based on extant scholarship and personal experience, we offer several suggestions for improving on this state of affairs. Specifically, we propose that future psychotherapy trainings focus on a few "big ideas," target psychotherapist meta-cognitive skills, and attend more closely to the organizational/treatment context in which the training takes place. In terms of future training research, we recommend that researchers include a wider range of intermediate outcomes in their studies, examine the nature of trainee skill development, and investigate the role that organizational/treatment culture plays in terms of the retention of changes elicited by psychotherapy training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of psychotherapy supervision.

Reviews the book, Handbook of psychotherapy supervision by C. Edward Watkins Jr. (see record 1997-08923-000). This book offers a forum for some of the most influential thinkers of our time to discuss what is probably the most critical aspect of learning how to become a therapist: clinical supervision. The book is well organized, comprehensive, and informative. In it, the elusive nature of teaching how to conduct psychotherapy is explored and clarified from a variety of perspectives and across myriad contexts. Overall, the book provides a wealth of information in an organized and readable fashion. Nonetheless, the topics explored include some areas that were not covered adequately. For example, the book would have been further enhanced had the subject of supervisory failures been given more attention, as we know that learning from past errors often provides the most valuable teaching opportunities. Despite a few minor criticisms, the book serves as a wonderful reference for practitioners, students, and teachers of psychotherapy. While extremely useful for the beginning supervisor, the book is also a valuable resource for seasoned supervisors who wish to expand or challenge their ways of thinking about supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating self-help into psychotherapy: 16 practical suggestions.

Psychologists routinely recommend self-help to their patients but desire guidance on the optimal methods and resources for doing so. This article provides 16 suggestions, culled from both the research literature and clinical experience, for integrating self-help into psychotherapy. Among the clinical recommendations are broadening the definition of self-help, assessing clients' self-help histories, offering tangible support in linking clients with self-help, tailoring the self-help resource to the person (not only the disorder), assisting clients with the administration of difficult self-help programs, using self-help during waiting and maintenance stages, and addressing clients' reservations about its use. Psychologists' top-rated self-help books, autobiographies, and films are presented. By their behavior, psychologists can enhance the effectiveness of self-help within the context of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mail-order training in psychotherapy.

Unaccredited schools purport to offer training in a variety of psychological and metapsychological methods of alleviating emotional problems and fostering self-realization. "Many of these schools offer correspondence courses and grant certificates, diplomas, and degrees, including doctor's degrees." Requested literature of 24 such institutions was analyzed. Degrees and diplomas offered are summarized in a table and include Doctor of Philosophy, of Psychology, of Metaphysics, of Science, and of Psychotherapy. "One school… grants a PhD after as little as 18-months study with no previous college education… . Corrective action has been made difficult because of the geographical scattering of the schools and the consequently minor problem that they represent to most individual states." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multicultural assessment supervision model to guide research and practice.

Multicultural assessment supervision is supervision of an assessment process in which the person assessed and the assessor are from different cultural backgrounds, the supervisor and the trainee are from different cultural backgrounds, or an instrument used in the assessment was developed with a cultural group different from that of the person assessed. A multicultural assessment competency model is presented to guide research and practice in multicultural assessment supervision. The model describes multicultural assessment competence areas, supervisor characteristics, supervision process variables, and supervision task areas important in the development of cultural competence in assessment practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hindering phenomena in group supervision: Implications for practice.

Although group supervision is practiced extensively, research on the subject remains scant. This study identified group supervision phenomena that hinder learning. Counseling and counseling psychology graduate students identified 61 group supervision experiences that they felt interfered with their learning. Then, 14 of the 49 original participants sorted the 61 phenomena on the basis of similarity. Hierarchical cluster analysis was used to identify 5 types of hindering phenomena: between-member problems, problems with supervisors, supervisee anxiety and other perceived negative affects, logistical constraints, and poor group time management. Implications for supervisors, supervisees, and training programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)