Commentary on Tracking and Revisiting the Evolving Perspective of an Intern

Abstract

The paper reminds me of the dilemmas students face when they write their clinical qualifying exams in our doctoral program. In these papers, students have to demonstrate both their clinical competencies and their dexterities with theories of change by juxtaposing a personal theory of change with the events of one of their therapy cases. In this benchmarking exercise, they need to show that they have expertise in both practicing therapy and describing/explaining/interpreting their own therapeutic practice. In other words, the students need to demonstrate that they have reached a certain level of reflective practice which must be assessed in the quality of both their walk and their talk and the coherent relationship between the two. For students, problems arise in three different forms. In form one, students have wonderfully articulate theories of change but no case material with which to connect and to illustrate their personal change theories and models of therapy. These students have the talk, but they have not mastered their walk. In form two, students have wonderful sets of clinical moments that exemplify clinical artistry, but they do not have sound ways of connecting these clinical events with a coherent theory of change. In contrast to the students of form one, these students have mastered the walk, but they have not found their talk. In these first two forms, the challenge is to bring the walk and the talk into a more harmonious relationship. What also makes this process especially difficult is that theories of change have a tendency to change too, but these papers come with an expectation of stabilizing change in order to commit thoughts and actions to words. In form three, there may not be a disconnect between students’ talk and walk, but problems arise when students’ papers are read by faculty committees that are clearly divided by allegiances to contrasting and possibly conflicting schools of Journal of Systemic Therapies, Vol. 23, No. 3, 2004