Therapist Students Research Articles

The Role of Theory and Research in the Practice of Cognitive-Behavioral Couple Therapy: If You Build It, They Will Come

Cognitive-behavioral couple therapy (CBCT), while empirically validated and highly efficacious, does not always have positive results for couples. One factor that may limit the efficacy of this intervention is the way in which therapists are trained to provide this type of therapy. More specifically, there is a need for therapists to gain a solid foundation in CBCT theory in order to maximize treatment results. This paper presents an argument for why an understanding of theory is necessary for therapists in treating couples. Then, this paper presents our training model and how we integrate theory into our training of both graduate student therapists and more experienced clinicians. We take the stance that “if you build it, they will come.”

A Survey of Music Therapy Students' Practica Experiences in Hospice and Palliative Care Settings

When students begin a new clinical placement, they often take time to become familiar with the skills, repertoire, and interventions necessary to implement effective music therapy in that particular setting. Sometimes there is very little information on what to expect or what to do as a music therapy student and there is not a music therapist or an opportunity to shadow a music therapist before working with a specific population for the first time. Some practica are structured in a similar way as internships in which students move from observing to co-leading and finally to leading sessions. Other universities have students leading indepen- dently from the first session onward. Beginning a practica with no information or experience could potentially set a student up for failure or a negative experience.At times students tend to dislike or avoid clinical populations with whom they are not familiar and which require them to think outside of their comfort zone. This is might occur in emotional and intense settings, such as hospice and palliative care (HPC). Working in HPC settings can involve aspects of music therapy, such as counseling and working with grieving families, that students are not comfort- able facilitating. Furthermore, the possibility of having a patient actively die can be a stressful and frightening experience for students who are not emotionally prepared.The primary researcher of this study was a student music therapist preparing for practicum in a HPC setting. During the preparation process, she found little to no information on what songs were useful to know or what to expect during session. This made it difficult for her to prepare adequately as she had for previous practica in other settings. Thus, she participated in many informal conversations with her professor, as well as other student music therapists, regarding what information students might want or need before beginning a HPC practicum. This dilemma sparked the questions on both surveys in this research study. Other questions were pulled from previous studies on students' responses regarding their clinical work (Grant & McCarty, 1990; McClain, 1993; Wheeler, 2002).The purpose of this study was to provide further information on student music therapists' views on the dying process and professional neutrality, two central yet complex issues in HPC. Also of importance was how student music therapists prepared for their HPC clinical placement, experiences they had in this setting, and other insights that might benefit student music therapists. Researchers wanted to provide information and data for both students and their clinical supervisors on working in a HPC setting.Literature ReviewHospice facilities in the United States have grown substantially in the last 20 years. In 2007, hospice services, both in-patient and home care, provided medical care to 1,400,000 patients. This is 56 times the number of patients served in 1982 when the hospice movement began (National Hospice & Palliative Care Organization [NHPCO], 2009). As the need for hospice facilities increased, so did the need for music therapists (Krout, 2000). Researchers have previously indicated that patients and their families can benefit from music therapy (Gilbert, 1977; Hilliard, 2001, 2005; West, 1994). Music therapists not only provided patients distractions from pain, anxiety, and physical discomfort, they also used music to give patients and families a medium to express emotions, reminisce about previous life events, and find closure (Gilbert, 1977; Hilliard, 2001; West, 1994).The multidimensional needs of the hospice patient brought up the question of whether student music therapists and interns in this particular setting needed to learn additional skills and competencies besides those identified by the American Music Therapy Association (AMTA) (AMTA, 2008; Krout, 2000). Music therapists must adapt interventions for patients' changing emotional, spiritual, physical, and medical needs as well as work around interdisciplinary teams' schedules (Krout, 2004; Mandel, 1993). …

Early Dropout in Men Voluntarily Undergoing Treatment for Intimate Partner Violence in Norway

This study investigated psychotherapy dropout rates and predictors of dropping out of therapy early. We enrolled 1,166 men voluntarily admitted to psychotherapy for violent behavior against a female partner. In total, 315 (23.8%) subjects dropped out of therapy within the first 3 sessions. Dropouts were significantly younger, more likely to have a non-Norwegian ethnic background, less likely to have received previous mental health care, and were more likely to have been treated by a student therapist. Among those treated by a student therapist, unemployment was strongly associated with early dropout. Unadjusted and adjusted results were similar. Clients and therapists may benefit by matching unemployed men with experienced therapists. Finally, the high dropout rates among ethnically non-Norwegian clients points to a need for special treatment approaches for this subgroup.

Acts of Remembering: Relationship in Feminist Therapy

This article is an act of remembering. In the first part of this article, the author remembers and reflects upon her own journey of being and becoming a feminist, healer and clinical psychologist in training. She then shares some of the most meaningful lessons on 1) the therapeutic alliance, 2) transference and countertransference, 3) the nature of change, and 4) cultural competence that she has learned from her sister of the heart relationship with the brilliant spirit and work of Black lesbian, feminist, warrior poet, and activist, Audre Lorde. In each of these lessons the author reflects on her efforts to translate her conceptual or applied practice as a feminist student therapist. It is her hope to invite exploration of new bridges and paths by which other feminist psychologists may connect more deeply and meaningfully to our work both professionally and personally. The author closes with some reflections on the path ahead for feminist psychology.

Training student therapists in prolonged exposure therapy: A case study demonstrating teaching, supervising, and learning a trauma focused treatment.

Few studies describe the training of student therapists in prolonged exposure (PE), an evidence-based psychotherapeutic approach to the treatment of trauma. Using a case study, this article describes training and supervision of a master-level graduate student in the implementation of PE with a research participant who had depression and posttraumatic stress disorder (PTSD) due to traumatic stress exposure. The participant's symptom severity of depression and PTSD decreased from pretreatment to posttreatment, and symptom gains were maintained at the 3-month follow-up assessment. Implications for the training and supervision of students in the mental health professions are discussed. Language: en

Development and Validation of Tools for Evaluation of Orthosis Fabrication

This study is the first phase of research aimed at developing new educational approaches to enhance occupational therapy students' orthosis fabrication skills. Before the effectiveness of training can be determined, a method for evaluating performance must be established. Using the Delphi method, we developed a global rating scale and checklist for evaluating technical competence when fabricating metacarpophalangeal (MCP) joint-stabilizing orthoses. To determine the reliability and validity of these tools, three evaluators used them to assess and score orthotic fabrication performance by experienced and student occupational therapists. The results suggest that these measurement tools are valid and reliable indicators of the technical skills involved in fabricating an MCP joint-stabilizing orthosis. Future studies should focus on building on these tools to evaluate communication skills, technical skills for making other types of orthoses, and effectiveness of training programs.

Confronting helplessness: A study of the acquisition of dynamic psychotherapeutic competence by psychology students

The helplessness student therapists initially feel while conducting their first dynamic psychotherapy is the main focus of a longitudinal study at the University of Oslo. The study involves 23 student therapists, the supervisors of the initial 21 student therapists and 23 patients. The analysis is based on triangulation of data from research interviews with student therapists, their supervisors and their patients, a completed Development of Psychotherapists Common Core questionnaire, and two evaluation essays with competence assessments for each student therapist. A qualitative research interview informed by psychoanalysis was developed in order to make it possible to collect data beyond the subjective reports of the student therapists. Data analysis of the supervision cases revealed substantial supervisor neglect of the inner drama experienced by the student therapists during the process. A pattern of salient supervision dynamics in the material is presented and implications for practice are introduced. A new method to evaluate dynamic psychotherapeutic competence is suggested and “strategic thinking” is introduced as a new competence concept. More than half the student therapists did not demonstrate their capacity for such strategic thinking.

Simulating disabilities as a tool for altering individual perceptions of working with children with special needs

The purpose of this study was to examine the impact of disability simulations on the attitudes of individuals who will be working with children with special needs in music settings and to compare these attitudes between student music therapists and pre-service music educators. Each participant completed a questionnaire on the first day of class and again after participating in a disability simulation approximately two weeks later. The disabilities simulated included an individual with a one-arm amputation, an individual requiring mobility in a wheelchair due to paralysis, an individual with a hearing impairment, and an individual with a visual impairment. Results indicated that participants had more positive attitudes after experiencing the simulation although there was no difference between majors (music therapy or music education). Results also indicated that attitudes showed a greater shift when statements on the questionnaire were stated negatively rather than positively. Limitations and implications for future studies were discussed.

The Role of Music Therapy for Anxious Adolescent School Refusers: The Importance of Identity

The specific role of music therapy for anxious adolescent school refusers is considered with particular emphasis upon identity and the self. Literature is examined covering areas of education theory, school refusal, psychoanalytically informed thinking, and music therapy. Two case studies with adolescents receiving music therapy at a large general hospital are discussed, and these illustrate new ways of thinking about music therapy and school refusal. The parallel processes between the student music therapist and her adolescent clients are discussed. Concepts of identity and paradox are explored, concluding that these multi-layered paradoxes can be experienced musically. They often manifest as a constantly changing balance between moments of chaos and calm, risk and safety, exploration and retreat. The case studies describe in-depth work where resistance and anxiety are addressed within the musical improvisations between therapist and adolescents in individual therapy. The authors point to the gap in knowledge in this specific field, and build on previous work, linking theoretical thinking to casework.

Disclosure or non-disclosure?

Contemporary supervision discussions often imply that non-disclosure may hinder the learning process of a supervisee. However, is disclosure always a benefit? What are the consequences of non-disclosure—or disclosure—for a student therapist's training? These questions are discussed through an in-depth analysis of longitudinal data from a single-case study of a student therapist conducting his first psychodynamic therapy. The perspectives of the student therapist, the supervisor, the patient and the research interviewer, are included as data, as well as an independent competence evaluation. The student therapist's non-disclosure of negative feelings towards the supervisor—and the supervisor's neglect of the student's inner drama—did not seem to affect his learning process, which progressed in a very constructive manner. Perhaps remaining silent was an expression of self-respect? With regards to the supervisor, it is assumed that recognition and acceptance of the student therapist's anxiety could have diminished the unfolding inner drama.

Lighting the Way: How Journeying with David, an Adult with a Learning Disability and Mental Health Problems, Helped a Student Music Therapist Make Sense of the Connections between Theory and Practice

This essay describes the journey of a student music therapist working with David, an adult with a learning disability and mental health problems. Through thinking about this work I present an overview of changes in my approach and understanding of learning disability. This is followed by a discussion about mental health, the complexity of diagnosis, and the prevalence of mental ill-health in people with learning disabilities. I consider Sinason's theory of Secondary handicap and link this with (omit Carol) Robbins and Robbin's notion of ‘the condition child’, and via the clinical work with David I think about how music therapy might help reveal a ‘music child’.

To Google or not to Google: Graduate students' use of the Internet to access personal information about clients.

The emergence of Internet search and social media sites now permits therapists to obtain a plethora of personal information about their clients online. These behaviors raise a number of ethical issues related to client privacy, self-determination, and informed consent. The purpose of this study is to examine student therapists’ opinions and behaviors in regard to the use these websites to search for information about their clients. A national sample of 854 psychology doctoral students was surveyed in regard to their online activities, attitudes, and frequency of searching for client information online. Results showed that Internet usage is pervasive in this group, with the majority reporting daily use of search engine or social networking sites. Most participants reported that searching for information about clients online using search engines (66.9%) or social networking websites (76.8%) was “always” or “usually” unacceptable. Nevertheless, 97.8% of participants reported searching for at least one client’s information using search engines in the past year; 94.4% reported searching for client information on social networking websites. Overall, student therapists reported searching for 16.5% of clients seen in the past year, using either search engine or social networking sites. The ethical and training implications of these results are discussed.

The Effects of Cognitive Behavior Therapy Delivered by Students in a Psychologist Training Program: An Effectiveness Study

Relatively little is known about the efficacy of clinically inexperienced student therapists carrying out cognitive behavior therapy (CBT) under supervision during a professional, psychologist training program. The current study evaluated this by collecting pre- and posttreatment data on 591 consecutive patients receiving treatment at the Psychotherapy Clinic of the Department of Psychology, Stockholm University, Sweden, over an 8-year period. The patients had mainly anxiety disorders or depression with a mean duration of 15years, and received individual CBT for a mean of 18 sessions. They improved significantly on both general measures (Beck Anxiety Inventory [BAI], Beck Depression Inventory [BDI], and Quality of Life Inventory [QOLI]) and disorder-specific self-report scales. The proportions of recovered patients on the BAI (63%) and the BDI (60%) were higher than those of a comparison effectiveness study. On the specific self-report scales the current sample improved as much as the samples in extant efficacy trials. We conclude that clinically inexperienced student therapists who receive supervision from experienced supervisors can achieve treatment effects that are on a par with those of experienced licensed psychotherapists.

Music Therapy and the Symphony: A University-Community Collaborative Project in Palliative Care

This article outlines a unique collaborative project designed to increase palliative care patient access to music therapy services by tapping into multiple university-community resources—resources of an undergraduate university music therapy program, of a professional symphony orchestra, and of funding available for university-community partnerships. Music therapy interventions were provided to palliative care patients within single sessions by 2-person music therapy teams (each comprised of one student music therapist and one symphony orchestra musician). Student music therapists served as team leaders and symphony musicians served as co-facilitators. The project was evaluated over a 3-year period in terms of student music therapy intervention effec- tiveness on the pain relief, relaxation, positive mood, and quality of life of 371 adult palliative care patients. Results indicated that there was a significant difference at the P < .0001 level in the pretest/posttest measures on all 4 variables. Study limitations and directions for future research are identified. Keywords complementary therapies, mood, music therapy, palliative care, pain, quality of life, relaxation, symphony orchestra

Comparison of Personal Formaldehyde Levels in Anatomy Laboratories of 5 Physical Therapist Education Programs

Background and Purpose.The current trend in anatomy education requires medical students to spend fewer hours with human donors, while physical therapist (PT) students are spending an increasing amount of time working in the human anatomy laboratory. Nearly all PT education programs in the United Sta

Many Faces of Simulation: Physical Therapist, Nursing, and Theater Student Collaboration

Many Faces of Simulation: Physical Therapist, Nursing, and Theater Student Collaboration

Exposure and Response Prevention for the Treatment of Late-Onset Obsessive-Compulsive Disorder in an 82-Year-Old Man

This case study demonstrates an effective course of exposure/response prevention (EX/RP) in an 82-year-old man with late-onset obsessive-compulsive disorder (OCD) with no apparent neurobiological changes. The results indicated significant reductions in time spent on rituals, anxiety associated with obsessions, and depression. Treatment gains were maintained and continued to progress through appropriate aftercare. In this case, a graduate student therapist learned and applied EX/RP after engaging in a training process. Results highlight the importance of life stressors in the development of OCD and that EX/RP can be applied to older adults with certain modifications. The results are promising for the implementation of EX/RP in older adults with OCD; however, future randomized controlled trials are needed.

State the Obvious

Before I begin my remarks to you this evening (Figure), I would like to take a just a moment to recognize and thank a very special group of first-time conference attendees … my family! Figure. R. Scott Ward, PT, PhD, APTA President. My wife, Diane, who is an accomplished scientist and an amazing life partner and mother, and my 3 remarkable daughters—Kristin, Sarah, and Mary—are truly the wind beneath my wings. It is their flexibility and gracious spirits that free me to serve and enable me to be effective on your behalf. I am grateful for them and so pleased they could be here in Boston with me for conference this year. Now, I invite you to take a short trip down memory lane with me to a time when I was a student physical therapist volunteering for a week at Muscular Dystrophy Association summer camp. It was a great experience to live with and assist a few young men with Duchenne muscular dystrophy for a week. I captured a glimpse of the effort and struggles associated with being a care provider for wonderful people with extraordinary needs. This perspective helped influence the way I looked at the material learned during my schooling. It was a perspective that was not obvious to me before that experience. I was allowed to attend daily medical clinics with the physical therapist, the neurologist, and the nurse. This firsthand experience with a medical team anchored my understanding that information and idea sharing are essential to maximize consumer care. The physical therapist allowed me to participate in his examinations, and we discussed treatment plans and goals. During one clinic, he asked me to express my conclusions from a gait assessment we had just completed, and I told him I was reluctant to do that because I …

A Widened Scope on Therapist Development: Designing a Research Interview Informed by Psychoanalysis

This article presents a qualitative research interview method informed by psychoanalysis, which can collect data beyond the subjective report of the participants. The method has been used to study acquisition of psychodynamic understanding and therapy technique among student therapists in psychology. Within the psychodynamic tradition, the subjective report of every person is viewed as potentially distorted by defense processes. Moreover, relational patterns in an interaction are viewed as significant data about the intrapsychic object relations of a person provided that the person is placed in a projective situation. Since common qualitative interview methods focus primarily on verbal data, such psychodynamic assumptions represent a methodological challenge. To collect a wider scope of data than merely the subjective report, a research interview has been developed based on a certain degree of projection, a psychoanalytic listening perspective, and the use of emotional expression in the interview relation as data. Subsequently, relational scenarios and incidences of defense processes in the research participants are inferred.

A Study on Understanding of Physical Therapist and Physical Therapy Students in FTA and Its Related Factors

A Study on Understanding of Physical Therapist and Physical Therapy Students in FTA and Its Related Factors