Clinical Psychology Trainees Research Articles

임상심리전문가 교육수련제도 개선을 위한 제언

Clinical psychologists in Korea have continuously grown and becoming as leading experts in the field of mental health over the past fifty years. The number of clinical psychologists along with members of the Korean Clinical Psychology Association have increased. More importantly, recent changes in mental health system require expanded and broadened expertise of clinical psychologists from traditional psychiatric hospitals or University Counseling Centers based work. Accordingly, training systems for clinical psychologists should accommodate the changes in mental health system and societal needs. The present article aimed to critically evaluate the current clinical psychology training system, and to propose ideas to improve the training system. First, we defined expert areas of clinical psychologists in Korea based on theoretical underpinning of clinical psychology. Second, we suggested ways to expand the scope and number of training institutions to modify the selection process of clinical psychology trainees, and to protect the rights and responsibility of trainees. Third, we discussed the changes in required activities during the training, including contents of psychological assessments and treatments. Fourth, we discussed diversification of training models from a traditional scientist-practitioner model to a practitioner-scholar model and a clinical scientist model. Fifth, we discussed the necessity of continuing education beyond the requirement of acquiring a license to maintain the expertise and be up-to-date. Finally, we highlighted the importance of integration of science and clinical practice in the training system, and discussed how the goals could be achieved during the training. We expect that this article may pave the direction of further discussions for advancing the clinical psychology training system.

Indirect exposure to client trauma and the impact on trainee clinical psychologists: Secondary traumatic stress or vicarious traumatization?

The study investigated the relationship between exposure to trauma work and well-being (general psychological distress, trauma symptoms, and disrupted beliefs) in trainee clinical psychologists. It also assessed the contribution of individual and situational factors to well-being. A Web-based survey was employed. The survey comprised the General Health Questionnaire, Secondary Traumatic Stress Scale, Trauma and Attachment Belief Scale, Trauma Screening Questionnaire, and specific questions about exposure to trauma work and other individual and situational factors. The link to the online survey was sent via email to trainee clinical psychologists attending courses throughout the UK RESULTS: Five hundred sixty-four trainee clinical psychologists participated. Most trainees had a caseload of one to two trauma cases in the previous 6months; the most common trauma being sexual abuse. Exposure to trauma work was not related to general psychological distress or disrupted beliefs but was a significant predictor of trauma symptoms. Situational factors contributed to the variance in trauma symptoms; level of stress of clinical work and quality of trauma training were significant predictors of trauma symptoms. Individual and situational factors were also found to be significant predictors of general psychological distress and disrupted beliefs. This study provides support for secondary traumatic stress but lacks evidence to support belief changes in vicarious traumatization or a relationship between exposure to trauma work and general psychological distress. The measurement and validity of vicarious traumatization is discussed along with clinical, theoretical implications, and suggestions for future research. Secondary traumatic stress is a potential risk for trainee clinical psychologists. Training courses should (a) focus on quality of trauma training as it may be protective; (b) advocate coping strategies to reduce stress of clinical work, as the level of stress of clinical work may contribute to trauma symptoms. Exposure to trauma work only uniquely explained a small proportion of variance in trauma symptoms. The study was cross-sectional in nature therefore cannot imply causality.

‘What a Lovely Baby’: Some Thoughts on Narcissism and Projective Identification Through the Lens of Infant Observation

Esther Bick introduced psychoanalytic infant observation courses at the Tavistock Clinic in London in 1948 as part of the training for child psychotherapists in order to facilitate clinical training. She thought that being able to observe infantile processes as they developed was a good grounding for psychoanalytic practice, and noted that it was helpful for mothers to have someone visiting who could admire and appreciate their baby. Since then, there has been considerable writing and some research about the value of infant observation to trainee psychotherapists (Sternberg, 2005), but relatively little has been written about the effect of being observed in this way. Watillon-Naveau (2008) wrote about the families she visited after they had been observed; Bekos (2006) did an MA study of three observed mothers. Both concluded that it was an important experience for the observed. This paper endeavours to understand more about what exactly can be perceived in the interrelated and intersubjective communication and feedback loops between the infant, their primary carers and the observer. The author argues for the theoretical possibility of healthy narcissism and for projective identification being a reactive process. The paper considers what learning from infant observation can offer psychoanalytic theory and what clinical implications could be drawn.

Learning in the crucible of supervision: Experiences of trainee psychotherapists in India

ABSTRACTTrainee perspectives about supervision were examined in the relatively unexplored landscape of psychotherapy training and development in India. Ninety-four trainee therapists drawn from eight centers completed a questionnaire, Development of Psychotherapists–Trainee Background and Process Forms, at the end of training. Results indicated significant relationships between supervision satisfaction and indices of stressful work involvement, experiences in therapy sessions with clients, and perceived professional development and growth among trainees. Qualitative analysis of narratives captured both the perceived benefits and inadequacies in their experience of supervision. The findings are discussed in the context of clinical and cultural realities in training frameworks in India.

The Effects of Expressive Arts on the Evoking of Automatic Thoughts during the Training at A Graduate Level of Personal and Professional Development of Cognitive-Behavioural Clinical Psychologists: A Qualitative Study

The Effects of Expressive Arts on the Evoking of Automatic Thoughts during the Training at A Graduate Level of Personal and Professional Development of Cognitive-Behavioural Clinical Psychologists: A Qualitative Study Rosangela Bertelli Abstract The clinical psychologist rooted in a cognitive-behavioural perspective of learning guides interventions on the principle that automatic thoughts have a controlling influence on emotions and behaviours and on the practice of accessing these thoughts and bringing them to the level of processing where they will be subjected to conscious analyses. Will expressive arts activities evoke automatic thoughts? Eleven graduate level cognitive-behavioural clinical psychologists in training described their unique subjective experiences with expressive arts activities during five sessions. Qualitative data collected from interpretations made by the participants themselves were subjected to triangulation and systematically converged in the way to confirm the theory that expressive arts do evoke automatic thoughts, lead to individual insights about personal problems and issues, and benefit the grasping of the theoretical concepts being trained. Full Text: PDF DOI: 10.15640/rah.v6n1a2

T21 - Harm Avoidance And Childhood Adversities In Patients With Obsessive-Compulsive Disorder And Unaffected First-Degree Relatives: Evidence For A Diathesis-Stress Model

Background Obsessive-compulsive disorder (OCD) is a severe psychiatric disorder, which aggregates in families. Its etiology is assumed to involve interactions between genetically determined vulnerability factors and critical environmental influences. In the present study, we aim to investigate how the personality trait harm avoidance and the experience of different childhood adversities contribute to the development of OCD. Methods One hundred and sixty-nine patients with OCD, 157 healthy comparison subjects and 57 unaffected first-degree relatives of OCD patients were examined by trained clinical psychologists using the Structured Clinical Interview for DSM-IV (SKID). Harm avoidance was assessed using the Temperament and Character Inventory (TCI) and the severity of childhood adversities was measured with the Childhood Adversity Questionnaire (CTQ). Associations with depressive and obsessive-compulsive symptoms were investigated using the Beck Depression Inventory-II (BDI-II) and the Obsessive-Compulsive Inventory-Revised (OCI-R). Results Both OCD patients and unaffected relatives showed elevated levels of harm avoidance compared to healthy volunteers. Furthermore, patients exhibited significantly higher scores than relatives. This linear pattern was observed throughout all subscales of harm avoidance, and remained stable after controlling for the severity of depressive and obsessive-compulsive symptoms. With regards to childhood adversities, OCD patients reported higher levels than unaffected relatives and healthy volunteers, specifically on the subscales emotional abuse, emotional neglect, and experience of inconsistencies. Discussion The present findings support the role of harm avoidance as a potential endophenotype of OCD, and provide further evidence for a diathesis-stress model. While patients with OCD and unaffected first-degree relatives share elevated levels of harm avoidance, a heightened severity of childhood adversity was only observed in patients. A predisposition to exaggerated anxiety responses may thus take different trajectories depending on adverse environmental influences during childhood. In future research, we aim to investigate the genetic and epigenetic mechanisms underlying these findings.

Two Ghazals

Jawid Mojaddedi is a professor of religion at Rutgers University. His area of research is early and medieval Sufism. He has published the first four volumes of Rumi’s magnum opus, The Masnavi, in the Oxford World’s Classics series, as well as a monograph on Rumi, Beyond Dogma (Oxford, 2012). Brad Gooch is a poet, novelist, and biographer whose most recent book is Rumi’s Secret: The Life of the Sufi Poet of Love. His previous books include the memoir Smash Cut and the biographies Flannery and City Poet. He is the recipient of Guggenheim and NEH fellowships and lives in New York City. Maryam Mortaz is an Iranian American writer and translator. Her work has been published in such journals as Bomb, New Review of Literature, and Callaloo. She is a trained psychotherapist in New York City. WORLDLIT.ORG 59 accurate and correct than to face Mecca as religious convention dictates. For present purposes, what is important is that his message is not that spiritual disciples can be individualistic and need not bother too much about proper actions, as SBNR adherents seem to prefer. Instead, to follow a spiritual master is actually more challenging than conventional religious practice because the latter is a matter of following rules accepted by the general population, while the former has a greater price to pay—it may appear shocking to others and will be understood only by a few. It also shows total surrender to the inner perception of the “scent” of the spiritual path. There is a lot of correspondence between the teachings of Rumi and the increasing Spiritual But Not Religious trend; the popularity of both are undoubtedly related. However, there is a huge difference between prioritizing the feeling of peace through individualistic practice and developing spirituality under the training of a master, even though neither need be religious in the conventional sense. Rutgers University Two Ghazals by Rumi The sky has never seen such a moon” The sky has never seen such a moon, not even in its dreams, No water could ever extinguish the fire of its light, Look at my body, and look at my soul From his cup of love, my soul is drunk, my body ruined The tavern keeper became my heart’s companion Love turned my blood into wine, and burned my heart As my eyes fill with the image of his face, a voice resounds, “Well done, cup. Excellent, wine.” Looking into the ocean of love My heart suddenly dove in, calling, “Find me!” The face of the sun is Shams, the glory of Tabriz, Our hearts, like clouds, trail after him. If there’s no trace of love” If there’s no trace of love in his heart Cover him like an angry cloud over the moon Dry tree, don’t grow in that garden, Poor thing, left without the shade of a tree Even if you’re a pearl, don’t separate from this love, Love is your father and your family In the world of lovers, a deadly sickness strikes Each day more painful than the last If you see the blush of love in someone’s face Know that he is no longer merely mortal If you see a reed-flute, bent by love, grab it Squeeze the reed until you taste the sweetest sugar Shams of Tabriz lures you into his trap Don’t look left or right, you can’t resist. Translations from the Persian By Brad Gooch & Maryam Mortaz “ “ ...

Corrective Experiences of Psychotherapists in Training.

Although the concept of corrective experiences (CEs) is usually linked to the process of change in psychotherapy patients, we investigated them in the professional development of therapists-in-training. Inasmuch as psychotherapy is a relational process, it is important to look closely at how therapists reach the position of a competent partner in corrective experiencing. In this study, we interviewed 10 therapists-in-training undergoing their own training therapy. Responses to these semistructured interviews were analyzed using a computer-assisted grounded theory method. The 499 first-level categories were grouped into 5 main themes: therapist characteristics, therapist technical interventions, therapist relational interventions, relationship experience, and outcome experience. Two core categories representing corrective experiencing were (a) unexpected unconditional support from and trust in their own therapist and (b) unexpected confrontation and limitation with their therapist as well as awareness of self-other boundaries. Results are discussed in the broader context of the CE literature, relational theory, and relational practice.

Clinical psychology trainees should routinely obtain service user feedback as part of their clinical experience and assessment during training: Why and how?

This study aimed to provide evidence based recommendations to the course team at the University of Birmingham on how to formally obtain and incorporate service user feedback (SUF) into trainee Clinical psychologists placement assessment and clinical experience. Focus groups were held separately with four stakeholders. This included the course team, adult mental health services users, supervisors and trainees. Interestingly, trainees, service users and the course team thought SUF for trainees is for the assessment and development of trainees than it also being useful for the service user and therapy. Supervisors thought SUF for trainees is no different to SUF used as part of routine clinical practice and is, additionally, being used in the assessment of trainees. Many of the stakeholder choices and concerns were influenced by their understanding of SUF for trainees. The results were discussed in a working group of representatives from each stakeholder group and recommendations were made.

‘You’ve hired a psychologist with autism?!’: Reflections on being a trainee clinical psychologist with autism

Early in my career I found many professionals were surprised, sceptical, and even apprehensive about me working in clinical psychology. My autism presents unique strengths and weaknesses in the practice of clinical psychology. This different balance of abilities is evaluated in respect to the role of a clinical psychologist, with reflections from supervisors on the effect autism has on my work.

‘The Remembering Group’: Facilitating a cognitive stimulation group in an inpatient health and rehabilitation setting

A trainee clinical psychologist and two occupational therapists reflect on the experience of adapting a cognitive stimulation therapy group for an inpatient health and rehabilitation setting. The adaptations, benefits and challenges of implementing the group are discussed.

A trans-theoretical training designed to promote understanding and management of countertransference for trainee therapists

Objective: There is evidence that awareness of countertransference (CT) in combination with a conceptualization of CT facilitates its management. This study examines the impact of a trans-theoretical training designed to make the construct of CT accessible to trainee therapists in programs oriented towards cognitive-behavioral therapy. The training aimed to enhance trainees’ awareness, understanding, and management of CT. Method: Academics at five New Zealand universities introduced the training into their curriculum. Five academics and 54 clinical psychology trainees evaluated it, responding to open-ended questions on the impact of the training on awareness, understanding, and management of CT. They also rated the training’s effectiveness. Results: The majority of trainees reported increased awareness and conceptualization of CT. They rated the training as useful for professional practice and reported increased commitment to monitoring CT. Academics also observed trainees’ increased awareness and understanding of CT and openness to discussing it. Trainees and academics were less confident in trainees’ abilities to manage CT in clinical practice, although trainees reported gains in this area. Conclusions: The training appeared to enhance awareness and conceptualization of CT, processes that support its management. However, future research into training models needs to examine the impact on CT management in clinical practice.

Comparisons between the attitudes of student nurses and other health and social care students toward illicit drug use: An attitudinal survey

In the context of a recent emphasis on compassion in the delivery of health care, the current study set out to measure the attitudes of different groups of health and social care students toward illicit drug users. Previous research has identified variations in the attitudes of different groups of health and social care professionals toward working with illicit drug users. Nurses, in particular, have been reported as holding moralistic or stereotypical views of illicit drug users. However, few studies have measured the attitudes of student nurses or compared their attitudes to other health and social care students. This article describes the use of a bespoke attitude scale to measure the attitudes of cohorts of student nurses, clinical psychology trainees, health and social care, social work and midwifery students at the start of their course (N=308). Results indicated that student nurses had the least tolerant attitudes, reinforcing the need for a specific educational focus on working with illicit drug users in nurse education. Variations between student groups indicate that Interprofessional Education can provide an opportunity to improve attitudes toward illicit drug users, particularly amongst student nurses.

The feasibility and acceptability of short-term, individual existential behavioural therapy for informal caregivers of patients recruited in a specialist palliative care unit.

BackgroundExistential behavioural therapy (EBT) is a recently developed intervention to support informal caregivers of patients in a specialist palliative care unit and was initially established as a six-session group programme. This pilot study aimed to test the feasibility and acceptability of an adapted short-term, individual approach of EBT in preparation for a randomized controlled trial (RCT).MethodsThe study was conducted in a prospective, mixed methods design including four quantitiative assessments with embedded qualitative interviews at one assessment.The intervention offered two one-hour therapeutic sessions focusing on (1) mindfulness and (2) existential meaning-in-life as a source of strength provided by a trained psychotherapist. To test the feasibility of the intervention, doubling of the participation rate, compared to the previous group study (13,6 %) as well as an attrition rate of less than 30 % were set as thresholds. To test the acceptability of the intervention, self-rated usefulness of individual aspects of the intervention and the frequency of implementing therapeutic elements by the carers were set as criteria. Acceptability testing also included the number of participants who completed both sessions, where we expected more than 75 % as a criterion for acceptability. Return rates of quantitative questionnaires were set as criteria for the feasibility of data collection (<33 % loss expected within the study period). Qualitative interviews were used to collect additional data on feasibililty and acceptability and to explore potential harms and benefits of the intervention.Results44/102 (43,1 %) of eligible informal caregivers agreed to participate in the study. Due to attrition of 13 caregivers (attrition rate: 29,5 %), 31 caregivers were included in the trial. Self-rated usefulness showed sufficiant results for all but one individual aspect. Frequency of implementing therapeutic elements showed wide inter-item as well as inter-participant ranges and decreased over the study period. All participants completed both sessions. Return rates of the questionnaires were within the expected range. According to the interviews, the intervention was associated with several participant-identified benefits. No severe adverse effects were observed.ConclusionsFindings suggest that the short-term, individual EBT proved feasible and mostly acceptable.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0160-1) contains supplementary material, which is available to authorized users.

Using the Repertory Grid Technique to Examine Trainee Clinical Psychologists' Construal of Their Personal and Professional Development.

Clinical psychology trainees experience training as demanding and stressful, which negatively impacts on their personal and professional self-image and self-esteem. However, they are optimistic that they will become more like their ideal self in the future. Stress in clinical training (and beyond) is normative, and thus, personal development and self-care should be recognized as clinical psychologist's core competencies.

Trainee clinical psychologists’ perceptions of unpaid assistant psychologist positions

This study explored trainee clinical psychologists’ experiences of unpaid assistant psychologist posts. Five semi-structured interviews were conducted with trainees and analysed using thematic analysis. Contrary to current debates, trainees described how well-supervised unpaid posts can benefit both post holders and services.

Creating ripples: Towards practice-based evidence for narrative therapy within NHS contexts

This article describes the experiences of three trainee clinical psychologists who each introduced a narrative therapy approach in their workplace. Reflections from a clinical tutor who supported this work are also provided.

Developing a Compassionate Internal Supervisor: Compassion-Focused Therapy for Trainee Therapists.

Compassion-focused therapy, and related compassionate-mind imagery exercises, can be adapted specifically to develop compassion in trainee psychotherapists. Creating, and engaging with, an 'ideal compassionate supervisor' in an imaginal form can support psychotherapy trainees in their clinical practice and development, their supervision and their personal lives. The cultivation of therapist self-compassion can reduce unhelpful cognitive processes such as worry, rumination and self-criticism whilst increasing self-reflection, attentional flexibility and approach behaviour. Identifying, and working with, blocks to compassion is important when cultivating clinician self-compassion Therapist self-practice of compassion-focused exercises can provide important insights into the nature of compassion and its cultivation in clients.

Concentric Circles Therapy Training: Clinical Psychology Trainee's Reflections on Participation in a Revised Interpersonal Therapy Training Group

ObjectiveThe Concentric Circles Therapy Training (CCTT) approach is a revised version of a previously developed interpersonal therapy training approach that primarily aims to develop therapist's awareness of interpersonal process. The CCTT approach enables students to take part in an interpersonal therapy training group both as a participant and as an observer. The aim of the study was to obtain in‐depth accounts of the experience of this revised approach to interpersonal therapy training.MethodsSeven Clinical Psychology post‐graduate students took part in the study, with each participant providing 6 weeks of in‐depth personal reflective journals regarding their psychotherapy training experience. Thematic analysis was used to determine the predominant themes.ResultsThree main themes emerged in the data: personal reflections, interpersonal reflections, and integration. Overall, participants indicated that being able to be both a participant and an observer was a unique and powerful learning experience, and all participants indicated that participation in the concentric circles training was an important part of their training to become psychotherapists.ConclusionThe CCTT approach was developed to provide a practical solution to enable interpersonal therapy training in clinical psychology courses where class sizes continue to increase.

Facilitating an evolving service user involvement group for people with dementia: what can we learn?

Purpose– The purpose of this paper is to demonstrate how service user involvement for people living with a diagnosis of dementia can contribute to innovate ways of training and educating a skilled healthcare workforce.Design/methodology/approach– The paper uses a case study approach, including interviews observations and reflections from facilitators and members of a service user group for people living with dementia in a recovery-based older adult service in East Kent, UK. In total, 11 people were involved in this study: five people are living with a diagnosis of dementia, two are clinical psychologists, two are trainee clinical psychologists and two are placement year psychology undergraduates.Findings– The paper shows how service user involvement groups can enable people with dementia to train a wide range of healthcare professionals in different areas, from the perspective of people living with dementia and healthcare professionals. It also reflects on the challenges that can arise through working with patients in a more collegiate way.Originality/value– This paper demonstrates that people with dementia can be involved in the training of healthcare professionals in innovative ways. It therefore suggests new ways of working with people with dementia to develop staff skills.