Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T12:49:00.431Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive Therapy Trainees’ Self-Reflections on their Professional Learning

Published online by Cambridge University Press:  20 November 2009

Päivi M. Niemi  and
Juhani Tiuraniemi
Päivi M. Niemi*
Affiliation:
University of Turku, Finland
Juhani Tiuraniemi
Affiliation:
University of Turku, Finland
*
Reprint requests to Päivi M. Niemi, Department of Teacher Education, University of Turku, FI-20014 Turku, Finland. E-mail: paivi.niemi@utu.fi
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The widening scope of cognitive therapy models and strategies poses a challenge for designing cognitive therapy training. What are the core skills to be learned? What do learners view as important to learn and what are the skills and knowledge they focus on? Aims: The present study describes the perceptions of CT trainees of both what is important and what is difficult to learn. We also analyse what the trainees focus on when evaluating their professional learning. In addition, we report on changes in self-assessed skills during the training. Method: Quantitative and qualitative data were collected after 2 years of training (n = 39) in three programmes and after the entire 4-year training in four programmes (n = 53). Results: Significant progress was reported in all domains of therapist skills, most clearly in cognitive and constructivist strategies. The trainees practised most those skills they considered important to be learned and, consequently, they also attained a higher level of mastery in these skills. The trainees’ learning orientation and foci of self-reflections remained relatively unchanged. They focused on technical and conceptual skills and knowledge, whereas interpersonal skills were peripheral in their self-reflection. Conclusions: Pedagogical and theoretical implications of the findings are discussed.

Keywords

Cognitive therapy trainingtherapist skillsself-reflectionprofessional learninginterpersonal skillstechnical skills
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 38 , Issue 3 , May 2010 , pp. 255 - 274
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baumgartner, L. M. (2001). An update on transformational learning. New Directions for Adult and Continuing Education, 89, 15–24.CrossRefGoogle Scholar
Bennett-Levy, J. (2006). Therapist skills: a cognitive model of their acquisition and refinement. Behavioural and Cognitive Psychotherapy, 34, 57–78.CrossRefGoogle Scholar
Bennett-Levy, J. and Beedie, A. (2007). The ups and downs of cognitive therapy training: what happens to trainees’ perception of their competence during a cognitive therapy training course? Behavioural and Cognitive Psychotherapy, 35, 61–75.CrossRefGoogle Scholar
Bennett-Levy, J., Lee, N., Travers, K., Pohlman, S. and Hamernik, E. (2003). Cognitive therapy from the inside: enhancing therapist skills through practising what we preach. Behavioural and Cognitive Psychotherapy, 31, 143–158.CrossRefGoogle Scholar
Bennett-Levy, J. and Thwaites, R. (2007). Self and self-reflection in the therapeutic relationship. In Gilbert, P. and Leahy, R.L. (Eds.), The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies (pp. 255–281). London: Routledge.Google Scholar
Bennett-Levy, J., Turner, F., Beaty, T., Smith, M., Paterson, B. and Farmer, S. (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy, 29, 203–220.CrossRefGoogle Scholar
Boshuizen, H. P. A. and Schmidt, H. G. (1992). On the role of biomedical knowledge in clinical reasoning by experts, intermediates and novices. Cognitive Science, 16, 153–184.CrossRefGoogle Scholar
Brosan, L., Reynolds, S. and Moore, R. G. (2007). Factors associated with competence in cognitive therapists. Behavioural and Cognitive Psychotherapy, 35, 179–190.CrossRefGoogle Scholar
Cassidy, S. (2007). Assessing “inexperienced” students’ ability to self-assess: exploring links with learning style and academic personal control. Assessment and Evaluation in Higher Education, 32, 313–330.CrossRefGoogle Scholar
Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J. and Hayes, A. M. (1996). Predicting the effect of cognitive therapy for depression: a study of unique and common factors. Journal of Consulting and Clinical Psychology, 64, 497–504.CrossRefGoogle ScholarPubMed
Chevron, E. S., Rounsaville, B. J., Rothblum, E. D. and Weissman, M. M. (1983). Selecting psychotherapists to participate in psychotherapy outcome studies: relationship between psychotherapist characteristics and assessment of clinical skills. Journal of Nervous and Mental Disease, 171, 348–353.CrossRefGoogle ScholarPubMed
Davis, D., Mazmanian, P., Fordis, M., Van Harrison, R., Thorpe, K. and Perrier, L. (2006). Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. Journal of the American Medical Association, 296, 1094–1102.CrossRefGoogle ScholarPubMed
Dunning, D., Heath, C. and Suls, J. (2004). Flawed self-assessment: implications for health, education, and the workplace. Psychological Science in the Public Interest, 5, 69–106.CrossRefGoogle ScholarPubMed
Elliot, R., Watson, J. C., Goldman, R. N. and Greenberg, L. S. (2004). Learning Emotion-Focused Therapy: the process-experiential approach to change. Washington DC: APA.CrossRefGoogle Scholar
Eva, K., Cunnington, J., Reiter, H., Keane, D. and Norman, G. (2004). How can I know what I don't know? Poor self-assessment in a well-defined domain. Advances in Health Sciences Education, 9, 211–224.CrossRefGoogle Scholar
Gruber, H., Palonen, T., Rehrl, M. and Lehtinen, E. (2007). Understanding the nature of expertise: individual knowledge, social resources and cultural context. In Gruber, H. and Palonen, T. (Eds.), Learning in the Workplace: new developments. Research in Educational Sciences, 32 (pp. 227–250). Turku: Finnish Educational Research Association.Google Scholar
Haarhoff, B. A. (2006). The importance of identifying and understanding therapist schema in cognitive therapy training and supervision. New Zealand Journal of Psychology, 35, 126–131.Google Scholar
Hawkins, P. and Shohet, R. (2006). Supervision in the Helping Professions (3rd ed.). London: Open University Press.Google Scholar
James, I. A., Blackburn, I-M., Milne, D. L. and Reichfelt, F. K. (2001). Moderators of trainee therapists’ competence in cognitive therapy. British Journal of Clinical Psychology, 40, 131–140.CrossRefGoogle ScholarPubMed
Laireiter, A-R. and Willutzki, U. (2003). Self-reflection and self-practice in training of cognitive behaviour therapy: an overview. Clinical Psychology and Psychotherapy, 10, 19–30.CrossRefGoogle Scholar
Langendyk, V. (2006). Not knowing that they do not know: self-assessment accuracy of third-year medical students. Medical Education, 40, 173–179.CrossRefGoogle Scholar
Leahy, R. L. (2004). Overcoming Resistance in Cognitive Therapy. New York: The Guilford Press.Google Scholar
Liotti, G. (2004). A model of dissociation based on attachment theory and research. Journal of Trauma and Dissociation, 7, 55–73.CrossRefGoogle Scholar
Marsick, V. J. and Watkins, K. E. (2001). Informal and incidental learning. New Directions for Adult and Continuing Education, 89, 25–34.CrossRefGoogle Scholar
Mezirow, J. (1991). Transformative Dimensions of Adult Learning. San Francisco: Jossey-Bass.Google Scholar
Mezirow, J. (1996). Contemporary paradigms of learning. Adult Education Quarterly, 46, 158–172.CrossRefGoogle Scholar
Mezirow, J. (2000). Learning to think like an adult: transformation theory: core concepts. In Mezirow, J. and Associates, (Eds.), Learning as Transformation: critical perspectives on a theory in progress (pp. 5–12). San Francisco: Jossey-Bass.Google Scholar
Milne, D. L., Baker, C., Blackburn, I., James, I. and Reichelt, K. (1999). Effectiveness of cognitive therapy training. Journal of Behavior Therapy and Experimental Psychiatry, 30, 81–92.CrossRefGoogle ScholarPubMed
Mok, M., Lung, C., Cheng, D., Cheung, R. and Ng, M. (2006). Self-assessment in higher education: experience in using a metacognitive approach in five case studies. Assessment and Evaluation in Higher Education, 31, 415–433.CrossRefGoogle Scholar
Niemi, P. M. (1997). Medical students’ professional identity: self-reflection during the preclinical years. Medical Education, 31, 408–415.CrossRefGoogle ScholarPubMed
Niemi, P. M. and Äärelä, E. (2000). Cognitive treatment of functional somatic symptoms: a pilot project in a psychiatric clinic for adult patients (in Finnish). Finnish Medical Journal, 34, 3335–3340.Google Scholar
Niemi, P. M. and Tiuraniemi, J. (2005). Novice Cognitive Therapists’ Emotions and Self-reflections in Difficult Patient Encounters. EABCT Conference Presentation, Thessaloniki.Google Scholar
Norton, P. J. and Price, E. C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. Journal of Nervous and Mental Disease, 195, 521–531.CrossRefGoogle ScholarPubMed
Orlinsky, D. E., Ambuhl, H., Rønnestad, M. H., Davis, J. D., Gerin, P., Davis, M. L., Willutzki, U., Botermans, J. F., Dazord, A., Cierpka, M. et al. (1999). The development of the psychotherapist: concepts, questions, and methods of a collaborative international study. Psychotherapy Research, 9, 127–153.CrossRefGoogle Scholar
Orlinsky, D. E. and Rønnestad, M. H. (2005). How Psychotherapists Develop: a study of therapeutic work and professional growth. Washington DC: APA.CrossRefGoogle Scholar
Roberts, M., Borden, K., Christiansen, M. and Lopez, S. (2005). Fostering a culture shift: assessment of competence in the education and careers of professional psychologists. Professional Psychology: Research and Practice, 36, 355–361.CrossRefGoogle Scholar
Rønnestad, M. H. and Skovholt, T. M. (2003). The journey of the counsellor and therapist: research findings and perspectives on professional development. Journal of Career Development, 30, 5–44.CrossRefGoogle Scholar
Saatsi, S., Hardy, G. E. and Cahill, J. (2007). Predictors of outcome and completion status in cognitive therapy for depression. Psychotherapy Research, 17, 185–195.CrossRefGoogle Scholar
Safran, J. D. and Muran, J. C. (2000). Negotiating the Therapeutic Alliance: a relational treatment guide. New York: The Guilford Press.Google Scholar
Salonen, P., Lehtinen, E. and Olkinuora, E. (1998). Expectations and beyond: the development of motivation and learning in a classroom context. In Brophy, J. (Ed.), Advances in Research on Teaching, Vol 7: expectations in the classroom (pp. 111–150). Greenwich, CT: JAI Press.Google Scholar
Schön, D. A. (1983). The Reflective Practitioner. New York: Basic Books.Google Scholar
Schön, D. A. (1987). Educating the Reflective Practitioner. San Francisco: Jossey-Bass.Google Scholar
Stoltenberg, C. D. (2005). Enhancing professional competence through developmental approaches to supervision. American Psychologist, 60, 857–864.CrossRefGoogle ScholarPubMed
Thwaites, R. and Bennett-Levy, J. (2007). Conceptualizing empathy in cognitive behaviour therapy: making the implicit explicit. Behavioural and Cognitive Psychotherapy, 35, 1–22.CrossRefGoogle Scholar
Van de Wiel, M. W. J., Boshuizen, H. P. A. and Schmidt, H. G. (2000). Knowledge structuring in expertise development: evidence from pathophysiological representations of clinical cases by students and physicians. European Journal of Cognitive Psychology, 12, 323–355.CrossRefGoogle Scholar
Vygotsky, L. S. (1978). Mind in Society: the development of higher psychological processes. Cambridge, MA: Harvard University Press.Google Scholar
Westbrook, D. and Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43, 1243–1261.CrossRefGoogle ScholarPubMed
Westbrook, D., Sedgwick-Taylor, A., Bennett-Levy, J., Butler, G. and McManus, F. (2008). A pilot evaluation of a brief CBT training course: impact on trainees’ satisfaction, clinical skills and patient outcomes. Behavioural and Cognitive Psychotherapy, 36, 569–579.CrossRefGoogle Scholar
Wills, F. and Sanders, D. (1997). Cognitive Therapy: transforming the image. London: Sage Publications.Google Scholar
Wood, D., Bruner, J. and Ross, G. (1976). The role of tutoring in problem solving. Journal of Child Psychology and Psychiatry, 17, 89–100.CrossRefGoogle ScholarPubMed
Yan, Z. and Fischer, K. (2002). Always under construction: dynamic variations in adult cognitive microdevelopment. Human Development, 45, 141–160.CrossRefGoogle Scholar
Yorks, L. and Marsick, V. (2000). Organizational learning and transformation. In Mezirow, J. and Associates, (Eds.), Learning as Transformation: critical perspectives on a theory in progress (pp. 253–284). San Francisco: Jossey Bass.Google Scholar
Submit a response

Comments

No Comments have been published for this article.