Further contact: Thomas Lindgren. Dept.Psychology, Stockholm university. S-106 91 Stockholm. SWEDEN. Phone: +46-8-163841. Email: thomas.lindgren@psychology.su.sewww.su.se

How do therapists learn to become therapists: A literature review

Thomas Lindgren , Lillian Döllinger, Patrick Schuster & Stephan Hau

Department of Psychology, Stockholm University

As   the   prevalence   of   psychological   diseases   con4nues   to  increase   (WHO,   2009),   the   study   and   applica4on   of  psychotherapy  becomes  especially  important.  Thus,  there  is  a  growing   need   to   merge   research   in   the   fields   of  psychotherapy,  educa4on  and  supervision.  

Developing  a  psychotherapeu4c  competence  largely  appears  to  develop  implicitly  (Buchholz,  2007;  Jacobsson  et  al.,  2012).  To   a   significant   extent,   a   psychotherapeu4c   competence  appears  to  be  comprised  of  procedural  knowledge  (Nielsen  &  Kvale,  2000).    

For  the  relevance  ra4ng  process  a  sample  of  422  publica4ons  was  used  for  training  consensus  decision.  The  final  inter-­‐rater  agreement  (Cohen’s  Kappa)  was  very  strong  (κ  =  0.8).  All  subsequent  classifica4on  of  references  deemed  relevant  for  the  purpose  of  the  present  study  was  done  by  either  the  first  or  the  last  author.  

References  

Buchholz,  M.B.  (2007).  Zur  Diskussion:  Entwicklungsdynamik  psychotherapeu4scher  Kompetenzen.  Psychotherapeutenjournal,  6,  373-­‐382.  

Jacobsson,  G.,  Lindgren,  T.E.,  &  Hau,  S.  (2012).  "Rites  of  passage:  Novice  students'  experiences  of  becoming  psychotherapist."  Nordic  Psychology  64(3):  192-­‐202.  

Nielsen,  K.,  &  Kvale,  S.  (2000).  Mästarlära.  Lärande  som  social  praxis.  (Appren4ceship  –  Learning  as  social  prac4ce  )  Lund:  Studentliieratur.    

WHO  (2009).  Global  health  risks:  mortality  and  burden  of  disease  aiributable  to  selected  major  risks,  hip://www.who.int/healthinfo/global_burden_disease/global_health_risks  

 

Review  notes  

There   was   a   shil   during   the   last   decade   from   mainly   theory-­‐based  studies  to  empirical  studies  on  supervision.  Earlier  studies  were  mainly  theory-­‐based  and  the   iden4fica4on  of   factors     relevant   for  supervision  was  based  on  clinical  observa4ons.  

Today  the  idea  of  evidence-­‐based  supervision   is  becoming  increasingly  relevant.    

The  criterion  of  pa2ent  progress  is  brought  into  ques2on  as  a  relevant  indicator  for  the  capaci4es  of  the  therapist.  

During  the  last  five  years  studies  have  emerged  discussing  the  effects  of  applying   new   techniques   and   media   to   supervision   (e.g.   videos,  internet-­‐based  supervision  via  Skype).  

Liile  is  known  about  the  4ming  of  learning  processes.  No  studies  could  be  found  dealing  with  the  ques4on,  when  ”learning”  takes  place.  

Most  studies  focus  on  the  content  of  what  has  to  be  learned  and  do  not  consider   the   process   of   how   the   contents   are   learned   by   the  psychotherapy  recipients.  

Main  research  ques4ons:  What  is  the  scope  and  quality  of  available   research?   What   is   considered   known   and  unknown  about  how  therapists   learn  what   is  required  of  them  as  prac4cing  psychotherapists?  

There  remains  an  emphasis   in  the   literature  on  what  should  be   learned,   rather   than   how   it   should   be   learned.  Furthermore,  there  is  a  clear  lack  of    empirical  research.  Only  a  few  studies  employ  a  quan4ta4ve  approach  to  measure  the  construct  in  ques4on.  

Ul4mately,   the   need   to   develop   evidence-­‐based  psychotherapy  educa4on,  as  well  as  to  evaluate  the  effects  of  new  media,  s4ll  remains.  

Publica4ons  from  the  year  2000  un4l  October  2014.    

Research  published  in  English  and  German  and  in  the  Nordic  languages.  Search  terms  were  conceived  based  on  familiarity  with  the  research  literature  and  selected  aler  consul4ng  the  official  mail-­‐list  of  the  Society  for  Psychotherapy  research.    

Search   performed   through   the   ProQuest   plasorm,   including  databases:  ASFA:  Aqua4c  Sciences  and  Fisheries  Abstracts,  ebrary®  ebooks,   ERIC,   Interna4onal   Bibliography   of   Art   (IBA),   Interna4onal,  Bibliography   of   the   Social   Sciences   (IBSS),   Linguis4cs   and   Language  Behavior   Abstracts   (LLBA),   Meteorological   &   Geoastrophysical  Abstracts,   PILOTS:   Published   Interna4onal   Literature   On   Trauma4c  Stress,   PILOTS:   Published   Interna4onal   Literature   On   Trauma4c  Stress,   ProQuest   Disserta4ons   &   Theses   A&I,   PsycARTICLES,  PsycBOOKS,   PsycCRITIQUES,   PsycINFO,   Social   Services   Abstracts,  Sociological  Abstracts,  The  Vogue  Archive.    

Selec,on  criteria  

A   list   of   opera4onally   defined   criteria,   conceived   and  employed  by   the  first   and   last   authors,  was  used   to   iden4fy  relevant   publica4ons   among   references   generated   by   the  database  search  terms.  The  inclusion  criteria  were  as  follows  (see  table  1):  (1)  A  reference  is  relevant  if  the  focus  is  on  the  process  of  learning  among  psychotherapists;  (2)  Explicit  focus  on   how   therapists   and   supervisors   learn;   (3)   Explicit   focus  when   learning   takes   place;   (4)   Review   ar4cles;   (5)   Empirical  studies.  

The   first   evalua4on   of   the   relevant   journal   ar4cles   revealed   that   the  research   publica4ons   showed   a   lack   of   focus   on   the   learning   processes  when  becoming  a  psychotherapist.  The  ar4cles  focused  on  contents  of  the  educa4on  and  external  factors,  rather  than  variables  describing  the  process  of  learning  psychotherapeu4c  competences.    

 

Poster   presented   at   the   EARLI   2015  Conference,  Limassol,  Cyprus.    

The   project   was   supported   by   a   grant   from  Stockholm   University´s   Centre   for   Teaching  and  Learning  in  the  Social  Sciences,  CeSam.    

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