Attitudes of Psychotherapists Toward the 1970 APA Standards for Psychotherapy Training

Transcription

1 JOEL RACHELSON AND PAULINE ROSE CLANCE Attitudes f Psychtherapists Tward the 9 APA Standards fr Psychtherapy Training Five hundred and eighteen members f the American Psychlgical Assciatin, Divisin 9, were sent a questinnaire asking them t review each f the recmmendatins f the Psychtherapy Curriculum and Cnsultatin Cmmittee n Psychtherapy Training. The recmmendatins were evaluated alng three dimensins: (a) the extent t which these recmmendatins were present in dctral training, (b) the extent t which the recmmendatins were cnsidered t facilitate therapeutic cmpetence, and (c) whether the respndents wuld include the recmmendatins in an ideal psychtherapy training prgram. The results f the study were that half f the respndents indicated that the recmmendatins were prevalent in their training. A majrity f the respndents fund the recmmendatins t facilitate cmpetence and wuld include them in ideal training. An imprtant implicatin f the study is that even thugh all the recmmendatins are nt prevalent in clinical psychlgy graduate prgrams, the respndents in the sample think they ught t be. Much energy has been invested in describing and elabrating n the nature f graduate educatin in clinical psychlgy. The largest prtin f this effrt has been directed by the American Psychlgical Assciatin in the frm f cnferences: Bulder (Raimy, 99), Miami (Re et al,, 99), Chicag (Hch, Rss, & Winder, 9), Vail (Krman, 9). In 9, APA Divisin 9 narrwed its fcus by establishing a Psychtherapy Curriculum and Cnsultatin Cmmittee t prvide training institutins with apprved standards fr psychtherapy educatin and training. The standards recmmended by this cmmittee represent the clearest statement t date cncerning psychtherapy educatin. The purpse f this study was t determine hw therapists wuld evaluate their graduate-level psychtherapy training, using the standards recmmended by APA Divisin 9. This research was stimulated by the findings in the literature that (a) the prfessinal-applied side f the Bulder mdel fr graduate training was neglected until 9; (b) applied practitiners (Gldschmidt, 99; Thelen & Ewing, 9), internship directrs (Shemberg & Kelly, 9), and students (Clement & Satris, 9) were dissatisfied with graduate-level psychtherapy training; (c) there was an absence f infrmatin utlining the specific cntent f psychtherapy educatin; and (d) there was n infrmatin n the attitudes f psychtherapists tward the Divisin 9 standards fr therapy training. Therapists were asked in a questinnaire t review each f the recmmendatins cncerning faculty, practicum setting, and curriculum cnsideratins, accrding t the fllwing criteria: (a) the extent t which these cnditins were present in their dctral training, (b) the extent t which these cnditins were cnsidered t facilitate the cmpetence f the practitiner, and (c) whether the therapists Prfessinal Psychlgy APRIL 9 Cpyright 9 by the American Psychlgical Assciatin, Inc. -//-J.

2 PSYCHOTHERAPY TRAINING wuld include the standards in their cnceptin f an ideal training prgram. THE SAMPLE The sample cnsisted f members f the APA Divisin f Psychtherapy (9) listed n the 9 mailing list fr Alabama, Arkansas, Flrida, Gergia, Kentucky, Luisiana, Mississippi, rth Carlina, Oklahma, Suth Carlina, Tennessee, Texas, and Virginia. THE QUESTIONNAIRE All members f the sample were sent a cpy f the Psychtherapy Training Questinnaire (PTQ). The PTQ, based n standards fr psychtherapy training recmmended by the APA Divisin 9 Psychtherapy Curriculum and Cnsultatin Cmmittee (9), cnsisted f a list f recmmendatins (see Table ) regarding faculty, settings fr practicum experiences, and curriculum cnsideratins. Adjacent t each recmmendatin were pint scales t be rated by the respndents alng three dimensins: (a) present in training (never, seldm, smetimes, ften, and always), (b) facilitative f yur therapeutic cmpetence (cannt determine, n, smetimes, yes), and (c) wuld include in an ideal therapy training prgram (yes, n). The PTQ cntained five additinal questins. Tw f these questins cncerning requirements and prvisins fr persnal therapy were presented in the same manner as the first. A third questin asked the respndents t rate the usefulness f their psychtherapy dctral educatin (ranging frm very useful t never useful) relative t their present practice. A furth questin asked therapists t rank graduate schl, alng with fur ther training methds (internship, persnal therapy, their practice, advanced training wrkshps r institutes), as t which methd prvided the mst learning abut being an effective therapist. The last questin asked therapists t describe what they cnsidered t be the mst critical experiences in their learning hw t be a psychtherapist. PROCEDURE The PTQ was sent t the members listed in the Divisin 9 membership mailing JOEL RACHELSON is currently a dctral candidate in the clinical prgram at Gergia State University. His prfessinal interests include experiential psychtherapy, issues in psychtherapy training, and develpment f mre cperative appraches t graduate educatin in psychlgy. He is a member f (he Cmmittee fr Equal Prfessinal Opprtunity f the Sutheastern Psychlgical Assciatin (SEPA) and C-chairpersn f the Graduate Student Netwrk f SEPA. PAULINE ROSE CLANCE received her PhD in clinical psychlgy frm the University f Kentucky and is currently an assciate prfessr at Gergia State- University. In additin, she is Assciate Directr f the Labratry fr Psychlgical Services at Gergia State'University and Membership Chairpersn f the Divisin f Psychtherapy, American'Psychlgical Assciatin. Her research interests include psychtherapy, psychtherapy training, bdy image, and wmen and achievement. REQUESTS FOR REPRINTS shuld be sent t Jel Rachelsn r Pauline Rse Glance, Psychlgy Department, Gergia State University, University Plaza, Atlanta, Gergia. APRIL 9 Prfessinal Psychlgy

3 list fr suthern states. A cver letter was included, explaining the nature f the research and requesting that the PTQ be read, filled ut, and returned in an enclsed, self-addressed, stamped envelpe. Results The number f returned, cdable questinnaires was 9, with a rate f %. The s were well distributed frm all states included in the sample. Als, the percentages frm each state clsely crrespnded t the percentage f Divisin 9 members in each state in the riginal ppulatin. Frequencies and percentages fr the demgraphic data and the alternatives marked fr each questin n the questinnaire were tabulated. The results that fllw are rganized in terms f the demgraphic characteristics f respndents and the percentages fr each questin n the questinnaire. DEMOGRAPHIC DATA OF RESPONDENTS Therapeutic Orientatin The respndents listed their therapeutic rientatins as fllws: eclectic, %; psychdynamic, %; humanistic-experiential, %; behavrial-scial learning, %; Rgerian-client centered, 9%; existential-phenmenlgical, %; Gestalt, %; transactinal analysis, %; cgnitive, ratinal emtive therapy, %. Distributin by Sex The distributin f respndents by sex was % male and % female. This rughly crrespnds t the rati (% male, 9% female) f the ppulatin sent questinnaires. PERCENTAGES FOR EACH QUESTION OF THE PTQ The average percentages f s fr Present in training, Facilitative f therapeutic cmpetence, Wuld include in ideal training fr the recmmended standards, and the added questins are listed in Table. Discussin The respndents, % f whm had been in practice fr less than years, indicated that sme f the standards were present in their graduate training and thers were nt. This finding is similar t the wrk f Jrgensen and Wiegel (9), wh termed the situatin a "mixed picture f cngruence." These authrs based their cnclusin n a survey f university clinical training directrs. They fund that althugh % f the prgrams have implemented the standard requiring expsure t ethical issues, nly % have implemented the standard that recmmends student participatin in persnal psychtherapy. A majrity f the respndents indicated that the recmmendatins were facilitative f therapeutic cmpetence. The recmmendatins that were cnsidered less prevalent Prfessinal Psychlgy APRIL 9

4 Table : Respnse Percentages fr Each Questin f the Psychtherapy Training Questinnaire "a r Questin One r mre full-time faculty represented the mdel f highly skilled psychtherapy practitiner (i.e., ABEP a ). Faculty was cmpetent in supervisin f psychtherapy. a. Faculty wh taught psychtherapy were cntinuusly practicing skills that they were helping students learn. b. Faculty prvided students pprtunity t learn by bserving them practice psychtherapy. Faculty and staff at practicum facilities view therapy as a wrthwhile activity. Yu had practicum experiences in a real-life setting delivering needed services. Part f yur practicum experience was in a setting where therapy by psychlgists was accepted. Psychtherapy educatin included awareness f scial frces shaping the field and scial respnsibilities f the prfessin. Students had experiences in situatins where the aim f treatment was preventative r maximizing ptential. Students prvided experiences in ne-t-ne therapy. Ethical standards were cntinually taught. Practicum was f sufficient length t allw students t bserve/experience develpment f therapeutic cmpetence. Was present in training,.. Often 9 9 Sel- dm 9 9 Al- ways 9 Facilitated cmpetence re- Never spnse Yes Wuld include in ideal training Cannt deter- remine spnse Yes H V

5 Table (cntinued) Was present in training Facilitated cmpetence Wuld include in ideal training Questin Often Sel- dm Always re- Never spnse Yes Cannt deter- remine spnse Yes ", st " v _^. Supervisin was lng enugh t allw students t bserve/experience develpment f therapeutic cmpetence.. Students received training in supervisin.. Methds fr enhancing sensitivity and persnal grwth were part f students' educatin. a. Psychtherapy educatin designed t prvide sund grunding in present knwledge and skills- b. Psychtherapy educatin designed t enhance awareness f inevitability/ desirability f change.. There was a frmal, terminal evaluatin f students' therapeutic skills prir t receiving degree.. Yu were required t be invlved in yur wn persnal therapy.. Prvisins were made fr inexpensive r free psychtherapy. 9. Overall, hw useful d yu cnsider yur dctral educatin relative t yur private practice? Very. Did yu learn mre abut being an effective therapist in Graduate schl Often 9 Internship 9 Persnal therapy Seldm 9 9 My practice Never Advanced training in wrkshps te. Questins are abbreviated t cnserve space. a ABEP = American Bard f Examiners in Psychlgy.

6 PSYCHOTHERAPY TRAINING were als rated less facilitative. Cnsequently, we are unable t determine whether a recmmendatin wuld have been rated mre facilitative if it had been mre prevalent. The large majrity f the respndents thught all the recmmendatins shuld exist in an ideal therapy training prgram. Each standard received the endrsement f at least % f the respndents. The nly standards nt receiving this level f endrsement were questins added by the present authrs, which specified mandatry persnal therapy (%, yes; %, n) and the prvisin f inexpensive r free psychtherapy (%, yes; %, n). One f the implicatins f the results cncerning the verall usefulness f graduate training, as cntrasted with the relative usefulness f ther training methds, is that therapists rated graduate-level training as a useful, but small, cntributin t the learning prcess. Seventy percent f the respndents indicated that their graduate-level training was very useful r ften useful, relative t their present practice. Hwever, when asked t rate five training methds accrding t which was mst imprtant, respndents gave the fewest ratings ( being the highest rating) t graduate schl. In additin, graduate schl was seldm listed as a critical learning experience ( ut f s). In these pen-ended s, mre therapists indicated that persnal therapy, supervisin, and practice in the field were critical experiences. Clearly, graduate schl training is nt seen as prviding the mst significant cntributin t being a psychtherapist. The strngest implicatin f the results is that even thugh all the recmmended cnditins were nt prevalent in their graduate-level training, the respndents thught they shuld be. This raises the issue f hw recmmendatins are translated int actins. Unfrtunately, there are n simple answers t this questin. Leitenberg (9), a directr f clinical training, pinpinted the surce f prevailing disaffectin with dctral training in clinical psychlgy "as the cntinuing gap between rhetric and practice" (p. ). With the increasing imprtance f clinical psychlgy tday, it is curius that there are n mechanisms fr ensuring bth that recmmendatins are implemented and that there be full participatin by thse invlved in the standards-making prcess. Summary The results f the present study highlighted the fllwing issues:. A "mixed picture f cngruence" exists between APA recmmendatins and implementatin.. The standards recmmended by the Divisin 9 Curriculum and Cnsultatin Cmmittee are viewed as being generally facilitative f therapeutic cmpetence.. A large majrity f the respndents supprt the implementatin f all the cmmittee's recmmendatins fr faculty, practicum settings, and curriculum cnsideratins.. The respndents view graduate-level psychtherapy training as a useful but small part f the prcess f becming a psychtherapist.. There are n explicit means fr ensuring that what is suggested will be implemented by graduate training prgrams.. Past graduates clearly supprt the full emphasis and implementatin f the applied "side" f the Bulder mdel. APRIL 9 Prfessinal Psychlgy

7 It is hped that the results f this study will mtivate actin. Minimally and initially this actin culd take the frm f university directrs f clinical training cmparing their training standards with thse that have been recmmended and are nw supprted by practitiners in the field. REFERENCES American Psychlgical Assciatin, Divisin f Psychtherapy, Psychtherapy Curriculum and Cnsultatin Cmmittee. Recmmended standards fr psychtherapy educatin in psychlgy dctral prgrams. Prfessinal Psychlgy, 9,, -. Clement, P. W., & Satris, P. C. Clinical students evaluate present APA apprved training prgrams and make suggestins fr changes. Jurnal f Clinical Psychlgy, 9,, -. Gldschmidt, M. L., Stein, D. D., Weissman, H. N., & Srrells, J. A survey, f training practices f clinical psychlgists. The Clinical Psychlgist, 99,, 9-9. Hch, E. L., Rss, A. O., & Winder, C. L. (Eds.). Preparatin f clinical psychlgists. Washingtn, D.C.: American Psychlgical Assciatin, 9. Jrgensen, G. T., & Weigel, R. G. Training psychtherapists: Practices regarding ethics, persnal grwth, and lcus f respnsibility. Prfessinal Psychlgy, 9,, -. Krman, M. (Ed.). Levels and patterns f prfessinal training in psychlgy. Washingtn, D.C.: American Psychlgical Assciatin, 9. Leitenberg, H. Training clinical researchers in psychlgy. Prfessinal Psychlgy, 9,, 9-9. Raimy, V. C. (Ed.). Training in clinical psychlgy. New Yrk: Prentice-Hall, 99. Re, A., Gustad, J. W., Mre, B. V., Rss, S., & Skdak, M. (Eds.). Graduate educatin in psychlgy. Washingtn, D.C.: American Psychlgical Assciatin, 99. Shemberg, K. M., Kelley, S. M., & Leventhal, D. B. University practices and attitudes f clinical directrs. Prfessinal Psychlgy, 9,, -. Thelen, H. M., & Ewing, D. R. Attitudes f applied clinicians tward rles, functins, and training in clinical psychlgy: A cmparative survey. Prfessinal Psychlgy, 9,, -. Received Octber, 9 Prfessinal Psychlgy APRIL 9