Psychotherapy Bulletin

2022 President’s Column 57(3)

past presidential column|psychotherapy articles

In this column, I want to give a shout-out to a new book that you all should read if you are interested in the training and supervision of and the practice of psychotherapy….and I imagine that is almost everyone in the Society for the Advancement of Psychotherapy. The book is edited by Louis Castonguay and myself and based on a set of conferences about training and supervision held at Penn State University. A group of scholars met to review what we know about training and supervision. We then all committed to writing a theoretical or empirical chapter about training and supervision. Three years later, we met to talk about progress and what we were learning. And then again two years later, we met to formulate conclusions about what we had learned and develop implications for the field. The book, to be published by the American Psychological Association, will appear in 2023. The citation is:

Castonguay, L. & Hill, C. E. (Eds.) (in press). Being and becoming a psychotherapist: Training and supervision. Washington DC: American Psychological Association.

In the first chapter, 10 trainers and supervisors from different theoretical orientations and countries (Louis Castonguay, James Boswell, Franz Caspar, Myrna Friedlander, Beatriz Gomez, Adele Hayes, Martin Grosse Holtforth, Stanley Messer, Michelle Newman, and Bernhard Strauss) describe the competencies required for practicing clinicians around the world and the methods that are used for training therapists.

In the next chapter, Sarah Knox and I provide a summary of the existing evidence about training and supervision for undergraduate and graduate students. We have a good evidence base for helping skills training and need more evidence for client outcomes for supervision.

In the subsequent chapter, Katie Aafjes-van Doorn and Jacques Barber describe some of the benefits that clinicians may gain from post-graduate educational experiences, such as an “antidote” to the loss of professional knowledge during one’s career. They then review the empirical evidence for a variety of such experiences, including conferences and workshops (in person and online), supervision, peer supervision, online supervision, and personal therapy.

Michael Constantino, James Boswell, Alice Coyne, Marvin R. Goldfried, and Louis G. Castonguay then describe how therapists can be trained to identify a range of markers of interventions and to respond to them in ways that are likely to be clinically successful.

In the next chapter, Catherine Eubanks, Christopher Muran, and Lisa Wallner Samstag describe a training program specifically aimed at teaching and supervising trainees in identifying various markers of alliance ruptures and in using different types of interventions to resolve such ruptures.

Jeffrey Hayes, Claire Cartwright, and Fanghui Zhao suggest in their chapter that emotional regulation and self-refection skills are at the core of the management of countertransference. They also present a pilot study to assess the impact of reflective practice on trainees’ management of their countertransference reactions.

William Stiles, Jordan Bate, and Timothy Anderson describe new developments related to responsiveness in psychotherapy, and elaborate their theory based on qualitative analysis of the experience of three therapists (with various level of training) who participated in a training workshop.

Martin and Dennis Kivlighan provide a description of deliberate practice. They also present additional data from an experimental study on the use of deliberate practice for training graduate students in using immediacy.

Wolfgang Lutz, Anne-Katharina Deisenhofer, Brigit Weinmann-Luz, and Michael Barkham describe a training clinic that integrates (and contributes to) advances in empirical knowledge, computer technology, and statistical analyses.

Matteo Bugatti, Zac Imel, and Jesse Owen review how training and supervision have been transformed by advanced technology, presenting cutting edge technological systems based on artificial intelligence and machine learning that are aimed at fostering various skills (e.g., open-ended questions) and interventions (e.g., motivational interviewing).

Myrna Friedlander, Laurie Heatherington, Sarah Knox, Catherine Eubanks, Lynne Angus, Mengfei Xu, and I present a qualitative investigation of the direct and indirect effects of formal supervision during graduate training. We found a variety of obstacles as well as benefits of supervision for both trainees and clients.

Ryan Kilcullen, Louis Castonguay, Dever Carney, Katherine Davis, Natalie Pottschmidt, Samuel Knapp, Corrie Jackson, Neil Hemmelstein, and Ann Marie Frakes then present a study on the feasibility and helpfulness of peer supervision for early career psychologists, revealing factors that can hinder peer supervision as well as benefits for early career therapists.

Next, Barry Farber and Daisy Ort examine the effects of informal supervision, which refers to guidance and support about clinical work that therapists receive by someone else than formal or peer supervisors, especially in terms of the provision of emotional support. Given that informal supervision seems to occur a lot, we need to know more about it.

Laurie Heatherington, Jacques Barber, Ryan Kilcullen, Louis Castonguay, Katherine Davis, Peter Barry, and Dennis Kivlighan present the results of a national survey of directors of clinical training programs about the positive (e.g., relational skills) and hindering (e.g., arrogance, narcissism) personal qualities of applicants. They also surveyed the methods used to evaluate candidates in their respective training program.

Bernhard Strauss and Dominique Frenzl argue in the following chapter that we need to give more attention to training students about preventing harmful or negative effects in therapy. The authors review the prevalence of various adverse effects, the occurrence of malpractice and boundary violations, and negative experiences during training and supervision.

In the next chapter, Sarah Knox, Heidi Zetzer, Barry Farber, Catherine Eubanks, Timothy Anderson, and I disclose key experiences of faith and doubt throughout our childhood and adulthood that influenced us in our work as trainers and supervisors. We emphasize the need for growing tolerance to ambiguity and uncertainty, as well as the value of collaboration with others.

The book ends with conclusions derived from the previous chapters and discussions at the Penn State Conference. We summarize what we have learned and offer clinical, research, and policy implications. We hope to inspire others to continue this important work so that we can advance the field of training and supervision. Although challenging to conduct such research, we clearly need more evidence for how to train and supervise students.

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