Thesis
Cognitive therapy in three dimensions : mapping the impact of self-practice and self-reflection (SP/SR) in the training of cognitive therapists
Southern Cross University
Doctor of Philosophy (PhD), Southern Cross University
2002
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Abstract
This thesis is the first study to test the proposition of several leading cognitive therapy trainers that practising cognitive therapy techniques on oneself may make a valuable, and perhaps unique, contribution to the development of cognitive therapists. 'Practising cognitive therapy techniques on oneself' was operationalised as self practice and self-reflection (SP/SR), drawing on the educational theory concepts of experiential learning and self-reflection.
The aim of the research was to map the territory: to determine if SP/SR was useful; if so, how; for whom, and under what circumstances. A further aim was to develop a theoretical framework to explain the findings. Three groups of participants, ranging from novice trainees to experienced practitioners (n=27), undertook cognitive therapy training courses with an SP/SR component. Data were derived from participants' written reflections, interviews, and group reflections. Trainer observations of two other training groups also contributed to parts of the analysis.
The pragmatic paradigm, which asserts the primacy of the research question in determining methodology, was used as the guiding paradigmatic framework. Within this context, qualitative methodologies were chosen to analyse data, and to determine process. Grounded theory provided the methodological framework, and a systematic set of methods to collect and analyse data; action research contributed the collaborative research process, and practitioner-researcher self-study provided the subject focus and orientation of the study.
Participants reported that SP/SR led to a 'deeper sense of knowing' of cognitive therapy practices. SP/SR impacted at a conceptual level on therapeutic understandings, at a practical level on therapist skills, and at an attitudinal level on therapist self-concept. The more experienced practitioners reported enhancement of therapist skills in the following areas: Refining specific cognitive therapy skills, communicating the conceptual framework of cognitive therapy, attention to the therapeutic foundation for change, being 'where the client is at', therapist self reflection, and therapist flexibility. For many participants, the value of SP/SR was personal as well as professional. It was concluded that SP/SR may accelerate therapist development and enhance 'professional artistry'.
However, these effects were context dependent. Moderator variables affecting individuals' engagement with the SP/SR process, and consequent benefit, included: Course structure and requirements; participants' expectation of benefit, feeling of safety with the process, personal background, and available personal resources; trainer qualities, and the group process.
Participant reports indicated that the major process variables, mediating between SP/SR training and outcomes, were: Experiencing cognitive therapy techniques from the client's perspective, and reflecting on experience, which led to the 'deeper sense of knowing'. A theoretical framework incorporating distinctions between experiential and rational information processing systems, declarative and procedural memory, and self-schema and self-as-therapist schema was invoked to explain the results.
Results from the study were combined with past research to create a new integrative information processing model of therapist skill development. This highlighted the role of interpersonal perceptual skills, the self-schema (personal development), and the evolution of a sophisticated set of when-then rules, skills and conceptualisations, in the development of therapist expertise. An innovative feature of the model was the inclusion of a 'reflective system', alongside declarative and procedural information processing systems, to account for the central role of reflection in therapist skill development. The model provides a useful conceptual map for trainers that can be empirically tested.
The study has a number of theoretical, practical and methodological implications for trainers, therapists and researchers. Among the conclusions are: first, that SP/SR may often be a very effective training strategy for novice and experienced therapists; second, that SP/SR may represent a safe middle path, acceptable to trainees and institutions, between personal therapy and no experiential work; third, that qualitative research methodologies can usefully be incorporated into therapy research to enhance theory development, and to examine process in therapy; fourth, that therapist skills cannot be divorced from personal development; and fifth, that the process of reflective learning is central to the development of therapists, despite the fact that it barely exists as a concept in clinical or experimental psychology literatures.
Details
- Title
- Cognitive therapy in three dimensions : mapping the impact of self-practice and self-reflection (SP/SR) in the training of cognitive therapists
- Creators
- James Bennett-Levy
- Contributors
- Bev Joan Taylor (Supervisor) - Southern Cross UniversityNicole Lee (Supervisor) - University of British Columbia
- Awarding Institution
- Southern Cross University; Doctor of Philosophy (PhD)
- Theses
- Doctor of Philosophy (PhD), Southern Cross University
- Publisher
- Southern Cross University
- Number of pages
- i-xvi, 17-347
- Identifiers
- 991013313628602368
- Copyright
- © James Bennett-Levy 2002
- Academic Unit
- School of Health and Human Sciences; Faculty of Health
- Resource Type
- Thesis