An Enquiry into Psychotherapy Training-Abstract

An Enquiry into Psychotherapy Training.
Challenges to developing a generic foundation year and links to clinical practice training.

A project submitted to Middlesex University in collaboration with Metanoia Institute in partial fulfilment of the requirement for the degree of Doctor in Psychotherapy by Professional studies in 2005.

Abstract

This document presents an action research enquiry into psychotherapy and counselling training within the context of a training institute.
The starting point for the enquiry were the apparent gaps that exist in clinical practice training. Recognising that the commonly used training structure in psychotherapy and counselling training, which separates clinical practice, formal teaching and supervision, often leads to practice and training disparity raising ethical concerns, I aimed to use the enquiry to enhance the effectiveness of clinical training.
I formulated two research questions:
•    Could a more generic psychotherapy training in the foundation year serve as a better preparation for clinical practice?
•    Would it be possible to develop an integrated structure between clinical practice, training and supervision?
These questions led to developing the project in two parts:
•    An exploration of the feasibility of a generic foundation year, and
•    The development of  an internship component.
The methodology I used was action research, particularly relevant to this enquiry because of the focus on developing practical knowledge through involvement with an organisational system. Another aspect of the enquiry was internal consultancy. As well as being a researcher, I acted as a consultant for the organisation I worked for.
The organisational setting was the Metanoia Institute, a counselling and psychotherapy training institute based in London. The Metanoia Institute runs several courses in counselling and psychotherapy – Person Centred, Transactional Analysis, Gestalt and Integrative – as well as a Doctoral programme in psychotherapy in collaboration with Middlesex University. Middlesex University validates the academic programme at the Metanoia Institute, which leads to BA and MSc awards in counselling and psychotherapy. The Institute also contains an internal clinical placement for students – Metanoia Counselling and Psychotherapy Service (MCPS), which I manage.
The Metanoia Institute sponsored the enquiry and acted as a principal collaborator throughout.
The project shows how the process of enquiry initiated a dynamic of organisational change, highlighting systemic issues and challenges to the development of psychotherapy training, particularly in relation to generic training. The implementation of the findings became possible through focusing on internship, which became the central area for development within the project. The final outcome of the research has been used to develop an extensive pilot project, entailing restructuring of the training programme in one of the academic departments.
As well as presenting the enquiry, this document discusses the theme of organisational change and suggests that it offers a lens through which issues of professional integration could be viewed from a systemic (organisational) perspective. Particular themes  highlighted by the enquiry relate to:
•    Issues of culture and identity related to allegiance to a particular theoretical orientation
•    Factors related to the structure and funding of training organisations, and
•    The role of clinical practice in the process of professional integration

preferred referencing: Van Rijn, B. (2005) An Enquiry into Psychotherapy Training. Challenges to developing a generic foundation year and links to clinical practice training.(D.Psych) Middlesex University, Metanoia Institute.

Thesis Bibliography

Van Rijn, B. (2005) An Enquiry into Psychotherapy Training. Challenges to developing a generic foundation year and links to clinical practice training.(D.Psych) Middlesex University, Metanoia Institute.

References and Bibliography

-ASSOCIATION FOR FAMILY THERAPY (2002) Information on Training http:/ /www.aft.org.uk
-ASSOCIATION OF PSYCHOLOGY POSTDOCTORAL AND INTERNSHIP CENTRES (undated), http:/ / http://www.appic.org
-ARGYRIS, C., PUTNAM, R., SMITH, D., (1985) Action Science: Concepts, Methods, and Skills for Research and Intervention San Francisco, CA: Jossey-Bass
-ARKNOFF, D.B (1983) Common and Specific Factors in Cognitive Therapy in M.D LAMBERT (Ed), Psychotherapy and Patient Relationships, Homewood, IL: Dorsey
-ARMSTRONG, J (2003) Training for Paraprofessional Counsellors: Evaluating the Meaning and Impact of a Common Factors Approach Counselling And Psychotherapy Research, December,Vol.3, No4, pp.270-277
-ARTHUR, A (2000) Do I Choose my Orientation: or Does it Choose Me? The Psychotherapist, Spring, No.14,pp. 24-27
-BARKER, PISTRANG, ELLIOTT (1994) Research Methods in Clinical and Counselling Psychology John Wiley
-BARLOW, D.H (1996) Health Care Policy, Psychotherapy Research and the Future of Psychotherapy American Psychologist October,51(10). pp.1050-58
-BERGIN A. E& GARFIELD S.L ,Eds (1994) Handbook of Psychotherapy and Behaviour Change 4th Edition, John Wiley
-BERRAGAN, L, (1998) Consultancy in Nursing: Roles and Opportunities Clinical Nursing March (2) pp.139-143
-BEUTLER, L.E (1983) Eclectic Psychotherapy: A Systematic Approach, Elmsford, NY: Pergamon
-BEUTLER, L.E; MACHADO P.P.P; NEUFELDT S (1994) Therapist Variables in Handbook of Psychotherapy and Behaviour Change 4th Edition (1994),Eds. BERGIN A. E& GARFIELD S.L John Wiley
-BRITISH ASSOCIATION FOR COUNSELLING AND PSYCHOTHERAPY (undated) Ethical Framework for Good Practice in Counselling and Psychotherapy http://www.bacp.co.uk
-BRITISH PSYCHOLOGICAL SOCIETY (undated) Ethical Principles for Conducting Research with Human Participants http://www.bps.org.uk
-BUNIN, N &TSUI-JAMES, E., P., (Ed.), (1996) The Blackwell Companion to Philosophy Blackwells
-CARTER, M (undated) Clinical Governance in Counselling and Psychotherapy in the NHS, BACP Information Sheets, http://www.bacp.co.uk
-CARROLL,M;(1996)Counselling Supervision- Theory ,Skills and Practice Casssell
-CLEARING HOUSE FOR POSTGRADUATE COURSES IN CLINICAL PSYCHOLOGY(2004) Handbook
-CLARKSON, P (1991) Transactional Analysis Psychotherapy: An Integrated Approach London: Tavistock/Routledge
–CORE SYSTEM GROUP, (1998) CORE System Information Management Handbook  CORE System Group, Leeds
-DEPARTMENT OF HEALTH, (2001) Treatment Choice in psychological Therapies and Counselling, Evidence Based Clinical Practice Guideline.Department of Health, UK
-DOLLARD, J AND MILLER, N., E (1950) Personality and Psychotherapy New York: McGraw-Hill
-DRYDEN, W (1987) Theoretically Consistent Eclecticism: Humanising a “Computer Addict” In Casebook of eclectic psychotherapy Ed. J.C NORCROSS pp.221-237
-DRYDEN, W; THORNE (1991) Key Issues in the Training of Counsellors Training and Supervision for Counselling in Action Sage
-DRYDEN, W; THORNE (1991) Approaches to the Training of Counsellors Training and Supervision for Counselling in Action Sage
-DRYDEN, W; THORNE (1991) Key Issues in the Training of Counsellors Training and Supervision for Counselling in Action (1991) Sage
-EGAN, G. (1990) The Skilled helper: A Systematic Approach for Effective Helping 4th Edition Pacific Grove:Brooks/Cole
– EVANS, R in association with CORE INFORMATION MANAGEMENT SYSTEMS Ltd.CORE System Data to Support the Management of  Brief Psychological Therapy Services-a Framework in Development (2003)
-FELTHAM, C. (1999) Against and Beyond CORE Theoretical Models; Controversies in Psychotherapy and Counselling; Sage
-FLOOD, R.L (2001) The Relationship of Systems Thinking to Action Research in Handbook of Action Research: Participative Inquiry and Practice Eds. REASON, P & BRADBURY, H, Sage
-FRANK, J. D & FRANK, J.B (1991) Persuasion and Healing: a Comparative Study of Psychotherapy Baltimore: John Hopkins University Press
-FRIEDMAN, V.J (2001) Action Science: Creating Communities of Inquiry in Communities of Practice in Handbook of Action research: Participative Inquiry and Practice) Eds. REASON, P & BRADBURY, H, Sage
-GARB, H.N, (1989)-Clinical Judgement, Clinical Training and Professional  Experience, Psychological Bulletin 105 pp.387-396
-GARFIELD, S, L. (1957) Introductory Clinical  Psychology New York: Macmillan
-GARFIELD, S., L (1973) Basic Ingredients or Common Factors in Psychotherapy? Journal of Consulting and Clinical Psychology 45 pp.78-83
-GARFIELD S.L & BERGIN A.E (1994) Introduction and Historical Overview in Handbook of Psychotherapy and Behaviour Change 4th Edition, Eds. GARFIELD S.L & BERGIN A.E  John Wiley
-GILBERT, C.M; EVANS, K (2000) Psychotherapy Supervision- an Integrative Relational Approach to Psychotherapy Supervision Open University Press
-GILL, M. (1984) Psychoanalytic, Psychodynamic, Cognitive Behaviour and Behaviour Therapies Compared in  Psychoanalytic therapy and behaviour therapy :Is integration possible? Eds.H. ARKOWITZ & S.B. MESSER pp.179-187New York:Plenum
-GOLDFRIED, M., R (1980); Toward the Delineation of Therapeutic Change Principles American psychologist 35 pp.911-999
-GOLDFRIED M.R & NEWMAN C.F (1992) A history of Psychotherapy Integration in Handbook of Psychotherapy Integration, Eds. NORCROSS,J.C &GOLDFRIED M.R Harper Collins
-GOLDFRIED, M & WOLFE, B (1996) Psychotherapy Practice and Research: Repairing the Strained Alliance; American Psychologist vol.51 (10) Oct  pp.1007-1016
-GOSS, S. &ROSE, S (2002) Evidence Based Practice: a Guide for Counsellors and Psychotherapists Counselling And Psychotherapy Research, June  2(2) pp.147-51
-GREENCAVAGE, L.M & NORCROSS J.C (1990) Where are the Commonalities Among the Therapeutic Factors? Professional Psychology: Research and Practice 21 pp.372-378
-HARGADEN,H & SILLS,C (2002) Transactional Analysis –A Relational Perspective Buner-Routledge
-HAWKINS, P; SHOHET, R;(2000) Supervision in the Helping Professions (2nd edition) Open University press
-HERON, JOHN, (1996) Co-operative Inquiry Sage
-HERZBERG, A (1945) Active Psychotherapy New York: Grune& Stratton
-HOLLANDERS, H& MCLEOD, J. (1999) Theoretical Orientation and Reported Practice: a Survey of Eclecticism Among Counsellors in Britain British Journal of Guidance and Counselling 27 pp.407-14
-HOLMES,J & LINDLEY,R (1989)The Values of Psychotherapy, Oxford : Oxford University press
-HONDERICH, T. (Ed.)(1995) The Oxford Companion to Philosophy Oxford University press
-HOSHMAND, L, T & POLKINGHORNE, D.E (1992) Redefining the Science-Practice Relationship and Professional Training American Psychologist January  47(1) pp.66-66
-HOWARD, K.I et. al (1996) Evaluation of Psychotherapy: Efficcy, Effectiveness and Patient progress American Psychologist 51(10) October  pp.1055-64
-KARASU, T.B (1986) The Specificity Against the Nonspecisficity Dilemma: Toward Identifying Therapeutic Change Agents American Journal of Psychiatry 143 pp.687-95
-KINGS COLLEGE LONDON (undated) Postgraduate Prospectus Undergraduate Programme Profile
-KUBLER-ROSS, E. (1970) On death and Dying Tavistock London
-LACEY, M, Y (1995) Internal Consulting: Perspectives on the Process of Planned Change Journal of Organisational Change 8(3) pp.75-84
-LAMBERT, M.J. & BERGIN, A.E (1994) The Effectiveness of Psychotherapy in Handbook of Psychotherapy and Behaviour Change 4th Edition Eds. GARFIELD S.L & BERGIN A.E  John Wiley& Sons Inc
-LECHTE, J (1994) Fifty Key Contemporary Thinkers – from Structuralism to Postmodernity, Routledge,
-LEES, J (2001) Reflexive Action Research: Developing Knowledge Through Practice Counselling and Psychotherapy Research, August  1(1) pp.132-138
-LEES, J (2004) Eclecticism and Integration Counselling and Psychotherapy Journal July Vol.15 (6), pp.25-27
–LEVY,A (1986) Organisational Transformation Praeger Publishers
-LONDON P., (1972) The End of Ideology in Behaviour Modification, American Psychologist 27 pp.913-920
-LUBORSKI, L (1990) Theory and Technique in Dynamic Psychotherapy- Curative Factors and Training Therapists to Maximise them; Psychotherapy and psychosomatics 53 pp.50-57
-LEWIN, K, (1951) Field Theory in Social Sciences New York: Harper&Row
-LYDDON, W.J. (1989); Personal Epistemology and Preference for Counselling Journal of
Counselling Psychology 36 pp.423-429
-MAHRER, A (1989) The Integration of Psychotherapies: a Guide for Practicing Therapists New York: Human Sciences Press
-McLEOD, J. (1997) Narrative and Psychotherapy Sage
-McLEOD, J (1999) Practitioner Research in Counselling Sage
-McLEOD, J (2001) Developing a Research Tradition Consistent with the Practices and Values of Counselling and Psychotherapy: Why Counselling and Psychotherapy Research is Necessary Counselling and Psychotherapy Research April  1(1) pp.3-17
-McLEOD,J (2003) An Introduction to Counselling 3rd edition Open University press
-MESSER S.B. (1986) Behavioural and Psychoanalytic Perspectives at Therapeutic Choice Points American Psychologist 41 pp.1261-1276
-MESSER, S., B (1992) A Critical Examination of Belief Structures in Integrative and Eclectic Psychotherapy in Handbook of Psychotherapy Integration. Eds.J.C NORCROSS&M.R GOLDFRIED New York: Basic Books
-METANOIA INSTITUTE (2002/2003) Diploma in Person Centred Counselling Student Handbook
-METANOIA INSTITUTE (2002/2003) Gestalt Psychotherapy MSc/Diploma Student Handbook
-METANOIA INSTITUTE (2002/2003) Integrative Counselling Psychology and Psychotherapy, MSC/Diploma Student Handbook
-METANOIA INSTITUTE (2002/2003) Integrative Psychotherapy MSc/Diploma Student Handbook 200
-METANOIA INSTITUTE (2002/2003) Transactional Analysis Psychotherapy, MSC/Diploma Student Handbook
-MIDDLESEX UNIVERSITY  (2002)– Internship Programme Summer Studies in London Course Catalogue
-NHS EXECUTIVE (1996) NHS Psychotherapy Services in England, Review of Strategic Policy, Department of Health
-NORCROSS, J., C. (1986) Handbook of Eclectic Psychotherapy New York: Brunner/Mazel
-NORCROSS J., C (1988) Supervision of Integrative Psychotherapy Journal of Integrative and Eclectic Psychotherapy 71 pp.157-166
-NORCROSS.J.C &THOMAS, B, L (1988) What’s Stopping Us Now? Obstacles to Psychotherapy Integration; Journal of Integrative and Eclectic psychotherapy 7 pp.74-80
-NORCROSS J.C & NEWMAN C.F (1992) Psychotherapy Integration: Setting the Context Handbook of Psychotherapy Integration Harper Collins
-ORLINSKY, D.E& HOWARD K.I (1986) Process and Outcome of Psychotherapy; Handbook of Psychotherapy and Behaviour Change 3rd Edition  John Wiley
-ORLINSKY, D.E.; GRAWE, K & PARKS, B (1994) Process and Outcome in Psychotherapy – Noch Einmal; Handbook of Psychotherapy and Behaviour Change 4th Edition, (1994) John Wiley& Sons Inc
-PALEY, G. &LAWTON, D (2001) Evidence Based Practice: Accounting for the Importance of the Therapeutic Relationship in the UK National Health Service Provision Counselling and Psychotherapy Research April  1(1) 12-17
-PASSMORE, W  (2001) Action Research in the Workplace: the Socio- Technical Perspective in Handbook of Action research: Participative Inquiry and Practice  Eds. REASON, P & BRADBURY, H Sage
-PARRY, G. (1996) NHS Psychotherapy Services in England, Review of Strategic Policy NHS Executive
-PARRY, G (2002) Evidence Based Psychotherapy: an Overview Metanoia Institute Specialist Seminar Material
-PATTERSON, C.H. (1967) Divergence and Convergence in Psychotherapy American Journal of Psychotherapy 21 pp.4-17
-POINTON, C (2004) Counselling and Psychotherapy: Is There a Difference?  Counselling and Psychotherapy Journal, March  vol.15 no.2 pp.5-9
-PRICE, A, (1996) Commissioning Nurse: In House Consultancy Projects Nursing economics pp.1-7
PRICE, A, (2000) How to Conduct an Internal Evaluative Consultancy Nursing Management, November  7(7) pp.16-21
-PRICE, A, (2000) How to Conduct a Feasibility Consultancy Nursing Management December/January 7(8) pp.16-21
– PRICE, A, (2001) Cost Benefit Analysis, Nursing Management February  7(9) pp.25-31
-PRICE, A, (2001) Conducting a Process Consultancy Nursing Management March  7(10) pp.29-34
-PROCHASKA, J.O, DI CLEMNTE, C.C (1992) The Transtheoretical approach in Handbook of Psychotherapy Integration, Eds.NORCROSS J.C& GOLDFRIED, M.R Harper Collins
-PROCTOR, B (1991) Approaches to the Training of Counsellors in Training and Supervision for Counselling in Action (1991)  Eds. DRYDEN, W   & THORNE, B Sage -RASHFORD, N, S &COGHLAN, D (1989) Phases and Levels of Organisational Change Journal of Managerial Psychology  Vol. 4 Issue 3 pp.17
-REASON, P., H. (2000) Action Research as Spiritual Practice prepared for the University of Surrey Learning Community Conference 4/5/2000
-REASON, P. H. & BRADBURY – (2001) Participative Inquiry and Practice, Handbook of Action research Sage
-REASON, P & BRADBURY, H (2001) Introduction: Inquiry and Participation in Search of a World Worthy of Human Aspiration  in Handbook of Action research: Participative Inquiry and Practice Eds. REASON, P & BRADBURY, H, Sage
-RENNIE, D., L.- Qualitative Research- a Matter of Hermeneutics and the Sociology of Knowledge Metanoia Institute Specialist Seminar Material
-RIORDAN, P (1995) The Philosophy of Action Science Journal of managerial psychology 10(6) pp.6-13
-ROSENZWIEG, S (1936). Some Implicit Common Factors in Diverse Methods of Psychotherapy American Journal of Orthopsychiatry 6 pp.412-415
-ROWAN, J., (2001) Counselling And Psychotherapy, Different and the Same Counselling and Psychotherapy Journal August
-ROWLAND, N (2001) Clinical Guidelines for Treatment Choice Decisions in Psychological Therapies and Counselling BACP Information sheets http:/ /www.bacp.co.uk
-SCHEIN, E, H (1985) Organisational Culture and Leadership Joyssey-Bass, San Francisco
– SCHEIN, E, H (1988) What is process consultation? In Process Consultation:(Volume 1):Its role in Organisational Development Addison-Wesley
-SCHEIN, E., H (1993)-On Dialogue, Culture and Organisational Learning Organisational Dynamics Autumn  pp.40-51
-SCHEIN, E, H (1995) Process Consultation, Action Research and Clinical Enquiry: Are They the Same Journal of Managerial Psychology 10(6) pp.14-19
SCHEIN, E, H (2001) Clinical Inquiry/Research in  Handbook of Action research: Participative Inquiry and Practice  Eds. REASON, P AND BRADBURY H Sage
-SCHON, D., A., (1983) The Reflective Practitioner. How Practitioners Think in Action Basic Books: New York 1983
-SILVERMAN, D (2001) Interpreting Qualitative Data Sage
-STRINGER, E., T. (1999) Action Research 2nd Edition Sage
-STRUPP, H.H (1973) On the Basic Ingredients of Psychotherapy; Journal of Consulting and Clinical Psychology 41 pp.1-8
-THE TRAINING & PRACTICE DEVELOPMENT SECTION OF SAINSBURY CENTRE FOR MENTAL HEALTH (2000) The Capable Practitioner – A Framework and List of Practitioner Capabilities Required to Implement the National Service Framework for Mental Health, A report for the National Service Framework Workforce Action team – Sainsbury Foundation
-UKCP (undated)– Generic Training Outcomes United Kingdom Council for Psychotherapy
-WAMPOLD, B.E (2001) – The Great Psychotherapy Debate Lawrence Erlbaum Associates
-WHEELER, S (1999)- Training in a Core Theoretical Model is Essential; in Controversies in Psychotherapy and Counselling Ed.Feltham, C. Sage
-WHITEHOUSE, F., A. (1967) The Concept of Therapy: A review of Some Essentials; Rehabilitation Literature 28 pp.238-347
-WOODY, R.H (1971)- Psychobehavioural Counselling and Therapy: Integrating Behavioural and Insight Techniques New York: Appleton-Century-Crofts
-WESSEX NHS – (2003) Summary of the Agreement for Doctors in Training, Pre- Registration House officers http:/www.org.co