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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical 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PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy

Related Topics
How Psychotherapists DevelopReview - How Psychotherapists Develop
A Study of Therapeutic Work and Professional Growth
by David E. Orlinsky and Michael Helge Ronnestad
American Psychological Association Books, 2004
Review by Marieke Geoghegan
Feb 13th 2007 (Volume 11, Issue 7)

In their 15- year study Orlinsky and Rǿnnestad have given the therapeutic community a great insight into the development and experiences of psychotherapists throughout their careers. The path from novice to experienced therapist can be a precarious one, and has been related to the stages of human development (Stovholt, 2001). The beginning counsellor has the awkwardness and self consiousness of an adolescent, and it has been a largely neglected subject as to how one moves from this awkwardness to becoming an experienced, effective and wise practitioner deriving a sense of satisfaction from one's work. Orlinsky and Rǿnnestad's work is timely due to the increasing awareness of burnout as a very real hazard of working with troubled clients.

It is interesting how little research has been conducted to date on the characteristics of psychotherapists and their experiences of working with their clients in therapeutic settings. This is despite research demonstrating repeatedly (eg. Teyber and McClure's research, 2000) that it is the relationship or therapist's ability to form a 'therapeutic alliance' with the client that determines the effectiveness of therapy, irrespective of theoretical orientation. One of the basic assumptions explained in the book is that as the therapist develops within themselves, the stronger this alliance is and the more easily t can be achieved. Orlinksy and Rǿnnestad include in the first section a thorough review of the relevant literature and discuss at great depth the concept of 'psychotherapist development'. As the authors state in the first section, 'the ultimate aim of development is the improvement of practice', and this is the focus of the work – how are we to improve our practice with clients, be more effective, increase our positive experiences of practice and prevent harmful negative experiences of practice.

The rationale behind the study is clearly stated as to investigate the development of psychotherapists, the circumstances that impact on this development and how it impacts of the therapist's career. The authors begin to describe how they conducted this immense study, involving almost 5000 participants (psychotherapists, psychologists, psychiatrists, counsellors, social workers), from novices to experienced therapists, across 15 countries and more than 15 theoretical orientations. As you might imagine, this was no straightforward study, and Orlinsky and Rǿnnestad give the reader a lengthy explanation of the questionnaire development, sample selection and methods of analysis. Throughout the book they remain acutely aware of the limitations of the study and warn the reader of the usual vicissitudes of data collection and the effects on the representativeness of the sample. The explanations are detailed and supported by quantitative data and tables. This will be of great importance to the researcher however the psychotherapist looking for some insight or validation into the therapeutic experience may find themselves skipping to the study findings.

The concept of 'therapeutic experience' was organised into two broad dimensions of Healing Involvement and Stressful Involvement, with Stressful Involvement being identified as placing the therapist at risk of burnout or damaging practice. Aspects such as Relational Manner, In Session Feelings and Relational Agency were examined. Development was organised into Currently Experienced Growth and Cumulative Career Development.

Interestingly, the biggest predictor of Cumulative Career Development, more so than even length of practice, was depth and breadth of a therapist's experience across treatment modalities. The expansion of a therapists' Cumulative Career Development also showed to significantly decrease the likelihood of therapeutic work as being experienced as Stressful Involvement, and perhaps thus safeguarding the therapist's longevity of practice. Currently Experienced Growth also predicted feelings of Healing Involvement.

Section IV - Integrations and Implications is, in my opinion the highlight of the book and likely of most interest to practicing psychotherapists looking for insights into the sometimes mysterious experiences of therapeutic involvement and 'being a therapist'. One might read this section to validate or compare their own experiences with other therapists, for the purposes of providing effective supervision to trainee counsellors or in regards to the development of a training programme. The authors do not disappoint, they clearly outline the findings for the reader and go on to make some extremely valuable suggestions for those providing training, supervision or in current practice. The authors' own experiences in teaching and therapy becomes increasingly apparent as they provide insightful, sensitive and realistic suggestions for the training and supervision of novices as well as how one may continue to experience work satisfaction many years into their career.

 

References

Stovholt, T.M, (2001). The Resilient Practitioner, Boston: Allyn & Bacon.

Teyber, E. & McClure F. (2000) Therapist Variables. In.Snyder, C. & Ingram, R. (Eds) Handbook of Psychological Change: Psychotherapy Processes and Practices for the 21st Century. New York: Wiley

 

© 2007 Marieke Geoghegan

 

Marieke Geoghegan studied Psychology and Rehabilitation Counselling at The University of Western Australia and Curtin University or Technology, Western Australia, before commencing a Masters in Counselling. She has a special interest in Burnout in the Counselling Profession and Therapist Development and Characteristics.

 


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