Becoming a Psychotherapist: Learning Practices and Identity Construction Across Communities of Practice

Within a perspective that views groups as communities of practice and sites of construction of knowledge, learning, and identity, this article aims to explore the contribution that participation in different groups over the course of one’s life provides to the development of the professional practices of psychotherapist trainees enrolled in the C.O.I.R.A.G. school, an Italian graduate program in group psychotherapy. Through qualitative analyses of 10 semi-structured interviews, our study empirically shows that by participating in groups, the trainees not only learn the practices of that group but also develop a sort of meta-learning which takes place across groups. The results highlight that: (1) Transversality, duration, and informality are found to be the group properties with the highest formative value; and (2) Learning practices across different groups have common characteristics: are organized around complex topics of group life (e.g., how to manage conflicts, how to join and leave groups, etc.), began in early group experiences, are in continuous evolution, are associated with a critical event, and a negative affect. At the same time, it seems that these critical events are exactly what triggered and sustained the learning practices. Data from the interviews also showed how professional identities are constructed as the outcome of learning in different communities of practice. The study outlines how the experience made in different groups is elaborated in and through meaningful self-narratives, highlighting them as a fundamentally collective and culturally shaped sense-making process. Overall, these results contribute to a better understanding of learning processes as situated and jointly constructed through multiple group participations over time. Furthermore, they contribute to highlighting the role of self-narratives as a primary way through which trainees shape their identity as self-reflexive professionals who are competent in reading group dynamics. Directions for future research and suggestions for psychotherapist training paths are outlined in the conclusions.

A digital Gesell chamber: adjustments for professional practices in social isolation

The aim of this study was to show the migration process, due to the covid-19 pandemic, of the psychotherapist training program provided by a psychological care center from a real Gesell chamber to a digital version. The method used was action-research with self-study from the practitioners and supervisor whom reported their experiences with this new mode of working. An informed consent was given to students and participants explaining the implications of the process and its limitations, as well as the intention to publish findings. As results: the digital Gesell chamber presented some technical difficulties; however, it was a useful and ethical response to continue with the training program, with broad benefit for users. What is more, it presented communication advantages that allowed the reflective group to intervene without interruption. In conclusion: the use of the digital chamber was an alternative that eased the supervision of practitioners as well as the optimal performance of psychological care during social isolation.

Can we agree on the quality of clinical supervision? Inter-rater reliability of the Short–SAGE (Supervision: Adherence and Guidance Evaluation) scale

Clinical supervision is a cornerstone in psychotherapist training, but research in this area is hampered by a lack of validated tools for assessing supervision quality. Short–SAGE (Supervision: Adherence and Guidance Evaluation) is an observational instrument designed for evaluating supervision in cognitive behavioural therapy. The aim of this study was to evaluate the inter-rater reliability of Short–SAGE. Four experienced clinical psychologists participated in three 3-hour Short–SAGE coding training sessions, followed by an additional meeting and coding instructions. In a cross-over design, codings of 20 supervision sessions were then assessed with intraclass correlations (ICC), for both the 3- and 7-point scales of the instrument. In the single measure analyses for both scales, only one item showed ICC in the good range, and the rest of the 14 item ICCs were in the poor to fair range. Moreover, on the 3-point scale, five of the 14 inter-rater correlations were non-significant. For research and training purposes, validated tools to assess supervision quality are highly needed. However, instruments for measuring adherence and/or competence are of little value if the coders do not attain inter-rater reliability. Whether quality of supervision is associated with improvements in supervisees’ competencies is not yet clear. Short–SAGE provides a tool that may enable empirical research in this area. Further studies are needed to assess whether extensive training can improve the inter-rater reliability of Short–SAGE. Key learning aims (1) Readers will be aware of the urgent need for validated tools to assess clinical supervision quality. (2) Readers will be familiar with some existing tools for assessing the quality of clinical supervision. (3) Readers will be able to identify common problems in the development of instruments for assessing clinical supervision.

Psychotherapy Practice and Research

This chapter reviews researches on the processes and outcomes of psychotherapy. The research indicates use of varied modalities including cognitive behavioural therapies, psychodynamic approaches, and couple and family therapy interventions. These techniques are used in varied contexts such as medical and surgical consultation-liaison settings. Models of care and service delivery have been translated to facilitate the shift from the clinic to the community, accompanied by an expanded role for counsellors and therapists. Cultural sensitivity in the practice of therapy and in the shift to culturally relevant models of therapy and practices like yoga and meditation is evident. Experiential, qualitative studies tapping psychotherapy processes and the inward gaze towards psychotherapist training, development, and professional issues collectively chart a path less trodden. The practical impediments to progress in psychotherapy practice, training, and research in the country are discussed and pathways for future are outlined.

Psychotherapy: A Very Short Introduction

Psychotherapy: A Very Short Introduction traces the development of psychotherapy from its origins in Freud’s psychoanalysis to the range of different approaches—counselling, cognitive behaviour therapy, other time-limited therapies, mindfulness, and group and family therapies. Describing the processes central to them all and highlighting their differences, it demonstrates what problems each therapy is best suited for. The principles behind the most commonly available types of psychotherapies are explained, and examples of what patients can expect when they seek such help are provided. This VSI concludes by examining the practice of psychotherapy: the types of psychotherapist training, the safeguards that exist to keep practice reliable, and how to choose a psychotherapist.