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Therapist Metamorphosis: Beginner and Experienced View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by South East Academic Libraries System (SEALS) THERAPIST METAMORPHOSIS: BEGINNER AND EXPERIENCED PSYCHOTHERAPISTS’ JOURNEYS OF PROFESSIONAL THERAPEUTIC DEVELOPMENT CHRISTINE LAIDLAW 209096015 Submitted in partial fulfilment of the requirements for the degree of Magister Artium in Clinical Psychology in the Faculty of Health Sciences at the Nelson Mandela Metropolitan University December 2010 Supervisor: Prof. C. N. Hoelson ii DEPARTMENT OF ACADEMIC ADMINISTRATION EXAMINER SECTION SUMMERSTRAND NORTH CAMPUS PO Box 77000 Nelson Mandela Metropolitan University Port Elizabeth 6013 Enquiries: Postgraduate Examination Officer DECLARATION BY CANDIDATE NAME: Christine Laidlaw STUDENT NUMBER: s209096015 QUALIFICATION: Magister Artium in Clinical Psychology TITLE: Therapist Metamorphosis: Beginner and Experienced Psychotherapists‟ Journeys of Professional Therapeutic Development DECLARATION: In accordance with Rule G4.6.3, I hereby declare that the above- mentioned treatise is my own work and that it has not previously been submitted for assessment to another university or for another qualification. SIGNATURE: ___________________________ DATE: ___________________________ iii Acknowledgements If you follow your bliss, you put yourself on a kind of track that has been there all the while, waiting for you, and the life you ought to be living is the one you are living. Wherever you are – if you are following your bliss, you are enjoying that refreshment, that life within you, all the time. – Joseph Campbell, The Power of Myth, (1988, p. 91). I wish to thank God, for this most amazing time I have had in writing this treatise to reflect on the vocation of being a psychologist and how I have been privileged to become part of those who bind up the brokenhearted. I wish to thank Professor Chris Hoelson, you were an answer to prayer! Thank you for being such a gifted Guide with your expertise, curiosity, attention to detail and patience as this journey unfolded. I wish to thank the participants of this study who so graciously gave of their time and of themselves to let me be a curious traveller in their inner world of being a therapist, and those colleagues who knew who I could ask and who encouraged me in my exploration of therapist landscapes. Thank you for making such a nerve-wracking endeavour so enjoyable. The profession is blessed to have you. iv I wish to convey my immense gratitude to Momentum and Tshikululu Social Investments for their award of a Momentum Research Bursary (2010) as well as Nelson Mandela Metropolitan University for a NMMU Postgraduate Research Scholarship (2009) which made financial assistance available for the current research study. I wish to thank my family who continually remembered to ask, “So, how is the thesis going?”, and who have selflessly supported me in following my bliss. May you know how much I love and appreciate you. I wish to thank my friends faraway who have lived through years of me being in books and who always asked, “So, tell us about the Friendly City and how therapists work?” Your prayers have been felt. I wish to thank my friends here, you were the hidden blessing. Thank you for making dinner and drinking countless coffees with me when I needed you, circling calendar deadlines and reassuring me that the End is in sight. I am really looking forward to being in the profession together. v Table of Contents Page Acknowledgements iii List of Appendices x List of Figures xi Summary xii Chapter 1: Introduction 1 The Broader Context of the Research 1 International Research of Psychotherapists‟ Professional Development 2 South African Research of Psychotherapists‟ Professional Development 3 Structure of the Treatise 4 Chapter 2: Theoretical Framework 5 Introduction 5 Key Concepts to Orientate Exploration of Psychotherapists 6 Developmental Milestones of Psychotherapists 6 Defining Expertise 6 Delineating Therapeutic Expertise 8 Models to Navigate Development of Psychotherapists 10 The Developmental Model of Psychotherapists 10 The Levels of Competency Model 14 The Skill Development Model 15 Facets of Psychotherapists and Therapeutic Work 18 Career Levels 18 Theoretical Orientation(s) of Therapists 19 vi Primacy of the Therapeutic Relationship 22 Personal Characteristics of Therapists 23 Key Qualities and Ethical Values of Therapists 26 Key Skills of Therapists 27 Developmental Influences 28 Critical Incidents in Professional Development 31 Professional Sources of Influence upon Psychotherapist Development 33 Experience with Patients 34 Therapists‟ Use of Personal Therapy 35 Supervision of Psychotherapists 37 Mentoring of Psychotherapists 41 Ongoing Professional Development 42 Approach to Therapeutic Process 45 Descriptions of Therapeutic Relationship Stances 45 Empowerment/Strength-based Approach 46 Metaphors of the Therapeutic Process 46 Complexity of the Therapeutic Process 50 Evaluation of One‟s Therapeutic Work 51 Conclusion 53 Chapter 3: Research Methodology 54 Introduction 54 Epistemology of Social Constructionism 54 Research Method: Qualitative Approach 56 vii The Self of the Researcher 57 Ethical Considerations 58 Selection of Participants 59 Data-gathering Procedure 62 Data-gathering Tool: Semi-structured Interviews 62 Data Analysis of Texts 64 Data Verification 67 Chapter 4: Findings 70 Developmental Influences 70 Hard-won Meanings: Motivations for Becoming a Psychotherapist 71 Formative Experiences: Taking a History 75 Wounded Healer: Therapists‟ Own Emotional Scarring 78 Theoretical Orientation(s) 88 Constructing a Personal Theoretical Framework 88 Matching the Know-how to the Need 94 Theoretical Differences 96 Systemic Ways of Thinking: The Butterfly Effect 98 Getting a Grip on Theory 100 Beyond Book Knowledge 102 Personal Qualities 107 Primacy of the Therapeutic Relationship 108 The Chameleon-like Therapeutic Stance 109 Concocting a Palatable Therapist Self 115 viii Basic Essence of Therapists 119 Other Personal Variations 120 The Imperfect Therapist 121 Curiouser Curiouser: Welcomed Interloper 123 Having an Intuitive Feel for People 125 Not Taking Oneself Too Seriously 126 Appreciating Diversity 127 Ministering to the Soul 128 Steering an Ethical Course 130 Approach to Therapeutic Process 131 Word Pictures of the Talking Cure 131 Complexity of the Therapeutic Process 144 Immeasurable Change: Evaluation of One‟s Therapeutic Work 148 Shifts in Felt Competency 156 Bursting Bubbles: Naivety to Groundedness 158 Thrown in the Deep End to Swimmingly Well: Trepidation to Anticipation 161 Handing Over the Reins: Empowering the Client 163 Loosening Up: Rigidity to Flexibility 165 Influences on Professional Growth 167 Learning from Direct Experience with Patients 168 Therapists‟ Use of Personal Therapy: “I would be in that chair” 170 A Bird‟s Eye-view: Supervision of Psychotherapists 173 Mentoring of Psychotherapists 179 ix Hungry to Grow: Ongoing Professional Development 181 Constructing a Professional Identity 182 Drawing the Line: Negotiating the Personal and Professional 182 The Never-ending Revolving Door: Increased Self-awareness 183 Switching Off…and Going Home: The Therapist‟s Own Life 185 The Never-not Changing Psychotherapist 187 Challenges to Practice 188 Psychology as a Business: Constrained by Managed Care 188 A Psychologised Society and the Stigma of Psychology 189 My Personal Journey 190 The Researcher in the Mirror: My Self-reflexivity in the Research 190 Chapter 5: Conclusion 194 Introduction 194 Overall Findings 194 Limitations of the Current Research 197 Recommendations for Future Research Directions 198 References 201 x List of Appendices Appendix A: Interview Guide 233 Appendix B: Information Letter 235 Appendix C: Informed Consent 237 Appendix D: Thematic Analysis: Categories, Main Themes and Subthemes 243 Appendix E: Ingredient List of the Participants‟ „Recipe‟ for a Master Therapist 245 Appendix F: Established Psychologist Participant K‟s Metaphor 248 Appendix G: A Narrative Reflection on My Personal Development as a Therapist 250 xi List of Figures Figure 1: Leary‟s Interpersonal Circumplex Model 252 xii Summary This research aimed to trace the development of psychologists as therapists within a South African context. Two distinct career levels were explored in relation to a competency model, a skills development model, and a developmental phase model of psychotherapists‟ professional development. Through purposive sampling five intern psychologists and six registered psychologists with at least seven years post-qualification client contact were selected according to the inclusion criteria of the study. Through semi-structured interviews, couched in the social constructionist position, the participants‟ experiences were thematically analysed. In addition, the researcher‟s own personal journey of developing as a psychotherapist was reflected upon. The current research study found that a number of aspects fostered the development of psychotherapists. Across the two career levels the life experiences of participants particularly featured events that were personally wounding or placed the participant in the helper role. The theoretical orientation(s) of participants were voiced as influential in their development, yet the ability to adjust their theoretical orientation to clients‟ needs was of overriding importance. Participants emphasised forming a strong therapeutic relationship with clients as the centrepiece of psychotherapy and depicted the therapeutic process using diverse metaphors.
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