O que Terapeutas Comportamentais Aprendem para sua Prática Clínica na Relação Terapêutica? / What Do the Behavioral Therapists Learn for their Clinical Practice in the Therapeutic Relationship? / ¿Qué Aprenden los Terapeutas Conductuales para su Práctica Clínica en la Relación Terapéutica?

De acordo com a visão vigente, aprende-se a ser psicoterapeuta comportamental em cursos, onde se ensinam teoria, intervenções e técnicas; e na supervisão, onde a atuação do terapeuta é aprimorada. O objetivo deste estudo foi examinar uma terceira via de aprendizagem. O que os terapeutas aprendem na relação com seus clientes? Foram entrevistados 14 terapeutas analítico-comportamentais, cognitivo comportamentais ou comportamentais contextuais, a respeito do que aprenderam com seus clientes para sua prática clínica. A análise das transcrições foi pautada nos preceitos da grounded theory analysis. Os resultados sugerem que os terapeutas aprendem sobre algumas coordenadas importantes do processo terapêutico: a singularidade de cada cliente, a responsabilidade do cliente e do terapeuta para o processo e sobre as suas limitações como terapeuta. Expandem suas competências clínicas: como enxergar além de rótulos e julgamentos, assumir uma postura terapêutica, flexibilidade e autenticidade. Adquirem estratégias clínicas, aprendem a ceder espaço para o cliente, a respeitar o tempo do cliente e responder às suas necessidades. Finalmente, aprendem a manejar riscos e contrariedades, a lidar com a proximidade no relacionamento, como usar dos seus equívocos a favor da terapia e conduzir aspectos burocráticos da sua profissão.

According to the current view, the role of a behavioral therapist is trained in courses which theory, interventions and techniques are taught and in clinical supervision supervision where the beginner's performance is shaped. The aim of this study was to explore a third learning pathway. What do therapists learn in their relationship with their clients? Fourteen behavioral and cognitive-behavioral therapists were interviewed about what they learned from their clients. The transcripts were examined according to the precepts of grounded theory analysis. The results suggest that therapists learn about important coordinates of the therapeutic process: the uniqueness of each client, the client's and therapist's responsibility in the process, and also about therapists limitations. They expand their clinical competencies: how to see beyond labels and evaluations, to assume a therapeutic stance, be flexible and authentic. They acquire clinical strategies, learning to allow due space to the client, to respect the client's time and to respond to their needs. Finally, they learn how to manage risks and setbacks, to deal with closeness in the relationship, take advantage of their errors in favor of therapy and how to manage bureaucratic aspects of their profession.

Según la visión actual, la profesión de psicoterapeuta se aprende de los profesores que imparten teoría, intervenciones y técnicas y de los supervisores que acompañan la actuación. El objetivo de este estudio fue identificar una tercera vía de aprendizaje: ¿qué aprenden los terapeutas con sus clientes? Se entrevistó a catorce terapeutas conductuales y cognitivo-conductuales sobre lo que aprendieron con sus clientes. El análisis de datos se basó en los preceptos del análisis de teoría fundamentada. Los resultados sugieren que los terapeutas aprenden sobre las coordenadas importantes del proceso terapéutico: la singularidad de cada cliente, la responsabilidad del cliente y del terapeuta por el proceso y sus limitaciones como terapeuta. Los terapeutas amplían sus competencias clínicas: cómo ver más allá de las etiquetas y los juicios, adoptar una postura terapéutica, desarrollar flexibilidad y autenticidad. Adquirir estrategias clínicas, aprender a darle espacio al cliente, respetar el tiempo del cliente y responder a sus necesidades. Finalmente, aprenden a gestionar los riesgos y contratiempos, a lidiar con la proximidad al cliente, a aprovechar los conceptos erróneos a favor de la terapia y a gestionar los aspectos burocráticos de su profesión.

Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.

We draw recommendations and conclusions from the articles presented in this special issue and the companion special section in Psychotherapy Research on evidence-based therapist skills and methods. For distal (end-of-treatment) outcome, 10 skills/methods were judged to be demonstrably effective (affirmation/validation, paradoxical interventions, homework, routine outcome monitoring, strength-based methods, emotional regulation, imagery rehearsal therapy and exposure relaxation and rescripting therapy for nightmares, meditation/mindfulness/acceptance, behavioral activation, cognitive restructuring) and four were probably effective (rupture repair, role induction, collaborative assessment methods, chairwork). For intermediate (postsession or midtreatment) outcome, one method was judged to be demonstrably effective (cognitive-experiential dreamwork) and two methods probably effective (paradoxical interventions, homework). For immediate (in-session) outcomes, five skills/methods were judged to be probably effective (in-dialog silences, extended silences, role induction, strength-based methods, and emotion regulation). For the rest of the immediate, intermediate, or distal outcomes for skills/methods, there was either no or insufficient research available upon which to base judgments. Possible harmful effects, diversity considerations, and research limitations are summarized. The article ends with training implications, therapeutic practices, and the formal conclusions of the interorganizational Task Force on Psychotherapy Skills and Methods that Work. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

[How Outpatient Psychotherapists Deal with Patients' Traumatic Experiences in Consideration of an Additional Qualification in Trauma Therapy]. / Umgang ambulanter Psychotherapeut*innen mit traumatischen Erfahrungen von Patient*innen unter Berücksichtigung einer traumatherapeutischen Zusatzqualifikation.

OBJECTIVE: Investigation of the differences in dealing with traumatic experiences of patients between psychotherapists with and without further training in trauma therapy or partial qualification. METHODS: Online survey of outpatient psychotherapists (N = 148) on possible obstacles in addressing traumatic experiences of patients and self-reported professional practice. RESULTS: Further training in trauma therapy is associated with a higher level of competence in professional practice and fewer obstacles in addressing traumatic experiences. CONCLUSION: A lower level of competence among psychotherapists without further training in trauma therapy speaks for the need for compulsory trainings. The expansion of low-threshold treatment offers for those affected by traumatic experiences and the dismantling of access barriers is urgently needed.

Micro-fenomenología de la subjetividad del psicoterapeuta sistémico / Micro-phenomenology of the subjectivity of the systemic psychotherapist / Micro-fenomenologia da subjetividade do psicoterapeuta sistêmico

La terapia psicológica sistémica acontece en un contexto relacional, donde interactúan las subjetividades de los consultantes y los terapeutas. Las investigaciones tradicionales han focalizado más las características de los consultantes, que la subjetividad del terapeuta. De ahí que hayan privilegiado perspectivas de "tercera persona". Los pocos estudios que indagan la subjetividad del terapeuta recurren a metodologías introspectivas, interpretativas y prescriptivas. ¿Cómo acceder a la subjetividad del terapeuta desde perspectivas distintas a las que ofrecen la observación en "tercera persona" y la introspección en "primera persona"? El propósito del artículo es explorar, mediante el método micro-fenomenológico, cómo se muestra la subjetividad del terapeuta en la primera impresión de un consultante. Para ello, se realizaron entrevistas a seis terapeutas. Los resultados evidencian que la emocionalidad en-activa aparece como una invariante de la subjetividad del terapeuta; y que esta invariante opera como una "motivación inteligente", la cual entra "en acción" en el trascurso de la relación intersubjetiva misma y, permanentemente, monitorea y orienta el proceso terapéutico. Los resultados permiten considerar, por un lado, que las investigaciones tradicionales han subvalorado la importancia de la emocionalidad en-activa en el proceso terapéutico; y, por otro, que el mejoramiento cualitativo de la terapia implica no sólo reconocer esta invariante, sino también cultivarla.

Systemic psychological therapy takes place in a relational context, where the subjectivities of the consultants and the therapists interact. Traditional research has focused more on the characteristics of the consultants than on the subjectivity of the therapist. Hence, "third person" perspectives have been privileged. The few studies that investigate the subjectivity of the therapist resort to introspective, interpretive and prescriptive methodologies. How to access the subjectivity of the therapist from different perspectives than those offered by "third person" observation and "first person" introspection? The purpose of the article is to explore, through the micro-phenomenological method, how the subjectivity of the therapist is shown in the first impression of a consultant. To do this, interviews were conducted with six therapists. The results show that en-active emotionality appears as an invariant of the therapist's subjectivity; and that this invariant operates as an "intelligent motivation", which enters "into action" in the course of the intersubjective relationship itself and permanently monitors and guides the therapeutic process. The results allow us to consider, on the one hand, that traditional research has undervalued the importance of en-active emotions in the therapeutic process; and, on the other, that the qualitative improvement of therapy implies not only recognizing this invariant, but also cultivating it.

A terapia psicológica sistêmica ocorre em um contexto relacional, onde as subjetividades das pessoas que consultam interagem. A pesquisa tradicional se concentrou mais nas características das pessoas que consultam do que na subjetividade do terapeuta. Portanto, as perspectivas da "terceira pessoa" foram privilegiadas. Os poucos estudos que investigam a subjetividade do terapeuta recorrem a metodologias introspectivas, interpretativas e prescritivas. Como acessar a subjetividade do terapeuta sob perspectivas diferentes daquelas oferecidas pela observação em "terceira pessoa" e introspecção em "primeira pessoa"? O objetivo do artigo é explorar, através do método micro-fenomenológico, como a subjetividade do terapeuta é mostrada na primeira impressão de um consultor. Para isso, foram realizadas entrevistas com seis terapeutas. Os resultados mostram que a emocionalidade em-ativa aparece como um invariante da subjetividade do terapeuta; e que esse invariante opera como uma "motivação inteligente", que entra em "ação" no curso da própria relação intersubjetiva e monitora e guia permanentemente o processo terapêutico. Os resultados permitem considerar, por um lado, que a pesquisa tradicional subvalorizou a importância das emoções em-ativas no processo terapêutico; e, por outro lado, que a melhoria qualitativa da terapia implica não apenas reconhecer esse invariável, mas também cultivá-lo.

Caring for women with substance use disorders through pregnancy and postpartum during the COVID-19 pandemic: Lessons learned from psychology trainees in an integrated OBGYN/substance use disorder outpatient treatment program.

OBJECTIVE: This article presents a brief overview of the challenges and facilitators to the provision of substance use disorder (SUD) treatment for pregnant and parenting women during the COVID-19 pandemic. Specifically, we highlight the deployment of telepsychology services during the pandemic by an integrated, trainee-based women & addictions program that provides care via a multidisciplinary team, including an obstetrician, addiction medicine fellow, nurse, behavioral health trainees, violence prevention advocates, and pediatric provider. METHODS: We outline unique adaptations that the program made to shift from in-person psychology trainee services to telepsychology. Additionally, we describe supporting factors and barriers to success for continued treatment planning, service provision, and educational training. RESULTS: The program identified and addressed numerous opportunities for improvement to implement and continue telepsychology within an integrated women & addictions program during the COVID-19 pandemic. The program maintained the unique components of care integration with the proliferation of digital resources for patients and providers, as well as the flexibility of attending physicians and supervising psychologists. CONCLUSIONS: Provision of telepsychology services within an integrated women & addictions program employing trainees is crucial during the COVID-19 pandemic. The program addressed barriers to care in creative ways, through the use of various technologies, to meet patients where they are. Continuing to have this option available requires adaptation to the maturing needs of the clinic.

[Qualitative Evaluation of the Implementation of Group Psychoeducation for Bipolar Disorder in Clinical Settings in Quebec]. / Évaluation qualitative de l'implantation de groupes psychoéducatifs pour le trouble bipolaire à Québec.

Objectives Bipolar disorder is a chronic condition which significantly impacts the functioning and quality of life of patients with the disorder. Recognized efficacious psychological interventions, such as group psychoeducation, can help better address some of the limitations observed when pharmacotherapy is used alone in the management of bipolar disorder. However, access to these evidence-based interventions seems to be limited for most patients. Indeed, the translation of knowledge acquired through research towards actual clinical settings poses a significant challenge. Assessing the implementation of these efficacious interventions in clinical practice is thus a priority. The objective of this study is to describe the implementation of a psychoeducative intervention, the Life Goals Program (LGP), for the treatment of bipolar disorder in community mental health settings in Quebec City. Methods The LGP was implemented in three different clinical settings located in Quebec City. Fifteen healthcare service providers chosen by their respective clinical site were trained to deliver the intervention. They delivered the treatment to 73 patients with a diagnosis of bipolar disorder. Healthcare service providers filled a log book after each group session, in order to assess whether they had properly delivered the content of the program. At the end of the study, they also participated in a group interview in order to get a better understanding of their experience delivering the intervention and their appreciation of the research process. Results Following qualitative content analysis, four main categories of factors that could influence the implementation of the intervention were identified: 1) healthcare service providers' characteristics (academic training, clinical experience, personality, knowledge of the program, and dynamic between animators); 2) participants' characteristics; 3) organizational context (physical and material environment, staff stability, administrative management and research requirements); and 4) facilitation (perception of research, research team support, and facilitation tools). These categories derived from data analysis coincide with those observed in the literature. The following factors seemed to have had the most impact in the differences observed between sites in the implementation of the LGP: the support offered by the research team; staff stability; and the academic training of healthcare services providers. Conclusion Dissemination and implantation studies can not only help determine factors that are important to consider when implementing a program, but can also help improve and adapt these programs in order to increase acceptability and effectiveness in real world clinical settings.

Film as an educational tool to train psychotherapists.

Starting with Freud who wrote about Dostoyevsky, Michelangelo, and da Vinci, therapists have acknowledged that the humanities and arts contain great sources of insight into human nature. In this paper, I argue for the need to incorporate insights acquired by artists into the training of psychotherapists. Specifically, I present and describe a graduate-level seminar I teach that uses cinema as a tool to train mental health practitioners. Films are used to expose students to a range of universal human issues; we discuss film characters' conflicts, motivations, sources of suffering, and attempts to cope. Further efforts should be devoted to search for ways to use art to inform and enrich the practice, training, and teaching of psychotherapDirected by Robert Redford and produced in the United Statesy.

The use of cinematherapy to illustrate systemic resilience.

Resilience is the process of coping with and overcoming adversity, finding purpose in the face of suffering, and preparing for the future with a focus on interconnections and personal strengths. Being resilient is the ability to flourish in the face of trauma or hardship. The traits and processes of resilience are woven throughout the film Little Miss Sunshine. As characters deal with suffering, they also embody systemic strengths, which align with the current resilience research. This paper explores the use of cinematherapy to illustrate concepts of resilience in systemic therapy and in training relational therapists.

Professional and Personal Development After Psychoanalytic Training: Interviews with Early Career Analysts.

After analytic training, graduates position their newly acquired identity as "psychoanalyst" in the context of their broader career, contemplating whether to start new analytic cases, adapting their new knowledge base to psychotherapy practice, and deciding how to focus their professional and personal interests going forward. Using questionnaires and interviews, the Columbia Postgraduate Analytic Practice Study (CPAPS) has prospectively tracked the career trajectory of 69 of 76 graduates (91%) from the Columbia University Center for Psychoanalytic Training and Research since 2003. In this paper grounded theory is used to identify developmental themes in interviews with analysts who have been followed for at least ten years. Recent graduates are negotiating the following challenges: developing a sense of competence, navigating relationships with colleagues and former supervisors as situations change and roles shift, transitioning into becoming mentors, and balancing the competing responsibilities of professional and personal life. Disillusionment about aspects of training, analytic practice, analysis as a treatment, institute politics, and the field in general emerges as a stark reality, despite a high level of career satisfaction. Educational recommendations include making career development opportunities available and providing a realistic view of both practice realities and expectations of analytic treatment outcome.

Combined Training of Candidates, Scholars, And Psychotherapists: A Model of Psychoanalytic Education for the Twenty-First Century.

A new model of psychoanalytic education is proposed that will meet the challenges of educating candidates in a new century. Prospective candidates have varying opinions about the value of analytic training, opinions that reflect economic and cultural conditions different from those facing previous generations. Overall, today's graduate-level students hold less favorable attitudes toward psychoanalysis than did their counterparts in the past. The proposed model calls for combining analytic candidates, psychotherapy students, and academic scholars for two years in a Psychoanalytic Studies Program (PSP), after which candidates take their subsequent years of training in a cohort made up exclusively of analytic candidates. A curriculum that focuses on the core concepts in psychoanalysis allows students in all three categories to learn the foundational knowledge of psychoanalysis that once was widely taught in graduate mental health programs. The philosophy that underlies the model and the structure and orientation of the course sequences are presented. Implementatiion of the model having shown positive results, its strengths and limitations are evaluated against the traditional model, in which candidates and psychotherapy students are educated separately.

[The Culturally Sensitive Therapy Relationship: A Concept for the Training and Further Education of Psychotherapists]. / Die kultursensible Therapiebeziehung: Ein Konzept für die Aus-, Fort- und Weiterbildung von Psychotherapeutinnen und Psychotherapeuten.

Already in 2002, the Sonnenberger Leitlinien called for the development of further training programs for psychotherapists in the context of the intercultural opening of the psychosocial health care system [1]. However, so far, there has been a lack of evaluated, accessible (published) training concepts to enhance the intercultural and transcultural competences of psychotherapists in German-speaking countries. This article presents a training concept for medical and psychological psychotherapists as well as for psychologists in training based on the guidelines for trainings in inter-/transcultural competence for psychotherapists [2]. The concept focusses especially on the reflection of one's own culturally influenced values as well as on knowledge and skills that facilitate the development of a therapeutic relationship in an intercultural setting. Implementation tips are presented to help readers to apply the concept.

Early phase child and adolescent psychiatry response after mass trauma: Lessons learned from the Easter Sunday attack in Sri Lanka.

BACKGROUND: Sri Lanka is a South-Asian nation with a multi-ethnic population. A 26-year-old armed conflict ended in 2009 and the relative stability over the last decade was unexpectedly disrupted by the Easter Sunday Bombings of Catholic Churches and luxury hotels in 2019. More than 250 were killed and most of the deaths were reported from the St. Sebastian's Church in Negombo in the District of Gampaha. This article describes how mental health services of the District of Gampaha, with a population of 2.3 million and only one child and adolescent psychiatrist responded to the psychological trauma in children. ACTIVITIES: The child and adolescent psychiatry response to the mass trauma was a collaboration between health, educational and voluntary organisations. The psychological support was provided at affected villages, schools and hospital settings. Medical and non-medical personnel were able to refer affected children directly to the child and adolescent psychiatrist. Children who had developed psychological consequences of trauma were provided with evidence-based psychotherapies and psychopharmacology where necessary. In addition, health staff members and teachers were trained to provide psychological support and a booklet was prepared in the local language based on trauma-focused cognitive behaviour therapy. Psychoeducation about the psychological response to trauma was provided through electronic, printed and social media. The limited number of trained psychotherapists and experts in child mental health were a major barrier to implement effective management strategies. CONCLUSION: Due to the severe shortage of child mental health experts, practical low-cost methodologies were employed to provide an early response to trauma. Traditional ways of mental health service provision were modified to be implemented via non-experts.

Sitting In: The Experience of Learning and Practicing Family Therapy through Being a Co-Therapist in Hong Kong.

This article explores family therapy trainees' subjective experiences of working as cotherapists with a supervisory-level therapist in a Chinese context, regarding their perceptions of and positioning in it and also their opinions on the benefits and/or pitfalls of cotherapy. Individual interviews with a total of six cotherapists revealed three themes: (1) Cotherapy was perceived as an experiential learning journey that evolved from anxiety and excitement to empowerment and nurturing; (2) a collaborative master-apprentice relationship of openness, trust, and mutual respect was developed with both sides' interactive effort, which included common commitment and concern for the client, the supervisor's awareness and explicit address of the role hierarchy, principle setting prior to the cooperation, and honest pre- and-postsession sharing and discussion; (3) the dual-purpose supervisor-trainee cotherapy brought direct benefits for all involved parties and for others. The findings have useful implications for integrating treatment and training for optimal training/learning outcomes and for advancing knowledge transfer from senior to junior and from academia to the field, with reference to local cultural characteristics.

Este artículo analiza las experiencias subjetivas de los practicantes de terapia familiar en su trabajo como coterapeutas con un terapeuta supervisor en un contexto chino, con respecto a sus percepciones de la coterapia y a su posicionamiento en ella, y también sus opiniones sobre los beneficios o los inconvenientes de la coterapia. Las entrevistas individuales con un total de seis coterapeutas revelaron tres temas: (1) la coterapia se percibió como un viaje de aprendizaje empírico que pasó de la ansiedad y el entusiasmo al empoderamiento y el estímulo; (2) se desarrolló una relación colaborativa de sinceridad, confianza y respeto mutuo entre el maestro y el aprendiz con el esfuerzo interactivo de ambas partes, que incluyó el compromiso común y la preocupación por el paciente, la comprensión del supervisor y el abordaje explícito de la jerarquía de roles, la fijación de principios antes de la cooperación, y el intercambio y el debate sinceros antes y después de la sesión; (3) la coterapia con doble finalidad entre el supervisor y el practicante tuvo beneficios directos para todas las partes implicadas y para los demás. Los hallazgos tienen consecuencias útiles para la integración del tratamiento y la capacitación a fin de obtener resultados óptimos a nivel de capacitación y aprendizaje, y de fomentar el traspaso de conocimiento desde los profesionales experimentados a los profesionales noveles, y desde el mundo académico al ejercicio de la profesión, con referencia a características culturales locales.

The impact of alliance-focused and facilitative interpersonal relationship training on therapist skills: An RCT of brief training.

Research on standard methods of therapist training has found mixed evidence to as to whether standard training methods are effective. This study investigated the impact of a novel, research-informed training protocol that integrated elements of alliance-focused training (AFT) and facilitative interpersonal skills (FIS). Beyond traditional training techniques of didactics and lecture, the AFT/FIS intervention incorporated empirically supported video simulations of therapy, which were reinforced by role plays and deliberate practice on key therapeutic interpersonal skills. Fifty-eight graduate-level therapy trainees and professional therapists from various helping fields were randomized to one of two brief trainings in a multi-site RCT: (i) the AFT/FIS workshop or (ii) a more traditional demonstration training (DT) workshop. Participants were assessed on critical, relational therapeutic skills before and after the training. After controlling for relevant covariates, participants in the AFT/FIS training saw a marginally higher post-intervention level of overall therapeutic skills. Subsequent exploratory analyses revealed AFT/FIS participants also had significantly higher levels of specifically targeted post-training therapist skills (i.e., empathy, alliance bond capacity, and alliance rupture-repair responsiveness) compared to participants in DT. Implications for future empirical investigations and training initiatives are discussed.

Exploring Relational Dialogue in Solution-Focused Coaching Sessions: An Analysis of Co-Construction and Reflection.

Purpose: To examine solution-focused coaching (SFC) as a means to enhance clinicians' professional development. Methods: Six pediatric rehabilitation clinicians (three physical, two occupational, and one behavior therapist) each received two SFC sessions targeting clinical listening goals. Conversational intervals were noted in session transcriptions. Frequencies of relational strategies and conversational intervals were calculated. The meaning of intervals > 10 s was examined. Results: The most frequent relational strategies indicated that SFC facilitates reflection and critical thinking, and encourages action. An appreciable number of long intervals (>10 s) occurred, indicating substantial reflection by participants. These were embedded in relational dialogue sequences involving coach questions and formulations, and participant pauses. Conclusions: The findings support the use of SFC as a professional development tool and substantiate the view that SFC 'works' through the coach's use of relational strategies designed to facilitate collaborative conversations that build solutions through an emphasis on reflection and action.

[Maintaining a Strong Therapeutic Alliance: Initial Experiences with the Alliance-Focused Training (AFT) in Germany]. / Umgang mit Spannungen und Krisen in der therapeutischen Beziehung: Erste Erfahrungen mit einem handlungsorientierten Ausbildungs- und Supervisionskonzept.

AIMS: Alliance Focused Training (AFT) 1 aims at enhancing therapists' competences in resolving ruptures in the therapeutic alliance using video recordings and role-plays. This pilot study funded by the Heigl Foundation aimed at presenting initial results and clinical experiences with AFT in Germany, and to prepare a subsequent RCT. METHODS: 7 trainee therapists participated. Therapies of 15 patients with depressive disorder were analyzed. RESULTS AND CONCLUSION: Trainees experienced AFT as very helpful for their professional development and for dealing with alliance ruptures. The therapeutic competence significantly improved both in self and in observer ratings. The results indicate that AFT is a promising approach to improve psychotherapy training, emphasizing the relevance of the planned proof of concept RCT.

Outsider Witness Groups as a Means of Professional Growth in Family Therapy Training: An Exploratory Qualitative Study.

This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees' participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees' experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees' development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.

Este estudio exploratorio cualitativo analiza las experiencias y los significados asociados con la participación de practicantes de terapia familiar en la práctica narrativa con grupos de testigos externos (OWG; White, 2007). En el Barcai Institute de Tel Aviv, incorporamos grupos de testigos externos en nuestros cursos de supervisión clínica en vivo. En algunas sesiones, ofrecemos a las familias que están en terapia la oportunidad de escuchar las reflexiones del grupo de practicantes con respecto a lo que observaron durante la sesión. Veintinueve practicantes de terapia familiar participaron en el estudio en cinco entrevistas de grupos focales. Los análisis de las entrevistas arrojaron cuatro temas principales relativos a las experiencias de los practicantes: (a) el análisis de la postura del terapeuta; (b) el arte de escuchar; (c) la reflexión sobre la jerarquía y la fijación de límites; y (d) la negociación de la autorrevelación. Los resultados indican que los practicantes de terapia familiar salen ganando considerablemente en su recorrido, desarrollo y crecimiento profesional como consecuencia de la integración de las prácticas de grupos de testigos externos en su formación. Los grupos de testigos externos fomentan el desarrollo de la reflexividad crítica en los practicantes, incluida la deconstrucción de los supuestos comunes y dados por sentado. También promueven las prácticas relacionadas con la terapia familiar, y quizá también con la terapia en general. Los resultados también sugieren que formar parte de los grupos de testigos externos durante la formación puede contribuir al desarrollo de la reflexividad crítica de los practicantes de terapia familiar como forma de incorporar un enfoque más crítico y político de la terapia y desarrollar sus propias historias preferidas como terapeutas.