Measuring psychotherapist functioning with the Therapist Work Involvement Scales (TWIS): reliability, factor structure, and measurement invariance.

OBJECTIVES: The Therapist Work Involvement Scales (TWIS) is a self-report research instrument that enables a multilayered description of psychotherapists' experiences when treating clients. The TWIS was created in a comprehensive study of close to 5,000 psychotherapists, and has been used in multiple studies. The aim of the current paper is to clarify the organization and statistical characteristics of the TWIS, and to present an updated version for longitudinal and cross-sectional research. METHODS: Collection of a large sample of psychotherapy trainees made possible the use of confirmatory factor analysis (CFA) to evaluate the dimensions and structure of therapists' process experiences, assessing reliabilities, measurement invariance over gender, item statistics, and correlations with other measures to show concurrent and predictive validity. RESULTS: The CFAs largely confirmed the factor structure of four of the five facets, and of the global super-factors. The global factors of Healing Involvement and Stressful Involvement each showed substantial correlations with therapists' attachment style and professional growth, and were used to describe four practice patterns that typify the experiences of therapists. CONCLUSION: The results have shown the TWIS to be a statistically sound, multidimensional research instrument enabling therapists to describe their experience in current therapeutic work.

Psychotherapist Trainees' Quality of Life: Patterns and Correlates.

While psychotherapists are trained to improve their clients' quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees' professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees' lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees' life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.

The personal self of psychotherapists: Dimensions, correlates, and relations with clients.

OBJECTIVE: The personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self-ratings on specific self-attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. METHOD: Data from the Development of Psychotherapists Common Core Questionnaire were available for > 10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. RESULTS: Most psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self-experiences, and parallel dimensions of relationship with clients correlated strongly. CONCLUSIONS: Analyses of > 10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life.

[Psychotherapy training in Austria: Baseline and socio-demographic background data from a SPRISTAD (Society of Psychotherapy Research Interest Section on Therapist Training and Development)-Pilotstudy]. / Psychotherapie-Berufsausbildung in Österreich: Basis- und soziodemographische Hintergrunddaten aus einer SPRISTAD-Pilotstudie (Society of Psychotherapy Research Interest Section on Therapist Training and Development).

Objectives: Description of the qualifications of psychotherapy-training candidates in Austria at the beginning of their training. Methods: Psychotherapists in training in Austria were interviewed at the beginning of their training concerning their socio-demographic background and prior education. These background data were collected using the Trainee Background Information Form (TBIF), which was designed by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (SPRISTAD). Results: The group of 197 psychotherapy trainees from Austria consists largely of women, of persons with high school education and with a satisfactory, financially secure life situation. One-third of them show a "second career" pattern, which is in line with the predominantly part-time training programs in Austria. A high percentage of the candidates have previous professional experience in the psychosocial field. Conclusions: As this is a pilot study, results can be seen as a starting point for further research in psychotherapy training and competence development. In discussing the findings, both national conditions and opportunities for future interdisciplinary research are considered.

Lessons from literature for psychotherapy practice and research1.

Insights from the study of literature can inform and clarify concepts to guide psychotherapy practice and research. The author offers instances from narrative fiction (Durrell's Alexandria Quartet) and poetry (Hopkins, Baudelaire) to illustrate how the formulation of experience in words that are evocative (vs. ordinary), original (vs. trite), and precise (vs. approximate) are able to capture attention, move the emotions, and challenge beliefs; and how linkages among experiences, vividly and precisely expressed, create and enhance narrative meaning-revealing the inherent relativity of individual meanings and the need to consider the aggregate of relevant perspectives in every interpersonal situation.

Psychotherapists Growing Older: A Study of Senior Practitioners.

A sample of 1,102 psychotherapists aged 60 years and older was selected from the multinational database of the Society for Psychotherapy Research Collaborative Research Network. These older therapists were first described in terms of gender, generation, years in practice, civil status, professional background, and theoretical orientation. To compare them on practice-related characteristics with cohorts of younger therapists, the following age-based taxonomy was developed: young adult (21 < 30); prime adult (30 < 45); mature adult (45 < 60); senior adult (60 to 90). Senior adults were further differentiated into young old (60 to 66), mid old (67 to 74), and long old (75 to 90). Comparisons between therapist age groups were made regarding practice setting, quality of therapeutic involvement, current use of supervision and personal therapy, currently experienced professional growth, personal life quality, and perceived aspects of self in close personal relationships. Given a series of positive results favoring senior adults as a group, and even long old compared to young old, it is suggested that these hardy "surviving" therapists typically have succeeded in mastering the developmental tasks of previous phases of professional development.

Utilization of personal therapy by psychotherapists: a practice-friendly review and a new study.

This article offers both a practice-friendly review of research on therapists' personal therapy and a new study of personal psychotherapy among 3,995 psychologists, counselors, social workers, psychiatrists, and nurses in 6 English-speaking countries. The prevalence of personal therapy as it relates to professional discipline, theoretical orientation, gender, and career level are studied. Findings showed that 87% of the overall sample embarked on personal therapy at least once: 94% of analytic/psychodynamic therapists, 91% of humanistic therapists, 73% of cognitive-behavioral therapists, 82% of the novice therapists to 89% of senior therapists. Both the existing research and this new study demonstrate the extraordinary commonality of personal therapy among psychotherapists, and encourage further use for professional training, clinical practice, and therapist self-care.

Professional development perceptions and activities of psychiatrists and mental health nurses in New Zealand.

AIMS: Psychiatrists (n=26) and mental health nurses (n=18) engaged in the practice of psychotherapy were surveyed regarding their perceptions and engagement in professional development activities. METHODS: Collaborative Research Network's (CRN) methodology was followed, and comparisons with CRN samples from Canada and the United States of America (USA) were undertaken. RESULTS: New Zealand psychiatrists reported perceived development across their careers, but their ratings were lower than those of nurses. Both professional groups rated their overall development lower their Canadian counterparts. However, New Zealand nurses reported more involvement in supervision than psychiatrists, and both groups reported rates that exceeded those reported in Canadian and USA samples. New Zealand subgroups reported low involvement in personal therapy in comparison to overseas samples. Supervision and personal therapy were highly regarded by New Zealand practitioners, but didactic training was rated as less important. CONCLUSIONS: New Zealand mental health professionals reported attainment of therapeutic mastery and skill acquisition. New Zealand psychiatrists reported less involvement in case supervision, but rated supervision as having the greatest influence to their development. The results highlight areas of need for continuing professional development for these professions.

Internalization of the therapeutic process: differences between borderline and neurotic patients.

Intersession process in psychotherapy refers to the thoughts, memories, and feelings about each other and about their therapy sessions that participants experience during the intervals between sessions. This study compared the intersession process experienced by patients who had been diagnosed with severe borderline personality disorders (BPD) with others who had not. A total of 76 patients with neurotic disturbances and 20 patients with BPD were treated in a therapeutic day clinic and completed the Intersession Experience Questionnaire (IEQ) before sessions of individual psychotherapy and the Session Questionnaire (Stundenbogen) after those sessions. Comparison of the two groups on these measures of intersession process and postsession outcome showed markedly different patterns in patients' evaluations and internalizations of in-session therapeutic experiences: most prominently, that BPD patients internalize therapy sessions with much more negative and contradictory emotions.

Becoming and being a psychotherapist: a psychodynamic memoir and meditation.

The author reflects on the circumstances of his becoming a psychotherapist and meditates on their meaning. He notes the effect on his survival through childhood of his grandparents' emigration from Europe and the influence of his close-knit family on his personal needs and values. He then reflects on his early vocational interests; the transformational power of his education, as a student and faculty, at the University of Chicago; and the constructive force of his professional collaboration and personal friendship with Kenneth Howard. Finally, he considers why it is important to him not only to have become but to continue to be a psychotherapist.

[The Intersession Questionnaire--an inventory for the measurement of patients' processing of psychotherapy between sessions]. / Der Inter-Session-Fragebogen (ISF)--Ein Instrument zur Erfassung von psychotherapierelevanten Prozessen zwischen Sitzungen.

In the intervals between psychotherapy sessions, patients often make use of the experiences that they have during sessions with their therapists, but these "intersession processes" (ISP) have been largely neglected in psychotherapy research. This study presents a German version of the Intersession Experience Questionnaire (IEQ, Orlinsky et al. ) called the Inter-Session-Fragebogen (ISF). The ISF was used to study a total of 3.778 intersession intervals in 249 therapy episodes involving 229 patients. The factor structure of the ISF appears to be stable over therapy (up to 25 or even 50 sessions), and also over therapy settings (outpatient, day clinic, inpatient). Just as in the original American samples, there were evidently cross-culturally invariant factors like "Recreating the therapeutic situation", "Applying therapy," and "Relationship fantasies". The emotional qualities of ISP are assessed by two independent factors, called "Remoralizing emotions" and "Negative emotions" (regarding therapy). Differences between therapy settings are evident concerning intensity and trajectories of the factor scores over time.