Exploring CBT therapists’ experience of feeling of safety within self-practice/self-reflection: an interpretative phenomenological analysis

Abstract

Self-practice/self-reflection (SP/SR) is an experiential training strategy implemented to develop the skills of CBT therapists through the self-application of CBT techniques and subsequent reflection on the experience in relation to clinical practice. Outcome studies report significant personal and professional benefits from SP/SR but engagement studies suggest that CBT therapists’ experience is mixed. In order to inform the design and implementation of SP/SR within CBT, this study aims to explore CBT therapists’ experience of feeling of safety (FOS) within SP/SR. FOS has been identified as an important engagement factor. Three CBT therapists were interviewed using semi-structured interviews. The data, which took the form of verbatim transcripts, were subjected to interpretative phenomenological analysis. Four superordinate themes relating to participants’ experience of FOS within SP/SR emerged: FOS and its absence as embodied and non-verbal, role of the instructor, awareness of others and venturing beyond safety. Ensuing recommendations for instructors include proactive use of interventions within SP/SR which directly impact embodied FOS, monitoring the wellbeing and engagement of participants through awareness of physical cues and employment of measures designed to promote a sense of equality among group members. Areas of future research include exploration of factors which influence FOS, investigation of the effect on FOS of pre-existing relationships within the SP/SR group and review of interventions which are currently used by SP/SR instructors to promote FOS. Key learning aims (1) To explore the lived experience of FOS within SP/SR as experienced by CBT therapists. (2) To identify factors which influence CBT therapists’ experience of FOS within SP/SR. (3) To identify practical recommendations for use in SP/SR instruction which will promote participants’ FOS.

‘Crossing the reflective bridge’: how therapists synthesise personal and professional development from self-practice/self-reflection during CBT training

“…SP/SR, in general terms, refers to CBT trainees practising therapeutic techniques upon themselves, and then reflecting upon the experience and outcome of this. SP/SR studies have pointed to factors that may interfere with successfully engaging trainees in SP/SR as part of CBT training, for example emotional discomfort (Bennett-Levy et al ., 2001) fear of negative evaluation from others (Spendelow and Butler, 2016), lack of time (Haarhoff et al ., 2015) or insufficient feelings of safety in the process (Mackenzie and O’Mahony, 2021). However, research has otherwise elucidated clear and numerous benefits of the inclusion of SP/SR in CBT training.…”