Trainees’ experiences in alliance-focused training: The risks and rewards of learning to negotiate ruptures.

Abstract

The current study explored trainee therapists' experiences in alliance-focused training (AFT), a form of group supervision focused on training therapists to recognize and negotiate alliance ruptures. We analyzed interviews with 36 former trainees who received AFT during their predoctoral psychology internships. Findings centered on trainees' views of the central AFT tasks of videotape analysis, awareness-oriented role-plays, and mindfulness training; the supervisor's stance, including the provision of support and validation and the extent to which the supervisor served as a positive role model; and the impact of AFT on trainees' clinical skills. Many trainees reported that AFT increased their awareness, acceptance, and comfort with navigating ruptures, but some trainees reported that AFT supervisory tasks were anxiety-provoking and that AFT made them less comfortable in session. The findings underscore the challenges that AFT presents for trainees, who are asked to take risks in supervision, and for supervisors, who need to create a safe space for trainees and model sensitivity to supervisory ruptures. The findings also point to the potential benefits for trainees who feel safe and supported enough to explore the most challenging therapeutic moments in the context of a group supervision.

The alliance in psychotherapy—Papers in honor of Jeremy D. Safran.

“…Lisa Samstag, writing with her student Kara Norlander, takes inspiration from Safran’s task analytic work to evaluate therapeutic process in trainee clinicians (Samstag & Norlander, 2019). Catherine F. Eubanks, writing with her students, evaluates the impact of Alliance-Focused Training on trainees’ capacity to identify and respond to ruptures in the treatment (Eubanks et al, 2019). Collectively, these articles represent not only the breadth of Safran’s ideas but also the reach of his mentorship.…”

Deepening the group training experience: Group cohesion and supervision impact in alliance-focused training.

“…Group supervision may also enhance trainees’ understanding of group dynamics (Tebb, Manning, & Klaumann, 1996). Eubanks et al (2019) identified two key advantages of conducting AFT in groups, above and beyond the practical savings of cost and time: (a) watching session videos and participating in role-plays of alliance ruptures negotiations within a group of peers offers in vivo performance pressure comparable with that of a real psychotherapy session; and (b) a group setting offers first-hand exposure to the prevalence of ruptures and the struggle (both own and others’) to achieve repair. This validating experience may encourage the trainee to take more therapeutic risks and develop the courage necessary to navigate ruptures.…”

“…Muran and colleagues suggest these results indicate the therapists’ increase in self-awareness and their increased ability to self-disclose in relation to the patient (see also Muran, 2019). These are capacities inherent to metacommunication (Kiesler, 1996), a key component of the principles central to alliance negotiation (Eubanks et al, 2019). Moreover, the patients also became more expressive after the addition of AFT in the supervision.…”

“…A recent exploration of trainee therapists’ experiences in AFT group supervision found that while many trainees reported that AFT increased their perceived competence in navigating ruptures, others found some of the supervision process anxiety-provoking, pointing to the need for a safe space for trainees (Eubanks et al, 2019). In a grounded theory model of group supervision, Fleming, Glass, Fujisaki, & Toner, 2010 suggested that group cohesion is one of the factors that promotes group safety, which they defined as trainees feeling as though they were not at risk of psychological harm in the group.…”

Abstract minimal impressionism: Thoughts on evidence, intervention, and training.

“…These changes, however, did not come without cost. Eubanks, Muran, Dreher, et al (2019) found that while AFT increased training therapists' awareness of ruptures and comfort levels navigating them, some reported the supervisory tasks (e.g., videotape review and role play) to be anxiety-provoking. A.A. Urmanche, M. Minges, Eubanks, C.F.…”