"CAN DELIBERATE PRACTICE FOR INNER SKILLS ENHANCE THERAPIST TRAINEES’ M" by Edmund W. Orlowski III

ORCID

https://orcid.org/0000-0002-0696-5693

Date of Award

Spring 2025

Language

English

Embargo Period

4-23-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Educational and Counseling Psychology

Program

Counseling Psychology

First Advisor

Myrna Friedlander

Committee Members

Mariola Moeyaert, Michael Ellis

Keywords

Counseling, deliberate practice, mindfulness, therapeutic presence

Subject Categories

Counseling | Counseling Psychology

Abstract

A replicated single-case design was used to assess the effectiveness of therapist trainees’ engagement in deliberate practice for inner psychotherapy skills (Rousmaniere, 2019). Deliberate practice (DP) is a structured approach to therapist skill development that involves repeatedly observing and responding to real or simulated clients (Rousmaniere, 2016). It was reasoned that by attending to their inner experience while repeatedly being exposed to challenging clinical material (e.g., a client’s suicidal ideation) outside of therapy, trainees may reduce their experiential avoidance and thus be more mindful and present in sessions with actual clients.

During the five-week baseline phase of the study, four therapists, all advanced practicum trainees, reported their (a) mindfulness on the State Mindfulness Scale (Tanay & Berstein, 2013) and (b) presence on the Therapist Presence Inventory (Geller et al., 2010) after a randomly selected session with one client. Then, during the intervention phase of the study, participants engaged in eight weekly DP exercises drawn from Rousmaniere’s (2019) DP manual for inner skills with standardized video stimuli. In the week after each DP exercise, they completed the mindfulness and presence measures about their in-session experience with a randomly selected client. Over the course of the study, the four participants provided data about their sessions with 4 to 8 different clients (Mdn = 4.5).

Based on a series of visual analyses, nonoverlap indices and regression, results indicated that all four participants reported meaningful increases in in-session mindfulness, while only two participants reported improvement in their felt presence with clients. One explanation for the mixed results is that the DP activities focus on enhancing inner awareness more so than on how to be more present with clients.

Replication of this study with versus without supervisor feedback is recommended to explore whether expert guidance is needed to improve trainees’ presence during psychotherapy sessions. Other future research should be conducted more diverse samples and with the addition of a follow-up evaluation of participants’ in-session mindfulness.

License

This work is licensed under the University at Albany Standard Author Agreement.

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