Developmental trajectories of psychotherapist trainees’ experiences of clinical practice: global and specific aspects of change in a multinational longitudinal sample

OBJECTIVE: To study, in a multinational sample, how psychotherapist trainees develop in their professional self-experience over the course of a year. METHODS: In the SPR Interest Section on Training and Development (SPRISTAD) Longitudinal Study, 168 therapist trainees from 11 countries filled out the comprehensive Therapist Work Involvement Scales (TWIS) at 6-month intervals at least 3 times. The TWIS assesses therapist trainees' i) role-performance; ii) role-identity; and iii) overall global experience of therapeutic work as either healing or stressful. Mixed linear modeling was used to test for statistically significant change in these facets of work experience. RESULTS: Trainees' experienced both their basic relational skills and more nuanced professional expertise to improve. Professional self-doubt, negative personal reactions to patients, and anxious in-session feelings with patients decreased significantly. However, the trajectories differed markedly based on trainees' initial profiles. About half of the trainees experienced a stable, effective practice. Others started either distressed or disengaged, both of which showed improvement. Some trainees also experienced a decline in therapeutic self-efficacy. CONCLUSION: This study demonstrates the generally beneficial impacts of therapist training. However, these impacts depend much on where the trainees start from. In particular, the determinants of decline in therapeutic self-efficacy call for further research.