“I had no idea this shame piece was in me”: Couple and family therapists’ experience with learning an evidence-based practice (original) (raw)
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Little research has been devoted to the treatment of shame. This exploratory study examined the understanding that current Marriage and Family Therapists have of shame and their thoughts of its importance in therapy. Six therapists participated in an individual interview. Three respondents were new graduates and three were approved supervisors through the American Association of Marriage and Family Therapists. Although the therapists interviewed reported various understandings of shame, overall the therapists agreed that shame is an important factor in therapy. The therapists interviewed also saw a need for more research on how to treat shame
Australian and New Zealand Journal of Family Therapy
This research concerns itself with the experiences of couple and family therapists (CFT) learning about and using an evidence-based practice. The engagement with evidence-based practice is growing across many aspects of the mental health and health care systems. The evidence-based practice model is now being applied in a broad range of health and human service systems, including mental and behavioral health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence-based approaches in the practice of couple and family therapy and research literature about same is also evolving (Sexton et al., 2011; Sprenkle 2012). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning and adopting an evidence-based practice. Using a phenomenological approach called interpretive phenomenological analysis
“Oh, this is What It Feels Like”: A Role for the Body in Learning an Evidence-Based Practice
Humanities, 2015
This paper will present research that explored the experiences of couple and family therapists learning about and using an evidence-based practice (EBP). Using a phenomenological approach called Interpretative Phenomenological Analysis, three themes emerged from the participants' experiences: the supports and challenges while learning an EBP, the experience of shame while learning, and the embodiment of a therapy practice. This paper will focus on the theme of embodiment. Research participants' experiences will be reviewed and further explored using Merleau-Ponty's notion of embodiment and Gendlin's (1978) more internally focused understanding of how awareness of a felt sense is experienced as a move "inside of a person". As researchers, educators, administrators, policy makers, and counsellors struggle with what works best with which populations and when, how best to allocate resources, how best to educate and support counsellors, and the complexity of doing research in real-life settings, this research has the potential to contribute to those varied dialogues.
Understanding and Treating Shame: The Role of the Clinician
2016
Shame is a powerful emotion and experience that impacts how individuals interpret a situation, and often their behavior. It correlates with a number of mental health conditions that are commonly treated by psychotherapists, and yet the explicit or implicit treatment of shame directly or simultaneous to the disorder is less common. A qualitative exploratory study was conducted in an attempt to gather insight regarding the conceptualization, observation, and treatment of shame in the context of psychotherapy by both generalists and specialists (those with and without explicit training in relation to shame and its treatment). Themes that emerged from the data included: the difference between guilt and shame, observations of shame, and the treatment of shame. Social workers can utilize this information to gain a better understanding of the importance of recognizing, understanding, and naming shame in a clinical context and to have more skills in addressing it with clients.
Shame in Psychotherapists research paper
Aim: The aim of this research was to investigate the area of shame in counsellors/psychotherapists whether in practice or during training following their own experiences of psychological and/or emotional difficulty. Method: This was a qualitative project, and data was collected via semi-structured interviews and a questionnaire about 'self conscious emotions' (Tangney, Dearing, Wagner & Granzow 2000) prior to interview. The questionnaires were scored prior to interview, and the interviews interviews analysed using thematic analysis. Results and Conclusions: The participants scored highly on shame -based responses in the questionnaire, potentially indicating a predisposition to experiencing shame in the psychotherapy field during/following a period of psychological and/or emotional difficulty. The analysis of the interview transcripts revealed a strong correlation between shame, survival and self-protection regardless of the environment, whether it was family of origin or the psychotherapy field, and is a response to and regulator of the 'field'/environment and has correlations with relationship for survival.
Shame-informed Counselling and Psychotherapy
While guilt typically speaks to acts of commission, as well as acts of omission, the construct of shame has a more pervasive effect on a person and often emerges from the deeper and darker edges of the soul. Shameinformed Counselling and Psychotherapy: Eastern and Western Perspectives by Dr Edmund Ng is a definitive text on the subject and offers the reader a broad and rich cultural framework in which to view the therapeutic alliance. Counselling, at its core, is based on the nature and quality of the relationship between client and therapist, and successful outcomes are frequently dependent on bringing those things that are hidden into the light and a place of greater freedom in one's life. Dr Ng masterfully addresses the interpersonal and intrapersonal nuances of shame, the inherent duality of its psychological dimensions, and presents clinical and practical strategies for both beginning and seasoned mental health practitioners".
Administration and Policy in Mental Health and Mental Health Services Research, 2016
This becomes more complicated as layers are added to the therapy process. When it comes to working with complex cases and systems, such as those often faced by couple, marital, and family therapists, increased clinician competencies, talent, and in some (but not all) cases, experience, are required to achieve success (Blow et al. 2007). We argue that the role of the therapist in working with these complex systems is even more crucial than in individual-only work. There are likely personal characteristics and qualities that are more beneficial for couple, marital, and family therapists to possess as compared to more individually focused Abstract In this paper we argue that the therapist is a crucial change variable in psychotherapy as a whole and in couple, marital, and family therapy specifically. Therapists who work with complex systems require more skills to negotiate demanding therapy contexts. Yet, little is known about what differentiates effective couple, marital, and family therapists from those who are less effective, what innate therapy skills they possess, how they learn, and how they operationalize their knowledge in the therapy room. We discuss the need to emphasize evidence based therapists (as opposed to therapies), and implications of the importance of the role therapists for training, practice, research priorities, and policy.
SHAME IN THE THERAPEUTIC DIALOGUE
The first step across the threshold into therapy is so often a painful one. Patients enter therapy with a volatile mix of hope and dread. When therapy is sought only after many other attempts at solving life's challenges have led to naught, patients view therapy as their last recourse. A sense of urgency pervades the description of their problems. If therapy does not work, they do not know where they will turn. They must reveal their " failures " to a total stranger. They do not know whether or not this stranger will scorn them, be kind to them, like them, or perhaps be indifferent to them and their sufferings. The patient is often awash in dread and shame, and usually unable to speak of it, because the relationship is so new and frightening.
Family therapy and the politics of evidence
Journal of Family Therapy, 2004
This article situates family therapy in the politics of evidence-based practice. While there is a wealth of outcome research showing that family therapy works, it remains on the margin of mainstream therapy and mental health practice. Until recently it has been difficult to satisfy 'gold standards' of randomized control research which require manualization and controlled replication by independent investigators. This is because systemic family therapy is language-based, client-directed and focused on relational process rather than step-by-step operational techniques. As a consequence family therapy is an empirically supported treatment unable to join the evidence-based club. The politics here concerns what is 'evidence', who defines it and the limitations of a scientist-practitioner model. Therapy is art and science and its research needs to be grounded in real-life clinical practice. Common factors such as personal hope and resourcefulness and the therapeutic relationship contribute more to change than technique or model. While arguing for a wider definition of science and evidence it is politic to seek evidence-based status for family therapy. Family therapy is a best practice approach for all therapists where systemic wisdom helps to decide what to do with whom when. A systemic-practitioner model is informed by quantitative and qualitative research and holds modern and postmodern perspectives in tension, a stance I call paramodern. Family therapy is both scientific and systemic; it is a science of context, narrative and relationship. Introduction: family therapy at the crossroads Family therapists today are under increasing challenge from public and private mental health funding bodies to demonstrate an evidence base. Here they face strong competition from biological and cognitive therapies backed by powerful voices of representation in the disciplines of psychiatry and clinical psychology. Recently practitioners have been encouraged by an emerging research literature showing family therapy is effective across a range of clinical populations and problems (for summaries of this research see Campbell, 1997;