Dissertation (DPhil)--University of Stellenbosch, 2008. / Bibliography. Also available via the Internet.

Thesis (Ph. D.)--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 58-76).

Thesis (Psy. D.) -- Virginia Consortium for Professional Psychology. / Advisor: Foss-Goodman, Deborah. Includes bibliography.

Thesis (Psy. D.)--Wheaton College Graduate School, 2008. / Abstract. Includes bibliographical references (leaves 45-51).

Thesis (Ph. D.)--Ohio State University, 2005. / Title from first page of PDF file. Document formatted into pages; contains ix, 132 p. Includes bibliographical references (p. 119-126). Available online via OhioLINK's ETD Center

Thesis (Psy. D.)--Wheaton College Graduate School, 2008. / Abstract. Includes bibliographical references (leaves 45-51).

Initiation as a rite of passage is strongly linked to the history and practice of psychotherapy and counselling psychology. The absence of recent studies on this topic encourages research in this area. This research investigates the initiation experiences of seven female participants as they became qualified as psychotherapists and counselling psychologists, i.e. in their ‘becoming a therapist’. Data were collected through open-ended interviews, and narratives analysed using the interpretive-constructivist version of grounded theory developed by Charmaz. The emerged grounded theory (considered a preliminary theory due to the limited number of participants) highlights the interplay between two fundamental agencies of the self: Being and Doing. Their interaction allows female therapists to engage in several inner and outer tasks affecting the shaping of their sense of self. The theory highlights a dynamic and non-linear process of identity transformation and shows how female therapists relate to transitions and changes on a personal and professional level. The emerged theory is relevant and informative for the current practice of counselling psychology, as it emphasises the importance of female therapists' personal and professional development. By considering the psychological impact and influence of initiation, it highlights how the process of female therapists' becoming unfolds and shows how this can serve their clinical practice.

The primary aim of this study was to investigate the ways that beginning therapists utilize ‘informal supervision’, the process wherein therapists in training engage individuals who are not their formally assigned supervisors in significant conversations about their clinical work. Because the research literature on formal supervision does not adequately acknowledge the frequent use and significance of informal supervision, this study sought to provide a comprehensive understanding of why therapists in training seek informal supervision, what they get out of it, how informal supervision differs from formal supervision, and how it influences trainees’ clinical work and their developing therapeutic identity. Participants were 16 doctoral trainees in clinical and counseling psychology programs. Semi-structured interviews were conducted and analyzed using the Consensual Qualitative Research (CQR) method. Eleven domains emerged from CQR analysis, and results suggest that informal supervision is a valid practice by which trainees in clinical and counseling doctoral programs in psychology develop clinical and professional competencies. The valuable practice of informal supervision was evident in a multiplicity of arenas: in seeking informal supervision, trainees received validation, reassurance, and emotional support. Additionally, trainees used informal supervision to openly and authentically discuss personal anxieties and self-doubt, strong countertransference reactions to patients, and salient clinical challenges and mistakes. Trainees who used informal supervision gained insight into their clinical work, explored diverse approaches to clinical interventions, and increased their capacity to access and use their personal reactions to patients to further their clinical work. Results also revealed important differences between formal and informal supervision, specifically that informal supervision provides trainees with a unique and important space to discuss clinical interactions that lead them to feel emotionally dysregulated, overwhelmed, confused, concerned, upset, and drained – i.e., those aspects of experience that are often not disclosed or are carefully curated in their presentation to formal supervisors – so that they could better understand and use their personal reactions to influence their clinical work. Regarding the former, i.e., personal challenges of clinical work, trainees revealed their personal anxiety, self-doubt, uncertainty, and shame frequently and non- defensively in informal supervision. Lastly, results showed that participants’ concerns about using informal supervision are considerable, and include anxiety about breaking APA’s ethics codes regarding patient privacy and confidentiality Recommendations are proposed for clinical practice and clinical training, including an ‘ethical’ proposal to integrate informal supervision as an important avenue for trainees’ clinical and personal development throughout their training, and thus legitimize its practice. Clear and innovative ethical guidelines regarding the use of informal supervision that are consistent with the APA’s ethics codes are outlined, and future directions are discussed.

Bibliography: leaves.

This portfolio addresses the moral, ethical and legal issues that impact upon decisions to maintain or disclose confidential communications. The tensions and moral dilemmas that are created when a conflict between these aspects arises are considered. Risk assessment procedures that inform decisions to maintain or disclose confidential information are discussed, as are issues related to the practical implementation of planned interventions. The topic is addressed by firstly reviewing professional codes of conduct and legal requirements to maintain confidentiality. The limits of confidentiality and privileged communication are then reviewed together with legal requirements of “duty to warn” or “duty of care”. These requirements are then related to risk assessment procedures and relevant interventions. Four case studies that illustrate the practical application of assessment techniques in the decision process and planned interventions are presented. They cover such diverse topics as disclosure and suicidal intent, threat of harm to a third party, risk of transmission of the AIDS virus and “duty to warn” and maintenance of a minor’s confidential communications. The ways in which these issues were addressed and the outcome is presented. NOTE: All names and details that have the potential to identify the people whose cases are presented here have been changed to protect their anonymity.