Esse estudo se propõe a analisar a relação entre dois processos estratégicos de Gestão de Pessoas Sistema de Educação Corporativa e Programa Trainee em uma organização de reconhecida reputação na gestão de suas pessoas. Definiram-se os seguintes objetivos: i) verificar os objetivos do Programa Trainee; ii) identificar, descrever e analisar as ações de desenvolvimento formais e não-formais propostas pelo Sistema de Educação Corporativa ao Programa Trainee conforme os Sete Princípios de Sucesso definidos por Eboli (2004a); e iii) verificar a relação percebida entre as ações do Programa Trainee e as competências requeridas nos Trainees. Trata-se de pesquisa qualitativa, onde foi utilizado o método de estudo de caso único, exploratório e descritivo, em uma organização do setor químico. Foram coletados dados primários por meio de entrevistas semi-estruturadas, orientadas por um roteiro, com gestores do Sistema de Educação Corporativa, gestores das áreas de negócio, e Trainees do Programa Trainee 2007 da organização. Os resultados evidenciaram a influência do Sistema de Educação Corporativa no desenvolvimento das competências requeridas nos Trainees pelo favorecimento da socialização do Trainee ao ambiente organizacional, pois possibilita o conhecimento amplo do negócio pela aprendizagem prática e conceitual que agregam valor ao patrimônio de conhecimentos e saberes da pessoa que podem ser mobilizados em favor do alcance dos objetivos estratégicos do negócio, ainda que cada pessoa perceba a influência das ações de formas diferentes / This study aims to analyze the links between two strategic Human Resources processes Corporate Education System and Trainee Program in a well-recognized organization due to its people management policies e practices. The following objectives were raised: i) verify the Trainee Program objectives; ii) identify, describe and analyze the formal and non-formal development actions proposed by the Corporate Education System to the Trainee Program regarding the seven principles of success defined by Eboli (2004a); and iii) verify the perceived relation between the actions proposed to the Trainee Program and the competencies required on the Trainees. This study is based on a qualitative research, where a single case study approach was used, exploratory and descriptive, in a chemical organization. Primary data was gathered by semi-structured interviews, guided by a script, applied in Corporate Education System and business areas managers and Trainees from the 2007 Trainee Program. The results made evident the Corporate Education System influence on the required Trainees competencies development through the enunciation of the Trainee socialization to the organization due to the wide organization awareness by conceptual and experiential learning which aggregate value to the persons knowledge endowment that can be used in order to achieve business strategic objectives, even tough each person understands the development actions influence in a different way.

Made available in DSpace on 2015-04-16T14:48:42Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1122771 bytes, checksum: 47ef984dcb205fad8b6ea3ef5c2bf8d5 (MD5) Previous issue date: 2011-09-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The intent of this research was to study how the learning process is for managers who participated in programs trainees SEBRAE / PB from the stories of their context of action professional. O methodological approach of the study complied with the following steps: a) conducting 10 semi-structured interviews with managers who participated in the trainee program in 2002 and 2008, recorded electronically on the desktop of the agencies surveyed in the cities of Campina Grande, Joao Pessoa, Monteiro and Guarabira, the approach used was qualitative type, using the method of oral history and narrative analysis technique to get the results. With major research findings concluded that the model adopted by the trainee program SEBRAE / PB selective in its early stages consists of using selection criteria of professionals with higher education curriculum that address supplemented by graduate students; by application logical and behavioral testing. The program emerged from individual and collective skills such as teamwork, group leadership, conflict management, creativity and communication. The reasons revealed to be a trainee: to know, learn, grow, contribute, merge experience, working with people, believe in the company. The dynamic learning environment and challenging routines and activities included in project execution; service to a diverse audience of artisans, farmers, entrepreneurs of micro and small agricultural businesses, conducting missions in conditions that made travel risky and unsafe ; achievements of local and state events. The meanings of experience as a trainee were the importance of context and social support in the face of difficulty of the exercise activity, to reflect on their practices and the discovery of skills and abilities acquired through professional performance. Learning as a manager is also revealed as surrounded by antagonistic feelings, some received social support in the internal and external environment where others lived and worked the experience of not being legitimized as managers worked in agencies where, colleagues and other senior managers, which led to isolation from peers. The legitimacy of the trainee program was through promotions, autonomy of action, the positive results and the dissemination of the results of their actions in the media nationwide and internationally. The factors that contributed to the practice of the trainees were able to work with people, represent the interests of SEBRAE / PB, build partnerships, strengthen existing relationships have developed through the skills and training, social support within and outside the work are limited and and for the management, structure and format of the trainee program, administrative and functional structure of the company; context of the practice, attitude and perception of colleagues and personal factors to deal with conflict and change. / Este estudo objetivou analisar como ocorre o processo de aprendizagem de gerentes que participaram de programas trainees do SEBRAE/PB a partir das histórias do seu contexto da ação profissional. O caminho metodológico do estudo abrangeu as seguintes etapas: a) realização de 10 entrevistas semi-estruturadas com gerentes que participaram do programa trainee nos anos de 2002 e 2008, gravadas por meio eletrônico no ambiente de trabalho dos pesquisados nas agências das cidades de Campina Grande, João Pessoa, Monteiro e Guarabira; a abordagem utilizada foi do tipo qualitativa, com utilização do método da História Oral e da técnica de análise de narrativa para chegar aos resultados. Os resultados da pesquisa revelaram que o modelo de programa trainee adotado pelo SEBRAE/PB em sua fase seletiva é constituído de etapas que utilizam critérios de escolha de profissionais com currículo que contemplem formação superior complementada por pós-graduação; por meio de aplicação de testes lógicos e comportamentais. Do programa emergiram competências individuais e coletivas como: trabalhar em equipe, liderança de grupos, gestão de conflitos, criatividade e comunicação. Os motivos revelados para ser um trainee são os seguintes: conhecer, aprender, crescer contribuir, mesclar experiências; trabalhar com pessoas, acreditar na empresa. O contexto de aprendizagem é dinâmico e desafiador, com rotinas e atividades que incluíam execução de projetos em; atendimento a um público diversificado de artesãos, agricultores, empresários de micro e pequenos negócios agrícolas; condução de missões com viagens feitas em condições consideradas arriscadas e pouco seguras; realizações de eventos locais e estaduais. Os significados da experiência como um trainee envolvem a importância do contexto e do apoio social diante das dificuldades do exercício da atividade; a reflexão sobre suas práticas e da descoberta de competências e habilidades adquiridas por meio da atuação profissional. O aprendizado como gerente é revelado também como permeado de sentimentos antagônicos, pois alguns receberam apoio social no ambiente interno e externo onde atuavam e outros viveram a experiência de não terem sido legitimados como gerentes nas agências onde atuavam pelos colegas e por outros gerentes mais antigos, o que acarretou isolamento dos pares. A legitimação do programa trainee ocorreu por meio de promoções; autonomia de ações, resultados positivos das avaliações; divulgação dos resultados de suas ações em veículos de comunicação de alcance nacional e internacional. Os fatores que contribuíram para a prática dos trainees foram a possibilidade de trabalhar com pessoas, representar os interesses do SEBRAE/PB, firmar parcerias, estreitar as relações, ter se desenvolvido por meio das capacitações e treinamentos, o apoio social dentro e fora do ambiente de trabalho e os limitaram são relativos à gestão, estrutura e formato do programa trainee; estrutura administrativa e funcional da empresa; contexto da prática, atitude e percepção de colegas e fatores pessoais para lidar com conflitos e mudança.

Apenas um seleto grupo de candidatos é aprovado nos Programas Trainee promovidos anualmente em nosso país por corporações multinacionais, as quais podem ser compreendidas como instituições paradigmáticas na sociedade contemporânea devido à grande influência que nela exercem. Este estudo tem como objetivo conhecer as atitudes de trainees frente às exigências feitas pelas empresas em que se colocaram. Fizemos uma pesquisa qualitativa, na qual realizamos entrevistas semi-estruturadas com três sujeitos provenientes de empresas diferentes. O referencial teórico utilizado foi a Psicanálise e a Teoria Crítica da Sociedade. A partir das análises das entrevistas pudemos inferir que as atitudes dos sujeitos para com as exigências das empresas em que se encontram são bastante similares: caracterizam-se por uma adesão às demandas corporativas e uma pré-disposição para se comportar de acordo com estas. Os resultados indicam que as empresas se utilizam de mecanismos de gestão de pessoas dirigidos à psicologia dos sujeitos, suscitando nestes uma adesão ao ideal corporativo com pouca ou nenhuma crítica. Os trainees aderem a este ideal, que tem como modelos ideais os executivos bem sucedidos e se caracteriza pela apologia ao sacrifício do sujeito, realizada pelo trabalho excessivo como meio para atingir um alto padrão de vida e uma posição de poder. O vínculo dos trainees com as empresas parece ser provisório e pragmático, assemelhando-se ao capital financeiro, que investe em determinado negócio enquanto este lhe traz lucros interessantes / Only a select group of candidates are approved in Trainee Programs that are organized annually in our country by multinational companies, these can be understood as paradigmatic institutions in contemporary society due to the large influence over it. The research objective is to know the attitudes of trainees against the requirements of the companies that they are employees. We did a qualitative research with half structured interviews with three differents employees companies. The theoretical framework was Psychoanalysis and Critical Theory of Society. From the analysis of the interviews we could infer that the attitudes of the employees against the requirements of their companies jobs are very similar: characterize by an adherence to corporate demands and a predisposition to behave in accordance with them. The results indicate that companies make use of people managements mechanisms throw the psychology of individuals, raising in these employees the idea company with little or no criticism. Trainees adhere this ideology which is ideal models successful executives and is characterized by the apology to the individual sacrifice carried out by overwork as a means to achieve a high standard of living and a power position. The link between trainees with the companies seem to be provisional and pragmatic resembling the financial capital, investing in certain business while it brings interesting profits

Esse estudo se propõe a analisar a relação entre dois processos estratégicos de Gestão de Pessoas Sistema de Educação Corporativa e Programa Trainee em uma organização de reconhecida reputação na gestão de suas pessoas. Definiram-se os seguintes objetivos: i) verificar os objetivos do Programa Trainee; ii) identificar, descrever e analisar as ações de desenvolvimento formais e não-formais propostas pelo Sistema de Educação Corporativa ao Programa Trainee conforme os Sete Princípios de Sucesso definidos por Eboli (2004a); e iii) verificar a relação percebida entre as ações do Programa Trainee e as competências requeridas nos Trainees. Trata-se de pesquisa qualitativa, onde foi utilizado o método de estudo de caso único, exploratório e descritivo, em uma organização do setor químico. Foram coletados dados primários por meio de entrevistas semi-estruturadas, orientadas por um roteiro, com gestores do Sistema de Educação Corporativa, gestores das áreas de negócio, e Trainees do Programa Trainee 2007 da organização. Os resultados evidenciaram a influência do Sistema de Educação Corporativa no desenvolvimento das competências requeridas nos Trainees pelo favorecimento da socialização do Trainee ao ambiente organizacional, pois possibilita o conhecimento amplo do negócio pela aprendizagem prática e conceitual que agregam valor ao patrimônio de conhecimentos e saberes da pessoa que podem ser mobilizados em favor do alcance dos objetivos estratégicos do negócio, ainda que cada pessoa perceba a influência das ações de formas diferentes / This study aims to analyze the links between two strategic Human Resources processes Corporate Education System and Trainee Program in a well-recognized organization due to its people management policies e practices. The following objectives were raised: i) verify the Trainee Program objectives; ii) identify, describe and analyze the formal and non-formal development actions proposed by the Corporate Education System to the Trainee Program regarding the seven principles of success defined by Eboli (2004a); and iii) verify the perceived relation between the actions proposed to the Trainee Program and the competencies required on the Trainees. This study is based on a qualitative research, where a single case study approach was used, exploratory and descriptive, in a chemical organization. Primary data was gathered by semi-structured interviews, guided by a script, applied in Corporate Education System and business areas managers and Trainees from the 2007 Trainee Program. The results made evident the Corporate Education System influence on the required Trainees competencies development through the enunciation of the Trainee socialization to the organization due to the wide organization awareness by conceptual and experiential learning which aggregate value to the persons knowledge endowment that can be used in order to achieve business strategic objectives, even tough each person understands the development actions influence in a different way.

<p>Background: Firms are today competing for educated and qualified people within the IT-industry, due to the high business activity. Firms require new employees to have both a formal education and relevant work expe-riences. Newspaper articles state that IT-companies have difficulties finding qualified employees and that they also see this shortage of competencies as the most prominent hinder to economic growth. To handle this shortage are an increased amount of companies starting structured training activities for their new employees, which by general terms is called trainee programs. Purpose: The purpose of this study is to do an explorative study of compa-nies in the Swedish IT-industry, to see if and why a trainee program could be a source of competitive advantage. Method: A qualitative approach has been applied when collecting data. Four small case studies were made by interviewing top managers and col-lecting company related information. The companies had diverse sizes and different experiences from trainee programs. The data was analyzed with the Resource-based view as a guiding theory applying the VRIN framework. Conclusion: By doing the studies three value adding aspects was found. They were staffing/recruitment, marketing and, organizational learning and development. Within the resource-based views boundaries were: recruitment and staffing found to be a source of at best tem-porary competitive advantage, the same conclusion applies for trai-nee program as a marketing tool. Organizational learning and de-velopment could be seen as a source of competitive advantage due to the complex impact a trainee program has to an organization. To summarize the above mentioned; trainee program could be a source of sustainable competitive advantage. Three obstacles for implementing trainee programs were found; feeling of being to small, short-term thinking and the lack of time.</p>

There is limited research examining the identities and experiences of those from mixed ethnic backgrounds and the research literature is almost non-existent for those who are from a mixed white ethnic (MWE) background. The existent evidence base in regards to the experiences of clinical psychology training of those from minority ethnic groups is focused on Black and ethnic minority (BME) backgrounds. This study therefore aimed to gain insight into the experiences of trainee clinical psychologists from a mixed white ethnic background, raising awareness of these individuals and their needs in the clinical psychology training arena. This study adopted a qualitative approach where eight participants were recruited and in-depth semi-structured interviews conducted. Interviews were analysed using interpretative phenomenological analysis. Three main themes emerged from participants’ accounts: ‘the double edged sword of invisible difference’, ‘uncovering the undercurrents of difference’ and ‘that which is sought and gained’. These findings are discussed in relation to the existing literature and clinical implications are presented. Methodological considerations and areas for future research are also considered. This study makes contribution to a sparsely researched area and provides rich insight into the experiences of trainee clinical psychologists from a MWE backgrounds. It is hoped the material presented here will encourage further thought, debate and study of this area.

Aims: Research examining the process of clinical psychology training has essentially focused on the outsider perspective and given little consideration of the trainee’s lived experience. Using qualitative methodology this project aims to listen and privilege personal narratives of individuals who occupy the role of trainee clinical psychologist and parent simultaneously during CAMHS training (i.e. placement and associated teaching) in order to increase awareness of the challenges and existing resources of this population. Method: Six parent-trainees were interviewed using semi-structured interviews. Transcripts were individually analysed using methodology drawn from Interpretative Phenomenological Analysis (IPA; Smith, 1996a) to identify emergent themes and complete cross-case analysis. Results: This study demonstrates how the occupancy of a parental role during Child and Adolescent Mental Health training has significant implications for individual trainees within both their professional and parental role. The three main themes emerging from the study are: i) A changed Identity: seeing and being seen in a different light ii) A journey from dependency towards autonomy and iii). Cutting the cord doesn’t destroy the bond: The inseparable nature of the parental and professional self. Implications: This study highlights the significant impact that the occupancy of a parental role may have in the experience of a trainee clinical psychologist’s CAMHS training, and how such findings may have been overlooked in the available literature base. Findings suggest that to optimise professional and personal wellbeing and minimise potential for compromised professional conduct the impact of the relationship between parent-trainees’ personal and professional self needs to be widely recognised by individual parent-trainees, training providers and the wider context of clinical psychology. The results from this study may also have wider implications for the ethical practice of those occupying any dual role in the training context as well as the broader field of therapeutic work.

This thesis examines the perspectives and experiences of primary Initial Teacher Education (ITE) trainee teachers, of working with Looked After Children (LAC), and the implications for training and Continuing Professional Development (CPD). The thesis is within the interpretivist paradigm, using a Grounded Theory Methodological approach. The research was carried out in one post-1992 English university, with trainee teachers on a three year undergraduate BA (Honours) Education teacher training route, and a one-year Post Graduate Certificate in Education (PGCE) route. Feedback was sought from wider organisations and professionals working directly with LAC. LAC continue to underperform academically in comparison to their peers, and for decades have been let down by systems and support, with many entering the criminal justice system at an early age. This study examines trainee teachers’ perspectives to conclude how specific training can support teachers and in turn impact on LAC. The thesis draws out four main themes from the trainees: the negative impact of previous experience on trainee values and beliefs towards LAC as they enter ITE; the positive and negative perceptions and experiences of trainees in relation to collaborative working; the negative perceptions and experiences of trainees in relation to the behaviour and learning needs of LAC; and trainees’ and mentors’ lack of knowledge in relation to LAC. The study concludes that trainees and mentors have a lack of knowledge and skills on how to support LAC in five key areas; policy and legislation, challenging negative perceptions, emotional well-being and supportive strategies, administrative knowledge, and collaborative working. A training model to support ITE and CPD is developed, gaining feedback from key organisations and professionals working with LAC.

The aim of this research was to longitudinally and quantitatively investigate sense of coherence (SOC) and coping strategies as predictors of compassion satisfaction (CS) and compassion fatigue (CF) as measured by secondary traumatic stress (STS) and burnout (BT) during the first six months of training in a professional psychology training programme. Trainee therapists’, “dramatically shift” their “focus of functioning over time” to adorn the personality and self of the therapist (Rønnestad & Skovholt, 2003, p. 28). This adaptive process may initially unravel over six months as trainees balance client and workload stressors (Hill, Sullivan, Knox & Schlosser, 2007; Tryssenaar & Perkins, 2001). However, research on the developmental processes behind the negative (CF) and positive (CS) avenues of therapeutic stressors is lacking in the trainee therapists’ population, especially quantitatively (Schwing, LaFollette, Steinfeldt & Wong, 2010; Thériault, Gazzola & Richardson, 2009). This research aimed to explore these issues in relation to professional development through SOC and coping as predictors of CS and CF over a six month training period. Variables were investigated quantitatively through the Professional Quality of Life Scale (ProQOL) (Stamm, 2010) the Brief COPE (BCOPE) (Carver, 1997) and the 29-item self-report Orientation to Life Questionnaire (OLQ) (Antonovsky, 1987). As such, the primary focus of this research was on how SOC and coping strategies were utilised by trainee therapists as process variables in predicting the positive (CS) and negative (CF) avenues of therapeutic work over a six month period of psychotherapy training. Findings suggested that, at the beginning of training, sense of coherence was directly associated with the core outcome variables (CS and CF (as measured by STS and BT). When trainee therapists started seeing clients two months later, the effect of SOC was mediated by coping. At the end of training, only coping was directly associated with outcome variables as the effect of SOC on CS and CF disappeared. These implications are further discussed in the research.

Background Many psychotherapy studies with trainees have been conducted, but few have investigated how effective baseline trainee-led psychotherapies are. Baseline trainee-led psychotherapies are often provided by a professional education, and the therapists are often young, untrained and inexperienced. The present study was conducted at the Clinical Psychology Program at Umeå University, in Sweden. The psychology students were in their fourth or fifth year of, in total, five years, and few had practiced therapy before. Clients, students and education providers are interested in the outcome of trainee-led psychotherapies because clients want an effective treatment, and students and the educators want the best education. In research, there is an interest in knowing more about training, how training influences clients’ benefits of therapy, and how training works in regular activity. In the present thesis, we investigate questions related to outcome and how different training factors affect outcome. The overall purpose of the present thesis was to examine 1) the effectiveness of trainee-led therapies in a psychology education setting and 2) if clients’ self-image patterns would predict the outcome 3) if different training conditions covary with treatment outcome 4) how novices develop in their professional characteristics and work involvement styles. Methods and Result The current thesis utilized data from the Swedish naturalistic study Effects of Student Therapies (EUT) at Umeå University. The EUT is a naturalistic psychotherapist research project, which comprises client data from 2003 to 2012. The present study included 235 clients. The mean age of the clients was 31 years (SD = 9.66), and 69% of the clients were women. The clients had mixed psychological symptoms and were well functioning. Psychological symptoms were measured by Symptom Check List 90 (SCL-90; Derogatis, Lipman, &amp; Covi, 1973). The patients’ self-image was measured using the Structural Analysis of Social Behavior (SASB), the introject questionnaire (Benjamin, 1974). All therapists were students at the psychology program. In Paper III, 76 therapists participated. The therapists’ mean age was 28 years (SD = 5.55), and 71% of the therapists were women. Therapists’ professional characteristics and work involvement styles were measured by Development of Psychotherapists’ Common Core Questionnaire (DPCCQ; Orlinsky et al., 1999). Four specific objectives have been addressed. The first objective was to investigate the overall effectiveness of treatment. In Papers I and II, the effect sizes implicated that the therapy outcome was moderate. Paper I showed that 67% of the clients were in the dysfunctional domain before therapy compared to 34% after completed therapy. Further in Paper I, it was found that 42% of the clients had recovered or improved at the end of the therapy, but most of the clients remained unchanged (55%) and a few percent had deteriorated (3%). This result is in line with a Norwegian training study (Ryum, Stiles &amp; Vogel, 2007) but less effective than effectiveness studies have shown with professional therapists (e.g. Hunsley &amp; Lee, 2007). Paper II, where we used a subsample of Paper I’s clients, showed a similar result. The second objective was to investigate if clients’ self-image pattern (attachment group, disrupted attachment group, self-control and self-autonomy) predicted change in psychological symptoms (GSI: global severity index) and personality symptoms (PSI: personality symptom index). The disrupted attachment group or the clients’ negative self-image had the strongest relationship to outcome and explained 8% vs. 10% in outcome (PSI vs. GSI). Self-control explained a further 3% (GSI) and 4% (PSI) of the result, and self-autonomy added 1% in both GSI and PSI. The result indicates that clients with an increased negative self-image, higher self-control, and lower level of self-autonomy before therapy improve more in both psychological symptoms and personality symptoms than clients with a less negative self-image, lower self-control, and higher level of self-autonomy. The third objective was to explore if treatment duration (one or two semesters) and training condition (cognitive therapy and psychodynamic therapy) could affect basic psychotherapy outcome. Paper II demonstrated that clients in all training conditions, cognitive therapy two semesters (CT2), psychodynamic therapy one semester (PDT1) and psychodynamic therapy two semesters (PDT2), had significant changes in self-image patterns and symptoms, except for cognitive therapy one semester (CT1). Analyses using clinically significant change demonstrated that fewer clients in CT1 had recovered and reliably improved compared to the other training conditions (in CT1: 20- 23%, in PDT1: 27- 43%, in CT2: 49- 54% and in PDT2: 35- 41%). Two hierarchical multiple regression analyses demonstrated that clients’ pre-tests characteristics self-image pattern (affiliation: AFF) and psychological symptoms (global severity index: GSI) explained 34% of the results. Treatment duration and training condition demonstrated an interaction effect between duration and theoretical approach, explaining about 2%. The regression lines for self-image pattern AFF and psychological symptoms GSI showed that clients in CT2 and PDT1 improved more than clients receiving CT1 and PDT2. The fourth objective was to examine how novice therapists in psychotherapy training develop in professional characteristics and work involvement styles (healing and stressful work involvement styles). The study was longitudinal and therapists were measured at session 2, 8, 16, 22 and endpoint. Mixed model analyses of the Development of Psychotherapists’ Common Core Questionnaire (DPCCQ) (when controlled for therapists’ age and gender) showed that the therapists’ professional characteristics and work involvement styles changed positively over time in training, except for in-session feelings of anxiety and boredom. The therapists increased most in technical expertise and less in basic relational skill. The result also indicated that the students changed linearly over time. Conclusion The present studies draw attention to the moderate outcome for clients in trainee-led psychotherapy. The novices appear to need time to increase in effectiveness possibly due to the high load of technical training in the beginning of the therapy. However, when exploring different training durations and training conditions, the contexts are shown to influence the outcome. In addition, clients with a more negative self-image pattern, with higher levels of self-control and lower levels of self-autonomy had better outcome, a finding with prognostic value. Finally, the training of students improves both a healing and a stressful involvement style, but in-session feelings of anxiety and boredom are more resistant to change. / Bakgrund Det finns en hel del forskning om psykoterapiträning men få studier har undersökt effekterna av träning på en grundläggande psykoterapi-utbildningsnivå och i reguljär verksamhet på ett psykologprogram. Terapeuterna karaktäriseras här ofta av att vara unga, oerfarna och otränade. Studenterna i denna studie går på ett femårigt psykologprogram vid Umeå Universitet, i Sverige, och övar psykoterapi under fjärde och femte året. Ett fåtal av dem har praktiserat psykoterapi före utbildningen. Resultatet av studien kan intressera klienter, studenter och utbildningsanordnare. Klienter vill kunna välja en beprövad och effektiv metod och studenter och utbildningsanordnare vill få en så bra utbildning som möjligt. Inom forskningen finns det ett intresse av att få veta mer om resultat av träningsterapier i reguljär verksamhet och om hur olika faktorer bidrar till resultatet som t.ex. träningsförhållanden och klientvariabler. Det finns även ett behov av att veta mer om hur terapeuter utvecklas i sina professionella karaktäristika och hur denna utveckling sker. Mer kunskap kan leda till en större förståelse för hur man på bästa sätt organiserar en psykoterapiutbildning. Syften Huvudfrågan i denna avhandling är huruvida klienter som träffar en psykoterapeut på grundläggande psykoterapiutbildning förbättras och vilka träningsfaktorer som samvarierar med klienteffekterna. Den här avhandlingen undersöker frågor som: Hur effektiva är studenterna på psykologprogrammet? Kan klientens självbild påverka klienternas symtomminskning? Kan träningstid och terapimetod påverka terapiresultatet? Hur utvecklas terapeuterna i deras professionella karaktäristika och arbetsstil? Metoder Den här studien har använt data från forskningsprojektet Effekter av utbildningsterapier (EUT), vid Umeå Universitet, i Sverige. Effekter av utbildningsterapier är ett naturalistiskt forskningsprojekt som har samlat in data från 2003 till 2012. Den här studien omfattar data från 2003 till 2010 och vi har inkluderat totalt 235 klienter i två studier. Medelåldern på klienterna var 31 år (SD = 9.66) och 69% var kvinnor. Klienterna hade en differentierad problematik men i huvudsak ångest-, depressions- och relationsproblem. Klienterna hade milda till moderata psykologiska symtom och de var välfungerande, ofta studenter. Psykologiska symptom mättes med självskattnings formuläret Symptom Check List 90 (SCL-90; Derogatis et al., 1973). Klienternas självbild undersöktes med formuläret Structural Analysis of Social Behavior (SASB) introject formulär (Benjamin, 1974). Terapeuterna i Studie III (N = 76) hade en medelålder på 28 år (SD = 5.55) och 71% var kvinnor. Terapeuternas karaktäristika studerades med hjälp av instrumentet Development of Psychotherapists’ Common Core Questionnaire (DPCCQ; Orlinsky et al., 1999). Resultat Fyra huvudfrågeställningar undersöktes i den här avhandlingen. Den första frågeställningen om outcome besvarades i studie I och II, och resultatet visade att klienterna i träningsterapierna hade en moderat symtomminskning och en moderat förbättring av den affektiva självbilden. I studie I beräknades att före behandlingen befann sig 67% av klienterna i en dysfunktionell domän och efter behandlingen, var det endast 34% av klienterna som uppskattades befinna sig i den dysfunktionella domänen. Klinisk signifikant förändring beräknat i studie I, visade att 42% av klienterna blev friska eller reliabelt bättre, de flesta klienterna förblev oförändrade (55%) och några få procent blev försämrade (3%). Detta är ett moderat resultat och ett något sämre resultat än vad fältstudier med professionella psykoterapeuter har erhållit. Den andra frågeställningen undersökte om klienternas självbildsmönster (positiv och negativ självbild, själv-kontroll och själv-autonomi) kunde predicera förändring i psykologiska symtom (GSI: global severity index) och relationssymtom (PSI: personality symptom index). Klienter med en mer negativ självbild fick det bästa utfallet och förklarade 8% i PSI och 10% i GSI. Klientvariabeln själv-kontroll förklarade ytterligare 3% i GSI och 4% i PSI, samt själv-autonomi predicerade 1% i både GSI och PSI. Resultatet indikerade att klienter med en mer negativ självbild, med högre nivåer av själv-kontroll, och med lägre nivåer av själv-autonomi före terapin förbättrades mer i både psykologiska symtom och personlighetssymtom, än klienter med en mindre negativ självbild, lägre själv-kontroll och en högre grad av själv-autonomi. Den tredje frågeställningen undersökte om behandlingslängd (en eller två terminer) och behandlingsmetod (kognitiv eller psykodynamisk terapi) kunde påverka resultatet i träningsterapierna. Studie II visade att det fanns skillnader mellan träningsförhållanden när man tog hänsyn till längd och metod i behandlingen. Det framkom att alla träningsförhållandena, kognitiv terapi två terminer (CT2), psykodynamisk terapi en (PDT1) och två terminer (PDT2), fick signifikanta resultat av träningsterapier, men inte kognitiv terapi en termin (CT1). Klinisk signifikant förändring beräknades för de olika grupperna och färre klienter i CT1 gruppen var friska och reliabelt förbättrade efter behandling än i de andra grupperna CT1: 20- 23%, i PDT1: 27- 43%, i CT2: 49- 54% och i PDT2: 35- 41%. Två hierarkiska regressions-analyser användes för att utforska om behandlingslängd och behandlingsmetoder kunde påverka resultatet. Båda regressionsanalyserna visade att klienternas initiala självbildsmönster och initiala symtom förklarade 34% av symtomen efter behandlingen. Detta stämmer med andra psykoterapistudier (t.ex. Lambert &amp; Ogles, 2004) som visar att klientfaktorer spelar en stor roll för psykoterapiresultat. Behandlingslängd och behandlingsmetoder förklarade inte i sig själva något resultat men interaktionen mellan dem förklarade 2% av resultatet. Regressions-analyserna visade att klienterna som behandlades i PDT1 och CT2 fick en mer positiv självbild och minskade mer i symtom än vad klienterna i CT1 och PDT2 gjorde. Genom en Ancova beräknades att klienterna i CT2 hade signifikant bättre resultat i den affektiva självbilden än klienterna i alla de andra träningsförhållandena. När det gäller psykologiska symtom beräknades att CT2 klienter hade färre symtom efter behandlingen än vad klienter i CT1 hade, men det var ingen signifikant skillnad mot PDT1 eller PDT2. Den fjärde frågeställningen tog reda på hur studenter på den grundläggande psykoterapiutbildningen utvecklades i sin professionella karaktäristika och arbetsstil (läkande eller stressande arbetsstil). Detta undersöktes i studie III. Data från terapeuter samlades in vid session 2, 8, 16, 22 och vid avslut av terapin. Multilevel analys modeller användes för att räkna ut hur och om terapeuterna utvecklades. Resultaten från DPCCQ visade att terapeuterna ökar sin läkande arbetsstil och minskar sin stressande arbetsstil under träningen. De utvecklades dock inte i ångest och uttråkningskänslor som de kände under terapisessionerna. Ett delresultat var att terapeuterna förbättrades mest i sin tekniska skicklighet och mindre i relationssförmågor. Resultatet indikerar också att terapeuterna utvecklas linjärt men ändå något mer under första delen av träningen om man jämför med den andra delen, dock är denna skillnad inte signifikant. Slutsatser Det verkar som klienterna på psykologprogrammet i Umeå, Sverige, får moderata resultat i terapin och detta ligger i linje med en norsk liknande studie på psykologprogrammet i Norge (Ryum et al., 2007). Resultatet är dock något lägre än vad som framkommit i större effectiveness studier med professionella terapeuter (t.ex. Hunsley &amp; Lee, 2007). Detta kan ändå ses som relativt goda resultat då klienterna inte var så sjuka innan terapin och därmed inte hade potential att förändras så mycket. En styrka med studien är att vi mätte både symtom och självbild eftersom olika perspektiv på förändring är viktigt. Självbildsförändringar kan ses som en viktig intern förändring som bidrar till att klienten känner mening och ökar sitt positiva handlande gentemot sig själv och andra. Självbildsförändringar och symtomförändringarna verkar i stort sett efterlikna varandra i förändringsmönster och forskning har visat att en mer negativ självbild också är relaterad till mer psykopatologi. Studie I visade att klienter med en mer negativ självbild, högre nivåer av själv-kontroll och mindre nivåer av själv-autonomi är relaterad till ett bättre resultat i utbildningsterapier. En mer negativ självbild är relaterad till psykologiskt lidande och kan motivera klienten att göra något åt sina problem. En mer kontrollerande självbild kan hjälpa klienten att slutföra terapin, göra hemuppgifter och vara noggrann med hur terapin implementeras. Våra klienter hade milda till moderata symtom och var relativt välfungerande, det är inte säkert att vi skulle få dessa resultat om klienterna hade haft mer psykologiska symtom. När vi undersökte effekten av behandlingslängd och träningsmetod visade det sig att CT2 och PDT1 fick större effekter än CT1 och PDT2. Dessa effekter kan tolkas på många sätt och en förklaring kan vara att teknikträning är ett viktigt inslag i kognitiva terapier t.ex. agenda, hemarbete, konceptualisering och övningar. Terapeuterna i CT1 var kanske alltför upptagna av teknikträning och fick därmed ett sämre resultat än i CT2 där det fanns mer tid till både teknikträning och fokus på klienten. Det är svårare att förklara varför PDT1 klienterna fick ett likartat resultat som klienterna i PDT2, men en förklaring kan vara att det beror på att terapeuterna i PDT1 bedriver en terapi där "common factors" t.ex. den terapeutiska relationen får stort utrymme och att klienterna där kände sig förstådda och därmed utvecklades positivt. Detta förhållningssätt tror vi inte räckte till i PDT2 då längre terapier ofta kräver mer av terapeuten, och möjligtvis fattades det mer specifik träning på specifika metoder, vilket traditionellt sett inte har praktiserats så ofta på grundläggande psykoterapiutbildningar. En annan förklaring kan vara att vi mäter en terapeuteffekt, terapeuterna i PDT1 kommer sen att tränas i CT2, så dessa terapeuter är kanske mer skickliga och/eller mer motiverade än terapeuterna i CT1 och PDT2. En motivationsfaktor skulle kunna varit att kognitiv beteende terapi, för tiden vid studien, var en eftertraktad terapiform pga. att det då efterfrågades evidensbaserade metoder i samhället och kognitiv terapi var mer förknippad med detta än vad psykodynamisk terapi var. I studie III kom vi fram till att studentterapeuterna utvecklar sig positivt i både sitt läkande och i sitt stressande arbetssätt, men inte i ångest och uttråkningskänslor under terapin. De upplever sig mer stödjande och effektiva och använder mer konstruktiva coping strategier efter terapiträningen. Dessutom känner de ett större självförtroende att de gör någon nytta för klienten. Det kan vara bekymmersamt att de få studenter som känner ångest och uttråkning, inte utvecklas i träningen. Negativa känslor från terapeuten har visat sig vara relaterade till en sämre allians mellan terapeut och klient och kan i förlängningen leda till ett sämre terapi- resultat. Här föreslår vi att utbildningar ska bli bättre på att ta upp dessa känslor tidigt i handledningen så att studenterna när det sen behövs, kan bearbeta och förhoppningsvis förändra dessa känslor. Resultatet visade också att terapeuterna utvecklades mest i sin tekniska skicklighet och lite mindre i sina relationsförmågor. Troligtvis var det lättare att utvecklas i tekniker än i relationsförmågor därför att studenterna upplevde sig ha lägre metodkunskaper före träningen, medan de skattade sig högre på relationsförmågor. I resultatet framkom även att terapeuterna utvecklades linjärt över tid, vilket motstrider de få teorier som beskriver en terapeuts utveckling i stadier eller faser. Dock kan utvecklingsfaser ha ett annat tidsintervall än vad som uppmätts i denna studie och mer forskning behövs på området. / Effects of Student Therapies (EUT)