This study explores trainees' experiences of power dynamics within a ritualised training context, with reference to the three major aspects of the study: training, ritual and power. The psychotherapeutic training took place at Agape, a community-based counselling service in Mamelodi, whose theoretical approach to training included a mixture of postmodern, ecosystemic and African traditions. A substantial literature survey examines the major concepts and issues related to the research subject, such as psychotherapeutic training approaches, the philosophies and theories that may inform training procedures, ritual practices in psychotherapy, and organisational and power aspects of psychotherapeutic training. The research process was executed using the qualitative, interpretive research methodology. A sample of six of the trainees who had completed their training at this placement was interviewed, and two of the trainers. The researcher's reflections on her own training experiences are woven into the material. Using the interview technique and through asking a series of open-ended questions, the researcher obtained an account of the subjective, sacralised training interactions at Agape. Themes were identified that had emerged during the interview process. In brief, the themes referred to trainees' theoretical and practical experiences in the training placement, how they made sense of the sacralised therapeutic experiences, and comments on their relationship with trainers and fellow trainees. The most common theme that emerged was that of power. The end product of this study portrays the trainees' understandings of power within a sacralised psychotherapeutic context and their responses to this. This study makes explicit the links between ritualisation and power within an evaluative psychotherapeutic training context, and the consequences of this for training. / Psychology / M.A. (Clinical Psychology)

This qualitative study aimed to trace the psychotherapeutic development of clinical and counselling psychologists across the careerspan within the South African context. Through purposive sampling 34 psychologists were recruited according to the inclusion criteria of the study. Five distinct career levels were explored, namely, student (n=10), intern (n=7), early career (n=7), experienced (n=5), and senior (n=5) psychologists in relation to the Society of Psychotherapy Research’s international model of psychotherapist development. By means of semi-structured interviews, couched in the social constructionist position, participants’ experiences were thematically analysed from over 600 pages of transcription. Additionally, the researcher’s personal journey of developing as a psychotherapist was reflected upon. The current study found that a number of aspects fostered the development of psychotherapists. Participants reflected on personal and familial wounding events that influenced them choosing a career as a psychologist; this awareness was gradual over their development. Across theoretical orientations, participants resisted adhering to one way of working in light of the diverse South African context. However, the need to limit the number of theoretical orientations taught within the first months of training was proposed. Professional sources of influence highlighted by participants were personal therapy and peer supervision or reading groups. Qualified professionals to a lesser extent made use of individual supervision which when pursued needed to be a ‘felt’ collaboration. Participants found as they developed they became more comfortable being a psychotherapist however the complexity of cases still kept them humble. Limitations of the study, potential future research directions as well as recommendations for practicing clinical and counselling psychology were outlined. / Psychology / Ph. D. (Psychology)

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<p>This research was a pilot study in a larger project that focused on how to retrieve knowledge from retiring long-term employees of a small university utility plant, incorporate that material into their existing training program, and during the process reduce the training time for current and future employees. Wade utility plant faced the retirement of eight employees with nearly 200 years of corporate knowledge within three years, but their current training program required seven to nine years to complete. The study utilized interviews, first-hand observation and partnership with current employees to explore how best to obtain the corporate knowledge that would be lost when the proletarian workers retired. The study revealed that the training program needed to be updated, and communication, trust and training evaluation continuity needed to be addressed. Due to these issues, trust was built through transparency by the researcher, and suggestions were made to management for moving forward. This study adds to the body of knowledge by utilizing knowledge capture techniques in a utility plant, highlighting effective knowledge capture techniques for proletarian workers, the importance of corporate planning for the effect of group retirements, and how incorporating proletarian workers into training creation can make a positive impact on company relationships.</p>

Background The coronavirus pandemic poses many challenges for medical personnel. During the first phase of the pandemic, psychological stress became increasingly apparent. This was a complex and difficult situation, especially for physician residents specializing in family practice (GP trainees), who were not yet able to draw on years of practical experience. In this context, the Kompetenzzentrum Weiterbildung Allgemeinmedizin Sachsen (Competence Center for Continuing Education in General Medicine Saxony) (KWASa) developed a survey on how to deal with the concerns and challenges perceived at the time. The purpose of the study was to obtain information on psychological well-being in the pandemic context, as well as on expectations, fears, and protective measures in everyday work. The aim was to identify stress factors for general practice (GP) trainees during a pandemic situation to be able to consider the support needs in the design of future residency training programs, especially for GP trainees. Methods An online questionnaire was distributed from May 5, 2020 to June 4, 2020 among GP trainees enrolled in KWASa since 2018. The questionnaire consisted of standardized items, which were evaluated descriptively, and open-ended items with free-text answers, which were evaluated according to the principle of qualitative content analysis. Results The results show the relevance of the topic as 61% of respondents indicated that they were concerned about the coronavirus. Most GP trainees also gave an affirmative response regarding emotional challenges. In this context, various stressors could be identified within both the professional and personal environments. There were four particularly salient factors: (1) the fear of infecting one’s family as well as patients with the SARS-CoV-2 virus; (2) missing or insufficiently existing protective measures; (3) an increased need for consultation due to unpredictable patient behavior as well as uncertainties in patient treatment; and (4) communication difficulties within the collegial environment. Conclusions The study aimed to identify the support needs of GP trainees in crisis situations such as the COVID-19 pandemic. The results of the survey can be used for the development of suitable continuing education programs for physicians in further training.

Indiana University-Purdue University Indianapolis (IUPUI) / While the majority of chronic pain patients report receiving inadequate care, there is evidence that female and Black patients receive less analgesic medications and treatment for their chronic pain compared to male and White patients, respectively. While treatment disparities have been evidenced in the literature, there is little understanding of provider-factors, such as their decision-making awareness and attitudes, which may contribute to the differences in treatment. This investigation employed quantitative and qualitative procedures to examine the relationship between patient demographics and chronic pain treatment variability, providers’ awareness of these non-medical influences on their decisions, and the extent to which providers’ gender and racial attitudes associate with their treatment decisions. Twenty healthcare trainees made pain treatment decisions (opioid, antidepressant, physical therapy, pain specialty referral) for 16 computer-simulated patients presenting with chronic low back pain; patient sex and race were manipulated across vignettes. Participants then selected among 9 factors, including patient demographics, to indicate which factors influenced their treatment decisions for the simulated patients and completed gender and racial attitude measures. After online study completion, follow-up semi-structured interviews were conducted to discuss the medical/non-medical factors that influence trainees’ clinical treatment decisions. Quantitative analysis indicated that 5%-25% of trainees were actually influenced (p<0.10) by patient sex and race in their treatments, and on the whole, trainees gave higher antidepressant ratings to White than Black patients (p<.05). Fifty-five percent demonstrated concordance, or awareness, between their actual and reported use of patient demographics. Follow-up McNemar’s test indicated trainees were generally aware of the influence of demographics on their decisions. Overall, gender and racial attitudes did not associate with trainees’ treatment decisions, except trainees’ complementary stereotypes about Black individuals were positively associated with their opioid decisions for White patients. During qualitative interviews, aware and unaware trainees discussed similar themes related to sex and racial/ethnic differences in pain presentation and tailoring treatments. We found that (1) a subset of trainees were influenced by patient sex and race when making chronic pain treatment decisions, (2) trainees were generally aware of the influence of patient demographics, and (3) trainees discussed differences in pain presentation based on patients’ sex and ethnic origin. These findings suggest trainees’ are influenced by patient demographics and hold stereotypes about patient populations, which may play a role in their decision-making.