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Item Behind the mask : recognising genuine and masked expressions of emotion : the effect of therapists' training and experience : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Palmerston North, New Zealand(Massey University, 2017) Curtis, Alexa AnneAccurately recognising facial expressions of emotion can enhance communication and the development of a therapeutic relationship. When emotions are masked or inhibited, duplicity can be betrayed through evidence of leakage of the underlying emotion occurring in the face. Being able to discern when emotions are masked or concealed may also contribute to therapy outcomes by alerting the therapist to areas requiring further exploration. Despite a large body of research on facial expression of emotion, there is a dearth of research into therapists’ emotion recognition competencies or ability to detect deception. This study sought to answer the following questions: First, is recognition of facial emotional expressions, including masked expressions, enhanced by training? Second, does clinical experience impact on emotion recognition ability? Finally, does training increase the ability to discern authentic from falsified expressions? In Study 1, 43 clinical psychologists were recruited for the study and undertook an emotion recognition and deception detection task. Twenty-‐two of the participants completed training in emotion recognition using the Subtle Expression Training Tool (SETT; http://www.paulekman.com). In Study 2, a partial replication of Study 1 was conducted with 25 participants, and an updated version of the SETT. Results for recognition of emotion were mixed, with partial support found for the hypothesis that training would enhance recognition ability. Training was effective for improving recognition of single emotion expressions, but had less impact on recognition for masked or leaked expressions, with the exception of sadness. Efficacy of training was also dependent on experience level, with more experienced participants benefiting the most. All participants were able to detect emotional deception at levels above chance prior to training. Following training, those with a high level of experience demonstrated the greatest improvement in deception detection, with half of this group accurately detecting deception at levels significantly above chance (M = .74).Item Evaluating the effects of self-practice/self-reflection on cognitive flexibility, empathy, insight, self-compassion, self-monitoring, and stress in postgraduate cognitive behaviour therapy trainees : a thesis presented in fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Albany, New Zealand(Massey University, 2017) Hume, Fleur AliceThere is considerable evidence to suggest that cognitive behaviour therapy (CBT) training programs can effectively enhance therapists’ CBT knowledge and skills. In response, research is now beginning to establish which specific training strategies are most effective in developing which CBT skills and competencies. Self-practice/self-reflection (SP/SR) is an experiential training strategy used to enhance CBT training and the ongoing professional development of CBT practitioners. Self-practice/self-reflection provides therapists with a structured experience of using CBT on themselves (self-practice) and reflecting on that experience (self-reflection). In order to build on previous SP/SR research, the aim of the current study was to explore the effects of SP/SR on six specific dimensions of CBT therapist competence: cognitive flexibility, empathy, insight, self-compassion, self-monitoring, and stress, among postgraduate CBT trainees. Seven students completing a SP/SR program as part of the Postgraduate Diploma in Cognitive Behaviour Therapy at Massey University were recruited to participate in the study. Quantitative data using six self-report measures of therapist competence was collected at five critical time points pertaining to the participants’ SP/SR program: baseline, pre-intervention, midpoint, post-intervention, and follow-up. Qualitative data was collected from participants’ written reflections. A mixed method design using descriptive quantitative and qualitative thematic analysis provided valuable quantitative (and some qualitative) support for the use of SP/SR as a CBT training and development strategy, particularly when targeting these six dimensions of CBT therapist competence.Item Getting the feel of therapy : understanding therapists' views and experiences regarding social-emotional skills in practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology at Massey University, Albany, New Zealand(Massey University, 2016) Boshra, VerenaEmotions are arguably at the heart of psychotherapy. While clients’ emotions in therapy have received a great deal of research attention, outside the realm of psychoanalytic and psychodynamic research, therapists’ emotions have largely been neglected. When applied to therapy, the concept of social-emotional skills describes therapists’ ability to be aware of their own and their clients’ emotions and then draw on that information to manage those emotions and in turn, the therapeutic interaction. As therapists’ social-emotional skills are a relatively new area of enquiry, this qualitative study sought to contribute to the literature by exploring therapists’ views and experiences regarding social-emotional skills in practice. Semi-structured interviews were carried out with ten practicing therapist participants between the ages of 31 and 62. Using Thematic Analysis, The Centrality of Emotions in Therapy was determined as a meta-theme and this was further organised into four main themes; Emotional Principles, Emotional Awareness Strategies, Emotional Practices as well as the Learning and Training of Social-Emotional Skills. The findings were visually represented using ‘The Tree of Therapists’ Social-Emotional Interactions’ model. Implications of the findings, limitations of the current study and future research directions are discussed.Item Knowledge, attitudes, and beliefs towards the therapeutic use of mindfulness amongst psychotherapists in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Manawatū, New Zealand(Massey University, 2016) Urgert, Samantha JaneMindfulness has infiltrated psychology in the last two decades, and clinical efficacy in utilising mindfulness is increasing worldwide. Very little research has explored what mental health professionals know about mindfulness, and their attitudes towards its therapeutic use. Understanding practitioners’ knowledge and attitudes towards clinical tools is essential in future integration within therapy. The current study explored knowledge, attitudes, and beliefs surrounding various aspects of mindfulness among New Zealand psychotherapists, to identify whether knowledge of mindfulness was related to attitudes towards its use. A total of 53 psychotherapists completed a questionnaire that elicited quantitative responses about personal mindfulness, attitudes towards alternative therapies, and beliefs surrounding perceived competencies with use of mindfulness clinically. Psychotherapists are in agreement with proposed competencies, have positive attitudes towards its use, and are personally highly mindful. ANOVA revealed attitudes and competencies towards the use of mindfulness are related to religious affiliation and professional specialisation. Most had previous mindfulness education and believed it benefits their daily life, but suggested they would consider clinical use if their knowledge was greater. Psychotherapists’ personal mindfulness was not associated with attitudes towards, or competencies with its use. Despite a number of limitations, possible implications of the findings suggest future clinical utilisation of mindfulness within New Zealand, is reliant on understanding its current location within the minds of mental health professionals. A lack of education about mindfulness may be the reason for low utilisation, and this research may provide insight into areas of deficiencies. Knowledge in therapeutic mindfulness is pertinent in the improvement of future utilisation and infiltration within mental health professions, in turn accomplishing its clinical potential.Item A grounded theory of the role of family in recovery and healing from child sexual abuse : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 2005) Morrison, Lana JaneThis thesis presents an exploration of therapist perceptions of the role of family in recovery and healing from Child Sexual Abuse (CSA). Consistent with the individualistic focus of Western society, the international body of literature tends to focus on intrapsychic effects and processes of CSA rather than emphasising the ecological and systemic influences which interact with CSA events. Consistent with the New Zealand Ministry of Health's calls to be more inclusive of family in mental health issues, this investigation attempted to provide new understandings of CSA from an ecological and systemic perspective. A grounded theory methodology was utilised. This incorporated the analysis of therapist data collected from a combination of focus groups, key informant interviews and a national survey. The core social process which emerged was "Belonging, Estrangement and Reintegratio". This model of recovery and healing in sexually abused families recognises the impact that abuse and neglect has across generations of a family, the evolving nature of their relationships before, during and after the sexual abuse event(s), and the impact these relationships have on the healing journey. Parallel to the core social process were a number of contextual variables which interacted with therapist practices. These factors influenced how practitioners conceptualise and work with sexually abused families. For the most part, these variables were barriers to including family in the recovery process. It is hoped that the themes which emerged from this investigation will further inform practice in the field by identifying ways in which therapists can successfully incorporate and address contextual family factors to facilitate recovery and healing. It is also hoped that this investigation will alert organisations to the ecological barriers which therapists encounter and which hinder their ability to incorporate family factors in their practice.Item Multiple holding : clinical supervision in the context of trauma and abuse : a thesis presented in partial fulfillment of the requirements for the degree of Master of Social Work at Massey University(Massey University, 2007) Virtue, ClaireThe purpose of this study was to explore the supervision relationship in the context of trauma and abuse. Interviews with supervisors and supervisees were conducted with supervisees and supervisors not in a supervision relationship with each other. Ten interviews were conducted, including two pilot interviews. At the end of the individual interviews, the researcher facilitated two focus groups with participants. A qualitative methodology, grounded theory, was adopted because it is well suited for researching areas where little or no previous research has been undertaken. The findings of this study are that supervision cannot meet all the needs of supervisees working in the context of trauma. The core category that emerged is that of multiple holding. Multiple holding is a theoretical construct that describes supervisees accessing resources outside the supervision relationship as well as within it to support and hold them in their work with trauma. The supervisors also identified a 'chain of holding' that is a sub set of multiple holding supporting supervision practice, Multiple holding is fully explored in this study. The recommendations from the research are that training is needed for supervisors providing supervision in the context of trauma. Finally, the research supported the supervisee's autonomy in choosing a supervisor.Item The development of the homework adherence and competence scale (HAACS) : a measure for assessing therapist adherence and competence in administering homework assignments within cognitive behaviour therapy : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 2005) Wedge, PaulHomework assignments are considered an integral feature of Cognitive Behaviour Therapy (CBT) and are believed important in producing and maintaining treatment gains. Accordingly, increasing attention has been focused on measuring therapist adherence and competence in administering homework assignments in CBT. Existing measurement instruments have been criticised for, among other things, having a limited homework focus. The present study describes the development of the Homework Adherence And Competence Scale (HAACS); a new measure for specifically assessing therapist adherence and competence in administering homework assignments within CBT. An empirically and theoretically based guiding model for practice is described, which underpinned the development process. The detailed pilot testing and measure revision process is also described. The final version of the HAACS has evidence for face and content validity, and had excellent interrater reliability for both the adherence and competence constructs.Item The prevalence and perceived effects on psychological practice of prior exposure to mental illness and/or psychological trauma in psychologists : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 2002) Boyland, Sheila LaraineOne hundred and fifty-six participants comprising registered psychologists and postgraduate psychology students responded to a mail survey requesting information on their experiences prior to undertaking their postgraduate study in psychology. Clinical and counselling psychologists/students were compared with psychologists and students specialising in other areas of psychology. The clinical/counselling group differed significantly from the comparison group in a number of ways. Clinical/counselling participants were more likely to report prior exposure to mental illness and some types of psychological trauma, as well as a greater number of these experiences. The influence of prior exposure to mental illness and/or traumatic events on the decision to study psychology, and the perceived effects of these experiences on future psychological practice, were investigated with mixed results. Motivators to enter the field of psychology were also investigated and clinical/counselling participants were more likely to have been motivated by dysfunctional reasons than the comparison participants. Additionally, the findings of this study suggest that psychology students with psychological problems may be fearful of disclosing these for fear of negative consequences. It is also suggested that, in general, psychologists and postgraduate psychology students in New Zealand may not be entirely satisfied with their education with regard [to] self-care and self-reflection issues. The results are discussed in terms of effects on psychological practice, and specific issues regarding the education of postgraduate psychology students are raised. Recommendations for further research are suggested.Item Transfer of training and therapist factors in Cognitive Behaviour Therapy : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Auckland, New Zealand(Massey University, 2012) Gedye, Robyn AThere is a call for the training of greater numbers of therapists in the use of Cognitive Behaviour Therapy (CBT) in order to meet the needs of growing populations worldwide. However, issues relating to transfer of training and therapist competence have been noted following the training process (Beidas & Kendall, 2010; Carroll, Martino, &Rounsaville, 2010; Kendall et al., 2004). To date, research investigating the impact that therapist characteristics, or effects,may have on therapist competence hasfocused on demographic data(McManus, Westbrook, Vasquez-Montez, Fennell, &Kennerley, 2010), with limited attentiongiven to therapist factors that may have a theoretical or empirical association with competence.To date, studies have reported mixed results concerning the relationshipbetween observed competenceand therapist self-confidence in using CBT (Brosnan, Reynolds, & Moore, 2006; Beidas & Kendall, 2010), anda positive relationship between observed competence and current practice (Mannix et al., 2006). Studies investigating therapy behaviours have suggestedpositive relationships between observed competence and career growth (Orlinsky&Rønnestad, 2005), and negative relationships with organisational barriers (Fadden, 1997; Kavanagh et al.,1993). The present study is an exploratory investigation of therapist competence and therapist factorsboth during and following postgraduate diploma training in CBT.Therapist factors investigated in the present study were therapist selfconfidence in using CBT, current CBT practice, perception of career growth, and perception of organisational barriers. Two separate studies were conducted.Study One employed a longitudinal design.Competence and therapist factorswere assessedfor trainees (N=16) at three time points during the diploma practicum. Training transfer was measured at 12 months follow-up.Study Two employed a cross-sectional design to investigate relationships between competence and therapist factorsfollowing training.Study Two participants were 20 postgraduate practitioners who had completed the practicum1 to 9 years prior to assessment within the present study. Results showed that 94% (N=16) of Study One participants were rated competent at the end of the practicum. Two of the nine participants who completed Study One showed evidence of training transfer at 12 months followup. Positive relationships between observed competence, self-confidence, and career growthwere consistently found throughout the training. However, at the end of training participants rated as more competent reportedpractice with fewer clients and a greater perception of organisational barriers. Results for Study Two showed65% of participants were rated competent 1-9 years following training. All relationships between observed competence and therapist factors were negative 1-9 years following training. Also, more competent participantsreportedlower self-confidence, less career growth, and practice with fewer clients, while the opposite was found for participants rated as less competent. These findings suggest that supervised practicum training in CBT increases trainee observed and self-reported competence, although the maintenance of training gains appears problematic. The implications of the findings are discussed and recommendations made for further research.Item In search of the master therapist : emotional competence and client outcome : a thesis submitted in partial fulfilment of the requirements for the degree of Master in Psychology, Massey University, Palmerston North, New Zealand(Massey University, 2012) de Vries, IvorPsychotherapy for clients is an interpersonal, often emotional, process facilitated under guidance from their therapist. Whilst the literature offers some tantalising clues as to which therapist-emotional qualities are beneficial for establishing good working relationships, which tend to lead to positive client change, little is known about which specific emotional skills successful therapists use to achieve this process. The purpose of the present study was to gain insight into how excellent therapists use their emotion in therapy to help clients achieve positive outcomes. Three therapists with high client outcome ratings engaged in semi-structured interviews, and resulting transcripts were analysed using interpretative phenomenological analysis. Participants spoke of genuine congruence in warmth and caring characteristics; sensitivity to client needs; harbouring positive expectations of their therapeutic methods and clients; possessing strong self-reflective and emotion regulation skills; often experiencing strong empathy but moderating their empathic expression; balancing the client relationship and therapeutic process; working collaboratively with their clients; and prioritising client emotional needs over their own. Implications, study limitations and future directions for research are discussed.