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The expectations of experienced and novice clinical psychologists regarding course of change for clients undertaking successful cognitive behavioural psychotherapy : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand
The present study explored the expectations of both experienced clinicians and clinical
psychology students when predicting the course of change for both a depressed client
and an anxious client undertaking successful cognitive behavioural therapy (CBT).
Experienced clinicians and clinical psychology students were asked to complete a task
based on case study scenarios. A specially designed graph enabled participants to plot
scores for three separate measures: an inventory for mood, an inventory for symptoms
and a behavioural record of activities.
The course of change in psychotherapy, whilst being an important component to
understanding the process of outcome in psychotherapy, has received little attention
from researchers. Although there has been a growing emphasis on the need to measure
outcomes and provide feedback, a unified understanding of the course of change has not
been identified. A number of theories have suggested stages of motivation and an
individual‘s likely process of assimilating problematic experiences, however these are
largely based on group data, and do not take into account individual characteristics. This
study therefore aimed to explore the course of change expected in successful CBT (the
dominant theoretical orientation used amongst New Zealand clinicians) to identify the
expected change patterns between clinicians and students, and their meaning. It also
aimed to identify relationships between mood, symptom and behaviour during the
therapeutic process, and determine key aspects that act as a basis for future research in
this area. Findings showed that overall participants predicted a gradually declining
linear progression, although differences in variance and trends were found between and
within the clinician and student groups. Limitations, implications and future directions
of this study are also discussed.