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

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Massey University
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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.
Clinical psychology, Psychotherapy outcomes, Psychotherapy evaluation