Characteristics Of Master Therapists Essay
Characteristics Of Master Therapists Essay
The Cognitive, Emotional, and Relational Characteristics of Master Therapists: A Journal Summary Jennings, L. , & Skovholt, T. M. (1999). The cognitive, emotional, and relational characteristics of master therapists.
Journal of Counseling Psychology, 46(1), 3-11. In a qualitative research study, Jennings and Skovholt sought to determine what characteristics, if any, comprise a master therapist. The study consisted of 10 peer-nominated master therapists, each therapist being nominated as a master therapist by a minimum of four peers within a major city.These nominations determined the participants of the study. Though the therapists ranged in theoretical orientation, education level, and years of experience, all of the therapists worked full-time in private practice.
Through a series of recorded interviews that were analyzed and studied for specific themes and patterns, analysis produced a set of nine characteristics found in master therapists. Characteristics Of Master Therapists Essay. These results were then organized under the three domains of cognitive, emotional, and relational characteristics, representing quality areas that were consistently indicative of master therapists.The cognitive domain suggests that master therapists are voracious learners who draw extensively from accumulated experience and value cognitive complexity. Beneath the emotional domain, master therapists are described as emotionally receptive, non-defensive, mentally healthy, and able to attend to their own emotional well-being.
Conducting oneself ethically is critical task of the competent therapist (http://www.Apa.org/ethics, January, 2003). Making the best ethical decisions can be extremely challenging for most therapist due to the multitude of complex ethical situations. The goal of this study is to examine the ethical values of master therapists considered to be “the best of the best” by their professional colleagues. It is hoped that such as examination will help to illuminate what ethical values master therapists seem to draw upon in their work.
Ethics are beliefs about conduct and principles that inform rules for proper behavior (Corey, Corey, & Callanan, 1998; Knauss, 1997). In psychology, ethics codes are intended to “set out expected professional behavior and responsibility” (Eberlein, 1987, p. 345). However, studies involving ethical dilemmas have found a discrepancy between therapists’ knowledge of what ought to be done and what they actually would do (Bernard & Jara, 1986; Bernard, Murphy, & Little, 1987; Smith, McGuire, Abbott, & Blau, 1991; Wilkins, McGuire, Abbott, & Blau, 1990).
Why the inconsistencies? Researchers suggest that when therapists though the ethical infraction violated a clear professional code, they were more likely to act as they felt they should. This happened especially when the violation was bolstered by a legal precedent (Bernard et al., 1987; Smith et al., 1991). However, in situations that depended more on individual judgment, practitioners were less likely to “do the right thing.” Characteristics Of Master Therapists Essay. It appears that when written ethical guidelines are unclear, psychologists rely on their own individual value systems and their understanding of the ethics code (Bersoff & Koeppl, 1993; Eberlein, 1987). One possibility for the discrepancy between knowing and doing what is right is that some clinicians suffer from deficits in principles such as integrity and honesty (Smith et al., 1991). Rest (1984) theorized that a therapist who is reluctant to follow through with understood ethical behavior may lack the courage to act. To date, studies on therapist values have tended to focus on therapists’ conceptualizations of what constitutes good mental health (Consoli & Williams, 1999; Haugen, Tyler, & Clark, 1991; Jensen & Bergin, 1988; Kelly, 1995; Khan & Cross, 1983; Myers & Truluck, 1998).
(p. 108) Kitchener (1984) believes that parts of formal organizational ethical codes are too broad, whereas other are too narrow. The fundamental ethical principles identified by Kitchener are autonomy, beneficence, nonmaleficence, justice, and fidelity. Meara, Schmidt, and Day (1996) expanded on Kitchener’s work by defining principle ethics (formal, obligatory codes) as distinct from virtue ethics (focus on character traits and ideals). Virtue ethics are rooted within the traditions of a cultural group and, therefore, present a more complete account of moral life than actions based on prescribed rules. Meara et al. (1996) proposed that virtue ethics complement principle ethics by assisting helping professionals to achieve the ideals of being competent, serving the common good, and retaining professional autonomy. Given that the authors argue professional decision making is “seldom either totally absolute or completely relative and thus requires virtuous, competent individuals to exercise careful professional judgment” (p. 5), the concept of ethics should encompass issues of character as well as professional obligations. The work of Kitchener and Meara et al. supports the idea that ethical decisions in psychology are complex and rarely absolute. In order to understand ethical decision making, it seems important to know the core value of the therapist that influence each unique situation. Characteristics Of Master Therapists Essay.
The majority of empirical studies that examine ethical decision making in practice have focused on therapists’ responses to particular ethical dilemmas (Conte, Plutchik, Picard, & Karasu, 1989; Haas, Malouf, & Mayerson, 1988; Smith et al., 1991; Wilkins et al., 1990). A limitation of this line of research is that it tends to be about specific areas of concern, such as sexual contact with clients. Another approach has been for researchers to survey practicing clinicians in an open-ended way about their ethically challenging critical incidents. This method, as described by Pope and Vetter (1992), mirrors the original process the American Psychological Association (APA) used to create the first ethics code for psychologists. In 1952, the APA surveyed its membership in an attempt to develop guidelines for ethical conduct that reflected the concerns of practitioners. Although useful, it appears that survey research cannot capture the complexity of the nuanced thinking involved in making ethical decisions.
In a departure from survey research, Prilleltensky, Walsh-Bowers, and Rossiter (1999) conducted a qualitative study exploring the underlying core values of practitioners. When examining practitioners’ professional ethics, three general principles emerge: respect for people’s rights, dignity, integrity, and privacy; compassion and responsible caring; and feeling a sense of responsibility for the community. Furthermore, the practitioners described additional values they believed were fundamental in their work: encouraging clients’ self-determination, advocacy for vulnerable clients, confidentiality and informed consent, strength-based empowerment, and paying attention to the best interests of the client under unique circumstances.
Thus far, little research on ethical values has focused on seasoned or expert therapists. However, studies have examined clinicians’ years of experience, providing a better understanding of the growth of professional ethical judgment over the course of a career (Conte et al., 1989; Haas, Malouf, & Mayerson, 1998; Jensen & Bergin, 1988). Conte et al.’s (1989) survey of therapists found that beliefs about ethical standards varied widely. Characteristics Of Master Therapists Essay. The authors concluded that certain behaviors were ethical standards varied widely. The authors concluded that certain behaviors were thought by some therapists to be inappropriate, but not necessarily unethical, whereas other therapists felt that similar behaviors were either clearly unethical or grounds for malpractice. In addition, therapists with more experience were more likely to feel that pledging (p. 109) to cure a client’s symptoms was unethical and less likely to break confidentially to warn a potential victim of harm.
Jensen and Bergin (1988) found that years of professional experience did not predict desirable mental health values. In addition, Haas et al. (1998) found the length of time after attaining one’s professional degree to be inversely related to the psychologist’s willingness to take the most ethically preferred course of action. The authors hypothesized that this surprising result may be due to burnout factors or a recent training focus for younger practitioners on specific ethical obligations.
Pope and Bajt (1988) surveyed ethically knowledgeable senior psychologists (e.g., served on boards of ethics, authors of ethics textbooks, ABPP status) and found that a majority admitted having willingly violated ethical codes. Further, 77 percent of respondents felt that formal ethical standards should be broken when necessary for client welfare “or other deeper values” (p. 828). Instead of “textbook ethics,” these experienced practitioners perhaps used context-based ethics developed over years of practice.
Though the APA puts forth a set of ethical principles designed to guide psychologists to practice ethically, survey or dilemma-based research methods have yielded limited data on therapists’ values in general and have, at times, painted an unfavorable portrayal of the ethical practices of experienced therapists. What appears lacking in the literature is an examination of actual values—perhaps those “deeper values” that guide therapists’ ethical behavior. Even more useful may be an examination of the ethical values that expert of master therapists seem to draw upon in their work. Utilizing Consensual Qualitative Research (CQR) methods (Hill, Thompson, & Williams, 1997), the present study attempts to provide an understanding of the ethical values of master therapists. Please see A for a complete description of the study’s methodology. Characteristics Of Master Therapists Essay.
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Results
The five most salient ethical values of master therapists identified were: (a) competence, (b) relational connection, (c) nonmaleficence, (d) autonomy, and (e) beneficence. Several quotations will be offered for each of the five ethical values. Hopefully, this will provide the reader with a better sense of the master therapists’ viewpoints that comprised each ethical value.
Competence
As outlined in the 2002 APA Ethical Standards, being competent in one’s work as a therapist is a hallmark of ethical practice. The master therapists in this study clearly value being exceptionally skilled in their clinical work. In fact, they are highly motivated to move beyond the minimum competency level required by ethical and practice standards and to be experts in their field. These therapists, even after years of experience and training that might have just as easily resulted in complacency, place a high value on building and maintaining their skill set. Throughout the interview data, references to becoming competent and maintaining competency as a practitioner (p. 110) lend support to this category. One master therapist recollects how the accumulation of experience aided in developing competence as a practitioner:
I’ve got a lot more experience, and as much as I used to want to believe when I was younger that age and experience didn’t count (and not just experience in the terms of being a therapist, but life experience), it counts a lot in terms of your ability to empathize and understand a wider range of things. The other parts is what I came out of school, I did not feel as though I knew much of anything. And the training and supervision and experience that I got during those years made an incredible difference. Characteristics Of Master Therapists Essay.
Similarly, another master therapist also discussed the vital role of experience in building competency:
I am really shockproof, and it took a long time not to be jarred by the stories I hear. I can’t imagine how to create a graduate school program that would turn out expert seasoned therapists immediately. It’s a long process.
Master therapists continually seek out formal and informal training to broaden their clinical abilities. Being perpetually open to opportunities for learning and growth in their profession seemed to be another defining characteristic of these master therapists. The drive for competency combined with an awareness of limitations inspired master therapists to be “life-long learners.” It is likely that keeping current on the latest developments in the profession and exposing their work to others for feedback minimizes the potential for unethical behavior. The master therapists spoke of the importance of looking for professional growth experiences beyond didactic venues and supervision, as well as their own therapy, master therapists seemed continually to seek out the opportunity to have others critically evaluate their work. As one master therapist stated:
I meet with other people who are calling me on my stuff so I get a change to look at myself on the outside over and over and over again, through personal therapy, through lots of supervision, through ongoing consultation. That helps incredibly. I think that’s essential.
Amassing years of clinical practice is only one component of commitment to professional development. For master therapists, experience combined with clinical consultation, ongoing traditional academic training, and personal reflection yields a deeper level of professional growth. Again, this commitment to professional growth appears to bolsters one’s competence, which in turn is an important ingredient in conducting ethical work. Challenging the idea that experience alone equals expertise, the same master therapist spoke eloquently of the importance of bolstering the accumulation of clinical experience with sustaining professional relationships to grow professionally:
I don’t think years of experience by itself does it, does it, because I might have the same year of experience twenty times, and so I need to put that together with good consultation and a good collegial system. So that you actually are learning from what you’re doing and [learning] more about how you’re impacting and affecting people.
(p. 111) It appears that part of master therapists’ becoming more competent in their work involves looking less and less for an immediate answer to clients’ presenting problems because they believe tolerance for ambiguity is an important part of the therapist’s role. Master therapists tend to not see easy answers in their work with clients and to conceptualize the process of staying open as a hallmark of competent practice. Characteristics Of Master Therapists Essay. They seem to be searching constantly for the uniqueness and intricacy of situations. This appreciation of complexity has ethical implications in that it helps prevent premature closure (Skovholt & Rønnested, 1995), which is a tendency of some therapists to reduce anxiety by, for example, latching onto one of the first solutions considered or to use the same techniques with virtually every situation. With a low comfort level for ambiguity and complexity, some therapists might hastily come to conclusions that primarily relieve their anxiety, yet may not be the best fit for the client. Thus, not being open to complexity and ambiguity leads to narrowing case conceptualization and treatment interventions, which can result in less than competent work. One master therapist said:
Every person is different. Therefore, any technique that one uses, to use it each time in the same way is in some ways denying the truth of the uniqueness of every individual and the uniqueness of every interaction.
Another master therapist noted how difficult it was to train therapists who were not open:
Having taught psychologists, they [often] grab onto an interpretation and come hell or high water, they’re going to prove they’re right. Instead of saying, here’s an interpretation, but does it fit?
The following examples further illustrate the therapists’ deep commitment to openness, which may lead to more competent, and therefore more ethical, interventions. For example, one master therapist said:
I think you have to have a certain amount of flexibility, in that you will hear things and you won’t make sudden decision and then push them through. You sort of wait and watch the pieces fit.
Similarly, one master therapist stated how important it is to avoid acting prematurely:
So, I think [it is important] to be open to not knowing and to an ambiguous situation, so that you can hear what it is that is emerging, rather than laying something on the situation… . When you don’t know, then you can listen more curiously and have more of an openness about what all might be coming here. So, I think the ambiguity is a part of that. It helps you stay more curious about sorting it out and understanding it, finding out more. Characteristics Of Master Therapists Essay.
Relation Connection
Establishing, maintaining, and honoring relationships is an extremely important ethical value for these master therapists, and an ethical value absent in the 1992 APA General Principles that we (p. 112) analyzed for this study. Master therapists seem to highly value the relational interaction and connection among colleagues, friends, clients, and the larger community. Developing sound professional relationship with colleagues is a core value of these therapists. They believe that in order to maintain competence and build expertise, therapists continually must be in relationship with others in the field, both for supervision or consultation for collegial support and friendship. One therapist commented on the need to avoid professional isolation through consistent contact with other professionals:
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I have made sure to practice here with colleagues that are close by. When the lease are up and some move out, we get others in, and we meet once a week for a long lunch, to talk about cases or plants for the waiting room or whatever. That sort of collegial connect, especially on a day-in-day-out basis, is really quite important.
Similarly, master therapists spoke about the need for good relationship in their personal lives that often serve as a safeguard against burnout or impairment:
You know, if you have good friends in your life, if you have a good support system, folks will let you know that you’re feeling worn out or depended or whatever and then will support you getting some help.
As would be expected, all of the master therapists believed that the client-therapist relationship is the key to effecting positive change in clients. One therapist stated:
… [T]he core of psychotherapy to me is the development of that relationship and the connection, and so it’s development of a relationship… the purpose of which is to heal or help the order person. But to me, psychotherapy is the relationship, as opposed to, you know, a technique that I do or whatever else. It’s really about forming and working in the “in-between.” Characteristics Of Master Therapists Essay.
Another master therapist also emphasized the relational aspect of effecting positive therapeutic change:
I really believe that [psychotherapy] is a two-person operation, so that it is about us together if change happens or doesn’t happens. So, I don’t think about it as if something is successful, that I did it. You know, I think it’s something that we did together, and I think if it’s not working, it’s something we’re not doing together.
One master therapist shared:
[Psychotherapy] sort of re-establishes that kind of bridge back to humanity, it re-establishes that sense of being in the community.
Many of the master therapists interviewed seem to uphold high ethical standards when interacting with others in both their professional and personal life. In most relationships, even those in (p. 113) the community at large, the master therapists strive for congruence between their values and how they relate to others. One therapist captured the commitment to maintaining positive relationships in a variety of settings:
It is honoring the integrity of the relationship. Whatever relationship I have, whether it’s with a friend that I’m having dinner with, or I am negotiating a price on a used car with a car dealer, or I am planning a vacation with my wife, or I’m talking with a client about his or her life, I’m going to be honest.
Nonmaleficence
Not only do master therapists value helping others, they are also aware of the tremendous potential to do damage in the context of the therapeutic relationship. They seem mindful of the ways they may potentially harm their clients and have developed measures to minimize this risk. For example, one master therapist said:
I think one of the ways therapy goes away is that the therapist starts to use the client for their own emotional sustenance … regulation of the therapist’s self-esteem, all those sorts of things. Characteristics Of Master Therapists Essay.
Master therapists strongly believed in managing their own personal and professional stressors that can lead to harming clients. One master therapist said it this way:
Those therapists who have been in consultation with me before who were not willing to do [personal therapy] were so difficult to deal with. Any time they were stuck for a period of time, they’d make it about the client, instead of about themselves or instead of about both of them. And when you do that, you’re going to be abusive to your client.
For master therapists, humility offsets the potential for grandiosity and arrogance, characteristics that may lead to harming clients. Because these master therapists realize they do not have “a corner on the truth,” they seem to have a healthy perspective on their limits as practitioners and human beings. In fact, awareness of these limitations seems to inspire them to continue growing professionally and personally. This attitude is in stark contrast to those who might think they have “arrived” as a therapist and therefore do not require ongoing training and development. In addition, some master therapists expressed concern for therapists who are not fully aware of their weaknesses. For example, one master therapist said:
One of the things that I tell people when they are looking for a therapist is to really ask them the question about what can’t they do. And boy, if they don’t have something they can’t do, get out!
Another master therapist said:
Bad therapists don’t know what they don’t know. They think they know everything, they have a “got to solve it” kind of perspective on everything. Their theory is very sound and [yet] they don’t really know how little they know.
(p. 114)
Display humility, one master therapist spoke of the hazard of grandiosity in considering oneself an expert:
I think if one begins to think of oneself as a master therapist, it can lead to grandiosity. It can pave the way to all sorts of misuse of power. There is one phenomenon that has to do with the seasoned clinician who is so confident that the rules no longer apply.
Master therapists expressed a deep commitment to awareness of their own life issues. Their self-awareness seemed to center around two issues: (a) understanding and fulfilling their personal emotional and physical needs and (b) awareness of their own “unfinished business,” personal conflicts, defenses, and vulnerabilities. Most importantly, the master therapists were well aware of the potential for these issues to intrude upon the therapy session and possibly do harm to the client. Characteristics Of Master Therapists Essay. Awareness of personal emotional needs and fulfilling those needs through various activities—including travel, exercise, spiritual practice, psychotherapy, contacts with colleagues, friends, and family—seemed paramount to the therapists. For example, one master therapist said:
When I think about therapists who’ve gotten themselves in difficulty, it’s often because there hasn’t been self-care, and there’s been a looking either to the client to provide something for them, or else not really being available for all that the client might need or want to do as part of their therapy work. Characteristics Of Master Therapists Essay.
