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The Daily Events and Emotions of Master's-Level Family Therapy Trainees in Off-Campus Practicum Settings

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Title: The Daily Events and Emotions of Master's-Level Family Therapy Trainees in Off-Campus Practicum Settings
Language: English
Authors: Edwards, Todd M., Patterson, Jo Ellen
Source: Journal of Marital and Family Therapy. Oct 2012 38(4):688-696.
Availability: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA/
Peer Reviewed: Y
Physical Description: PDF
Page Count: 9
Publication Date: 2012
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Descriptors: Therapy, Trainees, Practicums, Counselor Training, Masters Programs, Family Counseling, Comparative Analysis, Emotional Response, Theories
DOI: 10.1111/j.1752-0606.2012.00263.x
ISSN: 0194-472X
Abstract: The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers-in-training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a student's practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training. (Contains 4 tables and 1 figure.)
Abstractor: As Provided
Number of References: 29
Entry Date: 2012
Accession Number: EJ982561
Database: ERIC
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  Value: <anid>AN0082504150;jmf01oct.12;2019Jun04.11:43;v2.2.500</anid> <title id="AN0082504150-1">The Daily Events and Emotions of Master's-level Family Therapy Trainees in Off-campus Practicum Settings. </title> <p>The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's‐level family therapy trainees in off‐campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers‐in‐training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a student's practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training.</p> <p>A family therapy practicum or premaster's internship experience is arguably the most significant part of a student's training. When beginning a practicum at an off‐campus setting, trainees are commonly viewed as new employees who are expected to follow the rules and regulations of the particular clinical setting. Program faculty is usually familiar with the general activities of trainees in their practicum setting, but they may not know the specifics of a typical day, including students' emotional experiences during the day. With the assistance of a research technique called the Day Reconstruction Method ([<reflink idref="bib18" id="ref1">18</reflink>]), this study seeks to answer the following questions: How do family therapy trainees from one family therapy master's program spend their time in off‐campus practicum settings, and what emotions do they experience in their daily practicum activities?</p> <p>Research has been conducted on various aspects of a trainee's practicum experience, such as concerns and expectations related to the process of therapy ([<reflink idref="bib11" id="ref2">11</reflink>]; [<reflink idref="bib29" id="ref3">29</reflink>]), difficult situations encountered at one's practicum site ([<reflink idref="bib25" id="ref4">25</reflink>]), the challenges of working with transfer clients ([<reflink idref="bib20" id="ref5">20</reflink>]), the stress associated with learning counseling ([<reflink idref="bib26" id="ref6">26</reflink>]), the general experiences of trainees in their internships ([<reflink idref="bib14" id="ref7">14</reflink>]; [<reflink idref="bib28" id="ref8">28</reflink>]), and balancing multiple roles as a trainee ([<reflink idref="bib22" id="ref9">22</reflink>]; [<reflink idref="bib23" id="ref10">23</reflink>]). Research on the multiple roles that trainees assume in their practicum settings suggests that trainees are expected to simultaneously be therapists, students, supervisees, and colleagues, which can be challenging for trainees. [<reflink idref="bib22" id="ref11">22</reflink>] note that multiple relationships between trainees and on‐site staff members, namely sexual, social, therapeutic, and business relationships can prevent trainees from challenging staff members or supervisors, can violate personal and professional boundaries, and can cloud staff members' abilities to impartially evaluate the trainee's skills, ultimately compromising the individual's training and professional experience.</p> <p>Several studies used daily journals to understand critical incidents and experiences of trainees. [<reflink idref="bib19" id="ref12">19</reflink>] asked seven family therapy students to keep a daily journal for 15 weeks and learned that students identify peer relations as critical experiences, which include the joy of friendship and cotherapy, as well as stressful interactions associated with being coworkers and colleagues. Also, participants in [<reflink idref="bib19" id="ref13">19</reflink>] study reported feeling inadequate. [<reflink idref="bib17" id="ref14">17</reflink>] and [<reflink idref="bib16" id="ref15">16</reflink>] both examined journals of counseling trainees and found similar categories of critical incidents, including defining expectations in supervision, concerns about therapeutic abilities, and self‐criticism. These qualitative studies capture significant themes in the development of a therapist, including the common theme of questions about one's competence as a therapist.</p> <p>The theme of trainee self‐confidence is central in two additional studies. [<reflink idref="bib2" id="ref16">2</reflink>] investigated the first 3 months of clinical contact of master's‐level family therapy students and found that the development of confidence is a primary theme in the early stages of training. In a follow‐up study, [<reflink idref="bib3" id="ref17">3</reflink>] interviewed master's‐level family therapy trainees and asked them to describe influences on their clinical self‐confidence. Events significant to the development of self‐confidence include client contact, supervision, contact with peers, and personal life stress. Bischoff et al. state that the quality of clinical supervision has "the most enduring influence on the development of self‐confidence" (p. 376).</p> <p>The impact of supervision has been mentioned in other studies. In a study of trainees' evaluations of their best and worst experiences in supervision, [<reflink idref="bib1" id="ref18">1</reflink>] report that "the best supervision occurred in a facilitative environment characterized by openness, respect, support, and an appreciation for individual differences" (p. 88). A positive pattern of interaction between the supervisor and trainee that displays an appreciation of individual differences, or respect for one another's autonomy, also emerged in [<reflink idref="bib24" id="ref19">24</reflink>] study of supervision. Ratliff et al. state that trainees often want to present themselves as competent and cooperative in supervision. When a supervisor questions a trainee's competence, a trainee may no longer see the supervisor as a source of support, which may influence whether a trainee seeks clinical feedback and supervision.</p> <p>Several studies have examined trainee emotions and thoughts associated with clinical work. [<reflink idref="bib13" id="ref20">13</reflink>] report that trainees' clinical experiences led to personal stress and growth, but also increased confidence in their counseling skills. [<reflink idref="bib10" id="ref21">10</reflink>] report three common concerns of new trainees, namely feelings of inadequacy because ofthe lack of therapeutic experience, confusion over the various perspectives of psychopathology and therapy in the mental health field, and anxiety regarding supervision, especially in regard to revealing self‐doubt and receiving different opinions from multiple supervisors. In a study of trainees' thoughts during client sessions, [<reflink idref="bib21" id="ref22">21</reflink>] found that 13% of the trainees' in‐session thoughts were negative and self‐focused. Trainees reported concerns about their performance as therapists and about clients' responses to their interventions ([<reflink idref="bib21" id="ref23">21</reflink>]). In their study of trainee in‐session feelings and reactions, [<reflink idref="bib29" id="ref24">29</reflink>] found that all trainees reported experiencing some negative feelings that distracted them from fully engaging in the session, as well as some positive feelings toward the clients. Also, the trainees reported struggling with the responsibility of solving the client's problems, being concerned about their therapeutic skills and performance, being hesitant about probing the client's feelings, and feeling frustrated when unsure of how to proceed in session ([<reflink idref="bib29" id="ref25">29</reflink>]). To manage their feelings and reactions in session, the trainees tried to stay focused on their clients, or used their own feelings as a guide for intervening with the client ([<reflink idref="bib29" id="ref26">29</reflink>]).</p> <p>Recent findings from positive psychology on social networks, happiness, and work satisfaction provide a broader context for understanding trainees' emotions. Although a full review of this literature is beyond the scope of this paper, several themes from the positive psychology literature have implications for a trainee's practicum experience. First, positive emotions create a receptive, creative emotional milieu where learning can occur ([<reflink idref="bib12" id="ref27">12</reflink>]). Second, emotions are contagious. Members of social networks "infect" each other with happiness or unhappiness and with good or bad habits and attitudes ([<reflink idref="bib5" id="ref28">5</reflink>]). Third, the type of relationship (e.g., coworkers, friends, classmates) two people have influences the emotions they feel, including both negative and positive emotions such as anger, jealousy, sadness, loneliness, joy, happiness, or satisfaction ([<reflink idref="bib5" id="ref29">5</reflink>]). Finally, for optimal emotional well‐being, employers and educators need to create work environments where "flow" can occur. Flow occurs when a learner is immersed in an experience that is intrinsically rewarding and loses feelings of self‐consciousness. For learners to experience flow (see Figure 1), they must have a goal and a sense of purpose and have a context where their work is neither too difficult (resulting in anxiety) nor too easy (resulting in boredom) ([<reflink idref="bib7" id="ref30">7</reflink>], [<reflink idref="bib8" id="ref31">8</reflink>]; [<reflink idref="bib9" id="ref32">9</reflink>]).</p> <p>Graph: 1 Flow Theory.</p> <p>Flow Theory offers a framework for summarizing findings from the supervision literature and focuses on a person's skill level in an activity matching his or her perception of the challenge. Critical supervision, negative colleagues, unsuccessful therapy sessions, or feeling inadequate to meet specific clinical challenges can all lead to anxiety and the desire to withdraw. When trainees' face challenges that exceed their abilities, their anxiety increases. In contrast, none of the supervision literature identifies boredom or disengagement as a common trainee response to clinical training. In addition, few trainees report experiences that could be categorized as "flow" in which action and awareness are merged ([<reflink idref="bib8" id="ref33">8</reflink>]). According to flow theory, trainees' practicum experience and emotional responses hinder or facilitate learning.</p> <p>The literature to date reveals a variety of concerns, challenges, and consequences involved in, and resulting from, the trainee's practicum experience. This study seeks to uncover the range of activities that students engage in during a typical day at their practicum settings and the emotions they feel during these specific activities. More specifically, this study examines activities that garner the most and least positive emotions and how trainees' emotions change over time.</p> <hd id="AN0082504150-2">Methodology</hd> <p></p> <hd id="AN0082504150-3">Participants</hd> <p>Data were collected over 2 years with a convenience sample of 35 full‐time students in the second year of their accredited master's degree program in marriage and family therapy. The ethnic composition of the sample was 74% Caucasian, 17% Hispanic, 6% Asian, and 3% African American. The average number of months in practicum at the time of participation was 7 months. The range was 3–12 months. 85% of the sample were between the ages of 21–30; 9% were between 31 and 40; and 6% were between 41 and 50.</p> <hd id="AN0082504150-4">The Training Context</hd> <p>Each student works full‐time (30–35 hr per week) in an off‐campus, program‐approved community agency as part of a degree requirement to complete a 12‐month clinical practicum. The students work in a variety of clinical settings, including community mental health clinics, hospice, outpatient medical settings, and outpatient adult and child psychiatry centers. Each clinical setting provides clinical training to at least two students each year. Students receive weekly individual and group supervision provided by their agency supervisors who are Approved Supervisors or Approved Supervisor Candidates with the American Association for Marriage and Family Therapy and licensed as Marriage and Family Therapists, Social Workers, or Psychologists in the State of California. On average, each student sees 10–12 clients per week; approximately half of the clients are couples and families.</p> <hd id="AN0082504150-5">Questionnaire</hd> <p>The Day Reconstruction Method asks participants to recall memories of the previous day. Participants first completed a questionnaire responding to general questions about their mood (e.g., "How was your mood overall in your practicum setting yesterday?"). Next, they were asked to identify a sequence of episodes from the time they arrived at their practicum settings until the time they left their practicum settings at the end of the day: "Think of your day as a continuous series of scenes or episodes in a film. Give each episode a brief name that will help you remember it (for example, "completing paperwork", "seeing a couple"). Write down the approximate times at which each episode began and ended." Next, participants answered questions about each episode: The start and end times; what they were doing (by checking one or more of the 22 activities listed); and how they felt during the episode (impatient for it to end, happy, frustrated/annoyed, depressed/blue, competent/capable, hassled/pushed around, warm/friendly, angry/hostile, worried/anxious, enjoying myself, criticized/put down). The affect scales, which come directly from the day reconstruction method, ranged from 0 (not at all) to 6 (very much). Finally, participants were asked some demographic information.</p> <hd id="AN0082504150-6">Results</hd> <p>The 35 participants completed questionnaires on 464 total events. The average number of events per day is 13.26 for each trainee. When asked how typical the day was, 60.3% report the day was "Pretty Typical," 24.4% report the day was "Somewhat Worse," 12.9% report the day was "Somewhat Better," and 2.4% report the day was "Much Worse." The most common day to report the daily events was Tuesday (36.2%), following by Thursday (27.8%), Wednesday (23.9%), Friday (9.1%), and Monday (3%).</p> <p>Table 1 presents the affect ratings of events during a typical day at practicum. Positive affect is the average of happy, warm/friendly, and enjoying myself. Negative affect is the average of frustrated/annoyed, depressed/blue, hassled/pushed around, angry/hostile, worried/anxious, and criticized/put down. Talking with another trainee about personal issues is rated the most enjoyable activity. Of the different modalities of therapy, these practicum students rated family therapy as the most positive, followed by couples therapy, individual therapy with adults, and individual therapy with children. Individual supervision ranks just above the least enjoyable activities of preparing for session, attending trainings or workshops, and paperwork. Similar to [<reflink idref="bib18" id="ref34">18</reflink>], a large difference exists between positive and negative affect. Negative affect is infrequent and mild, and the absence of positive affect is rare.</p> <p>1 Mean Affect Ranking</p> <p> <ephtml> <table><thead valign="bottom"><tr><th>Event</th><th>Positive</th><th>Negative</th><th>Competent</th><th>Mean Length/Event (min)</th></tr></thead><tbody valign="top"><tr><td>Talking with another trainee (personal)</td><td>4.21</td><td>.62</td><td>3.38</td><td>31</td></tr><tr><td>Family therapy</td><td>3.89</td><td>.88</td><td>3.67</td><td>52</td></tr><tr><td>Couples therapy</td><td>3.83</td><td>.44</td><td>3.67</td><td>61</td></tr><tr><td>Lunch/dinner</td><td>3.82</td><td>.67</td><td>3.47</td><td>39</td></tr><tr><td>Staff meeting</td><td>3.79</td><td>.63</td><td>5.00</td><td>49</td></tr><tr><td>Individual therapy (adult)</td><td>3.73</td><td>.55</td><td>4.00</td><td>49</td></tr><tr><td>Talking with another trainee (work)</td><td>3.72</td><td>.77</td><td>3.74</td><td>39</td></tr><tr><td>Intake session</td><td>3.69</td><td>.45</td><td>4.29</td><td>63</td></tr><tr><td>Individual therapy (child)</td><td>3.68</td><td>.64</td><td>3.63</td><td>45</td></tr><tr><td>Break</td><td>3.66</td><td>.43</td><td>3.86</td><td>37</td></tr><tr><td>Group therapy</td><td>3.44</td><td>.67</td><td>4.25</td><td>68</td></tr><tr><td>Talking on the phone (personal)</td><td>3.42</td><td>.73</td><td>3.38</td><td>37</td></tr><tr><td>Talking on the phone (work)</td><td>3.37</td><td>.78</td><td>3.83</td><td>31</td></tr><tr><td>Computer/internet/email (personal)</td><td>3.30</td><td>.59</td><td>3.28</td><td>33</td></tr><tr><td>Talking with another professional</td><td>3.26</td><td>1.03</td><td>3.69</td><td>33</td></tr><tr><td>Group supervision</td><td>3.20</td><td>.83</td><td>3.52</td><td>21</td></tr><tr><td>Computer/internet/email (work)</td><td>3.05</td><td>.71</td><td>3.73</td><td>41</td></tr><tr><td>Individual supervision</td><td>3.03</td><td>1.46</td><td>3.32</td><td>19</td></tr><tr><td>Talking on the phone (client)</td><td>3.02</td><td>1.19</td><td>3.80</td><td>33</td></tr><tr><td>Preparation for session</td><td>2.89</td><td>.76</td><td>3.79</td><td>23</td></tr><tr><td>Training/workshop</td><td>2.67</td><td>1.26</td><td>2.71</td><td>72</td></tr><tr><td>Paperwork</td><td>2.49</td><td>.92</td><td>3.85</td><td>32</td></tr></tbody></table> </ephtml> </p> <p>Tables 2 and 3 present the highest and lowest net affect ratings, respectively, in which negative ratings were subtracted from positive ratings. Consistent with Table 1, talking with another trainee about personal issues is the activity rated most positively. Students experienced both higher positive emotions and higher negative emotions when doing family therapy, which accounts for family therapy's exclusion from Table 2. Table 3 shows that training/workshop is the least enjoyable activity, followed by individual supervision and paperwork.</p> <p>2 Net Affect Ranking—Most Positive Affect</p> <p> <ephtml> <table><tbody valign="top"><tr><td>Talking with another trainee (personal)</td><td>3.59</td></tr><tr><td>Couples therapy</td><td>3.39</td></tr><tr><td>Intake session</td><td>3.24</td></tr><tr><td>Break</td><td>3.23</td></tr><tr><td>Individual therapy (adult)</td><td>3.18</td></tr></tbody></table> </ephtml> </p> <p>3 Net Affect Ranking—Least Positive Affect</p> <p> <ephtml> <table><tbody valign="top"><tr><td>Training/workshop</td><td>1.41</td></tr><tr><td>Individual supervision</td><td>1.57</td></tr><tr><td>Paperwork</td><td>1.57</td></tr><tr><td>Talking on the phone (client)</td><td>1.83</td></tr><tr><td>Preparation for session</td><td>2.13</td></tr></tbody></table> </ephtml> </p> <p>Table 4 presents the standard regression coefficients (betas), <emph>t</emph>‐tests, and significance levels from the regression analysis. Three significant effects emerged. Positive affect is positively correlated with competence. Negative affect is negatively correlated with competence. The number of months in practicum is positively correlated with competence—the more experience students acquire, the more competent they feel. The results suggest that increased positive affect has a greater impact on competence in comparison with both a decrease in negative affect and the number of months a student has spent in practicum.</p> <p>4 Standardized Regression Coefficients of Competence</p> <p> <ephtml> <table><thead valign="bottom"><tr><th>Variables</th><th>β</th><th><italic>t</italic></th><th><italic>P</italic></th></tr></thead><tbody valign="top"><tr><td>Positive affect</td><td>3.44</td><td>6.825</td><td>.000</td></tr><tr><td>Negative affect</td><td>−1.08</td><td>−2.122</td><td>.034</td></tr><tr><td>Months in practicum</td><td>.132</td><td>3.075</td><td>.002</td></tr></tbody></table> </ephtml> </p> <hd id="AN0082504150-7">Discussion</hd> <p>The study's results suggest several important themes. First, positive contact with peers in the practicum setting has a critical influence on trainees' clinical training. The finding that talking with peers‐in‐training about personal issues can produce positive emotions makes intuitive sense: Clinical colleagues can be a resource for support, both professionally and personally. For example, trainees can discuss each other's frustrations and disappointments after a difficult session, when clinical work is negatively impacting their personal lives, and when personal lives are impacting their clinical work. Also, trainees can understand their shared stressors and challenges when family and friends might not. In addition, confidentiality and privilege creates pressure on trainees to maintain boundaries and share clinical information only with their colleagues—thus creating a setting for more intense interpersonal relationships between trainees. Multiple studies underscore the importance of supportive peer contact for family therapy trainees. [<reflink idref="bib3" id="ref35">3</reflink>] and [<reflink idref="bib2" id="ref36">2</reflink>] found that peers provide a normalizing function in early clinical experiences, which helps reduce stress, and peers also help influence the development of clinical confidence. [<reflink idref="bib19" id="ref37">19</reflink>] found that students consistently identify peer relations as a critical incident, which include the joy of friendship and cotherapy.</p> <p>Although supportive contact with peers is a significant benefit for trainees, negative peer relationships can have an insidious effect on training. Feelings of loneliness, jealously, resentment, or threat can distract trainees and make it difficult to focus on learning skills and knowledge ([<reflink idref="bib4" id="ref38">4</reflink>]; [<reflink idref="bib19" id="ref39">19</reflink>]). Relationships between trainees often have ambiguous boundaries. While the boundaries of the supervisory relationship and the client–therapist relationship are usually delineated for trainees, their peer relationships may be more ambiguous. Are they friends? Are they simply coworkers? Are some trainees excluded from the social network of the site while other trainees become the social leaders?</p> <p>Second, students experience more positive emotions during sessions with couples and families in comparison with therapy with individuals. However, it is important to note that students report both higher positive emotions and higher negative emotions in therapy with families. One possible explanation for this finding is that MFT trainees aspire to become competent in treating couples and families. In addition, MFT trainees frequently report the excitement they feel with couples and families in contrast to individual clients: the challenge of the presenting problem is directly in front of them rather than being described by one person. As they begin to experience themselves as competent working with couples and families, or when they have a particularly powerful family therapy session, they may also experience flow—thus achieving their goals and dreams.</p> <p>Family work also includes many challenges, such as the quick pace of the sessions, rapid change, and competing demands from multiple family members. In family sessions, trainees must cope with intense conflict between family members and maintain neutrality and balance when working with multiple expectations and desired outcomes. Thus, especially at the beginning of clinical training, the task demands are high (conducting a family session), and trainees might feel that their skill levels are low and feel anxious. Instead of experiencing flow, trainees might feel negative emotions like anxiety, shame, inadequacy, and discouragement.</p> <p>Third, positive affect increases over the course of the practicum year, which appears to be related to feelings of competence. The more competent the students feel as they master increasingly difficult clinical challenges, the greater their likelihood of experiencing positive affect during their clinical training. Such a finding is hardly surprising: When students think they are doing a good job, their professional joy and satisfaction increases. If they think their work is poor, they become self‐critical and apprehensive in their training activities. This finding confirms [<reflink idref="bib3" id="ref40">3</reflink>] finding that new therapists' confidence fluctuates. Confidence varies from session to session depending on how trainees feel about their work with each client.</p> <p>Increasing positive affect increasing over the course of the practicum year might also be related to peer contact: trainees typically feel a stronger sense of belonging and connection to other trainees as they spend more time together. At best, trainees increase each other's happiness by sharing experiences and information about their lives and work. In this study's sample, positive emotions are generated by strong peer relationships.</p> <p>Finally, individual supervision is rated as one of the top five least enjoyable training activities. Previous research has shown that supervision is viewed less positively when students' weaknesses and shortcoming are emphasized during supervision ([<reflink idref="bib1" id="ref41">1</reflink>]). These feelings reinforce beliefs about incompetence and lead students to focus on their own internal negative emotions, which can impede their readiness to learn, and their ability to focus on their clinical work. When trainees feel regularly criticized by their supervisors, they may also be disinclined to present the full range of their work because of the fears of more confrontation and criticism, which may lead trainees to handle complex situations on their own ([<reflink idref="bib24" id="ref42">24</reflink>]). Because critique and confrontation are common parts of supervision, supervisors can try to create an emotional context where supervisees feel safe to discuss their feelings about supervision. Supervisors can use safe, open discussions to ensure supervisees' emotional readiness to learn. Supervisors can then scaffold the clinical tasks and challenges that trainees confront. Matching the difficulty of the case and the trainee's skill level and experience should be carried out. Cases that could be interesting for a second year trainee might be overwhelming for the same trainee during her first month of clinical work.</p> <p>Students can have their best experiences in supervision when the supervisor welcomes mistakes, provides useful conceptual frameworks to understand clients, gives feedback that is direct and straightforward, and interacts with students in a collaborative manner ([<reflink idref="bib1" id="ref43">1</reflink>]). Like positive contact with peers, supportive supervision can increase positive emotions ([<reflink idref="bib3" id="ref44">3</reflink>]). Increasing trainees' positive emotions and decreasing their negative emotions by emphasizing what they are doing well expands and builds trainees' skills.</p> <p>Strategies to increase positive affect in supervision are consistent with characteristics of the flow experience ([<reflink idref="bib6" id="ref45">6</reflink>], [<reflink idref="bib7" id="ref46">7</reflink>]): Clear goals at every step of the way; immediate feedback to one's actions; a balance between challenges and skills; few if any distractions; no worry about failure; no self‐consciousness; lack of awareness of time passing; actions and awareness are merged, and activity focuses on seeking a goal. In addition, more recent research on flow notes that a certain level of challenge can help a person achieve optimal flow ([<reflink idref="bib9" id="ref47">9</reflink>]). Flow occurs when the skill level and challenge match or when the challenge only slightly exceeds the person's skill level. Recognizing the inevitable ups and downs of clinical training, supervisors could aim for students to experience flow, at least sometimes during their clinical training. Increased learning, exploration, and changes in behavior are by‐products of flow, and the learning process is both involved and enjoyable in a flow state ([<reflink idref="bib15" id="ref48">15</reflink>]; [<reflink idref="bib27" id="ref49">27</reflink>]).</p> <p>Trainees' clinical internships involve multiple challenges. While developing competence treating their clients is an essential skill, other challenges also exist. Trainees must fit into their work environment, they must develop working relationships with their supervisors, and they must develop competence with a wide array of techniques and theories, and learn how to match treatment and assessment goals. A special challenge for most MFT trainees is that they must develop competence in seeing individuals and also couples and families. As they face these challenges, flow theory could guide supervisors and clinic managers as they make decisions about how to create the optimal learning environment. Supervisors can be sensitive to the match between trainees' skill levels and the challenges they face—regardless of whether the challenge is fitting into the clinic environment or finding an appropriate treatment for a difficult client.</p> <hd id="AN0082504150-8">Limitations</hd> <p>There are several limitations to this study. The study was conducted over a 2‐year period with students in one marriage and family therapy program who are receiving training at multiple sites. Although their educational training is identical, there is a lack of consistency across sites and differing numbers of students at each site. Surveying students in the same type of setting (e.g., medical settings) from multiple MFT master's programs in different parts of the country could have yielded different results. The participants are mostly Caucasian, middle class, and in their mid‐20s. A more diverse sample would likely produce different results. For example, older students and students of color might report more positive emotions in some areas and more negative emotions in other areas. Finally, the methodology has some limitations. Students rated their emotions the day after events took place. Different results might have emerged if students immediately rated their emotions.</p> <p>Further research in this area is certainly needed. Future research should focus on learning more about the emotional experiences of trainees. Increasing the number of study participants who are training at similar sites (e.g., outpatient couples therapy) would be beneficial. As research suggests that trainees' positive emotions enhance learning, future research might focus on more ways to increase positive emotions and decrease negative emotions during clinical training. What variables most influence trainee's positive and negative emotions? For example, does the type of setting (i.e., psychiatric, medical, community clinic) matter or does the number of trainees working in a clinic affect trainee well‐being? Future studies should also consider a qualitative analysis to better understand the emotional experience of students in their practicum settings. For example, a key theme in this study is the importance of contact with peers. Collecting narratives about peer contact and friendship during training would further illuminate its importance and relationship to trainee happiness. In addition to trainees' emotional experiences, research could also consider the emotional experiences of supervisors. Finally, the Day Reconstruction Method is a useful tool that could be used in a variety of studies to better understand students' emotional experiences over time.</p> <p>In sum, this study provides a window into the daily events and emotions of a family therapy trainee. More specifically, the results provide an understanding of trainees' positive and negative emotions and the events associated with these emotions. Clinical training is a critical, formative part of students' education. Supervisors' sensitivity to trainees' emotional experiences during this challenging period can enhance student learning and lead to better student outcomes, both professionally and personally.</p> <ref id="AN0082504150-9"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref18" type="bt">1</bibl> <bibtext> Todd M. Edwards, PhD, Professor and Program Director, Marital and Family Therapy Program, School of Leadership and Education Sciences, University of San Diego; Jo Ellen Patterson, PhD, Professor, Marital and Family Therapy Program, School of Leadership and Education Sciences, University of San Diego.</bibtext> </blist> </ref> <ref id="AN0082504150-10"> <title> References </title> <blist> <bibtext> Anderson, S. A., Schlossberg, M., & Rigazio‐DiGilio, S. (2000). Family therapy trainees' evaluations of their best and worst supervision experiences. Journal of Marital and Family Therapy, 26, 79 – 92.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref16" type="bt">2</bibl> <bibtext> Bischoff, R. J. (1997). Themes in therapist development during the first three months of clinical experience. Contemporary Family Therapy, 19, 563 – 580.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref17" type="bt">3</bibl> <bibtext> Bischoff, R. J., Barton, M., Thobar, J., & Hawley, R. (2002). Events and experiences impacting the development of clinical self‐confidence: A study of the first year of client contact. Journal of Marital and Family Therapy, 28, 371 – 382.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref38" type="bt">4</bibl> <bibtext> Cacioppo, J., Fowler, J., & Christakis, N. (2009). Alone in the crowd: The structure and spread of loneliness in a large social network. Journal of Personality and Social Psychology, 96, 977 – 991.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref28" type="bt">5</bibl> <bibtext> Christakis, N., & Fowler, J. (2009). Connected: The surprising power of our social networks and how they shape our lives. New York: Little Brown.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref45" type="bt">6</bibl> <bibtext> Csikszentmihalyi, M. (1975). Beyond boredom and anxiety. San Francisco, CA: Jossey‐Bass.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref30" type="bt">7</bibl> <bibtext> Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper and Row.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref31" type="bt">8</bibl> <bibtext> Csikszentmihalyi, M. (1998). Finding flow: The psychology of engagement with everyday Life. New York: Basic Books.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref32" type="bt">9</bibl> <bibtext> Csikszentmihalyi, M., & Lefevre, J. (1989). Optimal experience in work and leisure. Journal of Personality and Social Psychology, 56, 815 – 822.</bibtext> </blist> <blist> <bibtext> Duryee, J., Brymer, M., & Gold, K. (1996). The supervisor needs of neophyte psychotherapy trainees. Journal of Clinical Psychology, 52, 663 – 671.</bibtext> </blist> <blist> <bibtext> Fauth, J., & Williams, E. N. (2005). The in‐session self‐awareness of therapist‐trainees: Hindering or helpful? Journal of Counseling Psychology, 5, 443 – 447.</bibtext> </blist> <blist> <bibtext> Fredrickson, B. (2009). Positivity. New York: Crown Publishers.</bibtext> </blist> <blist> <bibtext> Furr, S. R., & Carroll, J. J. (2003). Critical incidents in student counselor development. Journal of Counseling & Development, 81, 483 – 489.</bibtext> </blist> <blist> <bibtext> Gawinski, B. G., Edwards, T. M., & Speice, J. (1998). A family therapy internship in a multidisciplinary healthcare setting: Trainees' and supervisor's reflections. Journal of Marital and Family Therapy, 25, 469 – 484.</bibtext> </blist> <blist> <bibtext> Ghani, J. A., & Deshpande, D. (1994). Task characteristics and the experience of optimal flow in human computer interaction. The Journal of Psychology, 128, 381 – 391.</bibtext> </blist> <blist> <bibtext> Hill, C. E., Sullivan, C., Knox, S., & Schlosser, L. Z. (2007). Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class. Psychotherapy: Theory, Research, Practice, Training, 44, 434 – 449.</bibtext> </blist> <blist> <bibtext> Howard, E. E., Inman, A. G., & Altman, A. N. (2006). Innovative methods: Critical incidents among novice counselor trainees. Counselor Education and Supervision, 46, 88 – 102.</bibtext> </blist> <blist> <bibtext> Kahneman, D., Krueger, A. G., Schkade, D. A., Schwartz, N., & Stone, A. A. (2004). A survey method for characterizing daily life experience: The day reconstruction method. Science, 306, 1776 – 1780.</bibtext> </blist> <blist> <bibtext> Lee, R. E., Eppler, C., Kendal, N., & Latty, C. (2001). ritical incidents in the professional lives of first year MFT students. Contemporary Family Therapy, 23, 51 – 61.</bibtext> </blist> <blist> <bibtext> Muller, R. (1986). The trainee and the transfer case: Why is this case different from all other cases? American Journal of Psychotherapy, 40, 265 – 276.</bibtext> </blist> <blist> <bibtext> Nutt‐Williams, E., & Hill, C. E. (1996). The relationship between self‐talk and therapy process variables for novice therapists. 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The stresses of learning counselling: Six recent graduates comment on their personal experience of learning counselling and what can be done to reduce associated harm. Counselling Psychology Quarterly, 14, 67 – 89.</bibtext> </blist> <blist> <bibtext> Webster, J., Trevino, L., & Ryan, L. (1993). The dimensionality and correlates of flow in human computer interactions. Computers in Human Behavior, 9, 411 – 426.</bibtext> </blist> <blist> <bibtext> Williams, L. (1994). Choosing an MFT internship: Ingredients of successful experience. American Journal of Family Therapy, 22, 371 – 378.</bibtext> </blist> <blist> <bibtext> Williams, E. N., Judge, A. B., Hill, C. E., & Hoffman, M. A. (1997). Experiences of novice therapists in prepracticum: Trainees', clients', and supervisors' perceptions of therapists' personal reactions and management strategies. Journal of Counseling Psychology, 44, 390 – 399.</bibtext> </blist> </ref> <aug> <p>By Todd M. Edwards and Jo Ellen Patterson</p> <p>Reported by Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib18" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib29" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib25" firstref="ref4"></nolink> <nolink nlid="nl5" bibid="bib20" firstref="ref5"></nolink> <nolink nlid="nl6" bibid="bib26" firstref="ref6"></nolink> <nolink nlid="nl7" bibid="bib14" firstref="ref7"></nolink> <nolink nlid="nl8" bibid="bib28" firstref="ref8"></nolink> <nolink nlid="nl9" bibid="bib22" firstref="ref9"></nolink> <nolink nlid="nl10" bibid="bib23" firstref="ref10"></nolink> <nolink nlid="nl11" bibid="bib19" firstref="ref12"></nolink> <nolink nlid="nl12" bibid="bib17" firstref="ref14"></nolink> <nolink nlid="nl13" bibid="bib16" firstref="ref15"></nolink> <nolink nlid="nl14" bibid="bib24" firstref="ref19"></nolink> <nolink nlid="nl15" bibid="bib13" firstref="ref20"></nolink> <nolink nlid="nl16" bibid="bib10" firstref="ref21"></nolink> <nolink nlid="nl17" bibid="bib21" firstref="ref22"></nolink> <nolink nlid="nl18" bibid="bib12" firstref="ref27"></nolink> <nolink nlid="nl19" bibid="bib15" firstref="ref48"></nolink> <nolink nlid="nl20" bibid="bib27" firstref="ref49"></nolink>
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  Data: The Daily Events and Emotions of Master's-Level Family Therapy Trainees in Off-Campus Practicum Settings
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Marital+and+Family+Therapy%22"><i>Journal of Marital and Family Therapy</i></searchLink>. Oct 2012 38(4):688-696.
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  Data: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA/
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  Data: The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers-in-training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a student's practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training. (Contains 4 tables and 1 figure.)
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