Practising psychotherapy as a clinical psychologist: what facilitates capable practice?

This is a practitioner-based project, deriving from clinical experience and aiming to positively contribute to awareness and practice within the clinical psychology profession. Clinical psychologists’ experience of practising psychotherapy is explored and factors associated with confidence and capability in this area of work are identified.
Past research has shown that therapist confidence contributes to successful client outcome. However, it has also been found that professional self-doubt and feelings of inadequacy persist throughout psychologists’ careers, indicating an ongoing need for professional support to maintain confidence. Psychotherapy practitioners have reported many professional benefits from attending supervision, attending their own personal therapy and engaging in continuing professional development. This project explores whether these factors are relevant to clinical psychologists’ confidence in their psychotherapy practice.
This was a sequential mixed methods study. A nationwide survey in Ireland (46% full population response rate) was followed by four in-depth interviews, which were analysed using Interpretative Phenomenological Analysis (IPA).
The results from both the quantitative and qualitative stages of this study provide a consistent picture. They indicate the importance of having satisfying and cohesive training in psychotherapy knowledge and skills, the need to have satisfying supervisory support, and the value of longer experience of personal therapy. All these factors were found to significantly contribute to confidence in psychotherapy practice and were of greater significance than experience. Based on these research findings, I am making three key recommendations to clinical psychology trainers and managers: development of more cohesive, structured training in psychotherapy; introduction of mandated personal therapy during training; and attendance at clinical supervision to be established as standard, career-long practice.