Psychological mindedness and therapist attributes

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<ul><li><p>This article was downloaded by: [University of Bath]On: 26 November 2014, At: 05:09Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK</p><p>Counselling and Psychotherapy Research: Linkingresearch with practicePublication details, including instructions for authors and subscription information:</p><p>Psychological mindedness and therapist attributesBecky Daw a &amp; Stephen Joseph ba St Mary's CAMHS , Paddington Green , London, UKb School of Sociology and Social Policy , University of Nottingham , UKPublished online: 12 Oct 2009.</p><p>To cite this article: Becky Daw &amp; Stephen Joseph (2010) Psychological mindedness and therapist attributes, Counselling andPsychotherapy Research: Linking research with practice, 10:3, 233-236</p><p>To link to this article:</p><p>PLEASE SCROLL DOWN FOR ARTICLE</p><p>Taylor &amp; Francis makes every effort to ensure the accuracy of all the information (the Content) containedin the publications on our platform. 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Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms &amp; Conditions of access and use can be found at</p><p></p></li><li><p>Psychological mindedness and therapist attributes</p><p>BECKY DAW1 &amp; STEPHEN JOSEPH2*</p><p>1St Marys CAMHS, Paddington Green, London, UK, and 2School of Sociology and Social Policy, University of</p><p>Nottingham, UK</p><p>Abstract</p><p>Background to study: Psychological Mindedness (PM) involves an interest in and ability to extract and make sense of</p><p>psychological information (thoughts, feelings and behaviours) from a situation. The nature of the psychotherapeutic role</p><p>and training demands therapists think about motives, distortions and inner experiences of others. Aims: This study</p><p>empirically examined the association between PM and adaptive therapist attributes, clinician empathy, self understanding</p><p>and the therapeutic relationship in practitioners. Method: Forty eight therapists responded to a postal questionnaire. Results:</p><p>Statistically significant correlations were found between adaptive therapist attributes; empathy, the therapeutic relationship</p><p>and level of self-understanding and PM.</p><p>Keywords: Psychological Mindedness; therapeutic relationship; empathy</p><p>Introduction</p><p>Psychological Mindedness (PM) is defined as a</p><p>degree of access to ones feelings that leads, through</p><p>discussion of ones problems with others, to an</p><p>ability to acquire insight into meaning and motiva-</p><p>tion of ones own and others thoughts, feelings and</p><p>behaviour, and to a capacity for change (Conte &amp;</p><p>Ratto, 1997, p. 21). Hence PM involves an interest</p><p>in and ability to extract psychological information</p><p>(thoughts, feelings and behaviours) from a scenario</p><p>and note patterns or relationships among these</p><p>concepts in trying to make sense of the experience,</p><p>be it own or others.</p><p>Psychotherapists are a group shown to be especially</p><p>psychologically minded (Westen, Huebner, Boe-</p><p>kamp, Lifton, &amp; Silverman, 1991). The nature of</p><p>the psychotherapeutic role and training demands</p><p>therapists think about motives, distortions and inner</p><p>experiences of others (Farber, 1985). Farber and</p><p>colleagues recently questioned why psychotherapists</p><p>chose their career, and suggest many people become</p><p>psychotherapists as they have an especially strong</p><p>need to understand others, are fascinated with human</p><p>behaviour and enjoy the intellectual stimulation</p><p>trying to understand people brings (Farber,</p><p>Manevich, Metzer, &amp; Saypol, 2005). They propose</p><p>that many psychotherapists, early in life, begin to</p><p>think about the whys of behaviour (Farber et al.,</p><p>2005, p. 1016). This skill brings meaning to the</p><p>psychotherapists own experiences, but also influ-</p><p>ences their career path into mental health services.</p><p>Many psychotherapists state that for them this is the</p><p>one career that is really ego-syntonic, totally con-</p><p>sistent with the way they have understood, behaved</p><p>and felt all their life (Farber et al., 2005).</p><p>PM is a central aspect of a psychotherapists life</p><p>but one that has drawn little attention from the</p><p>therapeutic community. The aim of this study is to</p><p>investigate the association between PM and desir-</p><p>able therapist attributes. We would expect that</p><p>therapists who score higher on PM would be more</p><p>empathic, more able to develop collaborative and</p><p>affective working relationships and show greater self-</p><p>understanding.</p><p>Method</p><p>Sample</p><p>Participants comprised of 48 qualified therapists</p><p>who responded to a postal questionnaire distributed</p><p>*Corresponding author. Email:</p><p>Counselling and Psychotherapy Research, September 2010; 10(3): 233236</p><p>ISSN 1473-3145 print/1746-1405 online # 2010 British Association for Counselling and PsychotherapyDOI: 10.1080/14733140903226982</p><p>Dow</p><p>nloa</p><p>ded </p><p>by [</p><p>Uni</p><p>vers</p><p>ity o</p><p>f B</p><p>ath]</p><p> at 0</p><p>5:09</p><p> 26 </p><p>Nov</p><p>embe</p><p>r 20</p><p>14 </p></li><li><p>by the author (a 22% response rate). All therapists</p><p>(10 males, 38 females) worked within the Midlands</p><p>region of the UK. Ages ranged from 28 to 63 years</p><p>(M42.9); 69% described themselves as marriedor living as married (n33), 19% as single/nevermarried (n9), 4% as separated (n2), 4% asdivorced (n2) and 4% as widowed (n2). Theracial composition of the sample was 98% Caucasian</p><p>(n47), 2% Indian (n1). The sample had prac-ticed as qualified therapists for between 2 months</p><p>and 32 years (M10.75 years); 71% of the sampledescribed their professional role as Clinical Psychol-</p><p>ogist (n34), 17% as Counsellor (n8), 6% asOther (n3), 4% as Psychotherapist (n2) and2% as Counselling Psychologist (n1).</p><p>Procedure</p><p>A questionnaire was sent to all psychological thera-</p><p>pists (n220) in three National Health ServiceTrusts in the West Midlands requesting their parti-</p><p>cipation in research about clinical practice. Inter-</p><p>ested practitioners were asked to complete the</p><p>consent forms and return the questionnaire in an</p><p>enclosed stamped, self-addressed envelope to the</p><p>author. The first part of the questionnaire was used</p><p>to collect qualitative data which we have reported</p><p>elsewhere (see Daw &amp; Joseph, 2007), the second</p><p>part consisted of four widely used psychometric</p><p>scales:</p><p>1. Psychological Mindedness Scale (PM: Conte et</p><p>al., 1990) consists of 45 items (e.g. I am always</p><p>curious about the reasons people behave as they do)</p><p>each of which is rated on a 4 point scale that</p><p>ranges from 1 (strongly disagree) to 4 (strongly</p><p>agree). The total score is obtained by summing</p><p>responses on all items, such that scores on the</p><p>PM have a potential range of 45180.2. Jefferson Scale of Physician Empathy Health</p><p>Professional Version (JSPE HP; Hojat et al.,2002) consists of 20 items (e.g. I try to under-</p><p>stand what is going on in my clients minds by</p><p>paying attention to their non-verbal cues and body</p><p>language) each of which is rated on a seven-</p><p>point scale that ranges from 1 (strongly dis-</p><p>agree) to 7 (strongly agree). The total score is</p><p>calculated by summing responses on all items,</p><p>such that scores have a potential range of 20140. Higher scores indicate a higher degree of</p><p>empathy towards clients.</p><p>3. Self-Understanding of Interpersonal Patterns</p><p>(SUIP: Connolly et al., 1999) consists of 19</p><p>items (e.g. I am very dependent on others for</p><p>approval, and feel hurt when they reject me). The</p><p>respondent answers either yes or no to each item</p><p>to indicate whether the statement is relevant.</p><p>For each item that is answered yes, the respon-</p><p>dent then is asked to rate a four-point scale,</p><p>where: 1I recognise that I feel and act this waywith a significant person in my life, but I dont</p><p>know why; 2I can see that this experience hasbecome a pattern with multiple people in my life, but</p><p>I dont know why; 3I am beginning to see a linkbetween these experiences and past relationship</p><p>experiences, but the connection is not yet clear;</p><p>4I can clearly see that I feel and act this waybecause of past relationship experiences. Thus, two</p><p>scores are yielded; (1) the recognition score</p><p>(SUIP RECOG) which is the sum of theproblems recognised by the person (ranges</p><p>from 0-19), and (2) the average self-under-</p><p>standing (SUIP SU) score representing thepersons level of self-understanding (scores</p><p>range from 14).4. Working Alliance Inventory (WAI-Form </p><p>therapist version: Horvath, 1981; Horvath, &amp;</p><p>Greenberg, 1989).consists of 36 items (e.g. I</p><p>appreciate my clients as people), each of which is</p><p>rated on a seven-point scale that ranges from</p><p>1 (never) to 7 (always). Higher scores indicate</p><p>greater bonding, goal setting, and task agree-</p><p>ment. For the present study only the total score</p><p>is reported, which can range from 36252, withhigher scores indicating greater ability to form</p><p>a therapeutic working alliance.</p><p>Ethical approval</p><p>Prior to commencing the research, the project was</p><p>approved by the Multi Region Ethics Committee</p><p>(MREC).</p><p>Results</p><p>Pearsons r was computed between age and PM. No</p><p>association was found (r.13, ns).No differences were found between women and</p><p>men on PM (F [1,47]1.824, ns), thus subsequentanalyses were carried out on the total sample. Scale</p><p>descriptive statistics and intercorrelations are pre-</p><p>sented in Table I.</p><p>234 B. Daw &amp; S. Joseph</p><p>Dow</p><p>nloa</p><p>ded </p><p>by [</p><p>Uni</p><p>vers</p><p>ity o</p><p>f B</p><p>ath]</p><p> at 0</p><p>5:09</p><p> 26 </p><p>Nov</p><p>embe</p><p>r 20</p><p>14 </p></li><li><p>Pearsons product moment correlations revealed</p><p>that higher scores on PM were associated with</p><p>higher scores on empathy, working alliance, level of</p><p>self-understanding and with lower scores on the</p><p>number of interpersonal patterns recognized on the</p><p>SUIP.</p><p>Discussion</p><p>This study was intended to investigate the empirical</p><p>association between psychological mindedness and</p><p>desirable therapist attributes. The results suggest</p><p>that PM is related in predicted ways to therapist self-</p><p>understanding, working alliance, and clinician</p><p>empathy. PM was also negatively associated with</p><p>self-understanding recognition scores, as expected,</p><p>and consistent with other research which suggests</p><p>PM is associated with better psychological well-</p><p>being (Trudeau &amp; Reich, 1995) and emotional</p><p>adjustment (Bagby et al., 1994). These results</p><p>suggest that positive therapist attributes are related</p><p>to psychological mindedness.</p><p>Limitations</p><p>The study has several limitations. First, no gender</p><p>differences were found in this sample. Gender</p><p>differences would however be expected. Shill and</p><p>Lumley (2002) reported that females were more</p><p>psychologically minded than males. However, due to</p><p>the small sample size and small proportion of males</p><p>in this study it is likely that we simply did not have</p><p>the power to detect such difference. Thus, we would</p><p>encourage further research to investigate gender</p><p>differences. Second, although there is no reason</p><p>not to expect these findings to generalise to a wider</p><p>population of therapists, the sample was small and</p><p>from a discrete geographical area and as such further</p><p>research would be desirable to confirm the generali-</p><p>sability of the findings.</p><p>Third, and the main limitation, is the use of self-</p><p>report methods of data collection. The measures we</p><p>used are well validated and widely used, but none-</p><p>theless self-report methods are vulnerable to de-</p><p>mand characteristics and social desirability effects.</p><p>As such, we would encourage further research to</p><p>extend this study by examining the relation of</p><p>psychological mindedness to measures of social</p><p>desirability as well as to more observable objective</p><p>outcome measures, such as peer reports, and client-</p><p>outcome data.</p><p>Implications for research and practice</p><p>Currently, there is debate on the role of personal</p><p>therapy as part of training (e.g. Daw &amp; Joseph,</p><p>2007), and although these results do not support the</p><p>idea of person therapy per se as the vehicle for</p><p>personal development, they do lend support to the</p><p>notion that it is essential that therapeutic training</p><p>does somehow focus on personal development and</p><p>the cultivation of PM.</p><p>The key implication is that PM may be a main</p><p>ingredient in what makes for an effective therapist.</p><p>The question is raised as to whether therapeutic</p><p>training emphasises PM to an appropriate extent?</p><p>What is it in training that contributes to the</p><p>development of PM? Or is it that we expect trainees</p><p>to come with a high level of PM and training is</p><p>simply to teach skills? There are several questions for</p><p>future research. First, there are research questions</p><p>around training itself. In what way do training</p><p>courses take PM into account in their selection</p><p>process? In what way do training courses attempt</p><p>to foster PM in trainees? Second, there are research</p><p>questions around the development of PM itself.</p><p>Table I. Means, standard deviations and correlations among PM, WAI, JSPE and SUIP Scales.</p><p>Variable M SD PM JSPE WAI SUIP (AV)</p><p>PM 143.62 9.92</p><p>JSPE 120.04 9.17 .56**</p><p>WAI 187.38 20.63 .36* .16</p><p>SUIP (SU) 3.69 0.52 .40* .22 .04</p><p>SUIP (RECOG) 5.79 3.22 .37* .01 .11 .15</p><p>*Correlation is significant at the 0.05 level (2 tailed).</p><p>**Correlation is significant at the 0.01 level (2 tailed).</p><p>JSPE, Jefferson Scale of Physician Empathy; PM, Psychological Mindedness Scale; WAI, Working Alliance Inventory; SUIP (SU), Self</p><p>Understanding of interpersonal patterns level of self understanding; SUIP (RECOG), Self Understanding of interpersonal patterns</p><p>recognition score.</p><p>Psychological mindedness and therapist attributes 235</p><p>Dow</p><p>nloa</p><p>ded </p><p>by [</p><p>Uni</p><p>vers</p><p>ity o</p><p>f B</p><p>ath]</p><p> at 0</p><p>5:09</p><p> 26 </p><p>Nov</p><p>embe</p><p>r 20</p><p>14 </p></li><li><p>Attempts to develop PM through personal devel-</p><p>opment groups, personal therapy, and so on may be</p><p>common but it is not well documented that these</p><p>serve to facilitate PM effectively. While qualitative</p><p>research tells us that therapists value personal</p><p>therapy and perceive it to have contributed to their</p><p>PM, such research does not provide evidence that</p><p>personal therapy has actually served to facilitate PM.</p><p>What we need is stronger empirical statistical evi-</p><p>dence that those who experience personal therapy</p><p>show higher levels of PM. Personal therapy is only</p><p>one vehicle, and research is also needed into other</p><p>ways in which PM may be facilitated.</p><p>However, P...</p></li></ul>