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:http://www.tandfonline.com/loi/rcpr20</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: http://dx.doi.org/10.1080/14733140903226982</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. However, Taylor &amp; Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of theContent. Any opinions and views expressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor &amp; Francis. The accuracy of the Content should not be relied upon andshould be independently verified with primary sources of information. Taylor and Francis shall not be liable forany losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoeveror howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use ofthe Content.</p><p>This article may be used for research, teaching, and private study purposes. 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 http://www.tandfonline.com/page/terms-and-conditions</p><p>http://www.tandfonline.com/loi/rcpr20http://dx.doi.org/10.1080/14733140903226982http://www.tandfonline.com/page/terms-and-conditionshttp://www.tandfonline.com/page/terms-and-conditions</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: stephen.joseph@nottingham.ac.uk</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>