Developing Practitioner Confidence: Observations from Teaching Pluralism

Marcella Finnerty, IICP College, Dublin

As an institution, IICP College, has always been integrative, and more recently pluralistic, in its teaching approach. But we have struggled with how and when to present such ideas to our students. By the time we introduce pluralistic counselling and psychotherapy, our students are already in clinical placement, or indeed are qualified therapists. When discussing pluralistic concepts such as goals, tasks, methods, metacommunication, systematic feedback etc., the response we hear most often is ‘I am doing that already’ . Undoubtedly, many therapists utilise such methods in routine practice. However, training pluralistically offers learners the opportunity to engage in more deliberate practice to hone these skills and increase their expertise.  Research into the development of expert knowledge in other occupations such as sport and musicidentifies a commitment to deliberate practice as a key to excellence. These experts seek to gather feedback consistently, identify errors or gaps in competence to gain new skills, and to consult with others to devise action plans for improvement.

How good are therapists, in reality, at seeking feedback? How well do we hear the spoken and unspoken cues we are presented with by our clients, supervisors and colleagues?

Talking with clients seems like an obvious thing that we do as practitioners. However, delving deeper than surface communication, noticing changes in verbal and non-verbal language, and offering information in a manner that clients can understand means that practitioners need to first be mindful to avoid technical jargon and, second, to be responsive to cues.  These are skills that take time to develop and requires a confidence in approach, which some students struggle with initially.

Isn’t it interesting that, although we know the utilisation of feedback can enhance our practice, many of us still experience anxiety about formal mechanisms for gathering feedback? We often encounter a distinct discomfort with the use of paper or digital forms by therapists. Through examining what therapists think (e.g., ‘Most clients improve’) versus what we know (e.g., ‘Research shows 30% or more of clients don’t show reliable improvements during therapy’), we discuss with our students how to use feedback forms and tease out fears and anxieties. At this point, students can logically understand the benefits of such tools, but it’s the use of skills’ role-plays and real-world practice that sets students on the road to gaining profound knowledge on pluralism. Through utilising these measures in a humanistic and holistic manner—communicating before and after form-filling, eliciting feedback on the client’s experience, linking information from the client with marks on a piece of paper—students can see the client being held, acknowledged, and respected.

Clients often come in with vague undefined goals such as ‘I want to be happier’ or ‘I want to feel less anxious.’ Therapists do their best to work with these goals, yet without direction, it can be tiring and puzzling work. Striving to define goals and identifying signposts along the way not only provides the client with achievable steps towards fulfilling hopes and ambitions, but provides the therapist with a benchmark of sorts. By honing and nestling these skills, within the framework of pluralism, students report feeling more confident in their work as practitioners; and they can state with greater conviction that the work they are doing is based on theory and research interlocked with a client’s wishes and goals, achieved through communication and feedback. With confidence comes greater ability to offer a menu and choices to the client, and thus the cycle continues.

For us, as trainers at IICP College, a heartening outcome of our MA programme has been graduates reporting their client retention rates have increased and unplanned closures have decreased. Maybe looking critically at what we do and why we do it really does help us improve our practice! We look forward to further exploring and debating these, and other, issues at the 3rd International Conference for Pluralistic Counselling and Psychotherapy in Dublin, March 28-29, 2020.