When The Shoe Is On The Other Foot: A Qualitative Study of Intern-Level Trainees' Perceived Learning From Clients
Stahl, Jessica Vogel
Hill, Clara E.
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Although research on therapist development indicates that therapists attribute the majority of their learning about therapy to their clients (e.g., Orlinsky, Botermans & Ronnestad, 2001), learning from clients has only been explicitly addressed in anecdotal accounts (Bugental, 1991; Crawford, 1987; Freeman & Hayes, 2002; Kahn & Fromm, 2002). The closest researchers have come to empirically investigating learning from clients is by studying the impact of clients on their therapists (e.g., Farber, 1985; Myers 2002). However, this literature is still in its infancy and warrants further exploration. The purpose of this study was to extend the literature on therapist development and the impact of clients on their therapists to the study of learning from clients. To this end, 12 trainees (5 male; 7 female) who had recently completed pre-doctoral internships at university counseling centers were interviewed about what they learn from clients. In addition, participants were asked how they realized what they learned from clients, what they do with what they learn from clients and what variables contribute to how much they learn from clients. The data were analyzed using Consensual Qualitative Research (Hill, Knox, Thompson, Williams, Hess, & Ladany, 2005; Hill, Thompson, & Williams, 1997). Participants reported learning things about doing therapy, themselves, client dynamics, human nature, the therapy relationship, and the usefulness of supervision; these lessons were reflective or participants' level of development as they primarily reported learning higher-order skills (e.g., Cummings, Slemon & Hallberg, 1993; Sakai & Naasserbakht, 1997). In addition, participants highlighted the importance of consultation and self-reflection in order to recognize learning; this is consistent with literature on experiential learning (Abbey, Hunt & Weiser, 1985). In discussing what they do with what they learn from clients, participants indicated they have or will apply what was learned to future clinical work; in addition they indicated that their lessons from clients fostered some kind of personal growth. Finally, participants indicated that a number of variables influenced the amount they learned from their clients: therapist, client, and therapy relationship characteristics, time, a new or remarkable therapy process, and new supervisors or settings. Implications for practice and research are discussed.