2.4 CLINICAL PSYCHOLOGY TRAINING
2.4.2 The Intensity and Broadness of Training
47 o Explicit ground rules, including rules addressing how a group will attempt to respond to racist comments, which may be made within the context of learning. How will trainees and trainers allow each other to make mistakes and how should they be addressed;
o Support structures, which black and minority ethnic trainees may wish to use confidentiality, either within or outside of the course staff team;
o Trainers work in pairs, wherever possible, ideally as one black and one white trainer;
o Trainees are allowed to „self select‟ when they divide into groups for exercises and role plays;
o Trainers continue to explore their own feelings and experiences as black or white people, while continually developing their own skills and styles for managing the range of emotions and reactions which can result from training around issues of race, racism and culture. Working with other trainers who are different in relation to themselves with regard to ethnicity, is always a demanding but a very enriching and useful way to continually develop their skills in training with mixed ethnicity trainee groups;
o Enjoy the experience as this is a process of immense discovery and learning for trainees too.
48 demand highly rigorous research dissertation projects while others allow articles or case studies to be written for dissertation projects, this together with clinical training must be completed in one year. Due to the broadness and the intensity of the program, most institutions in South Africa prefer to equip their trainees with clinical training during the first year followed by a research project the following year. With regard to a research project, according to HPCSA, it must be completed prior to the commencement of the internship (www.hpcsa.co.za)
The intensity of clinical psychology training renders it one of the few post-graduate courses that require daily attendance (Plante, 2005). The first year of the master‟s program consists of university based training where a combination of both academic and practical training is undertaken. The nature and the content of both the academic and practical components vary widely between training institutions depending on variables such as theoretical orientation, availability and nature of the hospital or psychological clinic through which trainees may gain experience. Academic input and clinical training are more emphasized during the first year (Dlamini, 2005).
According to Luchins (2000), most institutions teaching psychotherapy tend to be devoted to the promulgating of the viewpoints of a particular school of thought. Psychoanalysis has been the dominant theoretical model of training since 1940, followed closely by Cognitive- Behavioural Therapy, Humanistic and lastly Family Systems. According to Knight (2004), it may be surprising to some but after many years of democracy, that the dominant theoretical perspective of psychotherapy remains the psychoanalytic/psychodynamic. Surprising in the sense that, as more members of other racial groups, besides white, become involved in psychotherapy training, psychoanalysis, in the heart of an African society in transition, should still find value. Granted psychoanalysis has changed over the years, and it is the more
49 contemporary, as well as Object Relations Theories, that are currently taught in psychotherapy classes in most South African universities.
While such training may have the advantage of producing therapists who are highly skilled in the application of a particular approach or school of thought, Luchins (2000) is of the opinion that it possesses certain disadvantages. Klein (1996:216) argues: “psychology has to move with the times and should welcome the opportunity”
Plante (2005) showed that such training maintains a rigid adherence to a particular approach hoping it can be universally applied to each and every situation and person. Strict adherence to a certain theoretical approach can result in limited, rigid views on human behaviour and behavioural change and cult-like zealousness. Whereas each approach had its advantages for understanding human behaviour and offers ideas for intervention, this limited view might lead a trainee to overlook important alternatives to understand, explain and treat patients and thus fail to provide effective assessment and treatment. Trainees about to begin their training in clinical psychology or psychotherapy often must make a decision as to the particular brand they will study before they had sufficient opportunity to acquaint themselves in a systematic manner with principles and practices of prevailing schools or disciplines, and before they have achieved the professional maturity which may be required for a wise choice.
Interestingly, the evolution of clinical psychology has witnessed increasing integration of various theoretical perspectives. While some argue that integrating approaches is a mistake and akin to mixing apples and oranges, more and more institutions are integrating various theoretical approaches and techniques with success in training. Biological, psychological and social factors clearly influence emotional, behavioural and interpersonal functioning.
Furthermore, as more research and clinical experience help to uncover the mysteries of human behaviour, approaches need to be adapted and shaped in order to best accommodate
50 the new discoveries and knowledge (Plante, 2005). Luchins (2000) states that the future will likely further expand the biopsychosocial perspective by better understanding the interplay between biological, psychological and social influences on behaviour and targeting interventions that better suit these influences.
Plante (2005) stipulates that theoretical approaches in which trainees are exposed to during the first year of training provides a comprehensive framework for understanding behaviour and planning interventions. Whether trainees are conducting research or providing clinical services, using a theoretical approach helps to provide competent and theory-driven strategies. Without these perspectives, trainees would “wing” each time they engage in clinical work, deprived of useful guidelines direction in their journey.
In order for the training is sufficiently broad, Luchins (2000) recommends that it should attempt to deal with psychotherapy in general instead of with just one particular type of therapy. The study of various approaches to psychotherapy may help produce a therapist with a broader viewpoint, possibly one who is interested in the refinement of psychotherapy in general. This view is further supported by Woody and Robertson (1997) who suggest that the curriculum must be flexible enough to allow trainees to be exposed to other courses and treatments related to the discipline. Therefore, trainees need to be exposed to a number of therapeutic approaches as training cannot be limited to one model and this will without no doubt challenge their thoughts, perceptions about the world and consequently their behaviour.