Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

Background: Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent.

Aims: This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training.

Method: The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data.

Results: A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR.

Conclusions: A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.