Experiential Training In Disclosure Elicitation And Emotional Awareness And Activation: A Randomized Test

Experiences of trauma or stressful conflicts are linked to physical and psychological health problems and relationship struggles. Many therapy approaches—such as psychodynamic, emotion-focused, and exposure-based—aim to help people disclose, activate, express, and process difficult, avoided emotional experiences. Such therapy approaches are beneficial for a range of populations and psychological and physical health problems; however, this therapeutic work can be challenging, and therapists often avoid implementing such approaches. Barriers to therapist implementation of such approaches include lack of adequate training, lack of confidence in the interventions, and lack confidence in one’s ability to handle a range of client emotional reactions. New training approaches are needed to address therapist-centric barriers to the use of disclosure elicitation and emotional activation and to increase therapist skills in clinical situations. This dissertation addressed this need by developing and testing a brief, experiential training program to improve these abilities in mental health trainees and tested its effects against a standard, didactic training approach in a randomized controlled study. This study was conducted on 102 trainees in clinical psychology and social work, and outcomes included trainees’ skills in disclosure elicitation and emotional activation, affect phobia, self-efficacy, and anxiety. Both the novel experiential and the standard trainings were delivered through a single, virtual training session with each individual trainee. Participants completed self-report questionnaires of affect phobia, self-efficacy. Participants also completed a behavioral assessment of the targeted skills before they received the training, immediately after training, and at 5-week follow-up. Participants’ skills were assessed by having them respond to brief video clips of actors portraying therapy patients in challenging therapeutic situations. Participants’ responses were video-recorded and coded for the targeted skills. It was hypothesized that the experiential training condition would result in greater improvement in performance of the skills and in higher participant ratings of satisfaction with the training compared to the standard training condition. It was also hypothesized that the experiential training condition would result in a greater decrease in trainees’ affect phobia and greater increase in trainees’ self-efficacy compared to the standard training condition. Results demonstrate that the experiential training led to greater improvement in the skills measured from pre- to post-training compared to the standard condition; however, the effects on skills of the experiential training condition were generally not maintained at follow-up. It is likely that more deliberate practice and training is needed for trainees’ skills to be retained over an extended period of time. Both training conditions led to a decrease in participants’ self-reported affect phobia, and an increase in self-efficacy. Findings from this study demonstrate the feasibility of training therapists in underutilized psychotherapy skills to facilitate patient disclosure and emotional experiencing and highlight the importance of experiential learning in clinical training. Study findings also highlight the importance of observation and behavioral assessment of skills in clinical training of therapists