Why Reflective Practice is Central to Psychotherapists’ Personal and Professional Development

ABSTRACT Introduction Anxiety is central to the psychotherapy process, yet psychotherapists routinely infer a client's anxiety intensity from observable behaviour rather than from formal measurement, with no widely accepted framework to organise which observable markers indicate which levels of anxiety. This exploratory study examined how therapists make such classifications. Method Ninety‐one mental health professionals were randomly assigned to classify 41 text‐described behavioural and physiological markers using either a 5‐level or a simplified 3‐level category system, both derived from an integrated model of state anxiety in psychotherapy. Results Response distributions departed significantly from uniformity for nearly all markers in both formats, and the rank ordering of markers by intensity was highly consistent across formats, suggesting that therapists may share broad intuitions about relative marker intensity. Which markers elicited agreement, however, was far less reproducible, depending substantially on the response format. Convergence also depended on where the agreement criterion was set, declining from 90.2% to 51.2% of markers in the 3‐level format and from 63.4% to 22.0% in the 5‐level format as the criterion rose from > 0.50 to > 0.70. The 3‐level format yielded more classifiable markers at every criterion, although this advantage was not consistent across indices, whereas the 5‐level format elicited fewer ‘Insufficient to Determine’ responses. Markers placed at the highest intensity levels were classified most consistently. Discussion These findings offer preliminary groundwork for research on marker operationalisation, contextualised rating tasks and the development of training materials for psychotherapy process research.

Abstract Background Repetitive negative thinking (RNT) is a transdiagnostic process relevant to common mental health problems in primary care. RNT-ACT is a brief acceptance and commitment therapy-based protocol targeting RNT in two sessions. This pilot study assessed the feasibility of RNT-ACT compared with therapist-supported internet-based cognitive behavioural therapy (iCBT) in Swedish primary care. Methods Thirteen participants were randomised: 7 to RNT-ACT and 6 to iCBT. The primary feasibility outcomes were recruitment rate, intervention non-completion, and patient satisfaction measured with the Client Satisfaction Questionnaire (CSQ-8). Symptom and process measures were secondary outcomes. Secondary outcomes were assessed at baseline and at 1- and 3-month follow-ups. Analyses were descriptive and exploratory, based on available observations without imputation of missing data. Results Thirteen of 20 eligible individuals were enrolled (65%), corresponding to 35% of all 37 individuals screened. All participants in the RNT-ACT group completed the intervention, whereas 4 of 6 participants in the iCBT group did not complete the intervention. Mean CSQ-8 scores were 27.8 (SD 3.7; n = 5) in the RNT-ACT group and 23.0 (SD 0.0; n = 2) in the iCBT group. Conclusions The small sample size and high iCBT non-completion limit between-group comparisons. Further investigation of recruitment, treatment engagement, and patient and therapist experiences is needed before determining whether and how to proceed to a full-scale RCT. Trial registration ClinicalTrials.gov NCT05946382 registered July 14, 2023.

Psychotherapy is supported by evidence across several psychological conditions, yet its value cannot be understood solely through symptom change. This thematic integrative review examines psychotherapy as both an intervention and a relational setting in which psychological safety, trust, collaboration, and self-understanding may support change. Literature discussed in the source synopsis is organized around three themes: psychotherapy outcomes across mood, anxiety, trauma-related, and personality difficulties; the therapeutic alliance and safety; and adapted, neurodiversity-affirming support for autistic people. Meta-analytic and theoretical literature generally supports psychotherapy effectiveness, while alliance research identifies the therapeutic relationship as a robust correlate of outcomes. Work on autistic youth suggests that adapted interventions can be beneficial, although outcomes and methods vary. Across these areas, the review identifies a need to connect clinical outcomes with clients? lived experience of safety, identity, accessibility, and agency. The review is integrative rather than systematic: the source material does not document reproducible database searches, screening counts, or formal quality appraisal. Accordingly, conclusions are interpretive and should not be treated as a comprehensive estimate of treatment effects. The paper argues for therapeutic spaces that combine evidence-informed care with collaborative, individualized, and affirming relationships.

Various disciplines view reflection as both a theory and a practice for helping make learning more visible to students as well as giving them a greater sense of agency; thus, the importance of reflection in higher education is well established. In recent years, scholars in SoTL have acknowledged and theorized about the importance of reflection for faculty. Our 360-degree model builds on this scholarship and research in writing studies in order to suggest that directional (inward, outward, forward, backward) reflection helps faculty analyze their teaching practices by integrating theoretical insights and evidence to evaluate effectiveness while also supporting ongoing professional growth. This poster shares an application of the 360-degree model of reflection, encouraging faculty to build reflective practices into their SoTL projects.

This study contributes to the scholarship of teaching and learning (SoTL) by examining how case-based teaching and threshold concepts promote culturally inclusive pedagogical practices among pre-service teachers (PSTs). Our research design reflects SoTL principles by taking a systematic, transparent, iterative, and collaborative approach to collecting, analysing, and sharing data. Our work is explicitly aligned with theoretical frameworks, and we address unresolved issues in order to facilitate transformative learning. We aimed to explore how PSTs perceive culturally inclusive pedagogy and professional competence in a case-based course. Three key findings emerged: increased awareness of classroom diversity, a change in the PSTs’ understanding of culturally inclusive teaching, and resistance to exploratory learning designs. Many PSTs demonstrated transformative learning and sound professional judgment. However, some expressed resistance and uncertainty, underscoring the importance of scaffolding and support. The findings align with the literature on threshold concepts as gateways to boundary crossing and a deeper understanding of diversity in SoTL. The results highlight the potential of case-based teaching to encourage metacognitive reflection and to promote inclusive educational practices in teacher education programs. The study demonstrates that designing inquiry-based learning activities that integrate case studies and threshold concepts can facilitate critical reflection and metacognition among PSTs.