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.