How Graduate-student or Recent Graduate Psychotherapists Experience and Manage Errors in Psychotherapy

ABSTRACT

We explored how graduate-student/recent graduate psychotherapists managed errors committed in psychotherapy, using consensual qualitative research (CQR) to analyze interview data. The 13 graduate-student/recent-graduate psychotherapist participants defined errors as something that leads to negative consequences or harm for clients or psychotherapy, identified inattention to important client factors as the most common error, and reported minimal/no formal graduate training regarding errors. When describing a specific psychotherapy error they had made, they noted a strong pre-error psychotherapy relationship, recounted a range of intrapersonal antecedents to the error, and described the error as their using an approach that was not helpful to the client/psychotherapy. Some realized the error in session via clients’ responses; others’ realization came post-session. The errors led to ruptures in psychotherapy and negative emotional responses in participants, as well as self-doubt; the errors also stimulated participant growth/learning. Participants used supervision to recover from the error and process their thoughts/feelings regarding the error. They also frequently discussed the error with clients, and advised others to be self-compassionate toward the inevitable errors that psychotherapists make. Implications for training, practice, and research are discussed.

KEYWORDS:

• Psychotherapy process
• psychotherapy errors

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Sarah Knox

Dr. Sarah Knox is a Professor in the Department of Counselor Education and Counseling Psychology, College of Education, at Marquette University. Her research interests focus on psychotherapy, supervision, and training processes, as well as qualitative research.

Karisse A. Callender

Dr. Karisse A Callender is an Assistant Professor in the department of Counselor Education and Counseling Psychology at Marquette University, a Licensed Professional Counselor (LPC) and Substance Abuse Counselor (SAC). Her areas of interest include single case research designs, trauma, substance use, and mindfulness.

Tin Weng Mak

Tin Weng Mak, M.A., is a doctoral student in the Counselor Education and Counseling Psychology department at Marquette University. Angel holds a Master's degree in Clinical Mental Health Counseling from Gonzaga University. She has previously worked with children and families in a trauma center in Spokane, Washington.

Shannon Skaistis

Shannon Skaistis is a relationally-oriented psychotherapist and doctoral student in counseling psychology. Their primary research interest is affirmative psychotherapy with transgender, nonbinary, and gender nonconforming (TNG) clients. This research aims to investigate how therapists can better meet the needs of TNG clients, particularly through the lens of cultural humility and the therapy relationship.

Graham Knowlton

Dr. Graham Knowlton completed his doctoral training in the Department of Counselor Education and Counseling Psychology at Marquette University. He currently works as a licensed psychologist at the Milwaukee VA.