EXPLORING THE EXPERIENCES OF COUPLE AND FAMILY THERAPISTS LEARNING AND USING AN EVIDENCE-BASED PRACTICE

Abstract

Couple and family therapists are rarely the focus of research yet are critical for positive outcomes in therapy. The field of couple and family therapy includes diverse theoretical approaches that focus on relationships and the environment as part of the understanding of how challenges emerge for couples and families as well a source of resources to help deal with those challenges. Initially developed in the medical field, evidence-based practices now pervade mental health fields including couple and family therapy. The attempts to integrate evidence-based approaches into the practice of couple and family therapy have been controversial resulting in passionate and at times divisive dialogue. The aims of this research project were to explore what influenced couple and family therapists to use an evidence-based practice and what do couple and family therapists experience when learning an evidence-based approach to working with couples and families. To examine these questions, a literature review was completed to explore the benefits, challenges, and social justice considerations of evidence-based practices. A total of 14 couple and family therapists were then interviewed about their experience with learning an evidence-based approach. The research was guided methodologically by interpretive phenomenological analysis. Drawing on phenomenology, hermeneutics, and ideography, this approach to research focuses on participants’ personal meaning and sense making of their experiences of learning an evidence-based practice. Three themes emerged from the participants’ experiences including: the supports and challenges in learning; the embodiment of a therapy practice; and the experience of shame while learning. The analysis of the supports and challenges while learning an evidence-based approach was aided by the use of the Dreyfus model of skill acquisition. The participants found evidence-based approaches a necessary step that helped to structure and organise their learning though a continued focus on an evidence-based approach may limit a therapist’s development over the long term. The role of embodiment while learning was examined with the aid of Gendlin’s understanding of focusing and Merleau-Ponty’s notion that we all have a view from somewhere. For some of the participants, the body was an important source of information and means for learning as they integrated a new therapeutic approach. Finally, shame was an experience discussed by half of the participants and this is further explored in light of one of the action tendencies while experiencing shame, which is to hide from others. This thesis concludes with further examination of each theme and options are discussed for therapists, supervisors, and trainers.