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In Pursuit of Evidence-Based Clinical Training
Adopting an evidence-based foundation for clinical training will require more than just identifying and adopting research results. Counselor educators will need to raise the value of "knowledge" based on scientific method to a primary position within the profession (Heppner et al., 1999). We will need to create a climate that values knowledge developed from clinical research in training and clinical decision making. According to Heppner et al. (1999), that will require us to foster the "scientific thinking" of counseling students, targeting their epistemological paradigm so that knowledge based on science and the systematic thinking processes characteristic of the scientific method become an integral part of the way they approach counseling. In an interesting way, this is a notion that is not unfamiliar to counselor educators. We have historically attempted to help students become "humanistic" thinkers, "behavioral" thinkers, or "systemic" thinkers. To promote "scientific thinking" is a move toward valuing knowledge based on systematic investigation with common methods, and systematic data gathered over time in unbiased ways. Thus, we will need to realize that it may be just as important to think systematically in the research process as it is to have final knowledge, which is the most helpful component of integrating research into practice.
Scientific thinking may have an additional benefit for clinical training. One of the characteristics of a "scientific thinker" is the ability to discover new ideas, systematically test those ideas, and integrate new knowledge into new explanations of phenomena. Thought of in this way, scientific thinking is a valuable component in helping counselors process information about specific clients in complex ways. According to Whiston and Coker, cognitively complex counselors are more effective counselors. There is also a self-corrective element in scientific clinical thinking in that counselors will have a natural inclination to evaluate the outcomes of their work. Those outcomes, whether they are positive or negative, can feed back into practice so that the next client benefits from the one who came before. In fact, Hoshmand and Martin (1995) argue that, with effort and time devoted to therapeutic research training, more innovative and creative counseling methods are very likely to develop.
Adopting an evidence-based approach will not eliminate the ambiguity in clinical training. There are well-documented problems with the research literature (Sexton et al., 1997). For example, adopting only a logical, positivist definition of science based exclusively on traditional quantitative inquiry methods will limit rather than enhance our understanding of human systems (Hoshmand & Martin, 1995). An evidence-based model will need to operationally define science to mean a systematic way of gathering and evaluating information based on diverse methods relevant to the topic (Sexton, 1996).
I would argue that these gaps and deficiencies in the evidence-based knowledge base are normal, to be expected, and therefore a natural state of affairs rather than a reason to avoid research. An evidence-based approach to clinical training does not require a knowledge base that is complete. In fact, given the complexities of human and social interaction we will never fully understand all the variables, mediators, and processes involved in clinical change. If, however, we adopt a pragmatic approach, thinking of research as a probabilistic problem-solving activity that can, along with solid theoretical knowledge and clinical experience, guide practice, we will have an open system in which new knowledge is constantly integrated in training and practice (Sexton et al., 1997).
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Table of Contents
Interpretative phenomenological analysis (IPA) is a contemporary qualitative research method grounded in phenomenology, hermeneutics, and idiography. Philosophical principles and rigorous methodology make this approach well suited for research in counselor education and supervision. In this primer, the authors introduce counselor educators, counseling students, and counseling researchers to IPA theory and methodology and discuss considerations for implementation in counseling research.
The authors recruited 11 doctoralâlevel counseling students to participate in a study exploring the lived experiences of people who have encountered social class microaggressions (SCMs). Findings (consisting of 6 themes) suggest that SCMs are a distinct phenomenon arising from interpersonal and environmental exchanges that damage recipients. The authors present implications for counselor education and future research trajectories.
The authors examined the influence of dispositional mindfulness and personal distress on counseling selfâefficacy among 162 counseling students. Results indicated that dispositional mindfulness and personal distress accounted for significant variance in counseling selfâefficacy. These findings suggest that internal dispositions may facilitate or hinder counseling selfâefficacy in counseling students.
The authors examined whether attributional style could explain burnout among 201 counseling graduate students. Hierarchical multiple regression analysis results indicated that stability and globality of attribution explain a significant amount of the variance in counselor traineesâ burnout. These findings suggest intervention and training should be used to promote a more flexible and positive orientation to handle stressful life events.
Flipped learning is a teaching approach in which instructors distribute content outside of class and lead application activities in class. In this qualitative case study, the authors explored the experiences of students (N = 10) in a flipped counseling course and identified 3 themes: enjoyment, benefits, and learning inside and outside of the classroom.
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