By Aidan Maloney
The demand for training in psychotherapy and sister disciplines has never been greater. Anyone attending an open day when the psychotherapy and counselling providers present themselves to the public will notice that sometimes the inquiries for training match those for the services themselves. While the providers are responding to this demand as best they can, those seeking instruction must often feel they are in a foreign country with very few road signs. Even where they exist the signposts are entirely in the native language.
To make it even more difficult for the individual (in the ‘travelling metaphor’) the numbers showing the distance to the next town are sometimes in miles and sometimes in kilometres. But they don’t say which on the signpost. In response to “How far is it to the next town?” the natives of this foreign country have a very Cheshire Puss reply. “It depends on where you are coming from,” they say. What extra training you need to become a psychotherapist or counsellor depends a great deal on what you have already. Some skills can transfer across occupational boundaries making it possible for some to take short cuts where others have to go the long way round.
Designing programmes to meet the variety of demand that exists for training is a complex task. Most training programmes in these areas evolve gradually and take shape over time. Some programmes rely heavily on the expertise of the presenters and their ability to adjust form and content to meet the students’ needs. Change the presenters and the programme would probably change radically.
At the other extreme there are programmes adopting a correspondence format with virtually no teacher student interaction. The student receives text and tapes, audio or video, and he/she is entirely responsible for his/her own learning. In psychotherapy any programme that depends entirely on the teachers or entirely on the students is unlikely to be a well designed programme meeting the needs of the students hoping to embark on a new profession. Of course between the two extremes there are a range of other approaches. Finding the right design to meet student needs is what instructional development is all about.
No one really starts as a professional presenter or trainer but skills of presenting, instructing and facilitating are becoming an adjunct of many occupations. The modern trainer uses tools from psychology, education, management and psychotherapy. Knowing how to define different training contexts, how people learn, how to establish rapport, the rules for feedback etc., makes instructing groups a very manageable task rather than a mystery that sometimes turns out all right. However long before the first student registers for the programme the seeds of success or failure have been sown. Much depends on the thought and care that has been given to its development.
In recent years instructional development has emerged as a discipline in its own right. Awareness of the principles and stages in instructional development can improve considerably course design and presentation.
There is a movement away from the traditional pedagogic model, where the teacher is the expert in a position of authority over the students, and towards a participative model. In the traditional model the student is expected to listen, take notes and sometimes ask questions. This almost uni-directional flow of information reduces student motivation and creates dependency. The model fails completely when the aim is to enable students to become more aware and respond dynamically to other people. To meet the requirements of this type of instruction, adult educators/trainers in many fields have adopted an andragogic approach (to distinguish it from the pedagogic approach) where the teacher/instructor serves as a facilitator to create the opportunities and experiences necessary to enable learners to learn. Psychotherapy itself has been a major source of influence in creating this trend. Education and training methods owe a debt a variety of psychotherapy schools, in particular to Carl Rogers and his client-centered approach.
This change in approach is further complemented by the adoption of a systems approach to designing training programmes that further reinforces the learning needs of the student. Figure 1 shows the standard model for developing systematic training. The cycle begins with identifying learning needs, moves on to planning the training intervention, implementing it and then assessing the result.
Each of the activities summarises sub-activities that need to be carried out to fulfil them. The process is an iterative one. By going through the process several times and fine-tuning it there is a continuous improvement.
Figure 2 looks into the cycle in greater detail by classifying the subactivities that make up the major elements in the cycle. The process begins with analysis and it is client-centred.
Students looking for psychotherapeutic training come from a wide range of backgrounds, educational and occupational. The “learning gap” represents the difference between what they have already and what they need to become professionals. The more open the intake for any particular programme then the more inputs and support will be needed to meet the needs of those with the greatest initial deficits. In contrast a course that selects an applicant only if he/she satisfies certain prescribed criteria regarding age, education and experience can have a much more standardised format. Analysing the students defines the lower limit of the “learning gap”; performance levels within the occupation define the upper limits. Specifying these levels requires an analysis of the level of competency required for the satisfactory performance of counselling and psychotherapy, the tasks.
At this stage of the process one needs to decide just how much of the gap the training unit, module, course, is going to span. Is it going to complete the bridge or represent a span from one support to another? Answering these questions gives one the level of treatment.
The next stage in programme development involves developing learning objectives. These objectives should be behaviourally stated and explicitly identify the types of behaviour that the course is designed to train people in. Formally a learning objective is a statement of what the student must do to show that he/she has learned. It contains;
(a) an action verb describing a performance (b) a statement of the conditions imposed on the performance (c) a statement of the standards to be reached.
An example would be “To establish rapport with a client in the first ten minutes of the consultation using verbal and non-verbal pacing” (Pacing describes matching the client’s behaviour in some way.)
Learning objectives fall into several broad categories, knowledge, skills and attitudes. For example, in the knowledge category, students may be expected to become familiar with various theories. In the skills’ category, students need to become adept at such skills as establishing and maintaining rapport, recognising and reading non-verbal communication, giving constructive feedback and a variety of other skills including such mundane activities as keeping records. Attitudes are perhaps the most difficult area to define and specify and will reflect the psychotherapeutic school. An additional classification, entitled self-knowledge, emphasises the importance of knowing one’s own strengths and weaknesses, likes and dislikes in an occupation where it is important to take account of the above in influencing the outcome of an interaction.
The above horizontal level of classification can be further developed into a more specific taxonomy by applying a vertical division to each classification. In the cognitive domain Pedlar has developed a four level hierarchy that can be applied to management training. These are memory, understanding, application and transfer (see Figure 3).
At the memory level a student can identify, define and describe. At the understanding level he/she can explain, compare and justify. At the application level he/she can apply techniques in the prescribed way and at the transfer level the student can modify or create new theories or tools to cope with unique situations where there are no right answers. The ultimate objective in psychotherapeutic training must be the level of transfer, however, foundation and intermediate modules or courses may aspire to lower levels of achievement.
Knowing the objectives and the level of treatment the programme developer can refocus again on the target group. They should be described in terms of age, experience, qualifications and aptitudes. Clarity at this stage in the design will minimise the likelihood of failure because a student does not have the prerequisites to embark on the course in the first place. Even if one wishes to make exceptions in the application of these criteria, people who are accepted for exceptional reasons will be clear on what is expected of them and what they may have to make up for independently of the programme.
Even at this early stage one should think about tests or methods of assessment that will measure the success or otherwise of students achieving the objectives. Thinking about them at this stage provides further clarity and guidance regarding the curriculum content required to take people to the declared objectives. One should favour tests designed to elicit practical demonstrations of the desired behaviour. Of course one is free to make this a negotiable part of the process between teacher and students and this happens on some programmes.
Once the objectives are understood one can begin to plan the sequence or order that the topics should take. The object of sequencing is to devise a pattern that will produce optimum learning in the shortest possible time. There may be a clear logical structure that needs to be followed when one topic builds on another, or freedom to arrange the sequence according to other criteria that seek to encourage and maintain student interest.
For each topic there may be several events or activities designed to impart the learning. Sometimes the delivery system is automatically determined by the learning event and at other times there is a choice. For example demonstrations can be live or videotaped.
Even if the programme has never been run before there are nearly always existing materials available that can be used to meet some of the course requirements. If the programme has been run often there maybe opportunities for developing new and better materials.
Validating instruction internally means to check whether the programme achieves the behavioural objectives specified. Do the exercises, lectures, group work, assignments etc. bring about the desired changes in knowledge, skills and attitudes? A second form of validation, external validation assesses whether the internally valid programme is based on an accurate identification of training needs. Both require some sort of testing with a sample of potential students. External validation can be supported by getting the agreement of one’s respective professional body that the standards to be attained have been correctly identified. No matter how carefully one designs the learning materials one is unlikely to get everything right first time. It is necessary therefore to try them out in some way before going ahead with the full programme. Testing the materials on people who represent the trainee population is the best way to conduct internal validation.
In practice validating is often done concurrently with pilot-testing. Pilot-testing involves testing out the entire programme to see if all one’s expectations and plans are fulfilled. It may also be the first run of the programme if it is a long one because it is often too expensive to test a comprehensive programme without charging. However no one should expect a newly designed programme to run without some alteration to cope with problems that only emerge when the whole thing is operational. The trainer needs to be prepared and open-minded to make these adjustments as a normal part of instructional development. Making students aware of the experimental nature of the programme and including their feedback can increase their motivation and sense of participation. Including student feedback should be regarded as an essential part of psychotherapeutic training because as one moves up the hierarchy of learning objectives learning becomes increasingly a cooperative venture between student and teacher.
Formative evaluation describes the process of improving the programme in the light of a pilot test by introducing changes to make it better. Summative evaluation is a process that evaluates whether or not the entire objectives and raison d’etre for the programme need reconsideration. This type of evaluation involves following up programme graduates to find out, if the training they received, meets the demands they experience in their professional careers.
The more of these steps that are explicitly addressed in developing a programme the greater the likelihood of the programme meeting the needs of students and achieving its objectives. With validation and evaluation built in to the process students are guaranteed the highest quality of instructional design. In practice programmes evolve and each time a programme is run the opportunity arises to make explicit what was done by assumption in earlier times.