Rachel Fried


Despite its importance, little is known about how psychologists are trained to reflect on their conduct of psychotherapy. These abilities are collectively known as reflective practice, which is considered a core competence within the field of psychology. This study examined the use of reflective practice by clinical, counseling, and school psychology interns and looked at how reflective practice is being facilitated by supervisors. The study examined the use of reflective practice in different clinical situations and obtained opinions about which reflective practices are believed to most impact clinical effectiveness. The study also examined barriers that may impede engagement in reflective practice. A mixed-method approach, including quantitative and qualitative analyses, was used to examine study questions in a sample of 69 pre-doctoral psychology interns. Results of this study indicated that for clinical cases in which the therapeutic work was “going well,” psychology interns engaged in reflective practice slightly more than once per month. However, for challenging cases (whether the “work was going well or not”) reflective practice was reported to increase, on average, to more than once per month, but less than once a week. There was no significant difference in frequency of reflective practices used between “challenging cases going well” and “challenging cases not going well.” This study found that supervisors facilitated an average of slightly over half of the total reflective practices measured. Further, the number of practices facilitated by supervisor was significantly correlated with the frequency of reflective practice use among interns. The reflective practices perceived to have the most impact on clinical effectiveness were (a) reflecting on feelings during session, (b) examining personal beliefs and values, and (c) reflecting on the quality of the therapeutic relationship. The most significant barrier to engagement in reflective practice was reported to be time. In regard to interns’ beliefs about how helpful reflective practice is to clinical practice, two major themes emerged: (a) whether reflective practice was helpful to the therapist (e.g., increased self-awareness) versus (b) if it was helpful to the client (e.g. helped client process their emotions more). Implications for future research and application to clinical practice are discussed.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Psychotherapists -- Training of; Self-evaluation

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Shafranske, Edward;