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ORIGINAL ARTICLE

What Are the Conditions Needed to Facilitate Online Self-Reflection for Cognitive Behaviour Therapy Trainees? Samantha Spafford1 and Beverly Haarhoff2 1

Positive Mind Works and 2School of Psychology, Massey University

Introduction: Self-practice (practicing cognitive behaviour therapy techniques on self as therapist and Self-reflection (reflecting on the experience of self-practice) is gaining increasing support as a mechanism supporting the improved acquisition and development of therapist skill in both novice and more experienced practitioners. Research in several countries has confirmed that participants have found SP/SP extremely useful both professionally and personally. Despite the increasing evidence of benefit it has also been observed that some participants fail to fully engage with the SP/SR process, drop out or do not complete SP/SR programmes. Recently, on-line interactive blogs have been identified as useful in improving SP/SR engagement in the training of practitioners involved in stepped care programmes. Objective: To qualitatively explore the utility of an online self-practice/ selfreflection blog as a mechanism with the potential to facilitate postgraduate cognitive behaviour therapy trainees engagement in self-practice/ selfreflection as a training strategy. Method: Nine trainees completed an online self-practice/ self-reflection programme as a component of a Postgraduate Diploma of Cognitive Behaviour Therapy. On completion trainees were invited to complete an electronic feedback form and participate in a focus group discussion regarding their experience of engaging with an interactive self-reflection blog. Results: Thematic analysis resulted in identifying one central theme: Experience of the SRB, under which six sub themes, namely: Obstacles, and Solutions, Being Observed, Online Synergy, Motivation and Time as a factor, were noted. Themes are discussed in relation to recommendations for future training providers to improve trainee engagement and utilisation of self-reflective online programmes. Key words:

blogging; CBT; online training; postgraduate training; self-practice/self-reflection, therapist training.

What is already known on this topic

What this paper adds

1 Within several countries, there is a steadily increasing body of research supporting SP/SR as a method to enhance therapist skill acquisition within cognitive behaviour therapy (CBT) training programmes. 2 Despite overall positive results, some trainees benefit less than others and a number “drop out.” Recent research suggests completion and the experience of benefit is closely linked with trainees’ level of engagement in the SP/SR process. 3 Manuals have been used to deliver SP/SR. Recently, online and interactive SP/SR has been introduced; initial findings suggest that this format facilitates trainee engagement for low-intensity CBT trainees.

1 Trainee therapists suggest that self-reflection activities that are well facilitated and highly structured are easier to engage with. 2 Peer interaction and learning from the experiences of others is thought to be an important part of this process and does not always occur spontaneously. 3 Having adequate time and a sense of safety within the group is likely to facilitate interaction and engagement.

The demand for practitioners trained in the evidence-based psychotherapies, predominantly cognitive behaviour therapy

Correspondence: Samantha Spafford, Positive Mind Works, Apartment 7, Merchants Exchange, 2 Bridge Street, York, North Yorkshire YO16LT, UK. Fax: +44 1347838092; email: [email protected] Research was undertaken at Massey University, School of Psychology, Albany Campus, Auckland, New Zealand Accepted for publication 6 July 2014 doi:10.1111/ap.12076

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(CBT) has greatly increased; alongside this is a parallel demand for evidence-based training methods. To meet the demand and build a diverse workforce, CBT trainees have been recruited from a number of registered health professions (including social workers, occupational therapists, psychiatric nurses and psychologists). Consistent with a stepped care model of service provision, training has also adopted a stepped care approach that differentiates high- and low-intensity CBT in the UK. Historically it was considered that training interventions provided little impact on therapist skill (Ford, 1979); thankfully, more recent studies support that a moderate relationship exists between training and therapist competence (Stein & Lambert, Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society

S Spafford and B Haarhoff

1995). Applying the same principles as those used to determine empirically supported treatments, training providers have begun addressing the questions of what works for whom, when, and under conditions? The declarative–procedural–reflective (DPR) model of psychotherapeutic skill acquisition (Bennett-Levy, 2006) provides a useful template to guide psychotherapist training, distinguishing three interacting knowledge-processing systems, namely the DPR systems. Declarative knowledge (DK) refers to factual knowledge obtained through traditional pedagogical methods such as reading books and attending lectures. Procedural knowledge (PK) is knowledge that combines DK with knowledge gained through experience resulting in sets of rules for action, described as “when? . . . then rules.” These rules guide decision-making, and therapeutic reactions in situ. PK is more difficult to teach and relies to some degree on the accumulation of clinical experience and innate interpersonal and perceptual skill. It has been noted that the extent and depth of PK differentiates novice from experienced practitioners (Bennett-Levy, 2006). The reflective system is described as the “engine” that drives the two other systems, coming into play when problems need solving, drawing on past and present knowledge and experience to provide perspective. The DPR model argues that facilitating the development of a strong reflective system is an important part of providing optimal psychotherapy training at all levels of proficiency. It has been proposed that practicing CBT techniques on self as therapist (self-practice [SP]) and reflecting on this process (selfreflection [SR]) offer a pathway to achieving this end (Bennett-Levy et al., 2001). Over the past decade, this assertion has been supported by a number of studies in Australia, New Zealand, the UK, Ireland, and Austria (Bennett-Levy et al., 2001; Chaddock, Thwaites, Freeston, & Bennett-Levy, 2006; Davis, Thwaites, Freeston, & Bennett-Levy, 2014; Farrand, Perry, & Linsley, 2010; Haarhoff, Gibson, & Flett, 2011; Laireiter & Willutzki, 2003). A recent meta-synthesis provides a good summary of this research and offers support for the value of SP/SR within training programmes (Gale & Schröder, 2014). In addition to strengthening the reflective system, SP/SR has consistently been found to enhance DK and PK in a number of ways, for example: understanding the CBT model and the process of change (DK); improving communication of therapy rationale, specific CBT skills, flexibility, creativity, selfawareness, self-knowledge and understanding the impact of therapist beliefs (PK). Despite the growing evidence in support of SP/SR, most of the studies to date have been qualitative in nature. In many instances, SP/SR has been run concurrently with training programmes, thus making it very difficult to isolate the impact of SP/SR without considering the other “active” training elements involved. Rakovshik and McManus (2013) found supervision to be the most effective form of training, while experiencing CBT from the patients perspective or SP was ranked in the lower third compared with other learning approaches. These findings indicate that although there is a strong rationale to consider SP/SR, there is much more research required to determine where it finds its place alongside more traditional teaching methods. Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society

Online self-reflection

The most widely used and researched SP/SR format utilised in training programmes are versions of SP/SR workbooks consisting of alternating SP exercises and SR questions (Bennett-Levy, Thwaites, Haarhoff, & Perry, 2014). The SP exercises are ubiquitous CBT interventions such as the five-area model (Greenberger & Padesky, 1995) and dysfunctional thought record (Beck, 1995). SR questions target the trainee’s observation and clarification of the SP experience by asking questions about the implications of the experience in terms of the way in which the “self” and “self-as-therapist” are perceived, and how the experience may have affected the interaction between trainees’ personal self and professional practice. The SP content is generally derived from a specific personal problem or change project identified by the trainee. In other words, the trainee is using his or her own experience as a starting point. A qualitative study comparing the results derived from four SP/SR groups reported positive overall feedback from those that have completed SP/SR (Bennett-Levy & Lee, 2014). Despite these findings, the level of benefit reported by individuals has been shown to vary from very beneficial through to having little or no benefit for a minority of participants. Some feedback indicates that the process can be both time consuming and emotionally draining. High dropout rates have also been reported in a number of studies including Bennett-Levy and Lee (2014). The experience of benefit and engagement appear intrinsically linked, results indicating that the higher the motivation of a trainee, the greater the perceived benefit and the more benefit, the greater the motivation (Bennett-Levy & Lee, 2014). Engagement with the process appears linked with richer reflections and also with a higher rate of completion (Bennett-Levy & Lee, 2014; Bennett-Levy, Lee, Travers, Pohlman, & Hamernik, 2003). One solution proposed to increase engagement has been the introduction of self-reflective blogs (SRB). Nineteen lowintensity CBT trainees in the UK participated in a SRB to support engagement with a SP/SR workbook designed to consolidate CBT skill acquisition (Farrand et al., 2010). The SRB’s were interactive in the sense that they were not anonymous and they were available for comment by both the other members of the group and the teaching staff. Ground rules specified that the SRB should contain only process information (no personal content was included). Feedback obtained through focus groups confirmed a number of advantages in using this method, for example, participants were more likely to meet the course deadlines and experienced increased engagement due to the public nature of the posts (Farrand et al., 2010). Initially, the style and quality of SRBs varied; however, as the programme progressed, the researchers observed a distinctive style emerge, which appeared to be modelled on the highest quality posts (Farrand et al., 2010). Trainees reported that reading each other’s comments established the value of the SP/SR process and improved the quality of the reflections via modelling. The current paper reports the results of a qualitative study exploring the impact of a SRB on the training experience of Postgraduate Diploma of CBT trainees in New Zealand. This study is differentiated from the previous study in that the participants involved were undergoing traditional postgraduate CBT training. The focus of the SP/SR workbook in the current study is self-conceptualisation as a pathway 233


to improving conceptualisation competency (Haarhoff, 2008), whereas Farrand et al.’s (2010) SP/SR programme was designed to consolidate low-intensity skills that did not extend to selfconceptualisation. The study was guided by the following questions: (a) Does a SRB enhance self-reflective experience and engagement of high-intensity CBT trainees? (b) What factors need to be considered to set up and effectively facilitate a reflective blog?

Method Participants Participants were nine trainees enrolled in the second year of a postgraduate CBT programme. The SP/SR training component was part of “training as usual” and had been a part of the Postgraduate Diploma of CBT course requirements since 2010. All trainees were therefore required to complete the programme, but were given the option to opt in or out of the study. Trainees were from various mental health professions, namely, two social workers, two psychiatrists, and one each from occupational therapy, forensics, nursing, and counselling, respectively. The group comprised seven women and two men aged between 31 and 47 years, the average age being 41 years (standard deviation = 6). Of the nine consenting participants, seven completed the electronic feedback questionnaire, and four of these agreed to take part in the focus group discussion.

Materials SP/SR Workbook: Understanding Myself The SP/SR workbook, entitled “Understanding Myself” (Haarhoff, 2008), is designed to lead the trainee through a number of CBT interventions that on completion would result in self-conceptualisation. The workbook is divided into three parts, which correspond to the three levels of thinking within the structural model of CBT. Seventeen SP/SR exercises guided the trainee to apply CBT methods to their presenting problem, first gaining an understanding of the problem and its context, before moving toward creating a personal case conceptualisation. The SP exercises were worded similarly to the instructions a client would receive from a CBT therapist. There was an additional SR module for concluding reflections.

SP/SR Blog The online forum was located within a university supported e-learning environment called the Stream Forum (see http:// moodle.com/ for further information). Trainees were given a timetable to guide completion of the SP/SR exercises over a period of 6 weeks. Three reflective modules were grouped together and revealed to students each week along with a message from the course coordinator encouraging participation.

Feedback questionnaire A SurveyMonkey (https://www.surveymonkey.com/s/MJCK GMD) questionnaire containing 10 items captured demographic 234


information and trainees’ initial impressions of the SRB. The questions included some areas of interest identified in previous studies, specifically Farrand et al.’s (2010) and a paper by Williams and Jacobs (2004) discussing blogs within the context of tertiary education. The questions included such items as: Do you think the selfreflective blog assisted with your learning? Please indicate your experience of the interactive element of the blog (i.e., commenting on others entries and input from teaching staff)?

Focus group Due to the logistical problems encountered in attempting to arrange a face-to-face meeting, a teleconference focus group methodology was selected, allowing the researcher to ascertain the “what?” and “why?” of trainees opinions. This method also generated an interactive element that would highlight consensus and disagreement between group members (Flick, 2009; Mann & Stewart, 2000). As per Flick’s (2009) suggestion, a starting point and structure were obtained by beginning with a set of open questions. The questions were emailed to participants 2 days prior to the focus group to give ample opportunity for consideration before the scheduled discussion. Reasons for non-participation in the focus group revolved around the difficulties in coordinating a geographically dispersed group each with a high level of professional responsibility.

Data Analysis A qualitative design was employed for this study with data generated from the electronic feedback questionnaire and the recorded focus group discussion. Thematic analysis followed the six phases described by Braun and Clarke (2006). The phases involved transcribing and repeated reading of the data in order to gain familiarity of the content; initially coding of interesting features of the data; identifying themes and sorting data that reflect these themes; reviewing themes and generating a thematic map; defining and naming themes; before finally producing the outcome results and report.

Procedure Ethical approval for this research was obtained from Massey University Human Ethics Committee. All participants had completed year one of the postgraduate diploma in CBT. At the time of the study they were undertaking the final year of the programme, involving clinical practicum, close supervision, and SP/SR. A half-day workshop introduced SP/SR to the trainees, providing a rationale for this training method and allowing for concerns and reservations regarding participation to be addressed. The workshop was also used to troubleshoot and resolve any technical difficulties preventing access to the online tool. Following Bennett-Levy and Lee’s (2014) guidelines for engagement, trainees were encouraged to develop a personal safety plan should they experience an unacceptable level of emotional discomfort. Trainees were also formally invited to participate in the study and provided with information and consent forms. A second member of the teaching staff (not involved in the research) collected and stored the completed consent forms. Following the return of consent forms, the first Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society


author was provided with the names and email addresses of those that had agreed to participate. These steps were carefully considered in order to minimise the influence of the second author/ course facilitator and to maintain participant confidentiality. Each trainee received a copy of the workbook in which to complete SP/SR. Trainees were encouraged to post their selfreflective responses to an online discussion forum, where they were visible (and identifiable) to fellow trainees and the teaching staff. It should be emphasised that the SP component, whereby the participant used CBT interventions to understand and explore their identified problem was not made available online. Content (SP) was therefore clearly separated from process (SR). To facilitate interaction, each posting triggered an email to trainees and teaching staff. On completion of the SP/SR component, the SRB entries were retrieved from the Stream site and made available for thematic analysis. Trainees who had consented to participate were emailed a copy of the Web link to access the online feedback questionnaire. An email prompt and a message on the Stream Forum page served as a reminder; this method returned seven completed feedback questionnaires. Questionnaires were both completed and submitted online. Only the first author had password access to the raw data thereby ensuring that participants were not identifiable to the course facilitator/ second author. Results from the feedback questionnaire were used to generate a number of questions to guide the focus group. Utilising teleconferencing technology and the coding strategy outlined by Flick (2009), the 55-min audio recording was transcribed by the first author. Acting as facilitator, the first author advised participants of the focus group that it was recorded and would be listened to by the first author only for the purposes of dictation. During transcription, all identifying material was removed before it was made available to the second author. In this sense, it was made explicit to participants that again the second author/course facilitator would not have access to the raw data and therefore participants could maintain confidentiality.


“Having the blog online as opposed to just the booklet was beneficial”. (trainee seven) Not all responses were positive; one trainee in particular indicated the experience was not enhanced by the discussion forum and in their experience, the self-guided SP/SR workbook provided a better format for their self-reflection. For example: “I got less out of sharing / reading the blogs than I got out of practically doing the work book exerices [sic] and the reflections that followed” (trainee four) The following discussion explores the six sub-themes and brings to light the variety of responses. Being observed. For some trainees, participating in the SRB brought with it an awareness of being observed by peers and teaching staff. As reflected in the following quotes, there was concern regarding their competency and a fear of being judged by their peers. This is illustrated in the following: “the downside to the anonymity meant that there was a level of self-consciousness [sic] about whether my answers were ‘sufficient’ enough/whether I was on the right track.” (trainee three) Trainees’ comments identified that although the SRB exposed them to a degree of vulnerability, there was also a beneficial element to this. These ideas are expressed thus: “How emotionally difficult it can be, but also how revealing.” (trainee eight) Although trainees expressed concern over appearing competent, they were less concerned about revealing personal information. One trainee reported the lack of anonymity may have limited his/her disclosure, while others were concerned less about disclosure than being judged by their peers. This is evidenced by the following quotation:

Results Data were taken from the two sources: (a) the Feedback questionnaire and (b) Focus Group. Due to considerable overlap in the themes identified, the authors decided to combine the qualitative data and report on it as a whole. The similarity between the two data sets also reflects the role of the initial feedback questionnaire in shaping the focus group discussion.

Thematic analysis Thematic analysis revealed one central theme; Experience of the SRB, followed by six sub-themes. The sub-themes are: Obstacles, Solutions, Being Observed, Online Synergy, Motivation, and Time as a factor. Individual themes are discussed and illustrated with participant quotations below. Experience of the SRB. Trainees reported both positive and negative accounts of their experience. Comments suggested that the discussion forum was a beneficial addition to the SP/SR self-guided workbook previously utilised in the programme. For example: Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society

“I would have preferred it to be anonymous, ah not that I was particularly concerned that I might be revealing things about myself but more that I think it would have just, I wouldn’t have had to think so much about how I wrote things” (trainee four) The comment above indicates the observable nature of the SRB resulted in participant four spending more time thinking about self-reflective entries. This was a view shared by a number of participants, for example: “I think with just actually doing it on the blog, and knowing that other people were going to read it, made me sort of think a little bit harder” (trainee six) It is not clear from these results if ”thinking harder” and “taking more time” relates primarily to trainees spending more time thinking about their presentation of ideas and an increased attentiveness to language, or if it also reflects an increase in the time spent reflecting on the content of their self-reflective entries. 235


Online synergy. The theme online synergy is used to refer to the interaction of participants and the effects of this interaction. The course leaders initially expected that online trainee interaction would be a facilitative factor. Lack of peer dialogue and feedback from trainees confirmed that limited interaction occurred. Trainees discussed the reasons behind this and also suggested ways of increasing interaction. “But I mean there wasn’t much dialogue going on there was only a few people that dialogued with each other” (trainee six) Despite encouragement provided by teaching staff, very few trainees commented on each other’s posts. Whether this was because of limited time available; the nature of the reflections being difficult to comment on; concern not to judge each other; or as suggested by this individual, a difficulty that is associated with the online format: “I wonder whether sometimes dialoguing on email can be a bit difficult as well.” (trainee six) When trainees were asked what would make communication on the blog easier, a number of ideas were generated, for example: “so you could build in a component of asking people to comment on somebody else’s blog, you could build that into the compulsory component so that you got that side of it going.” (trainee three) Time as a factor. All of the trainees in the focus group identified that time constraints limited the dialogue that occurred. Completing their own SRB entries was time consuming, preventing them from further blogging with peers. “I found that sometimes it’s hard to comment on each other, because I don’t have time to read it,” (trainee five) Time as a factor featured throughout student’s comments. Trainees reported the length of time it took to complete the SRB was greater than the time allocated within the course. Illustrations of this are as follows: “this is a personal opinion about the blog is that it was too much in one week, along with everything else we had to do, with the clients we working with, getting all the work done for that and spending a lot time on client work, to then spend an hour and a half sometimes longer and do 3, 3, reflections. You know you have the SP exercises and then the SR exercises, um, it was a lot of work,” (trainee three) Following each post to the blog, all trainees were sent an email advising that a new entry had been made. This was set up to encourage interaction and participation; however, the comment below suggests the number of alert emails were experienced as excessive: “There was quite a few blogs, weren’t there (others agree, yeah, hmmm), you know I was getting LOTS of emails around that time [laughs] of sort of blog entries” (trainee six) 236


Motivation. Trainees were able to view all posts and so they were aware who had completed each exercise and when it had been completed. Data reflected that the shared visibility of the online blog played a role in motivating trainees to complete their own reflections. This was expressed as follows: “I guess the fact that I did have to blog my reflections on-line motivated me to complete the exercises” (trainees four) Although SP/SR was considered a compulsory course requirement, only two out of the nine trainees completed the blog within the given timeframe. The limited number of trainees adhering to the timeline and the comments provided indicate that a number had difficulty with their motivation to complete. An example of this is as follows: “I think that there is some kind of issues when it comes to just university study itself, in that when you are a student, you quite often fall into that frame of mind, when you are just trying to get things done. . . . And so it kind of becomes a thing where the sort of compulsory part of the course, so I’ve got to do um and I’ll just get that done and that will be finished and then I can move onto other things I’ve got to do in life.” (trainee three) As indicated by previous researchers (Bennett-Levy & Lee, 2014; Farrand et al., 2010), engagement in the SP/SR process is thought to be integral to trainees completing quality selfreflective work. This participant commented on the difficulties of fostering engagement within a compulsory course requirement: “it’s difficult to facilitate more engagement in this process because it is supposed to be for people who want to self-reflect and yet when its linked into course requirements and you’ve got to do it and its part of the course, people will just end up as seeing it as just that,” (trainee three) Other trainees expressed that the compulsory nature of the activity was necessary to promote participation. For example: “The compulsory element is probably good because if it had of been voluntary I don’t know how motivated I would have been at the beginning to really get into it” (trainee six) Obstacles and solutions. Obstacles and solutions are discussed together; often when a difficulty was raised the discussion naturally turned to potential solutions. In reference to the preceding section on trainee’s motivation to complete, three out of the four trainees involved in the focus group indicated that they would have benefited from marks being allocated to the SP/SR work. As noted by trainee four: “It has taken us a really large amount of our time and it would be worth having some kind of um marks attached to it at least um contributing some way to your marks over the course of the year as we have spent a lot of time on it” Trainees also commented on the difficulty surrounding the allocation of marks to such personal work: Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society


“just for doing it yeah, but they couldn’t really mark it points because it is so personal” (trainee three) Overall, trainees reported that the blog was “pretty easy” to use. However, a couple of specific difficulties were raised including misinterpreting instructions and some technical difficulties. On the whole, comments reflected very few technical problems: “I have rudimentary computer skills only and I could use it so it must be fairly easy to use” (trainee six) In relation to the difficulty, trainees expressed completing the workload within the given timeframe; some felt that reducing the number of blog postings to two per week would address this issue: “I actually thought that probably two would be more manageable, probably two a week. I know that that ah you know it might be problematic in that the way that B has written the workbook, the exercises go together, there seemed to go with each other but I just felt that 3 was too many.” (trainee four) As discussed above there was very little interaction on the blog. In addition to the suggestion of making dialogue a compulsory course requirement, comments also indicated that having a structure or format for interaction would help to encourage participation. Another suggestion made by trainees involved using a facilitator to prompt interaction: “Or that if there is a facilitator to look after the blog and also ask the questions and to ask or facilitate the group to discuss that question, probably that would be more useful” (trainee five)

Summary of Findings Data indicated that the interactive and shared elements to the blog were perhaps only mildly useful. Reasons for this may include that little interaction took place despite the intentions of course leaders to encourage peer dialogue. Comments highlighted that trainees were conscious of being seen as competent and at times felt vulnerable. Trainees stated they spent more time thinking about what they wanted to submit into the shared space and for some this coincided with thinking more deeply about their experience. Overall, many participants found the time requirements challenging. Data indicated that being able to see their peer’s blog entries was useful and encouraged trainees to complete their own entries. Despite only one trainee having had experience with such a blog in previous studies, trainees generally reported little or no difficulty in using the online tool.

Discussion As mentioned, previous research supports the utility of SP/SR in facilitating therapist skill acquisition for novices and moreexperienced practitioners. This paper seeks to add to this research by exploring the use of a SRB and discover what impact this may have on engagement and completion. The following discussion addresses two questions: (a) Does a SRB enhance the Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society


self-reflective experience for CBT trainees at postgraduate level? And, (b) what factors need to be considered to set up and effectively facilitate a SRB?

Does a SRB enhance the self-reflective experience for CBT trainees at postgraduate level? The results of the feedback questionnaire gave the initial indication that the majority of participants felt the online blog enhanced their self-reflective experience. This sentiment was supported by the data from the focus group; however, a number of influencing factors were identified that warrant discussion. Past research suggests a barrier to self-reflection is the misuse of allocated course time on other tasks; subsequently limiting the time available and necessary for quality reflective work (Boud & Walker, 1998). Results indicated the observable nature of blogging had the effect of increasing the time trainees took to complete the SR exercises. While some trainees referred to the SRB as bringing about a deeper level of knowing via additional time spent thinking (thinking longer), other trainees experienced this as an additional depth of thinking (thinking harder). Trainee’s comments indicate that a number experienced additional thinking as thinking more about grammar and presentation, suggesting that additional thinking was used to further consider the presentation of ideas and how they would be perceived by others. Some trainees experienced a sense of being observed by an audience, even if on the most part this audience was silent. In the blogging world, the silent audience are referred to as lurkers (Williams & Jacobs, 2004). It is thought that bloggers assume a lurking audience and a risk of rebuttal or comment, this in turn prompts increased attention to the entry being made and an increase in participants’ critical and analytical thinking skills (Oravec, 2002; Williams & Jacobs, 2004). This helps to explain the additional time trainees felt was required for the SRB. The level of critical thinking undertaken by trainees is a difficult variable to measure and would be an interesting factor to explore in future studies. Increasing the time trainees spent reflecting would potentially have the effect of increasing the quality of their reflective experience; however, it may also contribute to the difficulties trainees had in completing the task due to excessive time requirements. This is an issue that has been previously raised in the literature (Bennett-Levy & Lee, 2014; Haarhoff, 2008) and appears linked to low completion rates. The findings from this study suggest that trainees were encouraged to complete their own blog entries after seeing their peers had posted. Despite trainees not adhering to the SR timetable, all trainees eventually did complete the SRB, suggesting that there is potential for a blog to increase engagement and completion.

What factors need to be considered to set up and effectively facilitate a reflective blog? The main factors identified as impacting on the effectiveness of the SRB were anonymity, structure, role of a facilitator, assessment, time, and completion. Each of these is discussed below and considered in reference to the implications these findings have for SP/SR training providers. 237


Anonymity. The current study involved trainees’ names appearing alongside their blog entries, making them visible to their peers and teaching staff. In the context of a Weblog, it is in keeping that posts are identifiable, thereby creating an environment in which ideas can be formed, shared, and debated (Oravec, 2002). Following the blog postings of others is also thought to give students an understanding of how others’ digest and make sense of material (Oravec, 2002). Two conflicting perspectives regarding anonymity (or lack of as was the case in this study) emerged from the results. Some trainees reported the lack of anonymity to be facilitative of thinking deeper and longer about their reflective posts, the lack of anonymity likely led to trainees feeling more accountable for their comments. Other positive comments indicated trainees’ felt more motivated to complete their entries after seeing their peers had completed. This study did not clearly indicate that the lack of anonymity helped to facilitate peer interaction as was the case in Farrand et al.’s (2010) study. It was expected that revealing contributor names alongside their posts would facilitate the development of a learning community (Farrand et al., 2010) as well as help to normalise the experience for trainees (Bennett-Levy et al., 2001; Farrand et al., 2010). In contrast to this, comments suggested that the lack of anonymity resulted in trainees limiting their self-disclosure, reducing peer dialogue, and potentially creating an increased sense of vulnerability. Bennett-Levy and Lee’s (2014) research suggest that an important factor influencing engagement is participants “Feeling of Safety with the Process” (p. 48). The failure to replicate Farrand et al.’s (2010) findings in regard to shared dialogue may be related to differences in the “perceived safety” between the two groups. The original SP/SR blog was set up in the context of a low-intensity training programme, participants had no previous CBT training and met 1 day every 3 weeks for SP/SR (Farrand et al., 2010). In contrast to this, the current study was a distance education programme in which participants met just twice a year. While the lowintensity trainees in Farrand et al.’s (2010) study were asked to apply five common CBT techniques with themselves, in the current study, participants were guided through 17 SP exercises, targeted at a real identified problem. They began working with negative automatic thoughts, underlying assumptions and then core beliefs, ultimately leading to a selfconceptualisation. These differences suggest the sense of personal vulnerability would understandably be greater in the current study. Comments also indicated that peer discussion could have been increased if there was a structured way of responding to each other’s posts. Course leaders had intended for meaningful interaction that would contribute to trainees’ reflective experience. Despite these intentions, very little interaction took place, indicating that an online learning community was not successfully established. With 77% of students from Williams and Jacobs (2004) study agreeing or strongly agreeing that a blog increased meaningful intellectual interaction with peers, ways of supporting interaction certainly warrants consideration when developing a self-reflective blog. This study suggests that interaction is more likely to occur in well-structured Weblogs when it is supported by a facilitator and deemed to be a safe environment. 238


Role of a facilitator. The complex role of the teacher to facilitate reflective group work is recognised in previous literature, suggesting that a fine balance is needed between directedness and flexibility (Boud & Walker, 1998). Bennett-Levy, Thwaites, Chaddock, and Davis (2009) also emphasise the importance of regular input from a facilitator. With this in mind the course leader (also the second author) in the present study made regular comments on the blog to commend trainees who had already posted and encourage those still to post. Despite the input from teaching staff, feedback from trainees highlighted their desire for further input. Comments indicated that some felt discouraged and suggested that further facilitative input may have triggered a greater sense of group cohesiveness. On reflection, the authors identified that the course leader was in a problematic position in a dual role as a researcher and course coordinator. This was problematic in the sense that the researcher–participant relationship and concern to adhere to ethical guidelines resulted in trainees receiving more flexibility in regards to completion of the SRB than they would have under normal course conditions. Group cohesiveness and feedback from a facilitator have been identified as “influencing factors” in regard to trainees’ engagement and experience of benefit with SP/SR (Bennett-Levy & Lee, 2014). Limits on facilitation and feedback within the current study may have resulted in reduced group cohesiveness and potentially less benefit. Assessment. The relationship between the allocation of marks, allocation of a trainees’ time, and the number of trainees completing coursework appears very much interconnected. This is particularly relevant in the current training environment, in which many trainees are often fulfilling a number of responsibilities, i.e., simultaneously in the role of employee, mother/ father, student, husband, or wife. When there are many demands on one’s time, it is understandable that a type of cost–benefit analysis will take place to guide how best to apply our time and effort. In the context of coursework, trainees are often guided by the allocated number of marks for any given piece of work. Therefore, it is difficult for trainees to gauge and allocate appropriate time to activities such as SR, in which there are no marks allocated. Solutions to this are not forthcoming when one considers how difficult it is to appropriately allocate marks against the highly subjective work involved in SR (Bennett-Levy et al., 2001). The current study considered SP/SR to be a formal course requirement that took considerable resources (both time and energy), yet no marks were allocated. A number of trainees raised this as an issue; many suggested awarding a small number of hurdle marks upon completion of the SRB. Time and completion. It has been said that when it comes to SP/SR, no shortcuts are possible; effective SP/SR requires a certain allocation of time and mental space in order for it to be beneficial (Bennett-Levy et al., 2001). Previous studies have reported that the time allocated to SP/SR has frequently been underestimated (Haarhoff, 2008); this appears to have occurred again in the present study. Feedback from participants indicates that scarcity of time negatively impacts on Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society


engagement and benefit (Bennett-Levy & Lee, 2014; Bennett-Levy et al., 2009). Utilising a SRB was hoped to be a solution by providing trainees with a flexible, free, and easy to access learning environment. However, results suggest trainees’ experienced self-reflective blogging as time costly. Trainees were emailed at the time of every blog post. Given that most trainees did not complete their postings in accordance with the proposed timeline, a number made multiple SRB postings in “bulk” so as to catch up. The result being that trainees received a large number of notifications at one time, potentially leading to what Oravec (2002) described as “blogging overload” (p. 620) whereby a blogger becomes overwhelmed by the number of posts to read. This also helps to explain why very little online peer interaction occurred. Although attempts were made to manage the time commitment required by trainees, it is evident that even further thought is required in order to adequately prepare trainees for the commitment involved (in terms of both personal resources and time).

Limitations and Barriers Sample Size As is often the case with research in this field, only a small number of participants were available to take part in this project. In this instance, participation was limited to the number of trainees enrolled in the Postgraduate Diploma of CBT. There were a total of nine students enrolled to participate in the online SRB, and eight of these students completed the final post. While all participants completed the SP/SR component of the study, fewer participated in the feedback questionnaire and focus group. A number of reasons could account for this, including conflicting pressures from study, work, and family, making it difficult to allocate time to this project.

Conclusions and Future Directions Previous studies have supported the interactive component of SP/SR as having a positive influence improving both engagement and benefit. The following recommendations arising from the current study are suggested as ways to improve the interactive qualities of online SP/SR training programmes. • Discuss the question of anonymity thoroughly using the introductory workshop as a forum to fully explore the pros and cons. • Pay attention to place the SP/SR training component within the context of the overall course demands and make sure trainees have sufficient time to complete the SP/SR work. This may involve reducing some of the other course requirements. • While assessing the quality of an individual’s SR has sometimes been employed in SP/SR programmes, this can be a controversial step as self-reflection is such a personal process. A recommendation arising from this study is the middle path. We suggest allocating a mark for SP/SR completion within the coursework timeframe and a parallel incremental deduction of marks for “lateness” can be motivating and affirming for trainees. Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society


• Encourage trainee interaction via the discussion forum by providing (at least initially) a structured framework to guide online interaction. • Increase facilitator participation by scheduling regular online or face-to-face “catch ups” and troubleshooting meetings to manage difficulties. Evidence continues to accumulate regarding the potential of SP/SR as an important, if not essential part of therapist training. SP/SR is increasingly offered in flexible formats, including distance or block education programmes. An online blog has considerable value in its potential to provide an adaptable format that can be both interactive and supportive.

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Australian Psychologist 50 (2015) 232–240 © 2015 The Australian Psychological Society