{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:43:53Z","timestamp":1790952233818,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Novice therapists often experience a complex interplay of self-doubt, emotional strain, and professional uncertainty as they transition from training to independent clinical practice. This study explored the lived experiences of novice cognitive behavioral therapy (CBT) therapists, focusing on the challenges of early practice and the strategies employed to support regulation and growth. Seven early-career CBT therapists participated in semi-structured interviews, and data were analyzed using Interpretative Phenomenological Analysis (IPA). Two overarching themes were identified: professional identity challenges and self-beliefs, and strategies for emotional regulation and continuous development. Participants reported difficulties managing anxiety, boundary-setting, and integrating their professional and personal selves, particularly when working with complex presentations such as grief, self-harm, and personality disorders. At the same time, supervision, personal therapy, peer and family support, and ongoing professional development were seen as crucial in building resilience and sustaining competence. The findings suggest that training and professional structures should place greater emphasis on reflective practice, boundary management, and preparation for emotionally charged cases, while framing supervision as both a clinical and emotional resource. By highlighting the perspectives of novice therapists, the study underscores the importance of supportive systems in fostering resilience and sustainable professional growth.<\/jats:p>","DOI":"10.3390\/bs15111504","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:09:47Z","timestamp":1762358987000},"page":"1504","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["From Doubt to Development: Professional Journeys of Novice CBT Therapists"],"prefix":"10.3390","volume":"15","author":[{"given":"Aikaterini","family":"Tsamalidou","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Derby, Derby DE22 3AW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9678-9928","authenticated-orcid":false,"given":"Panagiota","family":"Tragantzopoulou","sequence":"additional","affiliation":[{"name":"School of Social Sciences, University of Westminster, London W1B 2UW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","unstructured":"Beatty, E. (2012). A study of motivations amongst contemporary trainee counsellors for pursuing a career in psychotherapy. [Master\u2019s thesis, Dublin Business School]. Available online: http:\/\/esource.dbs.ie\/handle\/10788\/830."},{"key":"ref_2","unstructured":"Beck, J. S. (1995). Cognitive therapy: Basics and beyond, Guilford Press."},{"key":"ref_3","first-page":"1","article-title":"Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective","volume":"17","author":"Beidas","year":"2010","journal-title":"Clinical Psychology: Science and Practice"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1017\/S1352465805002420","article-title":"Therapist skills: A cognitive model of their acquisition and refinement","volume":"34","year":"2006","journal-title":"Behavioural and Cognitive Psychotherapy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/da.22027","article-title":"CBT competence in novice therapists improves anxiety outcomes","volume":"30","author":"Brown","year":"2013","journal-title":"Depression and Anxiety"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1037\/int0000151","article-title":"Impacts of challenging life experiences on professional development in graduate trainees","volume":"29","author":"Choudhury","year":"2019","journal-title":"Journal of Psychotherapy Integration"},{"key":"ref_7","unstructured":"Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches, Sage. [4th ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1177\/070674371305800702","article-title":"A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments","volume":"58","author":"Cuijpers","year":"2013","journal-title":"The Canadian Journal of Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"David, D., Cristea, I., and Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9.","DOI":"10.3389\/fpsyt.2018.00004"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Demirtzidou, M., and Tragantzopoulou, P. (2025). Mitigating burnout: A qualitative exploration of clinical supervision\u2019s impact on novice psychotherapists. European Journal of Psychotherapy & Counselling, 1\u201317.","DOI":"10.1080\/13642537.2024.2438924"},{"key":"ref_11","unstructured":"Denzin, N. K., and Lincoln, Y. S. (2011). The SAGE handbook of qualitative research, Sage. [4th ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1375\/bech.28.1.17","article-title":"The relationship between perfectionism, stress and burnout in clinical psychologists","volume":"28","author":"Egan","year":"2011","journal-title":"Behaviour Change"},{"key":"ref_13","first-page":"e12330","article-title":"Therapist training in evidence-based interventions for mental health: A systematic review of training approaches and outcomes","volume":"27","author":"Frank","year":"2020","journal-title":"Clinical Psychology: Science and Practice"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cpr.2015.01.006","article-title":"How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies","volume":"37","author":"Gu","year":"2015","journal-title":"Clinical Psychology Review"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e37763","DOI":"10.1016\/j.heliyon.2024.e37763","article-title":"From theory to practice: Revealing the real-world impact of cognitive behavioral therapy in psychological disorders through a dynamic bibliometric and survey study","volume":"10","author":"Almubaddel","year":"2024","journal-title":"Heliyon"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"102266","DOI":"10.1016\/j.cpr.2023.102266","article-title":"Systematic review of training in cognitive-behavioral therapy: Summarizing effects, costs and techniques","volume":"101","author":"Henrich","year":"2023","journal-title":"Clinical Psychology Review"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.cpr.2010.02.005","article-title":"The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations","volume":"30","author":"Herschell","year":"2010","journal-title":"Clinical Psychology Review"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10608-012-9476-1","article-title":"The efficacy of cognitive behavioral therapy: A review of meta-analyses","volume":"36","author":"Hofmann","year":"2012","journal-title":"Cognitive Therapy and Research"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1159\/000433555","article-title":"What do psychotherapists do? A systematic review and meta-regression of surveys","volume":"84","author":"Knapp","year":"2015","journal-title":"Psychotherapy and Psychosomatics"},{"key":"ref_20","unstructured":"Kottler, J. A., and Shepard, D. S. (2015). Introduction to counseling: Voices from the field, Cengage Learning."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1017\/S1754470X1800003X","article-title":"How beginning cognitive behavioural therapists develop professional confidence","volume":"11","author":"Maruniakova","year":"2018","journal-title":"The Cognitive Behaviour Therapist"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1017\/S1754470X16000246","article-title":"Training novice clinical psychologist trainees to implement effective CBT for anxiety disorders: Training model and clinic outcomes","volume":"9","author":"Watson","year":"2016","journal-title":"The Cognitive Behaviour Therapist"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Paunov, T., Weck, F., and K\u00fchne, F. (2025). \u201cnow we can think about it together\u201d\u2014A thematic analysis of what characterizes (in)effective supervision sessions for novice CBT supervisees. Psychotherapy Research, 1\u201313.","DOI":"10.1080\/10503307.2025.2569042"},{"key":"ref_24","first-page":"722","article-title":"Therapist self-awareness and perception of actual performance: The effects of listening to one recorded session","volume":"27","author":"Pereira","year":"2024","journal-title":"Research in Psychotherapy"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/jcad.12193","article-title":"Emotion regulation for counselors","volume":"96","author":"Prikhidko","year":"2018","journal-title":"Journal of Counseling & Development"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.cpr.2010.03.004","article-title":"Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance","volume":"30","author":"Rakovshik","year":"2010","journal-title":"Clinical Psychology Review"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/03069880701716208","article-title":"Training to be a volunteer rape crisis counsellor: A qualitative study of women\u2019s experience","volume":"36","author":"Rath","year":"2008","journal-title":"British Journal of Guidance & Counselling"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/10503307.2015.1065354","article-title":"How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists\u2019 experiences","volume":"26","author":"Moltu","year":"2016","journal-title":"Psychotherapy Research"},{"key":"ref_29","unstructured":"Ritchie, J., and Lewis, J. (2003). Qualitative research practice: A guide for social science students and researchers, Sage."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/capr.12198","article-title":"The professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice","volume":"19","author":"Orlinsky","year":"2019","journal-title":"Counseling and Psychotherapy Research"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Schaffrath, J., Bommer, J., Schwartz, B., Lutz, W., and Deisenhofer, A. K. (2024). Where it all begins: Predicting initial therapeutic skills before clinical training in cognitive behavior therapy. PLoS ONE, 19, (2).","DOI":"10.1371\/journal.pone.0294183"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/089484530303000103","article-title":"Struggles of the novice counselor and therapist","volume":"30","author":"Skovholt","year":"2003","journal-title":"Journal of Career Development"},{"key":"ref_33","unstructured":"Smith, J. A., Flowers, P., and Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research, Sage."},{"key":"ref_34","unstructured":"Stoltenberg, C. D., and McNeill, B. W. (2009). IDM supervision: An integrative developmental model for supervising counselors and therapists, Routledge."},{"key":"ref_35","first-page":"105","article-title":"Feelings of incompetence in novice therapists: Consequences, coping, and correctives","volume":"43","author":"Gazzola","year":"2009","journal-title":"Canadian Journal of Counselling and Psychotherapy"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"19","DOI":"10.26758\/10.1.3","article-title":"Eating disorders and body image disturbance among males and females: From the perspective of six therapists with different therapeutic orientations","volume":"10","author":"Tragantzopoulou","year":"2020","journal-title":"Anthropological Research Studies"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1080\/13642537.2023.2278088","article-title":"\u201cYou feel that you are stepping into a different world\u201d: Vulnerability and biases in the treatment of anorexia nervosa","volume":"25","author":"Tragantzopoulou","year":"2023","journal-title":"European Journal of Psychotherapy & Counselling"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Tragantzopoulou, P., Giannouli, V., Filippou, A., and Demirtzidou, M. (2024). Burnout and coping strategies in integrative psychotherapists: Findings from qualitative interviews. Healthcare, 12, (18).","DOI":"10.3390\/healthcare12181820"},{"key":"ref_39","unstructured":"Tran, Q. D., and Henriksen, H. (2015). Transitioning from academic to clinical practice. VISTAS Online, American Counseling Association. Available online: https:\/\/manifold.counseling.org\/read\/transitioning-from-academic-to-clinical-practice\/section\/0f9ff19d-2906-400e-bd85-47a541c4bc96."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5014\/ajot.55.1.19","article-title":"From student to therapist: Exploring the first year of practice","volume":"55","author":"Tryssenaar","year":"2001","journal-title":"American Journal of Occupational Therapy"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3","DOI":"10.53841\/bpscpf.1997.1.108.3","article-title":"Standards for research projects and theses involving qualitative methods: Suggested guidelines for trainees and courses","volume":"108","author":"Turpin","year":"1997","journal-title":"Clinical Psychology Forum"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"85","DOI":"10.12740\/PT\/30476","article-title":"Novice therapists\u2019 difficulties: A literature review","volume":"1","author":"Zielinska","year":"2015","journal-title":"Psychoterapia"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/11\/1504\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:29:28Z","timestamp":1762360168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/11\/1504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["bs15111504"],"URL":"https:\/\/doi.org\/10.3390\/bs15111504","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}