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The field of counseling psychology continues to see a perpetual underutilization of mental health resources by many cultural groups, including international populations. Underutilization of services is due, in part, to psychologists’ deficiency in cultural and international competency. International education—an experiential learning technique that involves cultural contact—has been proposed as an alternative method for training students to work effectively cross-culturally. The current article examines the effects of service learning embedded in a study abroad diversity course in Singapore. The course was designed for graduate counseling psychology students as an experiential vehicle for developing cultural competency and awareness of social justice issues through direct contact with diverse groups. Qualitative data are reviewed, and implications for training, such as integration of cross-cultural and social justice issues in counseling training programs, are discussed.

Research suggests that characteristics and attitudes of the therapist may be a significant contributor to psychotherapy outcome. Researchers using both quantitative and qualitative methods have explored the characteristics of expert practitioners. This chapter provides an overview of the literature on therapist variables and master therapists, describes the validity of the peer nomination process for selecting master therapists, and explains how qualitative meta-analysis is utilized to integrate findings from various countries. Finally, the importance of obtaining an international perspective on master therapists is emphasized. Qualitative studies on the practices of expert therapists in different countries offer rich descriptive narratives for how optimal therapy works in different country and cultural contexts. More qualitative studies are needed to understand old and new constructs from different cultural perspectives.

Personal characteristics, developmental influences, and therapy practices of nine peer-nominated expert psychotherapists practicing in the diverse country of Singapore were identified using qualitative methods. Sixteen themes were organized within four categories: (1) personal characteristics (empathic, nonjudgmental, and respectful), (2) developmental influences (experience, self-awareness, humility, and self-doubt), (3) approach to practice (balance between support and challenge, flexible therapeutic stance, empowerment/strength-based approach, primacy of the therapeutic alliance, comfortable addressing spirituality, and embraces working within a multicultural context), and (4) ongoing professional growth (professional development practices, benefits of teaching/training others, and challenges to professional development in Singapore). Cross-cultural comparisons between this study and Jennings and Skovholt’s 1999 study of Minnesota expert psychotherapists found considerable overlap of themes. Implications for research and practice of psychotherapy are offered.

Responding to calls for international psychotherapy research, a qualitative meta-analysis (QMA) exploring the essential qualities of master therapists from a global perspective was conducted on seven master therapist studies from the United States, Canada, Czech Republic, Portugal, Singapore, Japan, and Korea. Based on the analysis of 111 themes, we identified the following eight meta-categories representing common strengths and characteristics among 72 master therapists from seven countries: (1) Distinctive Clinical Abilities, (2) Professional Development, (3) Relational Orientation, (4) Cognitive Complexity and Intricate Conceptualization, (5) Therapeutic Alliance, (6) Pursuit of Deep Self Knowledge and Growth, (7) Humility, and (8) Experience. The meta-categories are discussed in relation to the psychotherapy research literature on therapist factors and expertise. The Synthesis Model of Master Therapists from Around the World is introduced, and recommendations for research and training are provided.

Existing research suggests that although many master therapists’ characteristics are interculturally valid, at least some of these characteristics are culturally bound. Interviews with nine peer-nominated Czech expert psychotherapists were subjected to thematic analysis that revealed 16 themes, organized into six categories: (1) humble attitude toward mastery, clients, and colleagues; (2) relationship; (3) awareness of one’s needs, limits, and resources; (4) continuous development; (5) engagement; and (6) awareness of the complexity of psychotherapeutic work. The results are discussed in the context of cultural differences, as well as specific historical circumstances of the development of the Czech therapeutic scene. Despite the fact that master therapists’ characteristics show fundamental similarity across countries and cultures, conducting studies in diverse environments may contribute to the formulation of a rich and culturally sensitive description of what is means to be a master therapist.

Trauma is ubiquitous in our society; therefore, it is important to explore how individuals cultivate healing after traumatic experiences. Yoga may be one avenue to cultivate healing. Qualitative methods were employed to study the role yoga practice played in the healing process of those who experienced interpersonal trauma. Eleven interpersonal trauma survivors who practiced yoga regularly were identified through a criterion sampling method. Data analysis revealed that the emphasis of yoga on mind and physical body fostered numerous positive outcomes, such as spiritual growth, self-acceptance, alleviation of trauma-related symptoms, and increased feelings of self-compassion, empowerment, and serenity. Our findings suggest that yoga may be helpful to regain mental and physical health, foster wellbeing, and cultivate personal growth after interpersonal trauma.

The study of expertise has a long and textured history, and it continues to be an active area of research among researchers and practitioners interested in human performance, giftedness, and achievement. In this chapter, Skovholt, Hanson, Jennings and Grier examine the broad and complicated topic of expertise.

Qualitative research methods were used to elicit master therapists' statements regarding their use and understanding of the therapy relationship. The master therapists were identified and recruited in a previous study (Jennings & Skovholt, 1999) through a procedure used to create a sample of information-rich cases. The result of the analysis is a Model of Relationship Stances. The Safe Relationship Domain is composed of three categories of therapist actions: Responding, Collaborating, and Joining. The Challenging Relationship Domain also is composed of three categories of therapist actions: Using Self, Engaging, and Objectivity. The domains and categories are conceptualized as relationship stances utilized by the master therapists to meet individual client needs.

Skovholt, Jennings, and Mullenbach summarize and integrate data from all four qualitative studies and offer pathways to expertise taken by the ten master therapists, culminating with a portrait of the master therapist. The portrait includes central characteristics, paradoxical characteristics, eight overall themes, and a major expansion of the Cognitive, Emotional, and Relational (CER) Model of Master Therapists.

This chapter presents a study in which the authors employed Consensual Qualitative Research (CQR) methods (Hill, Thompson, & Williams,1997) to reanalyze interview data from a previous qualitative study of the personal characteristics of master therapists (Jennings & Skovholt, 1999). The purpose of the study was to better understand the ethical values of therapists considered to be “the best of the best” by their professional colleagues. Previous research has demonstrated that therapists utilize a variety of resources when making ethical decisions, including professional codes of conduct and their own values. The current study’s analysis of 10 master therapists’ interviews resulted in the identification of nine ethical values related to their clinical practice: (a) relational connection, (b) autonomy, (c) beneficence, (d) nonmaleficence, (e) competence, (f) humility, (g) professional growth, (h) openness to complexity and ambiguity, and (i) self-awareness. It is hoped that these findings will help to illuminate the ethical values that these master therapists draw upon in their work.

Personal characteristics, developmental influences, and therapy practices of nine peer-nominated expert psychotherapists practicing in the diverse country of Singapore were identified using qualitative methods. Sixteen themes were organized within four categories: (a) personal characteristics (empathic, nonjudgmental, respectful); (b) developmental influences (experience, self-awareness, humility, self-doubt); (c) approach to practice (balance between support and challenge, flexible therapeutic stance, empowerment/strength-based approach, primacy of the therapeutic alliance, comfortable addressing spirituality, embraces working within a multicultural context); and (d) ongoing professional growth (professional development practices, benefits of teaching/training others, challenges to professional development in Singapore). Cross-cultural comparisons between this study and Jennings and Skovholt's (1999) study of Minnesota expert psychotherapists found considerable overlap of themes. Implications for research and practice of psychotherapy are offered.

Qualitative research methods were used to elicit master therapists' statements regarding their use and understanding of the therapy relationship. The master therapists were identified and recruited in a previous study (Jennings & Skovholt, 1999) through a procedure used to create a sample of information-rich cases.The result of the analysis is a Model of Relationship Stances.The Safe Relationship Domain is composed of three categories of therapist actions: Responding, Collaborating, and Joining. The Challenging Relationship Domain also is composed of three categories of therapist actions: Using Self, Engaging, and Objectivity.The domains and categories are conceptualized as relationship stances utilized by the master therapists to meet individual client needs.

As one of the great inventions of the last half of the 20th century, counseling offers great hope and promise. Yet for counseling practitioners, within this hope and promise, there is confusion about how to help and what constitutes mastery and expertise. It is like being in a fog and searching for mastery. And it matters because the counselor's contribution to counseling outcome is significant. Factors in counselor mastery and expertise are explored.

The study of expertise has a long and textured history, and it continues to be an active area of research among researchers and practitioners interested in human performance, giftedness, and achievement. In this literature review, we explore the concept of expertise across disciplines to gain a better understanding of the common elements of expertise and its relevance to the counseling profession.

This study employed the Consensual Qualitative Research method (Hill, Thompson, & Williams, 1997) to reanalyze interview data from a previous qualitative study of the personal characteristics of master therapists (Jennings & Skovholt, 1999). Previous research has demonstrated that therapists utilize a variety of resources when making ethical decisions, including professional codes of conduct and their own values. The current study's analysis of 10 master therapists' interviews resulted in the identification of nine ethical values related to their clinical practice: (a) relational connection, (b) autonomy, (c) beneficence, (d) nonmaleficence, (e) competence, (f) humility, (g) professional growth, (h) openness to complexity and ambiguity, and (i) self-awareness. Conducting oneself ethically is a critical task of the competent therapist (American Psychological Association, 2002). Making the best ethical decisions can be extremely challenging for most therapists due to the multitude of complex ethical situations that arise in practice. The goal of this study is to examine the ethical values of therapists considered to be "the best of the best" by their professional colleagues. It is hoped that such an examination will help to illuminate the ethical values that these master therapists seem to draw upon in their work.

Expertise in counseling and therapy is both desirable and elusive. Increasing our knowledge about expertise in counseling and therapy enhances understanding of the role it plays in our profession. This understanding has the potential to improve the training of counselors and therapists. Yet expertise in counseling and therapy appears to be a multifaceted and dynamic concept needing further definition and description. In this article, we outline challenges faced trying to describe expertise in counseling and therapy and present research-based factors that contribute to developing expertise in counseling and therapy. Important factors include: experience, personal characteristics of the counselor and therapist, cultural competence, and comfort with ambiguity.

Cognitive, emotional, and relational characteristics among 10 peer-nominated master therapists were identified through qualitative research methods. Results suggest that master therapists (a) are voracious learners; (b) draw heavily on accumulated experiences; (c) value cognitive complexity and ambiguity; (d) are emotionally receptive; (e) are mentally healthy and mature and attend to their own emotional well-being; (f) are aware of how their emotional health impacts their work; (g) possess strong relationship skills; (h) believe in the working alliance; and (i) are experts at using their exceptional relational skills in therapy. These findings suggest that researchers studying therapist expertise may want to explore emotional and relational characteristics in addition to an almost exclusive focus on the therapist's cognitive attributes.