Building Student Self-Confidence: How you can help

“I felt like a fraud, like I should know what I am doing, and like my clients looked to me as though I knew what I was doing but I didn’t feel like I knew what I was doing.” (a marriage and family therapist trainee about her first months of clinical contact, Bischoff & Barton, p. 231)

During the early stages of clinical experience, students often experience feelings of anxiety and lack of confidence in their clinical abilities. Bischoff and Barton (2002) acknowledge that clinical confidence develops over time and point out that different types of supervision are required at different stages of development. These stages may reflect not only change over the course of one placement, but gradual development of self-confidence over the course of all placements:

Ideas for the Clinical Educator:

  • Stage One: Characterized by great variability in confidence

emphasize what the student is doing well – i.e., identify specific behaviours and what is good about them; use observational data

encourage peer contact which serves to normalize students’ feelings

  • Stage Two: Emerging Confidence – no longer reactive to each situation

provide experiences for student clinicians to see their own success, particularly allowing repeat experiences (e.g., same tests, similar therapy goals) so that skills are reinforced and confidence fostered

support direction chosen by student, thus encouraging his/her decision-making and resourcefulness

  • Stage Three: Fragile Stabilization of Confidence

provide experiences for clinicians to consult with others (peers or other professionals) on cases

encourage students to reflect on their own work, identifying what was effective and coming up with ideas for improvement

What strategies do you find work well ? Let us know


Bischoff, R., and Barton, M. (2002). The pathway toward clinical self-confidence. The AmericanJournal of Family Therapy, 30:321-242.