Background and Method: The experiences of 454 psychotherapy trainees when providing therapy to patients were surveyed in a multinational sample largely from European countries, as part of the collaborative SPRISTAD study, using established measures of trainees' Healing Involvement (HI) and Stressful Involvement (SI).

Results: The results of cross-sectional analyses included the delineation of four differential patterns of therapeutic work involvement showing approximately half the trainees experienced an Effective Practice (high HI, low SI) while the other half experienced either a Challenging Practice (high HI, high SI), a Disengaged Practice (low HI, low SI) or a Distressing Practice (low HI, high SI).

Discussion: Strong-to-moderate correlations were found between involvement styles and trainees' individual personal and professional characteristics, and among training programme and workplace situational conditions, and their possible applications to candidate selection and training practices were discussed. A strong association was seen between HI and SI qualities of trainees' therapeutic work and their positive or negative experiences of current professional development. Implications for training and hypotheses for future longitudinal studies were proposed based on the results.