Team Supervision

[CHRISTY STEIMER]

Hi everyone. Sorry to be so unclear in my last message.
I was trying to write quickly, but still get everything
out there.
This is how team supervision works at UMSL:
Each team is headed by a faculty member who is the
"official" supervisor for all four doctoral students on
the team. All five of us meet once every two weeks to
discuss cases, general concerns, ethical issues, etc.
The topics are usually brought up in the context of
specific cases. First years are required to be on team to
get some sense of the therapy process, supervision, and
what we'll be doing next summer and for then on after!
On alternate weeks, each team member attends individual
supervision with the supervisor. This is when they get
more focused help with cases, discuss personal issues,
etc. First years are generally not offered individual
supervision because they don't have clients.
Regarding mirroring: This means that the first year picks
a client in therapy with one of the team members and
"tracks" the therapeutic process. They attend the
therapist's individual supervision (as far as it relates
to that specific client) and are required to listen to
tapes of therapy sessions.
Victoria: Our clinic serves the local community, and it is
made clear to every new client at their intake and initial
session that the therapists are doctoral students
supervised by a licensed psychologist (faculty member).
They are told that their tapes may be used for supervision
and training purposes, and that every team member involved
in their supervision is bound by confidentiality, etc.
etc. This covers the ethical issues that initially spring
to mind, but it would be a good thing to bring up and ask
my supervisor about. I had been wondering about it myself.
Marilyn: Your suggestions were very helpful. I think
UMSL uses their Personality Assessment class to teach
beginning clinical skills - clinical interviewing, etc.
I'm in that class right now and that's what my syllabus
says. Still, do you have some titles for those individual
workbooks that you mentioned? I would like to get a sense
of what they involve before I bring it up on team. Lots
of team time is spent discussing clients, not specific
skills, since we have an intense psychotherapy and
assessment classes that are supposed to cover this ground.
Sorry for taking up so much space. I appreciate
all of your suggestions. Hope this is clearer now!
Christy Steimer

[Victoria McCoy]

Christy--Thanks for explaining more about your training process. In my
master's program I had a marriage and family therapy class on which our entire
class mirrored the professor's therapy with a husband and wife. That was an
excellent learning experience. If you get the chance to mirror another
student, it might be helpful, as an observer, to pick a theoretical perspective
different from what the therapist is using and try to conceptualize the case
from that perspective. You might keep a journal in which you note what is
working (or not working) in the therapy you observe, while also comparing and
constrasting how the different orientations might view the presumed etiology,
goals for treatment, techniques used, evaluation of change, etc. I am
currenlty doing practicum work in an inpatient eating disorders unit. My
supervisor is a psychodynamically oriented psychologist. The treatment team
for the patient that I am treating includes her cognitive behaviorally oriented
psychiatrist. It has been a wonderful experience to have the opportunity to
look at the same case from these different perspectives.

[Marilyn Geist]

> That is, with your classmates, take turns being the therapist and
> the client. Do therapy with each other. I found that when I
> described this exercise to my internship class, they thought the whole
> thing was gastly. Who in their right mind would want to violate the
> bounderies of friendship and therapy by doing psychotherapy with your
> peers? Well, we did it at U. Ottawa. And I found that it helped me
> to develop therapy skills.

I totally agree with Matt on this exercise, done many times. It is
especially helpful in a triad, with a third person giving more objective
feedback. It's important to allow as much time for feedback and
reflection as for the actual "session," (15-20 minutes each). You can
also do initial interviews, suicide threats, termination, etc., and you
can practice specific skills (empathic responses and mirroring, probing,
cognitive techniques, and so on). Even if the "client" starts by
role-playing, it tends to get real, and there needs to be an agreement
about confidentiality and containment.

I also agree on practicing doing mental status exams, both very short
ones and more detailed ones.

Will get you the references I promised.