Crisis Management During "Live" Supervision: Clinical and Instructional Matters

Abstract

In this article, we illustrate two examples of "live" supervision with marriage and family therapy trainees whose clients presented in the therapy room in immediate crisis. The case examples, one a client with suicidal thoughts and the other a parent who had struck her child, demonstrate how the university-based therapy team managed the recursive clinical and supervision processes that unfolded during the sessions. We present the case examples from the perspective of both supervisees and supervisor, discussing how our different experiences of the supervision unfolded in real time. Case discussion and reflections later in the article illustrate the need for an open, transparent, dialogical process throughout supervision. A case is made for supervisory participants to create alternative formats in which multiple supervisory voices can be heard.

“There’s Something Not Right” and “Bringing it Forward”

“…What it appears is that these practitioners fostered “opened space” for difficult dialogue in their therapy sessions, which seems similar to how supervisees have described experiences of safety and openness in supervision that allowed for difficult dialogue on sensitive topics (Charlés, Ticheli-Kallikas, et al, 2005; Hernández & Rankin, 2008; Rutter et al, 2010; Watt et al, 2009). One of the hallmarks of systemic supervision is the notion of isomorphism, with the supervisor’s goal of facilitating a supervisory process that then translates into supervisees’ therapy sessions (e.g., Koltz, Odegard, Feit, Provost, & Smith, 2012; Weir, 2009; White & Russell, 1997).…”

“…Existing research specific to the study of how therapists manage difficult situations in systemic therapy has largely employed anecdotal or illustrative case study methods to advocate for the need for open dialogic exchange in the supervisor–supervisee relationship (e.g., Charlés, Thomas, et al, 2005; Charlés, Ticheli-Kallikas et al, 2005; Heatherington, Friedlander, & Escudero, 2013; Hernández & Rankin, 2008; Rutter et al, 2010); although evidenced-based, mixed-method, case studies exist (e.g., Friedlander et al, 2013). The term “challenging” refers to the experience of negative emotional reactions (Heatherington et al, 2013) and/or the experience of “stuckness” or perceived impasse in the progress of treatment (Friedlander et al, 2013).…”

“…In fact, trends in the literature reveal a significant increase in articles on supervision/training (Feinauer, Pistorius, Erwin, & Alonzo, 2006). An emerging thread within this literature consists of describing processes involved in managing difficult clinical issues and the need for open dialogic exchange and liberating spaces between supervisee and supervisor (e.g., Charlés, Thomas, & Thornton, 2005; Charlés, Ticheli-Kallikas, Tyner, & Barber-Stephens, 2005; Hernández & Rankin, 2008; Rutter, Leech, Anderson, & Saunders, 2010). Liberating spaces refer to relational contexts characterized by safety, affirmation, and transparency that foster increased awareness of self-in-context (Hernández & Rankin, 2008).…”

Using live demonstration to prepare students for direct counselling practice

“…It should also be emphasised that, some events are unexpected and clients may fall into crisis during the demonstration. In such cases, clinical support should be available and provided (Charles, Ticheli-Kallikas, Tyner & Barber-Stephens, 2005).…”

Negotiating Life and Death, and Meanings and Values

“…1 1 See Charlés, Ticheli‐Kallikas, Tyner, and Barber‐Stephens (2005) for a case description of how differently a supervisor and supervisee experienced the performance of collaborative supervision. …”