Supervising the advanced trainee: A multiple therapy training model.

Abstract

Multiple therapy (two therapists with one patient) has been extensively described in the treatment literature, but its value in therapist training has not been fully realized. The development and application of a multiple therapy training model is discussed. Two case illustrations describe the impact of the arrangement on patient, therapist, and supervisor. Treatment issues and supervision issues are highlighted.

Participant Supervision: Supervisor and Supervisee Experiences of Cotherapy

“…Similarly to what others have noted (Braver et al., ), a final advantage was our experience of increased collegiality that facilitates professional development. Cotherapy positions the supervisor as a teammate inside of the therapy room, rather than a spectator with a bird's eye view, requiring an increased amount of supervisor accountability (Braver et al., ) and performance. Essentially, both parties are on the spot: the supervisee to demonstrate competence and the supervisor to accurately illustrate principles and practices discussed in supervision.…”

“…We consider the benefits of participant supervision far reaching, having the ability to inspire greatness in both by enticing supervisees to demonstrate their best work and prompting the supervisor to "illustrate well the use of principles he has been teaching" (Birchler, 1975, p. 332). Supporting what others have championed, we believe participant supervision to be an essential approach for advanced supervisees (Braver et al, 1990), helping them develop more complex and refined skills. The advantages of shared clinical experience are numerous and respond well to some of the drawbacks of case note and behind-the-mirror supervision.…”

“…Similarly, Braver et al. () described an approach characterized by the supervisee conducting a 50‐min session in which the supervisor sits quietly in the room, followed by 10 min of supervisor reflections. Related, Ron () has described a model in which the therapist, supervisor, and team of students are present in the therapy session, and the supervisee plays a dual role of both therapist and student team member.…”

“…Working with a seasoned therapist can be intimidating causing supervisees to assume a less active role in which they simply follow their supervisor's lead (Tuckman & Finkelstein, 1999) or may remain observers for fear of making visible mistakes (Waldman, 1980). Another potential pitfall is competition between supervisees and supervisors (Bernard, Babineau, & Schwartz, 1980;Braver et al, 1990) that derails the therapy process.…”

“…For instance, Bernard et al (1980) forwarded a model in which the supervisee is expected to do the majority of the interventions while the supervisor, rather than directly interact with the client, aims to help the supervisee intervene more effectively. Similarly, Braver et al (1990) described an approach characterized by the supervisee conducting a 50-min session in which the supervisor sits quietly in the room, followed by 10 min of supervisor reflections. Related, Ron (1996) has described a model in which the therapist, supervisor, and team of students are present in the therapy session, and the supervisee plays a dual role of both therapist and student team member.…”