FTHY608 - Live Supervision and Reflecting Team Practice 1

Year

Credit points

Campus offering

Prerequisites

FTHY603 Practices and Processes of Family and Systemic Therapy 2

Teaching organisation

Unit rationale, description and aim

Family and systemic therapists work with the highly complex matrix of family relationships and the interaction that these relationships generate, including the complex array of emotions, behaviours and beliefs. Consequently, theories and models of practice that are supported by research have a highly significant role in guiding clinical decision-making, and combined with precisely delivered conversational-practices and intervention, generate change. Psychotherapy research is increasingly demonstrating that family and systemic therapy delivered thoughtfully and precisely, is a highly effective and enduring means of generating change in the treatment of individuals, dyads, couples, families and other relational systems. To deliver Family and Systemic Therapy and effectively utilise the complex array of models, processes and practice students will need to undertake a sequence of live-supervised practice and reflection-on-practice. This unit builds on FTHY602 & FTHY603 Practices and Processes of Family and Systemic Therapy 1&2, and provides students with an introduction to live supervised practice. This uses the reflecting team process which is a clinical supervisory format that is designed to be of benefit to both clients and therapists, enabling reflection and discussion of both the clients’ experience and the therapist’s practice. In this unit students will establish a reflecting teams and learn the basic principles of inviting clients to a Family and Systemic Therapy session, forming a balanced alliance, as well as conducting a first and subsequent sessions. Students will learn the ethics of Family and Systemic Therapy practices, including the ethics of balancing the clients’ rights to privacy and confidentiality with the benefits of transparency and collaboration. Students and their teams will generate systemic conceptualisation and formulations to guide the delivery of the treatment process. Students will also become familiar with the use of formal and informal treatment feedback and outcome measures. Students and their team will meet to review the recording of sessions, reflect on their decision-making, and evaluate the process and quality of outcomes and emerging Family and Systemic Therapy competencies. The aim of this unit is to develop students' practical knowledge, core Family and Systemic Therapy competencies and clinical decision-making, with specific clinical presentations.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Describe and reflect on the precision of delivery of a Family and Systemic Therapy reflecting team session, the development of the balanced alliance, the use of specific language and interventive interviewing methods, in the sessions (GA3, GA4, GA5, GA8)

LO2 - Reflect on and evaluate the performance of the reflecting-team in the session, and the quality of the contributions (GA4, GA5, GA7, GA8)

LO3 - Evaluate their current Family and Systemic Therapy competencies and identify their challenges and learning goals (GA4, GA5, GA7)

Graduate attributes

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

Content

Topics will include:

• Supervision in real-time or with participants’ recorded session using a reflecting-team process.
• Reflection and self-reflection: principles & clinical practice
• Providing generative feedback to clients and colleagues
• Clinical decision-making
• Application of feedback & outcome measures
• Monitoring micro & macro changes
• Assessment and the recognition of the differences between straightforward and complex client systems

Learning and teaching strategy and rationale

In this unit, a supervisor-guided reflecting team of no more than 6 members is established. The reflecting team delivers family and systemic therapy to families and also introduces students to live supervised practice. This unit builds on students' experiential learning about systemic process, practices and Family and Systemic Therapy competencies in FTY602 and FTHY 603 Practices and Processes of Family and Systemic Therapy 1&2. The unit involves 35 hours of reflecting-team supervised practice, delivered in the intensive mode of 2-3 day workshops. It is delivered concurrently with FTHY604 Research Informed Frameworks of Family & Systemic Therapy 1 which provides the research informed systemic constructs and descriptive language to generate systemic formulations. Students and their reflecting team are supported and guided by the supervisor in the entire process of conducting Family and Systemic Therapy with their client(s), and in identifying students' acquisition and integration of Family and Systemic Therapy competencies and development in using research-informed conceptual frameworks. The reflecting team process includes providing students with detailed feedback when they are the therapist, together with feedback to their reflecting team. The students and their teams will review in detail the recorded session, identify generative moments and the challenges they and their team faced with this particular client system. After each client session when students are the therapist, they will write a reflective review of their session identifying the competencies they are developing and the challenges they face. 

Assessment strategy and rationale

The three assessment tasks used in this unit assist students to achieve the unit learning outcomes and develop the associated graduate attributes. All three tasks focus on facilitating the individual development of students as therapists.

Task 1: Journal Keeping: Personal-Professional Journal, Hurdle

The Journal is an essential and comprehensive record of students' thoughts and experiences which they will use in Assessment Tasks 2 & 3. Students need to make this journal an emotionally honest and safe personal recording of their reflections, self-reflections, ideas, feelings, and emotional responses which emerge in the course of the interaction in the reflecting-team or while viewing a video recording of a family session. This journal builds the capacity for generative and precise reflection and self-reflection as an acquired tertiary skill. By writing and discussing with the lecturers, supervisors and reflecting-team students' observations and emotional responses, they develop their capacity to manage their emotional reactions and improve flexibility and emotional self-regulation, thus developing their clinical decision-making. The journal keeping task contributes to improving students' cognitive-relational functioning, developing their capacity to manage their attentional and memory process, so that they can notice and recall sequences of interaction and place their attention on important relational episodes. This task also builds students' confidence in their unique personal knowledge, capacity to share their expertise and skills in collaborative engagement in systemic process. This task has been found to facilitate development of the complex constellation of cognitive–affective competencies which under-pin development of automaticity of therapeutic responses, and sound clinical decision-making in the heat of the moment.

Task 2: Folio of clinical reviews and evaluation of recorded reflecting team session, Pass/Fail

The task of preparing a folio of 3 clinical reviews and evaluations emerging from live reflecting team sessions: i) where students are the therapist: succinctly describe and evaluate specific aspects of their process of conducting the therapy and then after watching the recording, describe, reflect on and evaluate what they notice about their own clinical work, ii) where students are in a reflecting team for the clients: describe and evaluate how they experienced and contributed to the reflecting team process, iii) where students are in a reflecting team for the therapist: describe and evaluate their contribution to the reflective dialogue. In each review identify the personally relevant moments, themes, strengths and challenges that were experienced. Apply appropriate evaluation instruments, such as the System for Observing the Therapeutic Alliance (SOFTA). The SOFTA provides research informed support to evaluations of the clinical work. The rationale here is that this process, including the evaluation instruments, alerts students to the core elements of precision and quality in the delivery of Family and Systemic Therapy treatments. Each clinical review is a 500 word piece which requires students to succinctly summarise their analysis of a specific aspect of the reflecting team process and coherently report it as reflection, self-reflection and evaluation. 

Task 3: Presentation of learning from readings participation in reflecting team and live supervision, Pass/Fail

This task requires students to identify themes in their learning process and succinctly present a summary to their colleagues. This task builds a number of core Family and Systemic Theray competencies requiring meta-cognitive skills. It is very challenging to observe oneself while in-the-moment attending to the processes unfolding in the session, however it is an essential competency that family and systemic therapists need to develop. This task focuses students on and develops ‘split attention’ to both being attentive to the process in the session while attending to ‘what am I doing, how well am I doing it’ and ‘what do I do next’? This task provides students with authentic practice of these Family and Systemic Therapy competencies, and shares their observations with colleagues by describing what and how they are learning. It enriches student learning at multiple levels. The discipline of summarising the themes of the learning process and producing a coherent and succinct narrative is an analogue for systemic formulation, within the larger training group, which provides students with both additional practice and valuable feedback.

This task allows students to practice core Family and Systemic Therapy competencies and genuinely builds their confidence and generates change within themselves, and adds to the richness of learning for their colleagues. It can be directly translated to students work with families.

Overview of assessments

Representative texts and references

Alvarez, I., Herro, M., Martinez-Pamplieg, V. (2021). Measuring therapeutic alliance in individuals, family, and group therapy from a systemic perspective: Structural validity of the SOFTA-s. Family Process, 60, 302-315. https://doi:10.111/famp.12565

Anderson T. (1987). Reflecting team: Dialogue and meta-dialogue in clinical work, Family Process, 26, 415-427

Anderson, H., & Gerhart, D. Eds., (2007). Collaborative therapy: Relationships and conversations that make a difference, Routledge

Cantwell, P., & Holmes, S. (2004). 'Cumulative process', Journal of Systemic Therapies, 15, 123-129

Escudero, V., & Friedlander, M.L. (2017). Focused issues in family therapy. Therapeutic alliance with families: Empowering clients in challenging cases, Springer International Publishing. https://doi.org/10.1007/978-3-319-59369-2.

Friedlander, M.L., Escudero, V., & Heatherington, L. (2006). Therapeutic alliance in couple and family therapy: An empirically informed guide to practice, American Psychological Association. https://doi.org/10.1037/11410-000.

Friedlander, M.L., Escudero, V., Welmers-van de Poll, M.J., & Heatherington, L. (2018). Meta-analysis of the alliance-outcome relation in couple and family therapy. Psychotherapy, 55, 356-371. https://doi.org/10.1073/0022-0167.55.1.118.

Gerhart, D. (2017). Mastering competencies in family therapy: A practical approach to theory and clinical case documentation. 3rd Ed, Brooks/Cole

Gilbert, P. (2005). Compassion: Conceptualisations, research and uses in psychotherapy, Routledge. 

Holmes, S., & Cantwell, P. (1994). Social construction: A paradigm shifts for systemic therapy and training. The Australian and New Zealand Journal of Family Therapy, 15,

Lambert, M.J. (2010). Prevention of treatment failure: The use of measuring, monitoring and feedback in clinical practice, APA

Lipchik, E. (2002). Beyond technique in solution focused therapy. Guilford.

Minuchin, S., Reiter, M.D., & Borda, C. (2014). The craft of family therapy, Routledge.

Seikkula, J., & Trimble, D. (2005). Healing elements of therapeutic conversation: Dialogue as an embodiment of love, Family Process, 44, 461–475

Wenger, E., McDermott, R., & Snyder, W.M. (2002). Cultivating communities of practice, Harvard Business Review Press