FTHY609 - Live Supervision and Reflecting Team Practice 2

Year

Credit points

Campus offering

Prerequisites

FTHY608 Live Supervision and Reflecting Team Practice 1

Teaching organisation

Unit rationale, description and aim

Psychotherapy research is increasingly demonstrating that family and systemic therapy delivered thoughtfully and precisely is a highly effective and enduring means of generating change. To deliver Family and Systemic Therapy and effectively utilise the complex array of models, processes and practice students will need to undertake live-supervised practice and deliberate extended reflection and evaluation of their practice. This unit builds on FTHY605 Live Supervision and Reflective-Team Practice 1, with students re-establishing their reflecting teams and learn to distinguish between complex and straightforward presentations, develop more detailed assessments of family functioning, and systemically conceptualise and generate treatment-relevant formulations. Students will learn to establish a balanced alliance with highly-conflicted relational systems, develop an agreed plan of treatment and conduct a sequence of session with an embedded feedback and review process. Students will learn to focus on ethics throughout their Family and Systemic Therapy practices; managing secrets, privacy and confidentiality, and they will become fluent in using formal and informal treatment feedback and outcome measures. Students and their team will generate and review students' learning plans, and meet to review the recording of sessions, reflect on their decision-making, evaluate the process and quality of outcomes, and discuss their emerging Family and Systemic Therapy competencies. The aim of this unit is to provide students with higher level live supervised practice while continuing to use the reflecting team process in order to further develop students' practical knowledge, core Family and Systemic Therapy competencies and clinical decision-making with more complex 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 the delivery of Family and Systemic Therapy reflecting team session, evaluation of the quality of the balanced alliance, the monitoring micro-change in systemic dynamics in the room and between sessions (GA4, GA5, GA8)

LO2 - Reflect on and evaluate the quality of their comments to the family while they are in the reflecting-team (GA1, GA5, GA8)

LO3 - Evaluate their current Family and Systemic Therapy competencies and identify their specific challenges and the competencies they wish to learn (GA4, GA5, GA7)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

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' own recorded session, and a reflecting team process.
• Advanced reflection & self-reflection and open dialogue
• Focused generative feedback to clients and colleagues
• Application of feedback & outcome measures
• Monitoring micro and macro changes 
• Effectiveness in clinical work with complex client systems

Learning and teaching strategy and rationale

In this unit, a supervisor-guided reflecting-team of no more than 6 members is re-established. The reflecting team is a well-established and effective clinical supervisory format that is designed to be of benefit to both clients and therapists. Because of the reflective process and discussion of both the clients’ experience and the therapist’s practices, new understanding emerges and provides students with higher level live supervised practice. This unit builds on FTY605 Live Supervision and Reflective-Team Practice 1 and is delivered concurrently with FTHY606 Research informed frameworks of Family & Systemic Therapy, which provides the research informed systemic constructs and descriptive language to generate systemic conceptualisation and useful formulations. This unit involves 35 hours of reflecting-team supervised practice, delivered in an intensive mode of 2-3 day workshops. Students and their reflecting team are supported and guided in identifying their process of acquiring and integrating Family and Systemic Therapy competencies and in using research-informed conceptual frameworks. The reflecting team process includes detailed feedback to students when they are the therapist, and feedback to their reflecting team. Students and their team will review in detail the recorded session, identify generative moments and the challenges the student and their team faced with that 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 assessment tasks focus on facilitating each student's individual development as a therapist.

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 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 students' 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 their observations and emotional responses, students develop their capacity to manage their emotional reactions and improve flexibility, manage anxiety and improve their emotional self-regulation, and thus develop their clinical decision-making. The journal keeping task contributes to improving students' cognitive-relational functioning, developing their capacity to manage 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, and their capacity to share expertise and skills in collaborative engagement in the systemic process. This task has been found to facilitate development of the complex constellation of cognitive–affective competencies which underpin 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 (3 x each 500 words; total: 1500 words), 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 therapists: 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 they are in a reflecting team for the clients: describe and evaluate how they experienced and contributed to the reflecting team process, iii) where they are in a reflecting team for the therapist: describe and evaluate their contribution to the reflective dialogue. In each review identify personally relevant moments, themes, strengths and challenges they experienced. Apply an appropriate evaluation instrument, such as The System for Observing the Therapeutic Alliance (SOFTA). The SOFTA provides research informed support to the evaluations of their 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: Major written report (3,000 words), Pass/Fail

The rationale for this assessment task is that the process requires students to look for themes emerging from their journal, as they need to do for client families. This systemic theme-recognition and reflection process is a fundamental Family and Systemic Therapy competency. Succinctly summarising and integrating these themes into a written piece of this length, is a cognitive-affective discipline and generates growth in precision of expression, thoughtful selection of what students wish to say and how they say it. This consequently improves their self-awareness and self-reflection on core themes that they find in their journal.  These fundamental competencies need deliberate extended practice and are known to contribute to the quality of the therapeutic alliance and effectiveness of Family and Systemic Therapy practice.

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

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 proactice, 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.

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

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.