FTHY610 - Live Supervision and Reflecting Team Practice 3

Year

Credit points

Campus offering

Prerequisites

FTHY609 Live Supervision and Reflecting Team Practice 2

Teaching organisation

Unit rationale, description and aim

Both psychotherapy and Family and Systemic Therapy research are increasingly identifying that disrupted attachment process are heavily involved in complex clinical presentation. Also, that apparently treatment resistant family systems are able to change but require a high level expertise in precisely delivered attachment based systemic therapy. To deliver effective Family and Systemic Therapy for complex families, students need to learn which aspects of the models, processes and practice they will need to use and how to tailor treatment to the specific family presentation. In addition, they will need to undertake live-supervised practice and deliberate extended reflection and evaluation of their practice. This unit builds on FTHY608 and FTHY609, Live Supervision and Reflecting-Team Practice 1&2 and provides students with advanced level live-supervised practice and teamwork for complex presentations. Students will learn to work with a clinical team to collaboratively assess and tailor a systemic conceptualisation to the level of family functioning, generate treatment-relevant formulations and deliver Family and Systemic Therapy. Students will learn to establish a broader balanced alliance, and manage the challenges involved in developing and delivering a coherent treatment plan. Students' reflective conversations with their clinical team will provide them with an anchor for their practice, managing boundaries, and confidentiality, and they will become fluent in using formal and informal treatment feedback, evaluation and outcome measures. In this unit students will continue to use the reflecting team process, reviewing the recording of sessions, generating and reviewing their collective learning plans, reflecting on their decision-making, evaluating the process and quality of outcomes, and discussing and assessing their emerging Family and Systemic Therapy competencies. The aim of this unit is for students to deepen their practical knowledge, develop advanced Family and Systemic Therapy and teamwork competencies, learn the clinical application of case-based research practices and refine the quality of clinical decision-making.

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 - Apply attachment-based family and systemic research-informed treatments for complex family presentations, including developing generative teamwork and complex balanced alliance (GA1, GA3, GA5, GA7, GA8, GA9)

LO2 - Systematically collect, analyse, evaluate and report clinical decision-making in a sequence of sessions of Family and Systemic Therapy treatment (GA3, GA4, GA5, GA8)

LO3 - Conduct an in-depth analysis and evaluation of In-the-moment clinical decision-making in a pivotal Family and Systemic Therapy session (GA4, GA5)

Graduate attributes

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

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 

GA9 - demonstrate effective communication in oral and written English language and visual media 

Content

Topics will include: 

• Supervision of complex family systems in real-time or with participants' own recorded session and a reflecting team  
• Teamwork and balanced alliance 
• Clinical application of Case-based research practices 
• Pragmatic case studies  
• In-depth analysis and evaluation of clinical decision-making in-the-moment   
• How to refine the quality of one's practice over a sequence of sessions   

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 and supervisory format that is designed to be of benefit to both clients and therapists. As a result of the reflective process and discussion of both the clients’ experience and the therapist’s practices, new understanding emerges and provides students with advanced level live supervised practice. This unit is delivered concurrently with FTHY608 Systemic Attachment Processes & Neuroscience, which provides students with the systemic attachment and neuroscience frameworks and a descriptive language to generate systemic conceptualisation and useful formulations. This unit involves 35 hours of reflecting-team and clinical teamwork supervised by senior supervisors, delivered in an intensive mode of 2-3 day workshops. Students and their clinical 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 record, analyse and evaluate therapy sessions, identify in-the-moment decision-making processes and focus on generative and challenging moments. Students and the team will discuss and reflect on challenges they faced with a particular client system and plan the subsequent sessions.   

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. 

Task 1: Record and review live supervision and feedback from clinical work, Hurdle 

Recording live supervision and feedback of clinical work is an essential task which students will use in Tasks 2 & 3. The act of recording and reviewing their clinical work and subsequent feedback allows students to learn to overcome the confronting and difficult feelings that emerge when we view ourselves and free themselves to be more attentive to the precise details of the process in the session. This task allows students to learn to become attentive, curious and engaged in the fine detail of what transpires in the process of therapy, and discover that there are multiple layers of process occurring in the session, many of which students were not aware of while conducting the session. Students can identify and reflect on the subtle and pivotal moments, the emotional reactions and experiences of the members of the family, and learn about their and their own automatic responses in these moments. Such moments often pass quickly, and while we may sense something has happened they take deliberate review and practice to notice and utilize in therapy sessions. Noticing and recognising such moments in retrospect, is the beginning of the learning process and alerts students to the conversations which evoked them and the importance they had in the unfolding experiences. In subsequent sessions students can refer back to these experiences by recording, reviewing and reflecting on these moments, so that they can become more skilled in deliberately evoking and/or utilizing them when they occur. Reviewing sessions also develops students' capacity to manage their emotional reactions and improve flexibility, deliberately improve their emotional self-regulation, and develop their clinical decision-making. The process of recording and reviewing contributes to improving students' cognitive-relational functioning, developing their capacity to manage their attentional resources 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 and awareness of their unique personal knowledge, capacity to share and ability to enact their expertise in collaborative engagement in systemic process. This task has been found to facilitate the 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:  In-depth session analysis (2000 words), Pass/Fail

This in-depth analysis requires students to take themselves back, immerse themselves into pivotal moments in the session and analyse their in-the-moment experience, and subsequent observation about the way they managed that moment. Reflective analysis of key moments allows students to mentally-rehearse other options and or acknowledge moments of sound decision making, further integrating these segments with post-session reflection from clients, peers, supervisor and if appropriate, formal outcome measures. The act of sequencing these in-the-moment observations into a coherent in-depth written narrative contributes to the quality and depth of the learning experience, and builds procedural knowledge and clinical confidence. The task becomes a profound learning experience and facilitates students' development as a researcher-practitioner family and systemic therapist. 

Task 3: Clinical review and evaluation of a sequence of therapy session using case-study method (2000 words), Pass/Fail

The case-study research method provides students with pragmatic and accessible guidelines on conducting structured and systematic research within the clinical role, in a way that significantly benefits the clients. It is valid tool for thoughtfully applying well-reasoned and ethically sound interventions and systematically investigating the quality of outcome. This task facilitates the development of both the Family and Systemic Therapy competencies, and investigative and analytic skills of a practitioner-researcher family therapist. It is well established that conducting case-based research with one's own cases develops students as both competent research-informed practitioners and practitioner-researchers. It provides them with a methodology to grow in Family and Systemic Therapy competencies and contribute to the body of knowledge on delivering effective family and systemic therapy.   

Overview of assessments

Representative texts and references

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

Carr, A. (2012). Family therapy: Concepts, process and practice, Wiley-Blackwell.

Crittenden, P., Dallos, R., Landini, A., & Kozlowska, K. (2014). Attachment and family therapy, Mcgraw-Hill Education & Open University Press

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.

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

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

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

McLeod, J. (2012). Case study research, Sage.

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