FTHY611 - Live Supervision and Reflecting Team Practice 4

Year

Credit points

Campus offering

Prerequisites

FTHY610 Live Supervision and Reflecting Team Practice 3

Teaching organisation

Unit rationale, description and aim

Research in many domains of practice, including psychotherapy and family and systemic therapy, are identifying that loss and trauma disrupts attachment process and generates systemic adaptations which cascade, increasing tension and stress and contribute significantly to mental illness. Complex and apparently treatment resistant family systems often have multiple problems and co-morbidities. However, FST research indicates that these families are able to change but require a high level expertise in family and systemic therapy. To develop higher level expertise in deliver of effective FST for complex families you need to tailor treatment to the specific family presentation, and undertake live-supervised practice and deliberate extended reflection and evaluation of your clinical work. This unit builds on FTHY610 Live Supervision and & Reflecting Team Practice 3 and provides you with advanced level Trauma focused live-supervised practice and teamwork with complex presentations. You will continue to use the reflecting team process to deepen your practical knowledge, develop advanced FST and teamwork competencies, learn the clinical application of Case-Based research practices and refine the quality of your clinical decision-making. You will collaboratively assess and tailor systemic conceptualisations to the level of family functioning, generate treatment-relevant formulations and deliver FST. You will learn to establish a complex and fluid balanced alliance, and manage the challenges involved modifying your treatment plan to meet the unfolding crises. Your reflective conversations with your clinical team will provide you with an anchor for your practice, managing boundaries, and confidentiality, and you will become fluent in using formal and informal treatment feedback, evaluation and outcome measures. You and your clinical team will review the recording of sessions, generate and review your collective learning plans, reflect on your decision-making, evaluate the process and quality of outcomes, and discuss and assess your emerging FST competencies.

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 - Communicate knowledge and demonstrate application of Loss & trauma-based family and systemic research-informed treatments for complex family presentations with mental illness, including developing generative teamwork and complex and flexible balanced alliance,(GA3, GA5, GA8) 

LO2 - Systematically collect, analyse, evaluate and report clinical decision-making in a sequence of sessions of FST treatment, (GA3, GA4, GA5, GA6) 

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

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 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

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

Content

Topics will include: 

• Supervision of complex work in real-time or with participants recorded session, and a reflecting team 
• Session review and evaluation frameworks in working with complex relational systems  
• Clinical application of case-based research practices 
• Refine the quality of personal practice,  
• Identifying patterns of micro-change and macro-changes, first and second order changes in relational systems   
• Clinical uses of Open-Dialogue process  
• Case-study research method to refine quality of practice 

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, and because of the reflective process and discussion of both the clients’ experience and the therapist’s practices, new understanding emerge and provide you with advanced level live supervised practice. This unit is delivered concurrently with FTHY610 Transgenerational Loss, Trauma & Mental Health in Relational Systems, which provides you with the research findings and treatment frameworks addressing the systemic impact of loss, trauma and the cascade that may result in loss of mental health. 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. You and your clinical team are supported and guided in identifying your process of acquiring and integrating FST competencies and in using research-informed conceptual frameworks. The reflecting team process includes detailed feedback to you when you are the therapist, and feedback to your reflecting team. You and your team will record, analyse and evaluate therapy sessions, identify in-the-moment decision-making processes and focus on generative and challenging moments. You and the team will discuss and reflect on challenges you faced with that particular client system and plan the subsequent sessions. 

Assessment strategy and rationale

The assessment procedures used in this unit are consistent with university assessment requirements, meet the unit learning outcomes and develop graduate attributes. One assessment is a hurdle task and two assessments are assessed but ungraded tasks. Achievement of the unit objectives are determined by: 

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

Recording live supervision and feedback of your clinical work is an essential task which you will use in Tasks 2 & 3. This task allows you to learn to become attentive, curious and engaged in the fine detail of what transpires in the process of therapy, and you discover that there are multiple layers of process occurring in the session of which you were not aware while conducting the session. You 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 your automatic responses in these moments. Noticing and recognizing such moments in retrospect, alerts you to the conversations that evoked them and the importance they had in the unfolding experiences. Reviewing your session develops your capacity to manage your emotional reactions and improve flexibility, manage anxiety and deliberately improve your emotional self-regulation, and develop you clinical decision-making. This process improves your cognitive-relational functioning, developing your capacity to manage your attentional resources and memory process, so that you can notice and recall sequences of interaction and place your attention on important relational episodes. This task also builds your confidence and awareness of your unique personal knowledge, your capacity to share and enact your expertise 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: In-depth session analysis (2,000 words), Ungraded with Feedback  

This in-depth analysis requires you to take yourself back, immerse yourself into pivotal moments in the session and analyse your in-the-moment experience, and subsequent observation about the way you managed that moment. Reflective analysis of key moments allows you to mentally rehearse other options and/or acknowledge moments of sound decision making, hence 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 your procedural knowledge and clinical confidence. The task becomes a profound learning experience and facilitates your 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, Ungraded with Feedback 

The case-study research method provides you with pragmatic and accessible guidelines on conducting structured and systematic research within your clinical role, in a way that significantly benefits your 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 your FST competencies and investigative and analytic skills of a practitioner-researcher Family therapist. It is well established that conducting case-based research with your own cases develops you as both a competent research-informed practitioner and practitioner-researcher. It provides you 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, NY, Routledge. 

Anderson T. 1987. Reflecting Team: Dialogue and Meta-dialogue in clinical work, Family Process, 26, 4: 415-427. 

Carr, A. 2012, Family Therapy: Concepts, Process and Practice, NY, Wiley-Blackwell. 

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

Gerhart, D., (2014) Mastering Competencies in Family Therapy: A Practical Approach to Theory and Clinical Case Documentation 2nd Ed, Belmont, CA, Brooks/Cole. 

Holmes, S. & Cantwell, P. (1994). Social construction: A paradigm shift for systemic therapy and training. The Australian and New Zealand Journal of Family Therapy, 15(1). 

Lambert, M.J., Prevention of Treatment Failure: The use of Measuring, Monitoring and Feedback in Clinical Practice, Washington, APA.  

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

McLeod, J. (2012) Case Study Research, London, Sage. 

Seikkula, J. & Trimble, D. 2005, Healing Elements of Therapeutic Conversation: Dialogue as an Embodiment of Love, Family Process, Vol 44, December, 461–475.