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, Family and Systemic Therapy 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 Family and Systemic Therapy for complex families, students need to tailor treatment to the specific family presentation, and undertake live-supervised practice and deliberate extended reflection and evaluation of their clinical work. This unit builds on FTHY610 Live Supervision and & Reflecting Team Practice 3 and provides students with advanced level trauma focused live-supervised practice and teamwork with complex presentations. Students will collaboratively assess and tailor systemic conceptualisations to the level of family functioning, generate treatment-relevant formulations and deliver Family and Systemic Therapy. Students will learn to establish a complex and fluid balanced alliance, and manage the challenges involved modifying their treatment plan to meet the unfolding crises. Students' reflective conversations with their clinical team will provide them with an anchor for their practice, managing boundaries and confidentiality, and assist them in becoming fluent in using formal and informal treatment feedback, evaluation and outcome measures. Students and their clinical team will review the recording of sessions, generate and review their collective learning plans, reflect on their decision-making, evaluate the process and quality of outcomes, and discuss and assess their emerging Family and Systemic Therapy competencies. The aim of this unit is to continue to use the reflecting team process to deepen your 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 your 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 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 Family and Systemic Therapy treatment (GA3, GA4, GA5, GA6)

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

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. 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 FTHY610 Transgenerational Loss, Trauma & Mental Health in Relational Systems, which provides students 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. Students and their clinical team are supported and guided in identifying the 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 their 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. 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 of which they were not aware 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. Noticing and recognising such moments in retrospect, alerts students to the conversations that evoked them and the importance they had in the unfolding experiences. Reviewing a session develops students' capacity to manage their emotional reactions and improve flexibility, deliberately improve their emotional self-regulation, and develop clinical decision-making. This process improves 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, along with their capacity to share and enact their expertise in collaborative engagement in the 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 (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, 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 procedural knowledge and clinical confidence. The task becomes a profound learning experience and facilitates students development as researcher-practitioner family and systemic therapists. 

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 a clinical role, in a way that significantly benefits clients. It is a 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 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 students 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.

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

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

Cantwell, P., & Holmes, S. (2004). 'Cumulative process', Journal of Systemic Therapies, 15, 123-1293

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.

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.

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.

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.