Supervision

As a Licensed Marriage and Family Therapist, I help therapists-in-training who are seeking MFT supervision to:

  • Receive needed supervision hours to become licensed clinicians
  • Develop their own treatment model that will guide their clinical work
  • Learn clinical competencies or interventions that will strengthen their work with couples and families
  • Guide them while they prepare to take their MFT exam and send DORA applications

Marta’s Personal Supervision Model: 5 Things to Know

In order to provide quality care to clients, therapist must have a clear understanding of their own treatment model, ways that change occurs in this model, as well as how their treatment model is implemented. Correspondingly, a supervisor must attend to their own treatment model first in order to effectively guide other therapists.  My supervision model is directly affected by my treatment model in that they are both: systemic, humanistic, experiential, and attachment focused.

1) My Personal Treatment Model

My Personal Treatment Model is systemic, humanistic, and experiential in nature. Importantly, my model is based on an attachment theory emphasizing the need for secure bonds and connection. I believe that causality is circular and that our responses are shaped by feedback loops or cycles of interactions. Whether it is a couple or a family system, each family member constructs reality based on how the other member feels, thinks, and acts. That patterned relationship between a husband and a wife, or a child and a parent, creates repeating cycles of interaction that are inherently influenced by attachment theory. If these cycles of interactions become more rigid and narrow, the relationship becomes distressed.

In my Personal Treatment Model, I help clients interrupt negative cycles of interaction and teach them more adaptive patterns. The way I do that differs from traditional, systemic approaches. Instead of focusing on power, hierarchies, or boundaries, I focus on nurturance and connection. I believe that the safer we feel, the more confident we are in reaching out to others and dealing with conflict and stress positively.

2) My Personal Supervision Model

During supervision, my supervisees, their clients, and I construct our own cycles of interactions based on our past experiences, perceptions, emotional experiences, our action tendencies, and our powerful—yet often unacknowledged—desires for reassurance and acceptance. Therefore, whether I am a therapist or a supervisor, I work hard on having a strong alliance with those with whom I work. In order for clients or supervisees to work with me effectively, they must feel safe with me. The way I build safety is by creating an egalitarian and collaborative relationship where my clients and supervisees are “experts,” not me. However, when it comes to safety or ethical issues with my clients and supervisees, I am direct and in the role of an “expert.” Also, depending on my supervisee’s clinical developmental stage, I know there are  times when a hierarchical and direct attitude is advisable. It can help my supervisees grow clinically.

3) How Does Change Happen in My Personal Treatment Model?

In my Personal Treatment Model, experience is the basis of change, and change involves new experiences and new relationship events. Also, in my Personal Treatment Model, I see emotion as a target and agent of change. Emotion is key in organizing attachment behaviors and in organizing the way the self and others are experienced in relationships. Emotional experiences and expressions are very important because they guide and give information about meaning to perceptions and motives behind actions.

I believe in second order change. Helping clients with their first order change is not sufficient or lasting. Second order change happens when clients are able to change the organization of the system by being aware of the process of their interaction and how that process is organized into a pattern, and how that pattern keeps them limited.

4) How Does Change Happen in my Personal Supervision Model?

Similarly, my personal approach to supervision also calls for experiential interventions in order to create change. When appropriate during the supervisory process, I look for ways to create new experiences for supervisees that will guide them in becoming skillful and attuned therapists. These experiences can be more easily elicited during supervision if my supervisees present video recordings of their sessions, have life therapy sessions, or are willing to engage in role-plays.

In my Personal Treatment and Supervision Model, I am a process consultant. While working with clients, second order change is about helping clients become aware of their processes of interactions and how these create often-rigid behavior. While working with supervisees, second order change has to do with building the same awareness about processes between clients, their therapists, and their supervisors.

5) Process of Therapy & Process of Supervision

In my clinical work, I have noticed a pattern in how I organize my therapy sessions and conceptualize my cases. That pattern can be explained in the following steps. Parallel patterns exist in my Personal Supervision Model:

  • Building alliance and gathering relevant, background information with the focus on clients’ and supervisees’ attachment histories. For example, I want to know whom, other than me, my supervisee may turn to for support after a stressful and difficult day of seeing clients.
  • Focusing on the systemic hypothesis. While in therapy, I ask, “Since we have seen each other last, have you noticed times when your negative cycle got the better of you and kept you two connected/disconnected?” While in supervision, I ask, “What is your systemic hypothesis about the family’s cycle of interactions that keeps them “stuck” and rigid?”
  • Using therapeutic leadership to help clients and supervisees reach their goals. For example, in therapy, I carefully choose what I want to attend to and intervene when the information given to me does not bring a therapeutic value. In supervision, I teach supervisees the competency of leadership by letting them lead their sessions, instead of telling them what they should do. I ask them “What would you like to focus on/accomplish in today’s session? How will you get there?”
  • Creating an intervention based on the systemic hypothesis. In the therapy room, I may create an enactment and help clients access previously unacknowledged emotions and choreograph a new interaction between family members. With a supervisee, I may create an experience such as a role-play that will help the supervisee use an intervention that will further assist him in meeting his session goal.
  • Providing strength-based feedback. My approach to treatment and supervision is non-pathologizing I want to instill confidence in my supervisees or clients by focusing on their strengths rather than their deficiencies.
  • Assessing the process. Therapeutically, it is important to solidify and organize clients’ new experiences and feelings around their new ways of relating to each other. In order to do so, I summarize the session and ask for feedback. In supervision I ask, “What was helpful and/or unhelpful about today’s supervision?”