The Therapeutic Process in On-Line Fieldwork Supervision of Master's Students

Eileen McCabe O’Mara, Ed.D., LADC, NCCAnn Melvin, Ph.D.,CRC, CADC, LCPC

NAADAC 2019

651-270-0180e-mail—eileen.omara@capella.edu

ann.melvin@capella.edu

I AND THOU

Relation is reciprocity. My You acts on me as I act on it. Out students teach us, our works form us. The “wicked” become a revelation when they are touched by the sacred word. How are we educated by children, by animals! Inscrutably involved, we live in the currents of universal reciprocity.• Martin Buber

Introduction:

The Therapeutic Process in On-Line Fieldwork Supervision of Master's Students

Goals and ObjectivesCreating Structure

Powell’s Model of SupervisionIT’s RoleCACREP standardsNAADAC Code of EthicsACA Code of Ethics

EvaluationSite Supervisor Evaluation ToolFaculty and Site Supervisor Evaluation

NAADAC 2019

Trans-theoretical therapeutic process

Trans-theoretical nature of the Therapeutic ProcessEngagementTransference and Counter-transference

Termination• Transference/counter-transference connection and intervention• Healing the connection• Sending summary e-mail or message

OBJECTIVES

1. Identify transference and counter-transference in on-line supervision.

2. Apply theory-based interventions to diffuse transference and counter-transference process.

3. Participants will be able to utilize the transference/ counter-transference process as a learning tool for supervisees.

GOALS

w Facilitating the therapeutic process of on-line supervision that challenges counselor educators.

w Identifies the supporting structure of the therapeutic process

w Explores therapeutic skills, including creative engagement.

BLENDED DEFINITION OF SUPERVISION

w CLINICAL SUPERVISION IS A DISCIPLINED, TUTORIAL PROCESS WHEREIN PRINCIPLES ARE TRANSFORMED INTO PRACTICAL SKILLS, WITH FOUR OVERLAPPING FOCI:

w ADMINISTRATIVEw EVALUATIVEw CLINICALw SUPPORTIVE

Is On-line Unique?

The computer’s filter Only see the head Miss body cues What you can’t see Location of student in home or office

STRUCTURE OF ON-LINE SUPERVISION

Engagement Boundaries IT set up Ethics—CFR 42, HIPPA, NAADAC &

ACA Behaviors Presenting schedule

Trans-theoretical nature of THERAPEUTIC PROCESSw The therapeutic process includes:w engagement, w behavioral rules, w boundary setting, w and application of codes of ethics and CFR

42 AND HIPPA.w trans-theoretical Stage of Change Model, w Termination

Therapeutic Process/ Engagement

Engagement: Welcome Video

• Welcome and thank you e-mail including requirements for learners and supervisors

Interview participants before start of the supervision process if possible

Interview site supervisor before start Schedule individual meeting with student

and supervisor during 1st week

ENGAGEMENT

w AVAILABILITY BY TEXT, E-MAIL AND PHONE

w MEMBERS ESTABLISH GROUND RULES FOR GROUP• Etiquette of On-line behaviors• Attendance, dress, eating, watching tv, etc.

THERAPEUTIC PROCESS

w Trans-theoretical Stage of Change Modelw Understanding counseling processw Appropriate interventions w Choice of therapeutic approach w Transference and counter-transference in

managing the counseling process

w

Transference and Counter-transference

Transference—originates from Psychodynamic /phycho analytic Therapy

A client’s unconscious conflicts that can cause problems in everyday life.

It is where the individual transfers feelings and attitudes from a person or situation in the past on to a person or situation in the present and where the process is likely to be, at least to some degree, inappropriate to the present.

Counter-transference

w Counter Transference is where you find yourself experiencing feelings and/or acting outside of your normal pattern of behavior towards a client.

w Those you LIKE and DISLIKEw Transference and counter transference is

something that is best addressed in supervision.

Counter-transference rule of thumb

w If you have counter-transference of the same nature 3 times in a period of time, a therapy tune up is needed.

w Explore the exact nature of the counter-transference

w Root of the issue

COUNTER-TRANSFERENCE

Prevention: Don’t work with clients with your current or

unresolved issue.• Recent death• Grieving clientsWhat is your vulnerability?The law of attraction draws clients to you with

your unresolved issue!

ON-LINE PRESENTATION OF TRANSFERENCE

MORE CONTACT THAN USUAL—PHONE CALLS, EMAILS, TEXTS

DEFENDS YOU TO THE GROUP YOU REMIND THEM OF SOMEONE.. WANTS TO BE YOUR FRIEND OR

FAMILY MEMBER ACTS LIKE YOUR CO-SUPERVISOR

ON-LINE COUNTER-TRANSFERENCE

THOSE YOU LOVE AND THOSE YOU DREAD

REMINDS YOU OF………… KNOW YOUR VULNERABILITY TO

COUNTER-TRANSFERENCE AWARENESS OF YOUR CURRENT

ISSUES• GRIEF, DIVORCE, KIDS, ETC.

INTERVENTIONS

TALK ABOUT IT EARLY IN THE PROCESS EXPLAIN IN DETAIL TALK—ASK FOR EXAMPLES BRING IT UP REGULARLY HELP MAKE CONNECTIONS BETWEEN

CURRENT EXPERIENCE AND PAST BRING IT TO LIFE REFER TO EAP OR COUNSELING

Transference

Exercise• Do I remind you of someone? What is your

gut reaction?• Does anyone in the group remind you of

someone?Example:

Tall, dark hair lady about my age—told me she now understood why she hated me---I reminded her of her short, blonde Mother!?

Transference/counter-transference

Always historical? Always a gut reaction Non-verbal Either pain or joy Intense feeling—does not make sense

PREVENTION

BE AWARE OF YOUR VULNERABILITY

HUNGRY, ANGRY, LONELY AND TIRED

TAKE TIME OFF DON’T MEET WHEN HUNGRY SEEK SUPERVISION YOURSELF

TERMINATION OF SUPERVISION

BEGIN PROCESS IN WEEK 1 TALK ABOUT LENGTH OF QTR OR

SEMESTER ROLE PLAY TERMINATING WITH CLIENT SCHEDULE INDIVIDUAL MEETING WITH

EACH STUDENT ON PHONE OR ON-LINE TALK ABOUT YOUR RELATIONSHIP—

REVIEW PROFESSIONAL BOUNDARIES AND ETHICS

Termination

Ceremony—borrowed from the treatment programs

Have group give positive feedback to each other

Create a self-care plan

WEEKLY PHONE AND VIDEO FORMAT

SCHEDULE 2 HOURS 15 MINUTES: WEEKLY INTRODUCTIONS

• PURPOSE IS TO IDENTIFY HOW INTERNSHIP IS GOING AND IDENTIFY ANY ISSUES TO ADDRESS.

• ASK EACH STUDENT TO CALL ON ANOTHER STUDENT. SCHEDULE TWO STUDENTS PRESENT CASES FOR

DISCUSSION EACH WEEK USE ROLE PLAYING AND OTHER INTERVENTIONS TO

FACILITATE LEARNING MIDDLE OF SEMESTER PRACTICE GROUP PROCESS END—CEREMONY TO HONOR THOSE GRADUATING. ASK

FOR POSITIVE COMMENTS FOR EACH STUDENT.

ETHICS OF TECHNOLOGY IN CLINICAL SUPERVISION NAADAC ACA—Most Clear—Section H ACES INCASE

ACA CODE OF ETHICSSECTION H

w Section Hw Distance Counseling,w Technology, andw Social Media

REFERENCES

Bernard, J. M., & Goodyear, R.K., (1992), Fundamentals of Clinical Supervision. Needham Heights, Ma: Allyn and Bacon.

Buber, M. (1923) I and Thou (1970) Translation by Walter Kaufmann.Charles Scribner’s Sons, New York, NY

Handbook of Counseling Supervision, (1987) Association for Counselor Education and Supervision, American Association for Counseling and Development, Arlington, Virginia.

Holloway, E., (1995). Clinical Supervision: A Systems Approach. Thousand Oaks, California, Sage Publications.

O’Mara, Eileen, (1990). July/August, “Burnout and the Counselor”. The Counselor, National Association of Alcohol and Drug Abuse Counselors, Arlington, Virginia.

O’Sullivan, Mary K, (1998). May/June, The Changing Demands of Clinical Supervision. The Counselor, National Association of Alcohol and Drug Abuse Counselors, Arlington, VA.

References

Powell, D., & Brodsky, A., (1993) Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods. New York, N.Y. Lexington Books, Macmillan, Inc..

Roth, G., Jacob, C. J., Jackson, C., Stoler, J. R., & Oloidi, W. (2019). Learning to be a Counselor at a Distance: A QualitativeInvestigation of the Distance Education Experience for Counselors-in-Training.The Journal of Counselor Preparation and Supervision,12(3). Retrieved fromhttps://repository.wcsu.edu/jcps/vol12/iss3/2

Thacker, N. E., & Diambra, J. F. (2019). Parallel Process of Professional Identity Development during Clinical Supervision. The Journal of Counselor Preparation and Supervision, 12(3). Retrieved from https://repository.wcsu.edu/jcps/vol12/iss3/6

Williams, F. (2007). Counter-transference and vicarious trauma in psychoterapy with PTSD/Addicted/clients. Hazelden-Betty Ford Presentation at Women Healing Conference.

Termination

wEnjoy the journey!