CRISIS MANAGEMENT DURING "LIVE" SUPERVISION: CLINICAL AND INSTRUCTIONAL MATTERS

Journal of Marital and Family Therapy, Jul 2005 by Charl�s, Laurie L, Ticheli-Kallikas, Michele, Tyner, Kelly, Barber-Stephens, Brandi

Part of the reason for the lack of information on this topic may be that, typically, crisis management-specifically, the guidance from a supervisor-often occurs out of synchronization with the trainee's interaction with the client's crisis event. That is, in most clinical situations, a client's crisis is managed out of the immediate awareness of or direct observation by the clinical supervisor. Live supervision is the exception to the rule. In live supervision, the unfolding of a client's crisis, its immediate clinical response, as well as the supervisory guidance from behind the mirror, can take place in the same context. In this article, we provide both the view of the supervisor and supervisees on cases of crisis management during live supervision as a way to illustrate the complexities, richness, and challenges of the live supervision process in the midst of a clinical crisis.

The Complexities of Live Supervision in Crisis Cases

In crisis sessions that occur during live supervision, the supervisor has multiple goals and responsibilities. The supervisor must make sure that the trainee meets legal and ethical responsibilities and ensures a reasonable standard of care in the session. In addition, it is especially important for supervisors working from a systemic perspective that the supervisee meet these responsibilities while maintaining (and quite possibly enriching) his or her relationship with the client. In a live crisis session, the supervisor finds a way to do all of this from behind the mirror, allowing the supervisee an opportunity to manage the client crisis. Supervisors do this knowing that such opportunities take place in the context of multiple legal and ethical duties, as supervisors are "legally liable for the work of their supervisees" (Todd & Storm, 1997, p. 3).

Introduction to Case Examples: A Supervisor's Perspective

As a supervisor working from a collaborative perspective, my intentions are to access and develop the ideas, views, and resources of my supervisees. I believe supervisees are more likely to do what I suggest if it fits with their own ideas. I also think they will do a better job as clinicians if they believe in and understand what they are doing. I see it as my goal to discover their beliefs and understandings, hone in on what is useful or significant to the case, and encourage the supervisee's use of that information in a way that is clinically relevant. Overall, I see this process as developing supervisees' clinical expertise-their confidence and their competence.

My model works well for me when I can find that fit between the supervisees' ideas and my own. However, when I cannot, I struggle, and my supervision tends to become directive. Also, when I discover that a supervisee's ideas are inconsistent with some component of my identity or experience as an MFT (i.e., my view of a systemic perspective, my take on the AAMFT ethical code), I slow down my collaborative model considerably. Instead, I primarily focus on guiding the supervisee toward identifying and challenging their beliefs. It is difficult for me to maintain this focus in a productive way during the intensity of live supervision. Interestingly, I have noticed that it is also at these times that my supervision tends to become directive.