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

Finally, we include a note on how we prepared for the presentation. Each of us constructed our narratives separately. I (LLC) did not ask to review or approve the supervisees' portions of the presentation, although both BBS and MTK consulted with me prior to the conference. I (LLC) also wrote my narratives after the trainees had written theirs, and I did so without consulting them. To write my part, I used notes I had taken behind the mirror and during supervision meetings as a way to reconstruct (Ellis, 2004) my memory and build on my ideas. The first time the trainees became aware of my supervisory thought processes at the time of their case crises was during the TAMFT conference presentation. I did not discuss my ideas with the supervisees prior to the conference for several reasons. Two of the supervisees (BBS and MTK) and I had little contact with each other after the semester ended; in the case with KT, I had assumed that our supervision on the case was complete and required no further discussion. It was only at the presentation, approximately 1 year later, that I realized my assumptions about my work with KT were mistaken.

The narratives we present next reflect ideas and understandings about our work prior to our collaborative presentation of it at the MFT conference. This is consistent with how we all experienced the supervision and clinical processes in real time. Discussion on how the presentation discovery shaped further supervisory reflection by LLC is presented later in the article.

CASE EXAMPLES: MULTIPLE PERSPECTIVES ON THE CRISIS SESSION AND ITS SUPERVISION

Case Example One: The Sad Woman (MTK and BBS, Master's Students)

Case overview. This case involved a young woman in her early thirties. She was separated from her second husband of 8 years and had three children who ranged in age from 8 to 14. The client, "Susan," had a recently widowed father and several sisters and brothers for whom she helped to care. Their ages ranged from 8 to 19. Susan's initial complaints included issues with her family and general feelings of being stressed out and unappreciated. Her ex-husband was unfaithful to her during each attempt at reconciliation, and she continued to move back and forth between her father's house and living with her husband. She complained of feeling used by everyone and at the end of her rope.

Synopsis of the session. During the session in which a crisis occurred, Susan discussed her role in the family and the obstacles she faced around being independent from her husband and father. She went on to say that very often after dealing with either of them she began to wonder why she is "still here." When we asked her to clarify what she meant, MTK posed the question: "Do you mean here as in this world?" she replied, "Yes. I mean, why am I still alive?" The conversation then turned toward a discussion of what she was dealing with that led her to feel like giving up.

Susan talked about her feelings of being used by everyone for something-sex, money, rides, and babysitting. She stated that everyone would be better off without her. We (MTK and BBS) pointed out how that idea contradicted all the prior information she had given us. We attempted to reframe her perception by telling her that, according to the information she had given us, it sounded as if she was very important and needed. The course of the conversation then turned away from Susan's comment about not wanting to be in this world and toward her attempted solutions. At this point in the session the supervisor called for a break and the team suggested that we go back to Susan's remark about "still being in the world." For the remainder of the session, we focused on questioning Susan about her suicidal thoughts.