Methods of supervision in marriage and family therapist training: A brief report

Although didactic supervision is convenient, direct observational supervision (e.g., audio- and video-tapes) is viewed as optimal. This study examined the types of supervision utilized by trainees in Marital and Family Therapy in the state of California. Results indicated that 38.9% of the sample used audio-tapes in supervision and 57.4% utilized video-tapes. These results are positive in that more opportunities for attending to the complexities and blind spots of therapy can be afforded using these methods. However, in light of the fact that the observational approach is a more powerful training modality than most others, the results indicating that 43% of the sample did not participate in observational practices can also be viewed as disappointing. Future research involving larger sample sizes, multiple domains of supervisory relationships (e.g., academic, non-academic) and across other US regions is needed to generalize these findings. ********** Although supervision is a fundamental component of mental health training, the field has not afforded significant attention to its regulation. There are a number of descriptive models of clinical supervision with unique and theory-driven approaches (Holloway, 1995; Mead, 1990; Stoltenberg & McNeill, 1997; Watkins, 1997). These approaches share the common goal of fostering the development of technical and interpersonal skills in the novice therapist, but vary in the mechanisms related to the pursuit of this goal. In an early review of supervision techniques, Birchler (1975) described four models of supervision: (a) traditional, which includes case report and didactic discussion; (b) co-therapy, which involves the participation of both the supervisor and the supervisee in therapy; (c) direct supervision with delayed feedback, which entails the use of observation techniques, such as video tapes, audio tapes, or two-way mirrors to observe the supervisee and client and the provision of feedback after the session; and (d) direct supervision with instant feedback, which involves live, observational methods such as two-way mirrors or television monitors combined with the use of phone-in or "bug in ear" devices to communicate feedback instantaneously. These four types of supervision methods have become models that are referred to throughout the current literature on supervision technique. While most supervisors agree that live supervision is the strongest supervisory technique, there is also consensus that this method is less efficient and practical than didactic and observational supervision methods (Romans, Boswell, Carlozzi,, & Ferguson, 1995). Thus, techniques such as computer-assisted live supervision are receiving increased attention (Miller, Miller, & Evans, 2002; Neukrug, 1991; Scherl & Haley, 2000; Smith, Mead & Kinsella, 1998). A group of researchers in Norway has even found that videoconferencing can be substituted for up to 50% of the direct supervision hours required for psychotherapists without a significant decrease in effectiveness (Gammon, Sorlie, Bergvik, Sorensen, & Hoifodt, 1997). Limited empirical and normative data are available on which methods of supervision are most frequently utilized effectively in psychotherapy supervision (Bubenzer & West, 1991; Compernolle, 1998; Gammon et al., 1997; Hess & Hess, 1983; Kaplan, 1987; McCarthy, Kulakowski, & Kenfield, 1994; McKenzie, Atkinson, Quinn, Heath, 1986; Romans et al., 1995; Townend, Ianetta, & Freeston, 2002; Tyler, Sloan, & King, 2000). Kaplan (1987) reported that 42% of MFT programs surveyed endorsed using direct supervision with immediate feedback for training. Bubenzer and West (1991) reported that 75% of the counselor programs that they had surveyed used this practice in individual, group, and family therapy. The most frequent methods of this supervision reported were co-therapy and in-session supervisor/supervisee phone communication. …