Supervision

It’s been a while since I posted. A lot has been happening lately. I’ve been running two intensive therapy groups for violent adolescent offenders that have been taking an undue amount of my time and energy.

I started outlining my second book, which will integrate the scientific data about emotions found in the first book into an effective, scientifically-based treatment strategy.

I was selected to present a workshop on emotion-focused approaches to treating psychological trauma at the Texas Psychological Association’s annual convention in November. I’ve started outlining that talk, too. Soon, I’ll need to turn my attention to developing the PowerPoint for it.

I went on a 17-day vacation to Alaska, which I found remarkable and exhilarating. However, I returned from the trip with walking pneumonia, from which I’m only now recovering. At times, I still get fatigued.

And this week, I launched a business that had been a dream for a while. I now provide supervision and clinical consultation face-to-face and via the internet. The technology is in place and I’m ready for new challenges. It seemed like a good time to make this move.

Supervision and training are fun. Therapy is fine, but one’s reach is restricted. A therapist can only impact a relative few by seeing them personally, but a supervisor or consultant can influence the treatment of a much larger number by focusing on others who actually do the work.

Besides, to be honest, I lose interest during the middle sections of treatment. Those parts are repetitive, so they’re not all that interesting or engaging. I’ll happily give those up to people who enjoy them more.

I like formulating tough cases nobody else seems to be able to figure out and talking to people who have transformed themselves into something new and different, helping them move forward with their lives. I’m also very good at those, but moving clients from the former to the latter is something others probably do as well as I, in some cases maybe better.

That’s not to say that there aren’t a lot of techniques available for moving cases along. However, it’s far easier to keep them from ever getting stuck. As a therapist, one way to ensure that happens is making sure you know what the case is about before you ever intervene. Most of your time and attention should be devoted to formulating and testing hypotheses.

Only when you can no longer rule out hypotheses should you conclude that you understand what a case is about and begin maneuvering. Before that, you should be preventing your clients’ doing anything that could make matters worse. People will do all sorts of crazy and futile things because of a compulsive need to “do something” when they’re anxious, depressed, or in emotional pain.

If you can prevent them from doing something harmful and keep them occupied with doing things that are at worst neutral (and may actually help, like meditating), clients will eventually help solve their own problems.

When people first arrive for therapy, within the first 5 minutes they’re together they tell the therapist everything the therapist needs to know in order to treat them effectively.

There are only two problems.

First, because the client’s word choices usually carry idiosyncratic meanings the therapist does not share, the therapist probably will not understand what the client says to him as fully as required to treat the client effectively.

Second, because the therapist assumes that each of them is speaking a common language, the first fact will escape the therapist, who will move forward with his or her assumptions about what the client meant. When the client does not respond as predicted, the therapist will feel threatened, determine that the client is “resistant,” and initiate attempts to force change to occur.

As we all know, this doesn’t work. I don’t respond well to naked pressure and control, you probably don’t, and your clients won’t, either.

I don’t respond well to name calling, you probably don’t, and your clients won’t, either.

I don’t respond well to contempt, you probably don’t, and your clients won’t, either.

Avoid those traps. Understand what you’re doing, what you’re trying to accomplish, and how you intend to do it before you get started.

If you need help, contact me. I love discussing cases.

Your clients deserve the best you can offer them.


Dr. Steven G. Brownlow trains clinicians and consults with therapeutic programs. If you’re a clinician or run a therapeutic program, please visit the ADEPT Therapy Consulting website. Enjoy the other posts on sgbrownlow, and thanks for visiting!


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2 Comments

  1. I enjoyed this – especially liked the insight about the compulsion to do something that’s probably futile when feeling anxious.

    • Steve
      Jul 13, 2012

      Thank you, Corrina. I’ve seen far worse than futile–breaking up families, for instance, with 13-year-old daughter leaving to live with 19-year-old “boyfriend.” Once those kinds of genies are out of the bottle they’re nearly impossible to put back in.

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