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The Reflecting Team Approach: Different Uses in Live Supervision and Group Supervision with both Family Therapy Trainees and Practitioners
Abstract
The reflecting team is a well-known and frequently used approach in the systemic supervision of groups. Such supervision can be facilitated both as live supervision and (retrospective) group supervision. This chapter will explore different uses of the reflecting team, both in pre-qualification and post-qualification supervision of family therapy and systemic practice. For example, the supervision group can be allocated different perspectives and roles, (for example, in family therapy, the perspective of the mother and the daughter; or in supervision of team process, the perspective of the psychologist and the manager, and so on) or different theoretical perspectives (for example, structural, narrative or solution focused, and so on) in the process of supervision. The supervisor can choose between many different positions both in live and in retrospective group supervision. Different positions will be described and discussed in relation to training and the development of students and qualified family therapists, the ethical issues and the impact for clients and on the therapy process. The chapter contains suggestions for exercises and activities and examples from practice will be given to illustrate the ideas and how they can be useful.
This chapter describes a variety of systemic practices with families with children that need extra care and where these family and child challenges will probably remain in some way or another. Work with families where children suffer with chronic conditions is viewed as a practice domain that demands a very broad range of systemic skills made available in the service of the whole family and its constituent parts. In addition, it also addresses the performance of these skills as part of a co-ordinating function aimed at enhancing the connectedness of the family’s helping system as a whole. How can good systemic interventions in such family contexts be characterized? What do these interventions look like? The chapter also describes systemic interventions that are responsive to the challenges arising from the poorly coordinated systems of help that surround these families.
Discusses arguments surrounding the application of epistemology to family therapy and how cybernetic thinking about therapeutic processes has evolved since the work of G. Bateson in the 1960's and 1970's. The consequences of this "2nd-order" cybernetics for the field of family therapy are outlined, focusing on systems therapy; the idea of the observing system; the complex of autopoiesis, informational closure, and conservational domains; and the idea of fit from the constructivist position. Bateson's focus on circular organization is applied to these topics in terms of mental process. The 2nd-order thinking is thought to be a viable framework for systemic change in family therapy. Any therapy that respects a cybernetic epistemology will have 6 characteristics: an observing system stance and inclusion of the therapist's own context; a collaborative rather than a hierarchical structure; goals that emphasize the setting of a context for change, not a specification of a change; ways of guarding against too much instrumentality; a "circular" assessment of the presenting problem; and a nonpejorative nonjudgmental view. (36 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The authors used a videotape-assisted recall procedure to study the content of family therapists' inner conversations during individual sessions with a standardized client. Grounded theory was used to analyze therapists' reflections, resulting in a taxonomy of 282 different codes in a hierarchical tree structure of six levels, organized into four general domains: attending to client process; processing the client's story; focusing on therapists' own experience; and managing the therapeutic process. In addition to providing a descriptive model of therapists' inner conversation, this research led to an appreciation of the wealth of therapists' inner conversation. In particular, the authors found that therapists work hard to create an intersubjective space within which to talk by trying to be in tune with their clients and by using clients as a guide.
The book aims to explore the exciting opportunities offered by a systemic approach for mental health professionals and psychotherapists when working with families and other systems where domestic violence in intimate relationships is of concern. The main purpose of the book lies in the application of systemic thinking to safety and to understanding the complexity of domestic violence on family relationships over time. The authors outline their approach to these complex issues based on their eight years of joint experience in the Reading Safer Families project. They draw from a broad field of family psychology and systemic psychotherapy to distil the theories, methods and techniques most helpful to practitioners working in modern public and voluntary agencies. Their systemic approach to issues of risk, responsibility and collaboration provides a coherent framework within which to integrate practice. The book also provides a practice orientated and detailed approach to risk assessment, risk management and family reunification. This book will be of interest to practitioners in clinical and educational psychology, social work, nursing, psychiatry, probation, health visiting, counselling and psychotherapy, who work with individuals living in intimate relationships where violence may be of concern, and also to practice supervisors, trainers, trainees and students in these disciplines.
This paper describes a randomised controlled trial (RCT) investigation of the added value of systemic family therapy (SFT) over individually focused cognitive behavioural therapy (CBT) for families in which one or more members has suffered trauma and been referred to a community-based psychotherapy centre. The results illustrate how an apparently robust design can be confounded by high attrition rates, low average number of therapeutic sessions and poor protocol adherence. The paper highlights a number of general and specific lessons regarding the resources and processes involved that can act as a model for those planning to undertake studies of this type and scope. A key message is that the challenges of conducting RCTs in 'real world' settings should not be underestimated. The wider implications in relation to the place of RCTs within the creation of the evidence base for complex psycho-social interventions is discussed and the current movement towards a phased mixed-methods approach, including the appropriate use of RCTs, which some might argue is a return to the original vision of evidence-based practice (EBP), is affirmed.
An approach to group supervision, applying reflecting team, is described. Interview data showing how the approach is practiced recently are presented and analyzed qualitatively, and the results are discussed in relation to the original approach. The conclusion is that there are many pitfalls in using reflecting teams in supervision, and that following the original approach may guard against these pitfalls, but that some revisions may be needed. Supervisors, supervisees, and reflecting team members are all generally satisfied with the approach, but it remains to be established to what extent it contributes to therapist development.
This second edition of the highly acclaimed "The Family Life Cycle" is much more than a simple update. Rather, "The Changing Family Life Cycle"—a provocative examination of family development and the variables that affect its course—emphasizes the changes in that life cycle as we move toward the 21st century.
"The Changing Family Life Cycle" offers essential guidance in understanding what happens in families in terms of the flow of life over the generations. The current edition provides a more in-depth perspective on the impact of gender on family life at each stage of the life cycle and on cultural variations in life cycle patterns. In addition to updated statistics and an integration of findings from research since 1980 on families through the life cycle, several important new chapters are included. Among the topics considered: chronic illness, alcoholism, single-parent families, rituals, genograms, and the contrasting of the life cycle of the poor with that of the upper middle classes.
The contributors, along with editor-writers Carter and McGoldrick, bring to this work a variety of expertise, experience, and vision that together constitute an invaluable resource for both the student and the working therapist. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This is an example of a postmodern, dialogical approach to teaching family therapy based on the work of such practitioners as Tom Andersen, Michael White, and Lynn Hoffman, among others. It demonstrates the way in which the reflecting process connects all of the participants in a web of meanings both educational and transformational. This particular consultation, which includes the author, her graduate students, the client, and guest participant Lynn Hoffman, ends with an unexpected ritual of intergenerational appreciation. Privileging the transcript, it is presented as a kind of theatre where the learning is revealed more through the dialogue than through authorial analysis. The experience is embedded in an “ethics of participation” (Hoffman, 1992) where social connectedness and attunement are key.
这是依据诸如Tom Andersen, Michael White 和 Lynn Hoffman等从业者的成果用后现代、对话式方法教授家庭治疗的一个案例。它展示了这个反思过程如何以既有教育意义又有转化意义的方式让所有参与者联系进来。这一具体咨询案例包含作者、作者的研究生、客户以及来宾Lynn Hoffman,并以意想不到的代间赞赏礼节结束。本案例注重脚本,以一种剧院形式呈现,知识在其中通过对话而非作者分析方式得以展现。本经历嵌入“参与伦理”(Hoffman, 1992),其关键在于社会联系与协调。
Este es un ejemplo de un enfoque posmoderno y dialógico de la enseñanza de la terapia familiar basado en el trabajo de profesionales como Tom Andersen, Michael White y Lynn Hoffman, entre otros. Dicho enfoque demuestra la manera en la cual el proceso reflexivo conecta a todos los participantes a una red de significados tanto educativos como transformacionales. El enfoque consiste en seminarios especiales, integrados por la autora, sus alumnos de postgrado, el paciente y la participante invitada, Lynn Hoffman, que concluyen con un ritual inesperado de agradecimiento intergeneracional. Privilegiando la transcripción, los seminarios se presentan como un tipo de teatro donde el aprendizaje se revela más claramente a través del diálogo que a través del análisis de la autora. La experiencia está arraigada en una “ética de la participación” (Hoffman, 1992) donde la conexión y la empatía son clave.
In this paper we describe how we bring together three major systems of thought: attachment theory; family systems theories; and theories of narrative development, in an integrated approach to systemic practice that we call attachment narrative therapy (ANT). ANT provides a four-stage framework for practice: creating a secure base; exploring narratives and attachment experiences within a systemic framework; considering alternatives and taking action; and the future and maintenance of the therapeutic base. Formulation, especially regarding the role of emotions and attachments in family dynamics and narratives, is at the heart of our approach and helps us hold ourselves accountable for our particular weave of theory and practice.
In this article, a distinction is made between the outer therapeutic conversation and the therapist's inner conversation. The therapeutic conversation is a circle of meaning in which both the therapist and the clients play a part. The therapist's inner conversation is described as a negotiation between the self of the therapist and his role. In this process of negotiation the therapist has to take seriously, not only his observations, but also what is evoked in him by these observations, that is, images, moods, emotions, associations, memories, and so on. Furthermore, therapeutic impasse is conceptualized as a paralysis of the circle of meaning and of the therapist's inner conversation. A process of reflection is proposed as a way out of the impasse. In that process, the inner conversation of the therapist is externalized with the help of an outsider. In the final part of this article, a case study illustrates the importance of these ideas for the family therapy practice.
In recent years several authors have made a beginning in describing therapeutic conversations from a dialogical perspective. Training and supervision, however, have not yet been addressed from a dialogical perspective. In this article, an experiential training exercise is described that is focused on the basic dialogical skills of the trainee: respectful inquiry and constructive reflecting. Rather than teaching and instructing, this training exercise is aimed at staging a dialogue. The trainees are invited to take part in this dialogue, as they are encouraged to experiment with new positions and new ways of encountering others, and as their different voices tell of their experiences, of the things they have learned, and of the new perspectives that have opened up for them. Leaning on ideas about the therapist's inner conversation (Rober, 1999, 2005b) and stressing the importance of polyphony, dialogism, and tolerance for uncertainty, the training exercise described in this article is consistent with a dialogical and postmodernist frame, as described by Seikkula and Olson (2003).
This article describes a process of live supervision that has been designed to encourage trainees to experience competing theoretical perspectives. It involves the use of separate T (treatment) and O (observation) teams who conceptualise the same case from two broadly-defined theoretical perspectives, variously called first and second order, modern and postmodern, or family systems and social constructionist. The process requires trainees to adopt multiple positions rather than identify with one perspective, and provides a basis for comparing and potentially integrating them. We provide examples of the approach, discuss important contextual issues for supervisors to consider when implementing it, and examine ways of adapting it to a wide range of training contexts.
A "stuck" system, that is, a family with a problem, needs new ideas in order to broaden its perspectives and its contextual premises. In this approach, a team behind a one-way screen watches and listens to an interviewer's conversation with the family members. The interviewer, with the permission of the family, then asks the team members about their perceptions of what went on in the interview. The family and the interviewer watch and listen to the team discussion. The interviewer then asks the family to comment on what they have heard. This may happen once or several times during an interview. In this article, we will first describe the way we interview the family because the interview is the source from which the reflections flow. We will then describe and exemplify the reflecting team's manner of working and give some guidelines because the process of observation has a tendency to magnify every utterance. Two case examples will be used as illustrations.
This paper has described some of the interventions developed at the Ackerman Brief Therapy Project in treating the families of symptomatic children. The interventions are based upon a differential diagnosis of the family system and upon an evaluation of that system's resistance to change. They are classified as compliance-based or defiance-based, depending upon the family's degree of anxiety, motivation, and resistance. Paradoxical interventions, which are defiance-based, are used as a clinical tool in dealing with resistance and circumventing the power struggle between therapist and family. A consultation group acting as a Greek chorus underlines the therapist's interventions and comments on the consequences of systemic change. This group is also sometimes used to form a therapeutic triangle among the family, therapist and group, with the therapist and group debating over the family's ability to change.
In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.
Mastering family therapy: Journeys and growth of transformation
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Reflecting processes: Acts of informing and forming. You can borrow my eyes, but you must not take them away from me! In
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