Providing Clinical Supervision for Home-Based Family Therapists Module

Module Sections:

Supervision Formats

Case Consultation – “Stories about stories”

Goal is to present information in order to get specific ideas about therapy. Therapists present case demographics, diagnoses, medications, a brief social history, and account the current course of treatment, any dilemmas currently encountered. A plan is formulated – often this model is used when searching for treatment modality options

Case consultation advantages over live supervision - They argue that while live supervision can capture the therapeutic moment and provide a view into the actual therapy process, it cannot accomplish other important things. Live supervision does not allow time to discuss the assumptions of the therapist, nor does it have the luxury of discussing the larger political, social, and cultural context of the therapy. People do not use live supervision primarily because the facilities are not available.

With case consultation, there is time to discuss the architecture, how therapy is constructed, as well as the contextual elements defining the therapeutic endeavor.  

Beginning therapists often appreciate case consultation because the less immediate format gives them an opportunity to discuss other issues, such as the structure of their jobs, relationship with co-workers, or other contextual concerns affecting their work. Case consultation allows them a chance to cover a variety of questions and /or concerns that may arise about their caseload, but do not require in-depth supervisory attention. Supervisors can take the time to ask about other aspects of therapists’ caseload. More experienced therapists often seek out case consultations because they offer them the opportunity to consider several alternative approaches simultaneously. Experienced therapists frequently report that their goals for supervision is the integration of their preferred ideas, beliefs, and methods from several therapy models into their unique approach to therapy.

Case consultation limitations – can never fully substitute for live supervision because it cannot capture or reveal all the important details that provide color and richness to the story of therapy.

Case consultation relies on the accounts given by the therapists but this can be used to the supervisor’s advantage to explore the perceptions, assumptions, and predispositions constraining therapists. Case consultation offers supervisors the opportunity to explore, take apart, and reconstruct therapists’ accounts of events. Consequently, supervisors hope to expand therapists’ future therapeutic possibilities which can result in a more rewarding story.