Letter: Patients' need vs. therapists' behavior.
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The present paper describes a model for supervision through co-therapy, developed in a training framework for interns of clinical psychology. The format presented includes a senior therapist and an intern as co-therapists. The model is conceptualized as one of participant supervision in psychodynamic psychotherapy. As such, the model is comprised of two elements. 1. Two therapists work together with one or more patient during a session. 2. The definition of the process as a supervisory situation, beyond the co-work in therapy of the two therapists. We offer the model as a significant and unique supplementary experience for both supervisor and supervise. The supervisory process is based on the principle of "reflection in action," and the actual participation of both partners in the clinical work, facilitating their mutual growth.
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At first we had a lot of information about what to expect from an adolescent group. But we quickly found an enormous gap between our information and the actual experience and gut feelings. It is important to anticipate many overwhelming feelings! It is also crucial for therapists to be open and honest with themselves and each other about their counter-transferences. Second, we discovered that it is not hopeless! However, it is essential to provide structure via firm, consistent limits and goals. Adolescents need to feel protected by therapists who can manage the group's turbulence. Third, creative techniques frequently provide ways of dealing with feelings. Four, a treatment group cannot survive with too many acters-out; one or two may add spice and give permission to others to recognize and express feelings. Also, despite the often chaotic atmosphere, serious treatment takes place. It has been helpful to have Mrs. Friedman as our supervisor. At critical points, when we were overwhelmed, she helped with her objectivity and support, offering a clearer vision of actual treatment issues when feelings were high. At times when we felt depleted, Mrs. Friedman's support replenished us and we were able to return to the group with enthusiasm. In conclusion, it has been fun working as co-therapists. We have found that the sharing and mutual confrontation contributed significantly to our professional growth.
The author presents some thoughs on the experience resulting from a 3 year individual supervision in the "Centre de Guidance Infantile" (Child Guidance Center) of the University of Louvain. The aim of the supervision is essentially the formation for child and adolescent psychotherapy. This supervision is done inside the Center, to be consistant, but this structure is causing some problems of interference : problems of responsability from the supervisors to the Center, to the patients ; problems of authority for the supervised ; problems of affective relationships between supervisors and supervised. To resolve these difficulties, the supervisors have established spontaneously regulations enabling them to limit as much as possible these interferences.
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