complex enterprise of training family therapy supervisors in a program that emphasizes the live observation of the supervisor-trainee$ work. Through the.
Journal of Marital and Family Therapy 1984, Vol. 10, NO. 2, 139-150
TRAINING FAMILY THERAPY SUPERVISORS: ISSUES OF CONTENT, FORM AND CONTEXT* Howard A. Liddle University of California School of Medicine
Douglas C. Breunlin Institute for Juvenile Research
Richard C . Schwartz Institute for Juvenile Research
John A. Constantine Purdue University
This paper describes a program designed to train advanced family therapists in the conceptual and technical skills of family therapy supervision. It elaborates upon the relevant content, overall organization, and contextual influences in the complex enterprise of training family therapy supervisors in a program that emphasizes the live observation of the supervisor-trainee$ work. Through the description of the interconnected elements of a particular program, the paper also identifies generic training issues for those interested in teaching the skills of family therapy supervision.
In the past decade, the field of famfiy therapyhas witnessed an impressive growth in the number of training programs in both independent institutes and academic settings (Bloch & Weiss, 1981; Liddle, Vance & Pastushak, 1979). There is also a growing literature of over 200 papers and chapters in books on family therapy training and supervision. Through this literature the parameters and ingredients of competent supervision are beginning to emerge, and although still somewhat fragmented, supervision, as a subspeciality within the field of family therapy, is developing a separate identity. Although the literature on supervision is impressive, it lacks the vital component specifying how supervisors best acquire this knowledge. Considerable clinical experience does not automatically qualify one to be a supervisor, but rather, just as the skills of family therapy can be taught, so also a separate and definable set of supervisory skills can and should be taught systematically to therapists who wish to be competent supervisors. For our field to advance, supervision, like therapy, must be conceived as a teachable enterprise, and more basically, it must be deemed necessary to teach. A recent study with AAMFT Approved Supervisors and AFTA members lends support to this *Presented a t the 39th Annual Conference of the American Association for Marriage and Family Therapy, San Diego, CA, October 1981. Howard A. Liddle, EdD, is a n Associate Professor and Director, Behavioral Sciences Program, Division of Family and Community Medicine, University of California School of Medicine-San Francisco, CA. Address reprint requests to Senior Author, San Francisco General Hospital, 1001 Potrero, Bldg. 90, San Francisco, CA 94110. Douglas C. Breunlin, MSSA, is Director, Family Systems Program, Institute for Juvenile Research, Chicago, IL 60612. Richard C . Schwartz, PhD, is a member of the Faculty, Family Systems Program, Institute for Juvenile Research, Chicago, IL 60612. John A. Constantine, PhD, is a n Assistant Professor, Department of Child Development and Family Studies, Purdue University, West Lafayette, IN 47907.
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position. When asked what they believed the most pressing family therapy training issues to be, most respondents listed the need for: (a) formal training as a supervisor; (b) continuing education in trainingisupervision methods; and (c) development of comprehensive theory-based, yet practical training models as crucial to the advancement of the field (Saba & Liddle, in press). In 1980, under the leadership of the senior author, a training program in the skills of family therapy supervision was begun by the Family Systems Program (FSP) a t the Institute for Juvenile Research in Chicago. This paper describes the form, structure and process of this training effort, called the Supervisor Extern Program (SEP).The description is intended as a prototype which reveals the complex, yet rewarding nature of training supervisors. The program described herewith might also serve as a base or stimulus, upon which similar programmatic endeavors might be formulated. Finally, the paper attempts to move beyond the straightforward exposition of a single training program by extrapolating from it the salient content, format and context issues requiring the attention of all trainers of supervisors. Before turning to a detailed discussion of our training philosophy and how it is implemented in the SEP, it is first necessary t o define the terms associated with this multifaceted program. Henceforth, supervisor refers to an individual training to become a supervisor, trainee refers to a family therapist in training, and trainer refers to an individual who orchestrates and participates in the training of both supervisors and trainees. In our program, for reasons which will be defined below, supervisors and trainees are trained simultaneously in one supervision group composed of three trainees, one supervisor, and a trainer. The trainees see the families and receive supervision from the supervisor or trainer. When the supervisor supervises a trainee, the trainer supervises the supervisor’s work. Hence in this format the supervisor is in a position “meta” t o the trainee and the trainer is meta to the supervisor. For reasons outlined below, we believe the format, although quite complex, is ideal for training supervisors. A CONCEPTUAL FOUNDATION FOR TRAINING SUPERVISORS Any successful training endeavor produces a variety of changes with trainees. In training supervisors, we attempt to facilitate a role change from clinician to supervisor, a change which requires both conceptual and behavioral shifts. This alteration of one’s professional identity from therapist to teacher is aided by the pragmatic expansion of the supervisor’s perceptual and conceptual unit of focus. The supervisor’sfield of vision and intervention is no longer only the family system and its interlocking extrafamilial subsystems (peers, school, extended family). It now encompasses the more complex therapist plus family unit-the therapeutic system. This process of conceptual alteration is as foundational to the task of training supervisors as it is to the training of clinicians (Liddle & Saba, in press-a). Another activity central to the training of supervisors is also a process that has been found useful in teaching therapists. This procedure, known as an epistemologic declaration (Liddle, 1982a), facilitates the clarification of one’s presuppositions about the therapeutic process and the nature of families (e.g., mechanisms of change, role of the therapist). This kind of ongoing consciousness and articulation of one’s operating premises in therapy has had equal applicability in the domains of therapy and training, with therapists and trainers alike. At a basic level, the present ideas about training supervisors relied on yet another, but broader, principle. Known as the isomorphic nature of training and therapy (Liddle & Saba, 1982, in press-a, in press-b, in press-c), this overarching concept has served an epistemologically foundational function in our work. Briefly stated, this principle spec-
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ifies that form, pattern, content, affect, etc., are recursively replicated in the interrelated domains of training and therapy. Thus, active, ongoing processes in these contexts are replicated in its counterpart. Further, clarifying the ways in which one’s theory of therapeut-ange are mirrored in one’s approach to trainee change (theory of learning) allows trainers to use these interconnecting dimensions as a blueprint or framework for action. This principle offers a dual-description (Bateson, 1979) of the mechanisms of change from the levels of training and therapy. It suggests that trainers would do well to understand and intentionally utilize with their trainees the same basic principles of change employed in therapy. For example, setting goals, thinking in stages, contextual sensitivity, joining, and challenging realities are all operational aspects of both therapy and training. This notion of the parallels between therapy and training has served already as a useful point of departure in our efforts to define the skills of live supervision (Liddle & Schwartz, in press). We postulate further that understanding the interconnected nature of therapy and training, especially the level of one’s premises about change, serves an equally useful function in beginning t o define a protocol for training supervisors. Despite the added complexity, the same essential principle still applies: pattern, content, affect and the principles of change tend to be replicated at different levels of the training system, and knowledge of this phenomenon of context replication can enhance our functioning a t these different levels. Thus, the foundation of our model of training supervisors consists of the identical premises about the facilitation of change with families (theory of therapeutic change) and with trainees (theory of trainee change and learning). A trainer’s sensitivity to these domains of interconnection promotes a consistent training program and context, and further, provides a practical guide to one’s work.
Structural-Strategic Therapy: A Working Theory of Change Therapy and training in the Family Systems Program is based upon a structuralstrategic approach1derived from a careful integration of the structural (Minuchin, 1974; Minuchin & Fishman, 1981) and strategic therapy (Fisch, Weakland & Segal, 1981; Haley, 1973, 1976, 1980; Watzlawick, Weakland & Fisch, 1974). Within this approach, change is achieved through the introduction of greater complexity in family systems. Likewise, training from this viewpoint is guided by the same objective: the generation of a broader conceptual and behavioral complexity with trainees. Further, just as the therapist challenges the realities of family members, the trainer similarly challenges the often narrow and monadic epistemologies of trainees in order to facilitate adoption of a contextually sensitive, systemic orientation. More than anything, family therapy training seeks to contextualize its students. They are taught, as Sluzki (1974) has said, to think in interactional terms. Just as structural-strategic therapists emphasize the competencies and untapped resources of their families, trainers from this orientation parallel this accessing of strengths with their trainees. Rather than working only from an error-activated, deficitfocused view of trainees, trainers build upon existent, but previously unavailable resources. The importance of a clinician’sability to expertly blend support and challenge also exists in the training domain. From this view, trainees learn and change when they are challenged in conceptual and behavioral ways, yet, a t the same time, these challenges lose their efficacy without support. A structural-strategic therapist is a creator of contexts, an architect of interactional events that allow alternative transactions to be experienced. Minuchin (1979)discussed how different social contexts can bring forth different “partial selves.” A trainer’s task is to create a learning context that accesses the most therapeutic partial selves of the trainee. In therapy, such contexts are created through the technique of enactment: a procedure which prepares, then puts family members in direct contact with each other.
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It embodies, in a n experimental and experiential fashion, a direct challenge to present patterns of relating, and introduces a new arena for change. The corresponding locus for change and learning in the training domain is live supervison (Liddle & Schwartz, in press; Montalvo, 19731.’ This context emphasizes a learning-by-doing philosophy (experiential aspect), and values a spirit of risk-taking in testing out new behaviors (experimental aspect). Just as therapists organize enactments among family members, so, too, do trainers organize contexts between the therapist and the family, as well as contexts between themselves and the trainees in which risks can be taken and fears of newness overcome in the process of acquiring increased skill. This learning-by-doing philosophy, when applied to training supervisors, requires a context wherein the supervisor can be actively guided in the supervision of a trainee working with a family. This context includes the live supervision of supervision (meta supervision) by an experienced trainer as well as other teaching formats that actively address the acquisition of supervisory skills. We turn now to a description of the Supervisor Extern Program (SEP) in which such learning takes place. SUPERVISOR EXTERN PROGRAM The SEP is a n advanced, didactic and practice-focused training program for experienced family therapists, committed to developing conceptual and pragmatic skills in family therapy supervision. To provide supervisors in training access to families and trainees for the purpose of practicing supervision, the SEP has been integrated with a one-year clinical externship in family therapy (CEP).Both programs are organized and run by senior trainers. Hence, one day a week four supervison groups consisting of a trainer, supervisor and three trainees convene t o see families for four hours. The hierarchical organization of this group is depicted in Figure 1.
Figure 1. Composition of Supervision Group Trainer (T) Supervisor (SE) Trainees 1 . 2 . 3 (CE) In addition to their involvement in a supervision group, the four supervisors and four trainers also hold a weekly supervision seminar, and each supervisor meets weekly with a trainer in a one-to-one context where the supervisor’s individualized training needs are discussed. Before addressing each of these contexts for learning supervision, we will briefly outline SEP objectives and criteria for selection. The SEP has four interrelated objectives: Developing skills i n epistemologcc articulation. Part of being an effective supervisor is the ability to specify the theoreticitherapeutic assumptions and propositions of one’s therapy and training approach. Therefore, our first objective in the SEP is t o help supervisors clarify their beliefs, assumptions, objectives and methods of therapy. Conceptual skills of supervision. This objective addresses the need to develop the conceptual complexity associated with supervision as opposed to therapy. Supervisors are helped to develop a knowledge, appreciation and ability to understand and use the family therapy training and supervision literature. Supervisory skills. Supervisors learn and practice the skills of family therapy supervision in an actual supervision situation. Skills of live, video and group supervision are included. Professional socialization skills. Through the seminar, individual meeting with the trainer, the experience of actually doing family therapy supervision, and through the
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esprit de corps that develops within the supervisorltraining subsystem, supervisors begin to develop a professional identity as a family therapy trainerlsupervisor. This identification complements their disciplinary affiliation (MSW, PhD, MD), and makes more sophisticated their identity as a family therapist. These are demanding objectives that we strive to achieve using a complex training formula. Needless t o say, if we are t o be successful, the first step is to select candidates who can meet these demands. We have, therefore, developed specific selection criteria and procedures for making our choices. The selection critiera include the following: Compatibility with the FSP orientation to therapy and training. Since our orientation to clinical training is structural-strategic, we believe it essential that supervisors enter the program with a similar framework. Otherwise, conceptual retraining must occur or conceptual differences interfere in the actual supervision, with the likelihood of negatively impacting therapy. Previous training in family therapy. We do not believe it is possible to train someone to be a family therapy supervisor if that person does not already possess high-level skills as a structural-strategic family therapist. Although not a prerequisite, most of our supervisors had already completed our one-year clinical training program. Personal maturity and flexibility. The training experience of the SEP is challenging and stressful because the supervisor must simultaneously assume the roles of teacher and learner, and thereby occupy a middle position between trainer and trainee. To survive in this sometimes tenuous and ambiguous position requires strength, the basis of which is a high level of personal maturity and flexibility. Interest in and opportunity to assume supervisory responsibility. Because we adopt a learning-by-doing philosophy of training, we expect supervisors to be working in a context wherein they are supervising in their work setting. This not only expands their practice base, but also affords a forum in which they can practice skills learned in the SEP in a less pressurized context. In addition to interviewing each candidate individually to assess the aforementioned criteria for admission, we also employ a selection exercise which utilizes a videotape stimulus in a small group interview situation. In this exercise applicants first view tape segments from a family therapy session. They are then asked to engage in a group discussion by responding to the segments from the point of view of a supervisor watching the interview, and to then reach a consensus on an appropriate supervisory intervention. They then hear the actual phone message used by the supervisor of the session (dubbed onto the videotape) and discuss it in relation t o their intervention. This kind of enactment-focused stimulus stiuation is consistent with our theory of learning and trainee change (learning-by-doing, emphasis on action vs. reflection). Further, it enables us to transcend self-report data of applicants, and as is the case with enactments between family members, this kind of procedure reveals a quite useful and relevant interactive class of information upon which more informed admission decisions can be made. TRAINING FORMAT The training format is designed to provide several complementary contexts for learning supervision. The supervision group is the context for the live supervision of supervision (meta supervision). The seminar provides a context for trainers and supervisors to discuss issues of supervision, and the individual meeting(s) between trainer and supervisor addresses specific issues relevant to each supervisor’sdevelopment.
The Supervision Seminar Held weekly for ninety minutes, the seminar constitutes an integral part of the SEP. It is a learning context where trainers and supervisors convene to discuss super-
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vision through structured presentations, assigned reading: review of videotapes and informal discussions. The seminar provides information about supervision, support, and a context for identity development as a trainee. It provides a haven away from the actual practice of supervision where issues arising in the supervision groups can be addressed with some distance, and creates a boundary around the trainers and supervisors by identifying this group as responsible for the supervision of trainees. The supervision seminar is analagous to a delayed supervision context in training therapists. In live supervision, the demand or performance characteristics of the setting are greatly magnified, especially in comparison with a delayed setting (e.g., videotape). In the supervision seminar, the trainers attempt to create a context where openness to examination of one’s actual supervisory work, as well as the workings of each supervision group could be discussed comfortably, and serve as learning material for the other supervisors and the trainers as well. At the outset of the year, supervisors are assigned the task of preparing a presentation for the seminar in which they each make an epistemologic declaration of their model of therapy (Liddle, 198213).This exercise constitutes a vital component of supervisor training in that a supervisor’s ability to help a therapist develop hisher own style within a particular therapeutic approach is a complex, demanding task. It is one which is largely dependent on the conceptual literacy of the supervisor; that ability to not only give clear direction to a trainee, but also explain, at the appropriate time, the rationale for a certain direction or suggestion. This requires considerable skill in communication, and conceptual articulation; the capacity to link the experiential and cognitive aspects of teaching and learning together in a unified, understandable whole. Again, our conceptualization of the process of training supervisors takes into account the permeable boundary between the target content areas of knowledge about therapy and knowledge about supervision. Although our supervisors were all well-trained and talented practicing family therapists, none previously had to so stringently clarify their premises about therapy. This activity allows them to identify aspects of their approach and manner of thinking about therapy that require strengthening. In addition to becoming the content of a particular seminar, the epistemological declaration also serves as basis for refinement of the supervisors’ conceptual skills throughout the training year. It also serves an important assessment function for each trainer-supervisor unit by clarifying conceptual differences operating in each of these dyads. These differences, though sometimes small, have often been found to have a n amplified effect in the actual handling of a case. One third of the seminars are also devoted to structured presentations of supervision issues. Although this content is still evolving, for purposes of illustration we will now briefly describe the following areas covered in separate seminars: the supervision context, establishing a baseline of trainee competence, skills of live video and delayed supervision and the supervisor-supervisee relationship, and supervision literature. The seminar on context is designed to prepare the supervisor for the complexity of the previously described training system (T, SE, CEl,2,3).The multiple, interacting subsystems are defined and operationalized, and the supervisor is sensitized to the reality that multiple levels of communication are in operation whenever the supervisor intervenes. Most supervisors are initially overwhelmed when presented with the degree of multilayered complexity of the training system. Yet, the net effect is that the supervisor approaches supervision with an increased appreciation for the position(s) and needs of all members of the training system, as well as a heightened degree of respect for a supervisor’s role. Another seminar, held early in the training year, is devoted to specifying the dimensions of trainee assessment. Consistent with the systems viewpoint, we emphasize that a trainee’s initial clinical performance is always a function of the training context,
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which includes a host of interacting variable^:^ a trainee’s previous background; hisher initial response to live supervision; differential experience levels of supervisor and trainee, and among the trainees themselves; level of difficulty of the family; and the trainee’s ability, potential and commitment to training. Supervisors are taught to assess the impact of these variables upon the trainee’s performance and to extrapolate an approximation of a trainee’s level of therapeutic functioning. This assessment becomes a baseline for establishing individualized training goals with each supervisor. Although the program has utilized training objectives in the past (Falicov, Constantine & Breunlin, 1981), they are no longer used at the same level of detail. Rather, skills a t the trainee level are more generically clustered, and take into account the potential of each trainee to become competent in the domains of observational, conceptual and executive skills. Another seminar addresses supervisor-trainee relationship issues and, in particular, the idiosyncratic potential and actual difficulties of our own training system. As we have indicated, the trainer, supervisor, trainee subsystem involves a reticulate pattern of relationships which, above all, needs an initial clear definition, as well as ongoing attention to issues of communication, clarity of role function, and boundary maintenance. The seminar also examines trainee learning styles and explores ways in which the supervisor-trainee relationship can be assessed and changed to maximize the trainee’s potential to learn. Several seminars focus on the mechanics of live supervision since this is a primary supervisory method emphasized throughout the program. Using concrete, sequential guidelines developed for supervisors wishing to conduct live supervision from a structural-strategic orientation (Liddle & Schwartz, in press), supervisors learn how to prepare for a live supervision session, decide about phone-in or consultation interventions, make a phone-in, and debrief a trainee after a session. Videotapes illustrating live supervision phone messages, and during-session consultations are used to illustrate the process of live supervision. The seminar on videotape supervision examines both guidelines for use of videotape, and strengths and drawbacks of a medium which places a trainee’s work on display in a way that can enhance rather than reduce vulnerability. Another seminar examines the process of group supervision operating from a structural-strategic perspective. Although this approach does not emphasize the group process to enhance training, we take these issues very seriously, believing that the supervision group constitutes a system whose interaction frequently mirrors patterns occurring in the therapy room, sometimes producing impasses in the ability of the group to assist the therapist (Cade, 1980). Beyond this phenomenon, the group also has its own set of rules with cohesion, flexibility, support, challenge and communication, constituting variables which can enhance or limit the group as a context for learning. The seminar on the literature of family therapy supervision and training field presents a select and topicicontent-organized outline of relevant source material. Following the recent outline developed by Liddle (1982b),the seminar reviews the content, methods and contexts of contemporary family therapy training. Required readings are assigned throughout the program. As in the training of therapists, this kind of conceptual input is awarded high priority in the SEP. Following completion of the structured seminars and epistemological clarification activities, supervisors and trainers alternate in using seminar time to present videotapes of supervision of the trainees’ cases. We use equipment which automatically records phone messages onto the tape of the family therapy session. Hence, the tape review provides an opportunity to analyze supervision from several related perspectives: the conceptualization of the case, trainee style and intervention, the pragmatics of phone messages, and the supervisor-trainee relationship.
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This seminar format enables the supervisory process to be dissected and then integrated. It constitutes a n exercise that enables supervisors to develop greater complexity and precision. The context ofthe seminar, with trainers and supervisors showing tapes of their work, defines both as part of the supervisory subsystem. It is also encouraging for supervisors to see a trainer present a tape in which supervision does not flow smoothly. The tapes also reveal the complexity of supervision, and can, thereby, reveal a sophisticated formulation of the supervisory process. Trainer-Supervisor Meeting Once a week for a n hour each supervisor-trainer dyad meets to discuss issues relevant to its supervision group and the emerging style of the supervisor. In this dyadic subsystem, a sense of we-ness-a joining a t the level of sameness (supervisory responsibility)-can be promoted while maintaining the appropriate hierarchical organization of trainer and supervisor. Away from the demands of the supervision group with its focus on helping families, live supervision and a multitude of complex relationships, the trainer and supervisor can reflect upon the events of a recently completed supervision session, and plan for the upcoming one. The meeting includes discussion around cases, the trainer-supervisor relationship, or the functioning of the training group as a whole. In this meeting the trainer gives the supervisor feedback on hisiher work apart from the trainees, thereby avoiding situations in which the supervisor’s work is criticized in the presence of the trainee (whichwould be similar to a supervisor critiquing a trainee in the presence of the family). Pragmatically speaking, we have become quite sensitive to the way the trainer, either implicitly or explicitly, contributes to the formulation of the strategy and interventions of a case being handled by a supervisor. That is, seemingly small actions in the trainer-supervisor subsystem, such as trainer-supervisor disagreement, or a trainer’s suggested or implied intervention, can have disproportionate reverberations in the supervisor-trainee dyad. The content and form of trainer-supervisor interaction can thus have deleterious (or beneficial) effects on the development of a supervisor’s autonomy, trainee’s confidence in the supervisor, as well as on the trainee’s clarity on the family’s interactions and proposed direction. Hence, if a trainer believes a supervisor is handling a case in a problematic way, this dicussion occurs i n their weekly meeting where the situation can be reviewed and plans made jointly for handling the case in subsequent sessions. The meeting also, of course, enables trainer and supervisor to monitor their relationship. We have found that stresses in this relationship are inevitable and best handled through direct negotiations in this meeting. Finally, the need for and focus on the trainer/supervisor meetings provides a poignant example of concurrent training in integrated supervisor and therapist training programs. In our context, the trainer’s input works a t supervisor and trainee levels simultaneously. The trainer’s task is enhanced by a flexible map that cqnceptualizes the training system as a series of interlocking subsystems, any of which can be the focus of histher interventions a t any point in time. The available training and supervisory methods (lecture, videotape review, individual reviewiplanning sessions, live supervision, etc.), are best thought of in interrelated ways. Each has its own goal(s) and focus, and yields certain results. Any single technique cannot be seen as sufficient to produce the desired results. This meeting and the seminar, although crucial to the program, essentially complement the primary forum of the program, the supervision group, to which we now turn.
The Supervision Group Since our training principles mandated the direct observationisupervision of a supervisor extern’s work, we integrated this supervisor training with our already complex clinical training system, the clinical extern program. This combination resulted in
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a training group with a high degree of structural complexity and a large number of simultaneously evolving relationships. Our experience suggests that this delicate system can benefit all members and work productively if certain conditions are met and potential problems considered in pre-programming and ongoing monitoring efforts. The pace at which a supervisor takes responsibility for a case depends on several factors: (a) the supervisor’s level of synchrony with the trainer’s model of therapy, (b) the supervisor’s ability to join the system as a leader, (c) the needs of the trainees and of the families, and (d) the pace at which the trainer can establish hidherself and feel comfortable sharing the spotlight. For most supervisors the integration process has been gradual. Initially, the supervisor observes the trainer in action, discussing the reasons for the trainer’s interventions and adding ideas which are filtered t o the trainee through the trainer. Gradually, the supervisor is given responsibility to supervise a case, but the trainer may closely supervise this supervision, participating in pre-session discussions and discussing calls before the supervisor makes them. Later, the supervisor may supervise cases while the trainer intervenes only when absolutely necessary. Finally, and perhaps most crucially, the supervisor handles cases apart from the trainer’s presence, later reviewing the videotape with the trainer, which includes the during-session consultations with their therapist-trainee and their live supervision phone-ins. As one might imagine, issues of role definition and boundaries are extremely important as the supervisor is gradually integrated into the training group. The trainer’s directives or suggestions to the supervisor must be made judiciously and selectively, with a full awareness that, because they are made in the presence of the trainees behind the mirror, these inputs have the potential to disempower the supervisor. It is important for the trainer to remember that the opportunity for detailed input to the supervisor exists in the seminar and in the individual meetings. Therefore, the trainer’s input during the training group can be carefully tempered. Also, the seating in the observation room can be organized to reflect the proper structure of the group at any point in the training year. That is, as the supervisor begins to take supervisory responsibility, he/ she sits near the phone with the trainer, and the observing trainees cluster in the back of the observation room. As the training progresses the trainer may relocate and the observing trainees may move closer. Thus, just as in family therapy, the proximity of the members of the training group can be used to clarify boundaries and control the flow of information. In addition to these structural considerations, several other predictable issues in the development of the supervision group need to be anticipated and addressed. Since supervisors and trainees begin their training at the same time, a conflict in developmental needs between them arises midway through the training year. About the time the supervisor has been given a good deal of supervisory responsibility and is eager to practice the skills of supervision, the trainees are often approaching a point where they should increasingly rely on their own clinical judgment and receive less supervisory input. Fortunately, the families being supervised also evolve through a number of stages of therapy which require different skills at each stage. Thus, a trainer who is sensitive to the potentially conflicting needs of supervisors and trainees can arrange for the supervisor t o supervise a case which requires skills that the trainee has not yet mastered. Clearly, there is potential for difficulties within the organization of such a supervision group. For illustrative and discussion purposes, the supervisor’s position might be thought of as analogous to that of a parental child (PC) in a single-parent family. The PC is, by definition, working a t a middle position between the parent and hisiher siblings. The parent relies upon the older child for assistance in household chores and childrearing responsibilities with the younger siblings, which often include disciplinary functions. Minuchin (19741,and Minuchin and Fishman (1981) have correctly reminded us that a PC situation is not inherently dysfunctional. It is true that the web of rela-
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tionships between parent(s), parental child and younger children is a delicate area. Yet, as Minuchin and Fishman (1981) observe: “this arrangement works well as long as the parental child’s responsibilities are clearly defined by the parents and fall within the capabilities of the child, given her level of maturity” (p. 54). On the other hand, if the parents delegate authority inconsistently or completely abdicate responsibility to the PC, the demands on the PC can be overwhelming, clash with hislher own childhood needs, and outstrip the child‘s ability t o cope with them (Minuchin, 1974, p. 97). In our training system, the supervisor must be given clear supervisory responsibility and authority in relation t o trainees. Yet, it is also clear to the trainees that the supervisor is in training. If a clinicalisupervisory situation thus necessitates additional intervention, all levels of the system are aware that such intervention is possible. In sum, although the supervisor as parental child analogy, is admittedly imperfect, it does provide a way of sensitizing the trainer to the precarious position ofthe supervisor, and the complex nature of the entire training system. The supervisor’s position at the interface of the trainer and trainees is not defined as inherently problematic. Rather, it is seen as inevitable in the simultaneous training of therapists and supervisors. With a clear and fluid conception of the system’s overall configuration, as well as an equally articulate sense of the ways in which the subsystems are connected and are separate, the trainer’s task is made manifestly more possible and enjoyable. CONCLUSIONS Although we have stressed the positives of this training endeavor, we are aware that the experience of training supervisors can, a t times, be taxing and overwhelming. The complexity of such an undertaking requires careful thought and much planning. Even then there will emerge many challenges, but also many rewards. Crucial to our work has been a clear sense of our basic premises about therapy (theory of change) and training (theory of learning). Further, our epistemologic foundation has relied significantly on the isomorphic nature of one’s view of therapy and corresponding view of training. This framework has served as an indispensible conceptual and pragmatic guide in a training system made more complex by the simultaneous operation of therapist and supervisor instruction. More specifically, the SEP program embodies a multi-method training philosophy. The following activities are all viewed as instrumental to effective training: (a) live observation of supervision; (b) theory seminar; (c) opportunity t o receive feedback on supervisory skills and style (videotape supervision, case discussion with trainee); (d) learning and support from peers; and (el practice of supervisory role and skills at primary work site-the opportunity to supervise. Not surprisingly, the preceding list resembles one that might be articulated as elements of any therapist training program. The training of supervisors, indeed, should follow the general form of our therapist training. Yet, there are key differences. First, we must become specific about what we believe to be the skills of supervision. Although an appreciation of the isomorphism between training and therapy can serve as a guide in specifying these skills, it cannot, in and of itself, generate all the particular guidelines necessary for a trainer’s work. A second key difference involves the availability for trainers of a sufficiently complex map which can portray, in a manageable way, the training system and its interdependent component subsystems. Thinking in terms of subsystems (function of each, interaction of different subsystems) is an invaluable device for trainers in contexts similar to the one described in this paper.
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REFERENCES Batson, G. Mind and nature. New York: Dutton, 1979. Bloch, D. & Weiss, H. Training facilities in marital and family therapy. Family Process, 1981,20, 131-146. Cade, B. W. Resolving therapeutic deadlocks using a contrived team conflict. International Journal of Family Therapy, 1980,2,253-262. Falicov, C., Constantine, I. & Breunlin, D. C. Teaching family therapy: A program based on learning objectives. Journal of Marital and Family Therapy, 1981, 7,497-506. Fisch, R., Weakland, J . & Segal, L. The tactics of change: Doing therapy briefly. San Francisco: Jossey-Bass, 1982. Haley, J . Uncommon therapy: The psychiatric techniques of Milton Erickson, M.D. New York: Norton, 1973. Haley, J . Problem solving therapy. San Francisco: Jossey-Bass, 1976. Haley, J . Leaving home: The therapy of disturbed young people. New York: McGraw-Hill, 1980. Liddle, H. A. On the problems of eclecticism: A call for epistemologic clarification and human-scale theories. Family Process, 1982,21, 243-250. (a) Liddle, H. A. Family therapy training: Current issues, future trends. International Journal of Family Therapy, 1982,4, 81-97. (b) Liddle, H. A. Five factors of failure in Structural-Strategic therapy: A contextual construction. In S. Coleman (Ed.), Faitures in family therapy. New York: Guilford, in press. Liddle, H. A. & Halpin, R. Family therapy training and supervision literature: A comparative review. Journal of Marriage and Family Counseling, 1978,4, 77-98. Liddle, H. A. & Saba, G. W. On teaching family therapy at the introductory level: A conceptual model emphasizing a pattern which connects training and therapy. Journal of Marital and Family Therapy, 1982,8,63-73. Liddle, H. A. & Saba, G. W. The isomorphic nature of training and therapy: Epistemologic foundation for a Structural-Strategic training model. In J. Schwartzman (Ed.), Macrosystemic approaches to family therapy. New York: Guilford, in press. (a) Liddle, H. A. & Saba, G. W. On context replication: An isomorph of training and therapy. Journal of Strategic and Systemic Therapies, in press. (b) Liddle, H. A. & Saba, G. W. Training family therapists: Creating contexts of competence. New York: Grune & Stratton, in press. (c) Liddle, H. A. & Schwartz, R. C. Live supervisioniconsultation:Conceptual and pragmatic guidelines for family therapy trainers. Family Process, in press. Liddle, H. A., Vance, S. & Pastushak, R. Family therapy training opportunities in psychology and counselor education. Professional Psychology, 1979,10, 760-765. Minuchin, S. Families and family therapy. Cambridge, MA: Harvard University Press, 1974. Minuchin, S. Constructing a therapeutic reality. In E. Kaufmann & F! Kaufmann (Eds.), Family therapy of drug and alcohol abuse. New York: Guilford, 1979. Minuchin, S. & Fishman, H. C. Family therapy techniques. Cambridge, MA: Harvard University Press, 1981. Monalvo, S. Aspects of live supervision. Family Process, 1973,12, 343-359. Saba, G. & Liddle, H. A. Family therapy training and subervision: The state of the art. Zeitschrift fur Systemische Therapie (Journal of Systemic Therapy), in press. Sluzki, C. On training to think “interactionally.” Social Science in Medicine, 1974,8,483-485. Watzlawick, F!, Weakland, J . & Fisch, R. Change: Principles of problem formation and problem resolution. New York: Norton, 1974. NOTES ’Although the current paper, as well as our other work, has presented aspects of a structuralstrategic therapy (Liddle, in press) and training model, the isomorphic nature of training and therapy is not only applicable within this theoretic orientation. Our belief is that the principle of the connections between training and therapy can help all approaches become more appropriately complex, refined, and ultimately, more effective.
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JOURNAL OF MARITAL AND FAMILY THERAPY
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2This should not imply the live supervision context as the only locus of change in training. Individual and group supervision, with and without videotape, training situations promoting peer interaction, and the supervisee's opportunity to practice the new ideas and skills in a n external work setting, are all significant contexts of trainee learning and change. "he SEP reading list, organized according to topic (training methods, program descriptions, etc.) is available. The present list is a n extension of the Liddle and Halpin (1978) review and containsover200references. 4Here we are reminded of the importance of first defining the elements of our own training context to the supervisors.
American Association for Marriage and Family Therapy 1984 Directory of Clinical Membe 'S An excellent referral source for qualified marital and family therapists throughout the United States and Canada. The 1984 Directory of Clinical Members lists addresses and telephone numbers in alphabetical and geographic sections. To order your copy of the AAMFT 1984 Directory of Clinical Members send your check or money order for $20.00 to:
AAMFT, 1717 K St., N.W. #407, Washington, D.C. 20006
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