EP85 Supervision Panel 01 - Robert Goulding, MD; Jay Haley, MA; Lewis R. Wolberg, MD; Jeffrey K. Zeig, PhD

Description:

Educational Objectives:

1. To compare and contrast clinical and philosophical perspectives of experts.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

• Session Introduction

  • Ann Wright Edwards introduces an open supervision session with Bob Goulding, Jay Haley, Jeffrey Zeig, and Lewis Wolberg.

  • Focus: Real-life clinical issues, therapist growth, and supervisory insight.

• Elder and Family Abuse

  • Case shared on elder abuse and violent family members.

  • Some institutes refuse violent patients, especially those under substance influence.

  • Strategies include clear behavioral contracts and terminating therapy if violence arises.

• Spouse Abuse

  • Case discussed involving pathological jealousy and potential violence.

  • Clear boundaries and warnings are vital.

  • External factors like alcohol often intensify abuse.

• Violence in Emergency Settings

  • Emphasis on calm, non-threatening communication with violent patients.

  • Avoid tranquilizers when possible—focus on reassurance to reduce fear-based reactions.

• Supervising New Trainees

  • Use video recordings for peer reviews and learning.

  • Encourage innovation and independent thinking.

  • Supervisors should guide without being overly directive.

• Obsessive-Compulsive Disorder

  • Case of severe OCD discussed.

  • Behavioral intervention: introducing a red bag into routines.

  • Medication (clomipramine) and cognitive strategies also recommended.

• Supervising Residents and Students

  • Challenges with students outside formal programs (e.g., at Stanford).

  • Suggestions: use one-way mirrors, video reviews, and manage supervisor conflicts.

  • Keep supervision content distinct from other instructors' input.

• Violence in Adopted Children

  • Case of a 12-year-old with violent behavior.

  • Recommend engaging father through structured activities like martial arts.

  • Emphasize love, structure, and focusing on the child’s needs, not just behaviors.

• Lack of Parental Participation

  • Father refusing family therapy involvement.

  • Create structured agendas and empathize with his reluctance.

  • Supportive involvement may increase willingness to engage.

• Balancing Innovation and Structure

  • Encourage trainees to think independently and creatively.

  • Supervisors should support experimentation while managing guidance and consistency.

  • Address and resolve supervision conflicts clearly.