EP95 Workshop 01 - Supervision of Structural Family Therapy - Salvador Minuchin, MD

Description:

Minuchin will supervise a therapist who brings a live family or a videotape of a family therapy session.

Educational Objectives:

1. To describe the foundations that every therapist has, and the idiosyncratic styles that constrain their intervention.
2. To describe a form of supervision that, accepting the therapist's baselines, moves toward an expansion on the repertory of therapeutic possibilities.
3. To describe the process of the relationship between supervisor and supervisee. 

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

Outline:

Evolution of Psychotherapy and Supervision Introduction

• Overview of supervision structure: six UNLV students, supervisors Tom Sexton and Jim Alexander

• Supervision framed as a dialogic process requiring familiarity with supervisees’ prior sessions

• Historical shift in teaching: from psychoanalytic techniques to focus on therapist instrumentality and self-awareness

Development of Therapist Skills and Techniques

• Emphasis on therapists’ self-understanding and emotional range (analogy: different violins)

• Therapist must build trust with supervisees and embody humor and healing

• Focus on systemic thinking and family transformation concepts as foundational knowledge

Family Therapy Approaches and Techniques

• Contrast between active, system-embedded therapist vs. democratic, non-intrusive therapist

• Describes radical transparency: families observe therapy teams to expose therapist assumptions

• Encourages therapists to know personal limits over strict analytic neutrality

Introduction of First Therapist Team

• Johnson and Norris (UNLV master’s students) describe couple: 46-year-old wife, 60-year-old husband

• Wife highly sexual; concern raised about husband sleeping with their son

• Discussion of wife’s dominance, husband’s passivity, and therapists’ emotional responses

Evaluation of First Intervention

• Initial focus on sexual dynamics; Speaker urges deeper exploration of relationship patterns

• Paradoxical task used; critique that symptoms were targeted rather than structural conflict

• Highlight: need to activate husband’s voice and engage in systemic power analysis

Therapists' Reflections and Learning

• Johnson and Norris reflect on countertransference and real-time emotional navigation

• Emphasis on spontaneity, coordination with co-therapist, and widening scope of focus

• Shown session segment where husband is successfully engaged

Introduction of Second Therapist Team

• Lassoff and Black present couple with 2-year marriage and 1-year-old child

• Financial stressors and escalating conflict identified as central concerns

• Intervention includes ritual “dumping” of grievances and communication role work

Second Team’s Intervention and Learning

• Session clip: wife escalates, husband withdraws; focus on inviting husband to engage

• Reflection highlights deeper appreciation of systemic conflict beneath surface complaints

• Speaker reiterates value of co-therapist trust and capacity for spontaneous intervention

Introduction of Third Therapist Team

• Hughes and Wilson present reserved couple with entrenched household role imbalances

• Wife left husband for 8 months; family of origin explored

• Goals include reenactment, exception identification, and reframing responsibilities

Third Team’s Intervention and Learning

• Segment shows discussion of role expectations and emotional disengagement

• Team reflects on learning to address root dynamics over superficial complaints

• Speaker affirms growth in spontaneity, observational stance, and therapist self-awareness

Transition from Involvement to Reflection

• Shift from direct “therapy of involvement” to more reflective “therapy of observation”

• Practicing alone requires intellectual distance not available in co-therapy

• Middle-distance therapy seen as limited; quiet therapy encouraged for deeper insight

Supervision and Therapeutic Process

• Supervision framed as support for therapist evolution, not correction

• Emphasis on impactful, not authoritarian, presence

• Therapists should avoid participating in enactments to retain observational clarity

• Active stance encouraged during training to build emotional repertoire

Enactment and Therapist’s Role

• Metaphor: square dance (participation) vs. enactment (observing the dance)

• Therapist must “think without acting” to understand system’s choreography

• Separation of thought and action expands clinical flexibility and responsiveness

Final Remarks and Questions

• Acknowledgment of Tom Sexton’s name by an audience member

• Ends with emphasis on the importance of developing both spontaneity and distance in therapy