SUPERVISING THERAPISTS WORKING WITH FAMILIES EXPERIENCING HIGH CONFLICT
SUPERVISING THERAPISTS WORKING WITH FAMILIES EXPERIENCING HIGH CONFLICT DIVORCE AND PARENTING Jeff Chang, PhD, R.Psych. Athabasca University & Calgary Family Therapy Centre Canadian Counselling and Psychotherapy Association, Winnipeg, MB, May 10 , 2018 TO ACCESS THE PRESENTATION AND ARTICLE Drjeffchang.webs.com
Speaking engagements Scroll down Publications Chang, J. (2016). Postdivorce counselling and dispute resolution: Services, ethics, and competencies. Canadian Journal of Counselling and Psychotherapy, 50(3S), S23S42. ACKNOWLEDGEMENTS
Athabasca University for financial support and time. Calgary Family Therapy Centre ABOUT ME
Ph.D., Counselling Psychology, University of Calgary Registered Psychologist, Alberta; Clinical Fellow & Approved Supervisor, AAMFT Associate Professor/Program Director, Athabasca University (Counselling) Clinical Supervisor, Calgary Family Therapy Centre ABOUT ME
23 years of excitement working with high-conflict divorce and parenting in private practice Bilateral parenting evaluations (approx. 170) Mediation
Parenting coordination Litigation support for family lawyers Current private practice only in high-conflict divorce ABOUT ME Calgary Family Therapy Centre: seeing families experiencing high conflict separations and
post-separation parenting PI for controlled multi-site study of New Ways for Families (funded by Palix Foundation) ABOUT YOU Disciplinary backgrounds? Work settings? Supervise at work? Academics? Disciplines?
Do you love this population? Do you they scare the crap out of you? ABOUT YOU Complaints? Who feels competent to supervise practitioners working with families embroiled in high-conflict separation and parenting?
Who knows what they dont know? Who is afraid you dont know what you dont know? (and something is going to come out of the blue and bite you in the butt!) HIGH CONFLICT DIVORCE High-conflict separation, divorce and parenting is deleterious to children and adults About one-third of former spouses have significant difficulty establishing a healthy relationship with each other after divorce 75% of divorces with children have no
court appearances that are not by agreement HIGH CONFLICT DIVORCE Another 10 to 15% require one contested application Between 5 to 15% have what can be described as high conflict relationships, characterized by:
Emotional reactivity Immediate blamefulness and attribution of intentionality for parenting slip-ups Exaggeration of parenting differences Court applications to restrict the parenting time of the other parent. HIGH CONFLICT DIVORCE
Court applications over issues that most former couples can manage on a month-to-month or season-byseason basis Pathologizing the other parent and talking about it in front of the children Case-building and recruiting coalitions partners. leading to long
HIGH CONFLICT DIVORCE For the purposes of this presentation, I am excluding cases where there is corroborated child abuse, IPV, severe/persistent mental illness, and/ or substance use disorder garden variety high conflict separation, divorce, and coparenting.
FOOTBALL SHOES AND CAMPING GEAR: DAD WRITES Have not seen what you are looking for. I believe Jason's [school] camping trip has been known for quite some time and it is unfortunate you have not organized his equipment before now, a lot on your plate with the girls horse show and overnight/out of town guests you were entertaining. FOOTBALL SHOES AND CAMPING GEAR: DAD WRITES
Unfortunately also for Jason is that Jason has no shoes for the first half hour of his 1.5 hour football clinic at 5pm today and that he had to participate in his socks. Please advise if you would like me to have standby items that you can't locate. Thank you. John FOOTBALL SHOES AND CAMPING GEAR: MOM RESPONDS
Yes we all had a fantastic weekend and wonderful memorable times with our out of town guests. BTW Kyle had Jason's shoes and he forgot practice started at five and brought them late. But I will be sure to show him this email so I can pass your criticism along to him. FOOTBALL SHOES AND CAMPING GEAR: MOM RESPONDS As for standby items John. I think it is long long overdue for you to
get a job and contribute to supporting your children. And yes fill your home with clothes and shoes and toys and bikes and helmets and scooters and sport equipment and pay for some of their education and activities. That would be amazing!! It's funny but Chris says in the U.S. people who YOUR EXPERIENCES . with high-conflict postdivorce parents/families?
THE PROFESSIONALS Invitations to pathologize Hard work and heart-breaking for us
Scares us many practitioners off Some authors suggest this is the most stressful area of psychological practice Area of practice drawing a plurality of ethical complaints Some therapists risk THE PROFESSIONALS And the toll it takes on us. THE PROFESSIONALS The Split:
Specialists who choose to work in this area, and EVERYONE ELSE who recoils in fear, revulsion, and defensive practice THE PROFESSIONALS The purpose of this presentation is to get you thinking about building capacity to work with these families in your workplaces.
What would you need to do to lead your organization to do this work more competently, or to educate/train others? Realistic appraisal vs. aversion SUPERVISORY COMPETENCE SUPERVISORY COMPETENCE
It is a truism that we must have sufficient competence to provide clinical supervision, but specifics are scant SUPERVISORY COMPETENCE CCPA Code of Ethics A3. Boundaries of Competence Counsellors limit their counselling services and practices to those which are within their professional competence by virtue of their education and professional experience, and consistent with any
requirements for provincial and national credentials. They refer to other professionals when the counselling needs of clients exceed their level of competence. (See also F2) SUPERVISORY COMPETENCE F2. Boundaries of Competence Counsellors who conduct counsellor education, training and supervision have the necessary knowledge and skills to do so, and limit their involvement to such competencies
SUPERVISORY COMPETENCE CRPO Standards of Practice 4. 1 The clinical supervisor must be competent in the area of practice/ modality that s/he has agreed to supervise. SUPERVISORY COMPETENCE ACES Best Practices in Clinical Supervision 2. Goal-Setting iii. The supervisor ensures that the supervisee chooses goals that fit within the supervisors areas of competence. b. The supervisor continually monitors his/her
own level of competence in providing supervision and acts accordingly. i. The supervisor provides supervision only for those supervisees and clients for whom the supervisor has adequate training and experience. SUPERVISORY COMPETENCE APA Guidelines for Clinical Supervision in Health Service Psychology Domain A: Supervisor Competence 1. Supervisors strive to be competent in the psychological services provided
to clients/patients by supervisees under their supervision SUPERVISORY COMPETENCE and when supervising in areas in which they are less familiar they take reasonable steps to ensure the competence of their work and to protect others from harm. SUPERVISORY COMPETENCE Recommendation Since competence is not a binary,
consider what support and resources are available: Consultation with legal counsel (professional liability and family law) Find a senior mental health professional experienced in highconflict divorce and services SCREENING AND CASE ASSIGNMENT
Screening is an imperfect science Cases that seem straightforward may throw you a curveball. High conflict separation/divorce cases sometimes come in through the side door Some parents generously interpret parenting arrangements in their own favour SCREENING AND CASE ASSIGNMENT Recommendation If possible, train intake staff (clinical and admin) to:
Ask and note on the file when parents are separating, separated, or divorced Request the parent calling bring in any orders pertaining to parenting Give the supervisee clear instructions/plan about what to cover in the phone call. Explain the ethical implications of high-conflict separation and co-parenting Support the supervisee to plan the phone call SETTING UP FOR SYSTEMIC SUCCESS Set the tone for systemic success.
Initial phone call In addition to typical intake info: Ask about if both parents will be involved. Emphasize with child or adolescent therapy, its important that both parents be involved to support changes the young person makes State that the family is the focus of intervention
SETTING UP FOR SYSTEMIC SUCCESS Make sure they know that we dont take an advocacy position in the even of an litigation Tell them we have no interest in compelling a parent to be in the same room as the other parent, but
we do think things go better for kids when their parents do make decisions together E-mail and copy to other parent SETTING UP FOR SYSTEMIC SUCCESS Clarify agency policy, your code(s) of ethics, legislation, quasi-judicial bodies, and case law about informed consent and access to information Recommendations: Coach re: phone call and consider live supervision Advocate with management for clarity on
informed consent and access to information policies SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES Knowledge: Supervisees should have better than basic proficiency with: Case conceptualization and treatment planning Typical child development Ethical reasoning
Dual roles and relationships Informed consent and access to information SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES Family systems conceptualization
Seeing things in patterns and in terms of social organization is essential for avoiding aligning too much with one parent Family life cycle Divorce process and dynamics of high-conflict divorce Dynamics of abuse -- subclinical
SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES Recommendations Evaluate supervisees knowledge about areas above and fill in any gaps, assign readings Provide support for ethical decision-making Find best practice guidelines for courtinvolved therapy (Association of Family and Conciliation Courts) Use a legal consultation service if one is provided by your professional association -do it with your supervisee as you sit together SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND
ATTITUDES Recommendations Connect with a family lawyer so you have someone on speed dial. Invite one to do PD with your organization HIPS AND PIPS Dr. Karl Tomm & Colleagues developed the ipScope. IP= Interpersonal Patterns PIPs = Pathologizing
Interpersonal Patterns HIPs = Healing Interpersonal Patterns HIPS AND PIPS Express it the gerund (--ing) form of the verb These vicious cycles can amplify pre-existing problems
EXERCISE In pairs, the speaker describes two typical recurrent interactions between you and a loved one one positive and one negative The listener takes notes about the interactions.
Discuss the situation with the goal of expressing the interaction in at least one set of coupled behaviors SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES Recommendations Evaluate supervisees knowledge about areas above Fill in any gaps SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES
Skills Executing basic interventions Balancing support with confrontation Managing the working alliance with multiple clients simultaneously Engaging and interviewing children SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND ATTITUDES
Managing highly conflictual interactions Maintaining even emotional demeanor in the face of provocative and blameful statements (poker face) Acknowledging without endorsing truth (accurate empathy) When he does X, you experience that as an effort at control. You interpret her asking the kids about the time they spent as monitoring you. SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND
ATTITUDES Attitudes Therapeutic neutrality Best interests of the children = effective parental decision-making Patience: the long view Recommendation Be prepared to increase support supervisees to fill enhance supervisees skill set Model actual words, phrases, and practices SUPERVISEE COMPETENCE: KNOWLEDGE, SKILLS, AND
ATTITUDES Supervise live (in room or behind mirror) to support skill development Watch for triangulation or supervisees alignment with one parent Support patience, use pre- and postsessions to calm and reassure
Like any other supervision, think about the case and the supervisees development; be alert to feelings of disempowerment and self-denigration SELF OF THE THERAPIST ISSUES For supervisee and supervisor Countertransference (and supervisory transference) Avoiding triangulation Dealing with helplessness Parallel process/isomorphism Dealing with professional attack sometimes via complaint to
regulatory bodies SELF OF THE THERAPIST ISSUES Recommendations: Reflect on your responses to the situation If necessary, seek consultation for yourself Parallel process/isomorphism Consider your stress level and how you can model calm well-informed coping TRAINEE NONDISCLOSURE
84.3% of trainees withheld information from their supervisors (Ladany & colleagues) more about supervisory issues than clinical issues trainees negative perception of
supervision, personal life concerns, and negative perception of supervisor. Because. deference to supervisor and perceived negative consequences. TRAINEE NONDISCLOSURE
nondisclosures involved concerns about supervisors perception of supervisee (20.6%) worried about how supervisors view them both professionally and personally concerns about professional inadequacy strong supervisory alliance less trainee nondisclosure and more TRAINEE NONDISCLOSURE
The more the anxiety experienced by the trainee, the greater amount of trainee nondisclosure and a lower overall willingness to disclose in supervision. INFORMAL SUPERVISION
Barry Farber study -- 146 trainees surveyed: peers, therapists, and significant others are often recruited not because formal supervision is perceived as poor or unhelpful -respondents found formal supervision more helpful supervisees feel anxious, stressed, inadequate, unknowledgeable, and SUPERVISEE NONDISCLOSURE AND INFORMAL SUPERVISION
The link between nondisclosure and informal supervision: no research yet But logically I argue that: nondisclosure and informal supervision are linked Extant research indicates that both are (unsurprisingly) negatively correlated
strong supervisory alliance SUPERVISEE NONDISCLOSURE AND INFORMAL SUPERVISION Recommendations Tend to the supervisory alliance Self-disclose your own anxiety about working with high conflict families as appropriate If comfortable, tell you own stories to preempt supervisees fear of being poorly evaluated by you Ask specifically about high-conflict separation cases if you dont they might not say
Support supervisee to reduce anxiety in other domains of the supervisees performance OVERCOMING LAWYERAND COURT-PHOBIA OVERCOMING LAWYER- AND COURT-PHOBIA Most therapists enter the field to be altruistic and conciliatory, not
adversarial Lawyers are obligated to advocate for their clients Some have not gotten the memo about adversarial process not being helpful for children OVERCOMING LAWYER- AND COURT-PHOBIA
If a lawyer thinks you know something that is helpful to his/her position, they may come fishing in your pond Dont expect them to know or care about our ethics or standards of practice Even though we might say we wont go to Court, there is no real way to decline to go if a judge thinks you know something worthwhile so go on your own terms! OVERCOMING LAWYER- AND COURT-PHOBIA Remember the author of any document placed in evidence can be examined and cross-examined
Fact witness Only direct knowledge What you have actually seen or heard Expert witness Qualified by experience and training Required when knowledge is outside of the scope of the general public OVERCOMING LAWYER- AND COURT-PHOBIA May give opinion evidence
May use hearsay There is no property in a witness CCPA has an excellent brochure on responding to subpoenas You may be required to turn over a file, but you can often negotiate to release less information ACQUIRING COMPETENCE
Focus for this presentation is generalist therapists who work with kids and families As specialists, many different kinds of services counsellors can offer
Family law section of local or provincial/state bar association Continuing education departments at law schools, social work and psychology programs Supervision and consultation CONCLUSION
Emotionally trying area of practice leading many practitioners to be avoidant to their own detriment Complex ethical issues Requires greater than basic skills and knowledge This is a mission for me! CONTACT INFORMATION E-mail: Web: [email protected]
drjeffchang.webs.com Chang, J. (2016). Postdivorce counselling and dispute resolution: Serv ices, ethics, and competencies. Canadian Journal of Counselling and Psy chotherapy, 50 (3S), S23S42.
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