Anderson Timothy, Crowley Maryellen J, Binder Jeffrey L, Heckman Bernadette D, Patterson Candace L
a Department of Psychology , Ohio University , Athens , OH , USA.
b Department of Psychology , Harvard Medical School , Boston , MA , USA.
Psychother Res. 2017 Sep;27(5):549-557. doi: 10.1080/10503307.2015.1136442. Epub 2016 Mar 7.
This study examined the directive and non-directive supervisors' instructional styles, supervisees' interactive communications within supervision sessions as well as the relative success of supervisees' learning to apply specific techniques within psychotherapy.
The developers of Time-Limited Dynamic Psychotherapy (TLDP) provided the supervised training for 16 therapists as part of the "Vanderbilt II" psychotherapy project. Supervision sessions were rated for supervisors' adherence to TLDP content. Both supervisors and supervisee were rated for classroom interactive behaviors of "initiation" speech (e.g., introducing ideas) and "responsive" speech (e.g., amplifying the other speaker's topic). The third therapy session was targeted for discussion within supervision. Therapy sessions immediately before and after supervision were rated on TLDP adherence.
One of the supervisors (Supervisor A) was found to use an instructional style of relatively more initiation-based speech, whereas the other (Supervisor B) used more response-based speech. Technical adherence for supervisees of Supervisor A was significantly higher than those assigned to Supervisor B. Supervisees' initiation-based speech during supervision predicted less use of TLDP techniques in the therapy session after supervision. Supervisors' interactive style was not associated with therapy adherence.
Relatively more directive and structured supervision may influence the acquisition and use of manual-prescribed therapy techniques.
本研究考察了指导性和非指导性督导的教学风格、被督导者在督导过程中的互动交流,以及被督导者在心理治疗中学习应用特定技术的相对成效。
限时动力心理治疗(TLDP)的开发者为16名治疗师提供了督导培训,这是“范德比尔特二号”心理治疗项目的一部分。对督导过程进行评分,以评估督导对TLDP内容的遵循程度。对督导和被督导者在课堂上的互动行为进行评分,包括“发起性”言语(如提出想法)和“回应性”言语(如扩展对方的话题)。第三次治疗 session被选定在督导过程中进行讨论。对督导前后的治疗session进行TLDP遵循程度评分。
发现其中一位督导(督导A)使用的教学风格相对更多地基于发起性言语,而另一位(督导B)则使用更多基于回应性的言语。督导A的被督导者在技术遵循方面显著高于分配给督导B的被督导者。被督导者在督导过程中基于发起性的言语预测其在督导后的治疗session中较少使用TLDP技术。督导的互动风格与治疗遵循程度无关。
相对更具指导性和结构化的督导可能会影响手册规定的治疗技术的习得和使用。