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| Interpersonal Process Recall: Dynamic Use of Videotapes in Supervision |
| Columns - Clinical Supervision | |
| Sunday, 30 September 2001 | |
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The thought of videotaping a clinical session provokes anxiety for many counselors and presents the potential for creating a less than relaxed atmosphere for conducting therapy. One might even argue that it is disruptive and anti-therapeutic and claim that what is captured on videotape is not an accurate picture of the counselor's skill level. However, when properly introduced by a supervisor who has demonstrated a viable comfort level with the use of videotapes, any performance anxiety felt by the supervisee can eventually be reduced. Consider, too, that stated concerns about the patient's resistance to being videotaped may be a projection of the counselor's own resistance.Effective use of videotaping The use of Kagan's Interpersonal Process Recall (IPR) model (Bernard & Goodyear, 1998) as it is applied to clinical supervision is an example of effective use of videotaping. IPR, originally developed as a therapy model (Kagan, 1980), encourages the exploration of the therapeutic relationship by a review of a videotaped session by both the counselor and patient. Used as a supervision model, IPR encourages the supervisee to recognize and explore his or her internal processes while viewing a videotaped session. When the review occurs in the presence of the supervisor, the supervisee is encouraged to recall and process thoughts and feelings that occurred during a session. Questions provoke "recall" Supervisors who use the IPR model typically act as an "inquirer" and draw from a list of direct and catalytic questions. These questions may inspire affective exploration, check out unstated agendas, or encourage cognitive evaluation. When these questions are posed to the supervisee during the review of a videotaped session, they provoke "recall" of what happened in the session. As a result, the supervisee experiences self-awareness, and obstacles are removed that existed in the therapeutic and supervisory relationships. The questions and the videotape provide a structured format to follow and enable the supervisee to explore internal dynamics and to interpret what occurred in both the taped interaction and the "recall." The clinical relationship becomes a vehicle for professional development for the supervisee, which in turn enhances the therapeutic experience for the patient. The IPR method can also be a valuable tool in developing an effective supervisory relationship. The inevitable hierarchical nature of the supervisory relationship can create barriers to communication often resulting in what Bernard and Goodyear (1998) call the "strongly socialized habit of behaving diplomatically." Traditionally, the thoughts and intuitions of supervisees are discounted in supervision to avoid any disruption of diplomacy and to keep the relationship in its hierarchical perspective. By providing a safe environment for the supervisee to process internal reactions, the IPR method removes many of the barriers to supervisor-supervisee communication. Supervisor and supervisee benefit Although IPR focuses on the supervisee's internal reactions, the use of videotapes also gives the supervisor an opportunity to discern salient examples of the supervisee's work. As a sample of effective clinical work, a videotaped segment of a session can be used as a training tool during group supervision. For example, a therapist along with his or her supervisor may choose to share segments of a session with other members of a clinical team as a training tool. The videotaped session is shown and processed, giving the supervisee an opportunity to discuss what was done and why and what alternatives would have been more effective. Having experienced the process of investigating his or her internal reactions to the nuances of a counseling session on videotape, the supervisee, through an increased awareness of what is happening in the videotaped segment, can provide a meaningful and educational presentation to fellow therapists. Videotapes also give the supervisor an opportunity to discuss alternative interventions and strategies after processing segments of the recorded session. When alternatives are agreed upon, for example, a role-play can then be enacted between the supervisor and supervisee as a means of rehearsing these alternatives. Another example of using videotapes in supervision is showing videotaped segments of the supervisor's own work with patients. This not only shows that the supervisor is not infallible, but also allows the supervisor to demonstrate his or her own interpersonal recall. This demonstration also has the added benefit of reducing some of the anxiety a supervisee may have prior to being videotaped. Conclusive benefits Videotapes provide the supervisor with direct access to the supervisee's clinical skills and behavior while providing concrete examples of significant reactions on the part of the patient. The IPR model's use of videotaped sessions presents somewhat of a paradox due to the fact it allows an immediacy of re-experiencing the session that rarely occurs during the session. This phenomenon includes the emergence of insights experienced by the supervisee that may be exposed more readily when the session is reviewed on videotape. The IPR model is not new, however, it is congruent with the current philosophy of individualizing treatment and clinical supervision - a philosophy that encourages the exploration of unique needs and learning styles of the individual. When skillfully used, the IPR model and its use of videotapes, provides an effective means for this type of exploration. G Thomas G. Durham, MA, LADC, is a corporate officer at ETP, Inc., in East Hartford, Conn., where he coordinates a worldwide program of clinical supervision to alcohol to alcohol and drug counselors throughout the U.S. Navy and Marine Corps. A certified clinical supervisor with more than 25 years of experience, he frequently conducts training workshops and is a part-time faculty member at Tunxis Community College in Connecticut, where he teaches courses in counseling. References Bernard, J. M. & Goodyear, R. K. (1998). Fundamentals of clinical supervision. (2nd ed.). Boston: Allyn and Bacon. Kagan, N. (1980). Influencing human interaction - eighteen years with IPR. In A. K. Hess (Ed.), Psychotherapy supervision: Theory, research, and practice. (pp. 262 - 286). New York: Wiley. Powell, D. J. (1993). Clinical supervision in alcohol and drug abuse counseling. New York: Lexington Books. Stoltenberg, C. D., McNeill, B. & Delworth, U. (1998). IDM supervision: An integrated developmental model for supervising counselors and therapists. San Francisco: Jossey-Bass.              |
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