A huge part of the practicum experience was supervision and planning. I spent at least two hours a week discussing cases and planning what to do next. As laborious as this felt at times I am grateful that my supervisors allowed me to use their experience as a guide, enhanced by my ideas, a systems perspective and four years of school. So how did the planning work?
For the most part, it went well. There were weeks where supervision was brief. There were weeks where only one side of the co-therapy partnership could attend and there were weeks when there was no guidance at all. In the end it all worked out and the clients suffered no ill benefits. Clients were happy and, interestingly, the structure of the session often took on a life of its own despite the most careful planning. There was one session in particular that sticks with me. My supervisor, co-therapist and I spent a considerable amount of time planning systematically what directions to take and what topics to discuss. I felt well prepared and excited for the work we were about to undertake. At the beginning of the session, an act of violence in the client’s world that had taken place since our last meeting rendered our careful plan moot and the session looked very different from what we had intended. The clients simply needed our assistance in a different capacity. Acknowledging that the time spent together is the clients helped me to forgo the planning and be with the client in whatever capacity they needed me.
I actually quite enjoyed the more ‘free range’ sessions, there unscripted nature and ability to just join with the client with no pre-emptive plan. These “improvised” sessions often felt less contrived and more responsive to the clients’ specific needs. As with all planning and good therapy, do not forget the basics of active listening, reflection and summaries all of which went a long way towards joining and helping the client - planned or not – realize what they first sought therapy for. When there was no plan it sometimes worked, but I left a few sessions feeling like little was achieved despite positive feedback from the client.
So was all the time spent in supervision and planning worth it? I think so. I enjoyed the processing of the previous session with my supervisor, learning about and discussing my own reactions and being able to devise a plan of action that fit the treatment plan I was required to create after three sessions. The treatment plan involves short and long term goals and a brief description of interventions that might aid the client in achieving what they initiated therapy for. One aspect that was somewhat bothersome was the scheduling and timing of supervision, but that is the nature of striving to be the best possible help to the clients you work with and balancing full time employment.
Additionally, co therapy supervision was great because it allowed for a variety of perspectives, experience and knowledge to blossom into some of the most productive and satisfying therapy sessions I have so far experienced. Planning with experienced and thoughtful professionals is worth the time and effort if you can make it work.
So what’s your plan? And how good are you at improvising?
Christian Billington is a counselor in training. He is passionate about end of life issues, grief and loss, trauma and the development of training to better prepare the emergency services for what they experience in the field.