1. BMFT 602: Internship I February 9, 2010

2. agenda Exam #1 (8:00-9:00) Break (9:00-9:15) Building an effective co-therapy team (9:15-10:00) Case management & record keeping (10:00-10:50) Exam #1 (8:00-9:00) Break (9:00-9:15) Building an effective co-therapy team (9:15-10:00) Case management & record keeping (10:00-10:50)

3. building an effective co- therapy team

4. co-therapy: definitions Form of psychotherapy treatment in which the therapist relates not only to a client or clients but also to a peer or peers Professional relationship that has the potential to develop & deepen over time and to affect and alter profoundly the lives of its practitioners Form of psychotherapy treatment in which the therapist relates not only to a client or clients but also to a peer or peers Professional relationship that has the potential to develop & deepen over time and to affect and alter profoundly the lives of its practitioners

5. general benefits of co- therapy Greater opportunity for learning through discussion & collaboration with another therapist Widened perspectives for therapists Widened transference possibilities for clients (if that’s your theoretical stance) Greater learning opportunities for clients Opportunity for therapists to check & balance complementary behavior Greater opportunity for learning through discussion & collaboration with another therapist Widened perspectives for therapists Widened transference possibilities for clients (if that’s your theoretical stance) Greater learning opportunities for clients Opportunity for therapists to check & balance complementary behavior

6. benefits that enhance therapist self-care Sharing the burden & loss of clients who terminate prematurely Source of acknowledgement & appreciation Can prevent burnout Source of emotional support Provide encouragement for tough cases Personal growth through collaboration Sharing the burden & loss of clients who terminate prematurely Source of acknowledgement & appreciation Can prevent burnout Source of emotional support Provide encouragement for tough cases Personal growth through collaboration

7. benefits to therapists & clients Help to stay centered & to avoid problematic countertransference Less likelihood of being manipulated by clients Ability to take greater risks in therapy Help to stay centered & to avoid problematic countertransference Less likelihood of being manipulated by clients Ability to take greater risks in therapy

8. benefits to clients Opportunity to learn about relationships between equals Opportunity to see desired behavior modeled between co-therapists Opportunity to see multiple choices Observation of relationship development over time Correction of misperceptions Role flexibility More available to clients Opportunity to see people who disagree with one another maintain a relationship Opportunity to learn about relationships between equals Opportunity to see desired behavior modeled between co-therapists Opportunity to see multiple choices Observation of relationship development over time Correction of misperceptions Role flexibility More available to clients Opportunity to see people who disagree with one another maintain a relationship

9. characteristics of successful co- therapists Complementary balance of therapist skills Compatibility of therapist’s theoretical viewpoints Openness in communication Equality in participation Liking each other as people Respect Complementary balance of therapist skills Compatibility of therapist’s theoretical viewpoints Openness in communication Equality in participation Liking each other as people Respect

10. dysfunctional co-therapy teams Encompasses more than mistakes committed by co- therapists Systematic failure to perform as a treatment team or to communicate as colleagues or both Will produce negative results for clients & themselves Do not recognize or acknowledge their mistakes Encompasses more than mistakes committed by co- therapists Systematic failure to perform as a treatment team or to communicate as colleagues or both Will produce negative results for clients & themselves Do not recognize or acknowledge their mistakes

11. Five C’s of co-therapy dilemmas Competition How will decisions be made? Who will talk & who will be silent & when? Will conflicts be resolved or avoided? Countertransference Confusion & lack of communication Lack of congruence Co-dependency Competition How will decisions be made? Who will talk & who will be silent & when? Will conflicts be resolved or avoided? Countertransference Confusion & lack of communication Lack of congruence Co-dependency

12. stages of development in co- therapy teams Phase 1: Creating a contract Phase 2: Forming an identity Phase 3: Building a team Phase 4: Developing closeness Phase 5: Defining strengths & limitations Phase 6: Exploring possibilities Phase 7: Supporting self-confrontation Phase 8: Integrating & implementing changes Phase 9: Closing Phase 1: Creating a contract Phase 2: Forming an identity Phase 3: Building a team Phase 4: Developing closeness Phase 5: Defining strengths & limitations Phase 6: Exploring possibilities Phase 7: Supporting self-confrontation Phase 8: Integrating & implementing changes Phase 9: Closing

13. Record-keeping & case management

14. required reports Weekly Hours report for MarDee - filling out form in schedule book; must be filled out each week after your last client of the week is seen Hours report for supervisor Old system - Excel sheet (posted on MFI Blackboard) New system - Access database (tutorial posted on MFI Blackboard) Weekly Hours report for MarDee - filling out form in schedule book; must be filled out each week after your last client of the week is seen Hours report for supervisor Old system - Excel sheet (posted on MFI Blackboard) New system - Access database (tutorial posted on MFI Blackboard)

15. required reports At end of each reporting period Record of all hours seen & supervision received - turned in to Teri Old system - format included in MFI Manual New system - Access database will generate report for you At end of each reporting period Record of all hours seen & supervision received - turned in to Teri Old system - format included in MFI Manual New system - Access database will generate report for you

16. casenotes & progress records

17. elements of the casenote Identifying information Client name Therapists’ names Session # Date of session Fee - collected/balance Content Description of what actually transpired in the session Identified patient, presenting problems, goals Ethical issues - suicide, child abuse, etc. Process Theoretical hypotheses, assumptions, & descriptions Use theoretical & relational process terms Describe patterns of interaction Homework assigned Supervisor recommendations Space for supervisor’s signature Identifying information Client name Therapists’ names Session # Date of session Fee - collected/balance Content Description of what actually transpired in the session Identified patient, presenting problems, goals Ethical issues - suicide, child abuse, etc. Process Theoretical hypotheses, assumptions, & descriptions Use theoretical & relational process terms Describe patterns of interaction Homework assigned Supervisor recommendations Space for supervisor’s signature

19. progress record Purpose - to provide a consistent record of progress in terms of signs, symptoms, & mental status for the IP in the client system More appropriate to release to other mental health professionals, attorneys, clients, doctors, etc. Review Progress Record Purpose - to provide a consistent record of progress in terms of signs, symptoms, & mental status for the IP in the client system More appropriate to release to other mental health professionals, attorneys, clients, doctors, etc. Review Progress Record

20. next week Topics Interventions Collaboration Treatment planning Reading Midori Hanna, 8-9 Cozolino, 9-10 Gerhart & Tuttle, 1 Topics Interventions Collaboration Treatment planning Reading Midori Hanna, 8-9 Cozolino, 9-10 Gerhart & Tuttle, 1