Clinical Supervision: A New Intern!

One of the better ways I think I can be of use to the community is by training other therapists and interns.  Have now hired and am doing clinical supervision with a new Marriage and Family Therapist Intern, Sarah Wood, MS, MFTI (#66300).

Am really happy about getting to do this.  With the Partners in Recovery program for interns sunsetting at the end of the last school semester, there’s been less opportunity to get to work with folk that way.  Am double excited about getting to do so with Sarah, because she’s already great at what she does, and really has a taste for The Work.

She comes on the recommendation of one of our last interns, Melissa Lamoureux, who was also at Partners in Recovery.  Sarah did her graduate work at the amazing program at Cal State Fullerton.  She’s done a lot of great work in the community already, specializing in therapy with children, trauma services for all ages, eating disorders/other addictions and more.

I feel like it’s a stroke of luck to get to work with her, am happy to get to recommend her services.  Please go by her website and learn more about Sarah at sarahwoodtherapy.com.  Welcome Sarah!

7400 Hours, Psychology, Clinical Supervision

About three years ago, my friend and colleague Judy McGehee LMFT (Partners in Recovery) began a supervision program for Marriage and Family Therapist interns (people that have completed their coursework for Masters degrees) and trainees (those who are about to complete Masters degree coursework).  Borne solely out of a desire to be helpful, and pass on the ability to provide effective human service, for fun and for free, Judy took on supervising 8 or so trainees and interns.  We were joined also by a visiting therapist, Ted Aaseland, Psy.D.  A little over two years ago I joined her in this endeavor, as I care deeply about passing on how to do “The Work”.

Over the course of those years, those interns provided services to the Glendora School District and elsewhere to children and adolescents for free.  Some of these turned into outpatient clients, individuals and families, also for free.  There were also public speaking engagements for adults and adolescents, professionals and non-professionals.  After all was said and done, over 7400 hours of free therapy (not including the speaking/community education efforts) were provided, all for free.

Interestingly and tragically, there are several stories that run in parallel with this one.  Before I get there though, it would be instructive to tell you a little about this process, both from the perspective of the licensed folk/interns/trainees, and from the folk we hope we were helpful to.

Will start with the experience of the trainees/interns/licensed folk.  Most universities require several hundred hours of internship/clinical experience for graduation.  The processing of these hours is supervised by a licensed therapist (who can be a supervisor, as regulated by the Board of Behavioral Sciences), and the student must pay for this process.  Most universities, in an uncomfortable wrenching of common sense, either don’t have someone to organize/and or set up/maintain these supervision placements, or they’re simply not updated for various reasons.  The student/trainee however, is still required to do this.  To add insult to injury, the trainee when in supervision, if they can find an agency, is rarely given a real experience of being supervised at their work.  It seems flabbergasting to consider this, yet it’s tragically true.

Similarly, interns (therapists just out of school) have to complete over 3000 hours of work with patients/clients, just to sit for the two licensing exams.  They have six years to complete this process, requiring continuing education to reset their chance to sit for the exams.  That means that they have to see clients, and that those hours also have to be supervised.  Related to both this issue and Judy’s (Ted’s, and mine) efforts, we were completely unable to get other clinicians to volunteer for either of these processes (for trainees or interns)- not even a couple of hours a month, let alone the minimal 2-4 hours a week.  In light of the complaints of most people we know not feeling like they received quality supervision, this is no small issue.

The second body of material that is really important here is the students and families.  There were of course the predictable experiences with clients who struggled with behavioral problems, substance use/addiction, depression, stress, bullying, pregnancy, self esteem, eating disorders, anxiety and the like.  It was also really common to have active suicidality, reports of abuse, the precursors of “thought disorders” (schizophrenia, and the like), violence, abandonment, PTSD, mood disorders (bipolar disorder and related problems) and more.  There was psychoeducation, crisis intervention, abuse reporting, ensuring of safety, documentation, creation and use of materials, referrals to resources, interfacing with administrators/Department of Children and Family Services/other clinicians/teachers/families and more, interviewing, showing up for IEP/planning meetings and more, and oh yeah… individual and family therapy.

The interns (and will give a little credit to us as well) braved all of these issues and more.  All for free.  Seven thousand, four hundred hours of it, and the attendant signing off of supervision hours.

We met weekly for all this time, as individuals and as a group, to meet the requirements for the relevant university, and for the Board of Behavioral Sciences.  We met in between to take care of paperwork.  To problem-solve.  To handle questions.  We met for lunches, at each others’ homes, in restaurants, in parking lots.  We celebrated birthdays, mourned losses, processed issues, checked one anothers’ heads.  There was a lot of happiness, crying, efforts to glean resource support to continue the work, discovery.

There’s certainly more to be said, and obviously, more work to be done.  Though this cycle of supervision is over, we still have a lot of passion and ideas for what might be next.  The whole point of writing this though, is simply to honor the work of Michael Cardenas, Eryka Gayoso, Elva Cortez, Jessica Wilson, Jeffrey Craig, Melissa Lamoureux MS, Ted Aaselund Psy.D, and most of all, Judy McGehee LMFT.  Thanks so much for making all this matter, and letting me participate.

Recognition for Partners in Recovery

Last Monday (9-26-11), Judy McGehee MFT, Melissa Lamoureux MS, Erika Gayoso MA, Ted Aaselund PsyD, Michael Cardenas, Jeffrey Craig, Jessica Wilson, Elvia Cortes MA and myself were recognized by the board of the Glendora Unified School District at their monthly meeting.  Formally, the agency is called “Partners in Recovery”, a nonprofit organization of clinicians providing services in Glendora and surrounding communities.

Judy, and I have been providing clinical supervision (a necessary component for grads and soon-to-be grads to get their “hours of experience” to sit for licensure as therapists or social workers) for the above mentioned interns and trainees.  Trainees are obtaining hours to graduate with their Masters degrees, interns are working on their hours (3000 hours of service over 104 weeks) to sit for the licensing examination with the Board of Behavioral Sciences.  In turn, the supervisees (the ones above and others from previous years) have provided thousands of hours of free services to the Glendora Unified School district, from elementary thru high school.  The supervisees from Partners have been assisting with issues of depression, abuse, family discord, eating disorders, suicide, addiction, grief and loss, bullying, self esteem, anxiety problems and more.

The program has been running since 2009 with Judy at the helm, and will continue at least through this year.  Judy, Ted, and the interns/trainees are all highly skilled clinicians.  It is a fantastic way for people to get services that might not have otherwise.  Nicely done everybody.

Communication With Adolescents? Communication With Everybody.

Got to do a talk with the aforementioned Judy McGehee MA, LMFT (www.mcgeheepartners.org) tonight at the “Parent Summit” organized by the Glendora School District. There were breakout sessions with different professionals and agencies providing talks on different topics. Dr. Mary Suzuki (wife of Dr. Dan Suzuki) began the session with Captain Rob Castro of Glendora PD, who discussed a previous summit focusing on adolescents and use of pharmaceuticals (illicitly).

Judy and I did a talk entitled “How to Talk so Your Kids Will Listen, How to Listen so Your Kids Will Talk”. As we discussed in our PowerPoint presentation, it became pretty clear that this was a misnomer- not only because it has more to do with relationships with kids, and further, much of the skills we discussed were relevant for most relationships in general.

During her talk, Judy identified the importance of being interested in your kids, not letting technology like cell phones and iPods get in the way of communication, ideas about developmental stages, roadblocks to communication and more. The parents and professionals who attended asked her a lot of questions about different types of age-appropriate communication, problem-solving specific issues and etc.

My talk endeavored a practical approach that highlighted suggestions to put me out of a job (one of my personal goals), principled ideas for use in communication, and some adolescent/child specific tools. We also discussed problem-solving issues like when/when not to intervene between siblings, children (who were sometimes adults in the examples) “stonewalling”, giving short and/or avoidant responses, even what might be described as resentful feelings prompting one or another to not talk all together. The details of these are of course beyond a blog.

That said though, will copy/paste some of the suggestions I had here. Any questions, ideas, encouragements etc are welcome. Again, would offer that many of these are useful in communicating with all types of people, in all different types of relationships. Here’s the abbreviated list:

• Don’t yell.
• Don’t be critical and/or judgmental.
• Don’t try to change others’ mind or behavior.
• Don’t interrupt.
• Don’t only have feelings of fear or anger, or not have feelings at all.
• Be graceful with the feelings you do have.
• Don’t interrogate. *only be a parent* (meaning, resist the temptation to be a police officer, financial adviser, career counselor, etc)
• Don’t interrupt.
• Don’t say one thing, then do another.
• If someone says something you don’t understand, ask them to explain it.
• If someone starts yelling, speak quietly.
• Avoid power struggles.
(Here is where some of the adolescent specific ideas began)
• It might be a good answer to them.
• Don’t be afraid of technology. Learn to text. Email.
• Ask their opinion.
• Tell them you love them, and what you like about them.
• Learn their language. You don’t have to use it. (www.urbandictionary.com)
• Use the “rule of five”, particularly in crisis. Five words a sentence, five letters a word.
• Find a way to be interested in them- what they think, what they like and care about, and why.

This is certainly not an exhaustive list. It also doesn’t address some of the principles that might otherwise be employed, doesn’t give some answers in context, and doesn’t explain why some of these tools might be important. Those ideas, as a rule, have to be discussed, processed. They also don’t address specifics about working through problems or issues. Most of these things are best done with a professional, over time. Hope some of these can be helpful.

More information about Petar at April30th.org.