Therapy Supervision Research Articles

Development of a Biomechatronic Device for Motion Analysis Through a RGB-D Camera

This work investigates the validity and reliability of a novel biomechatronic device providing an interactive environment in Augmented Reality (AR) for neuromotor rehabilitation. A RGB-depth camera and telemonitoring/remote signaling module are the main components of the device, together with a PC-based interface. The interactive environment, which implements some optimized algorithms of body motion capture and novel methodologies for human body motion analysis, enables neuromotor rehabilitation treatments that are adaptable to the performance and individual characteristics of the patient. The RGB-Depth camera module is implemented through a Microsoft Kinect, ORBBEC ZED2K devices; the telemonitoring module for teleassistance and therapy supervision is implemented as a cloud service.
 Within the module of body motion tracking, the abduction and adduction movements of the limbs of the full-body structure are tracked and the joints angles are measured in real-time; the most distinctive feature of the tracking module is the control of the trunk and shoulder posture during the exercises performed by the patient. Indeed, the device recognizes an incorrect position of the patient's body that could affect the objective of the exercise to be performed. The recognition of an incorrect exercise is associated to the generation of an alert both to the patient and the physician, in order to maximize the effectiveness of the treatment based on the user's potential and to increase the chances of a better biofeedback.
 The experimental tests, which have been carried out by reproducing several neuromotor exercises on the interactive environment, show that the feature recognition and extraction of the joints and segments of the musculo-skeletal structure of the patient's, and of wrong posture during exercises, can achieve good performance in the different experimental conditions. 
 The developed device is a valid tool for patients affected by chronic disability, but it could be extended to neurodegenerative diseases in the early stages of the disease. Thanks to the enhanced interactivity in augmented reality, the patient can overcome some difficulties in interaction with the most common IT tools and technologies; at the meanwhile she/he can perform rehabilitation at home. The physician can also check in real time the results and customize the care pathway.
 The enhanced interactivity provided by the device during rehabilitation session increases both the motivation by the patient and the continuity of the care, as well as it supports low-cost remote assistance and telemedicine by optimizing therapy costs.
 The key points are:
 
 i) making rehabilitation motivating for the patient, becoming a "player";
 ii) optimize effectiveness and costs;
 
 iii) possibility of low-cost remote assistance and telemedicine.

Clinical supervision in cognitive behavior therapy improves therapists’ competence: a single-case experimental pilot study

ABSTRACT Clinical supervision is a cornerstone in psychotherapists’ training but there are few empirical evaluations on the effects of supervision on therapists’ competencies. The aim of this study was therefore to evaluate the effects of standardized supervision on rater-assessed competency in Cognitive Behavior Therapy (CBT). Six therapists with basic training in CBT were provided with protocol-based clinical supervision in CBT in a single-case experimental multiple baseline design. The supervision focused on specific CBT competencies and used experiential learning methods such as role-play. Each therapist recorded weekly treatment sessions during phases without and with supervision. The therapists’ CBT competence was assessed by third-party raters using the Revised Cognitive Therapy Scale (CTS-R). Statistical analyses showed that the therapists’ CTS-R scores increased significantly during the phase with supervision with a mean item increase of M = 0.71 (range = 0.50–1.0) on the supervision focus areas. This is one of the first empirical studies that can confirm that supervision affect CBT competencies. The results also suggest that supervision can be manualized and that supervisees have a positive perception of more active training methods. Further studies are needed to replicate the results and to find ways to improve the impact of supervision.

Reflective practice facilitation within occupational therapy supervision processes: A mixed method study.

Supervisors of occupational therapists play a key role facilitating reflective practice with their supervisees. Through reflective practice, supervisees can optimise their skills in professional reasoning and decision making. The aim of this study was to describe to what degree reflective practice is facilitated within occupational therapy supervision processes. A mixed methods study design was used, collecting data via online surveys and focus groups. Quantitative data were initially analysed using descriptive statistics. Qualitative and quantitative data were then thematically analysed to identify hindering and enabling mechanisms to reflective practice facilitation. Eighteen supervisees and 17 supervising occupational therapists completed the surveys and 14 supervisors participated in a focus group. Half of the supervisees reported that reflective practice was facilitated through supervision only "rarely" or "sometimes." A hindering mechanism to reflective practice facilitation was the awareness of reflective practice models. Enabling mechanisms for reflective practice facilitation included understanding the benefits of reflective practice; recognising the attributes of a reflective practice practitioner; setting up an optimal supervision environment; and flexibly facilitating reflective practice. Findings suggest that reflective practice is not always regularly facilitated through supervision. This may limit opportunities for supervisees to optimise the development of their professional reasoning and clinical skills in the early stages of their careers.

Can we agree on the quality of clinical supervision? Inter-rater reliability of the Short–SAGE (Supervision: Adherence and Guidance Evaluation) scale

Abstract Clinical supervision is a cornerstone in psychotherapist training, but research in this area is hampered by a lack of validated tools for assessing supervision quality. Short–SAGE (Supervision: Adherence and Guidance Evaluation) is an observational instrument designed for evaluating supervision in cognitive behavioural therapy. The aim of this study was to evaluate the inter-rater reliability of Short–SAGE. Four experienced clinical psychologists participated in three 3-hour Short–SAGE coding training sessions, followed by an additional meeting and coding instructions. In a cross-over design, codings of 20 supervision sessions were then assessed with intraclass correlations (ICC), for both the 3- and 7-point scales of the instrument. In the single measure analyses for both scales, only one item showed ICC in the good range, and the rest of the 14 item ICCs were in the poor to fair range. Moreover, on the 3-point scale, five of the 14 inter-rater correlations were non-significant. For research and training purposes, validated tools to assess supervision quality are highly needed. However, instruments for measuring adherence and/or competence are of little value if the coders do not attain inter-rater reliability. Whether quality of supervision is associated with improvements in supervisees’ competencies is not yet clear. Short–SAGE provides a tool that may enable empirical research in this area. Further studies are needed to assess whether extensive training can improve the inter-rater reliability of Short–SAGE. Key learning aims (1) Readers will be aware of the urgent need for validated tools to assess clinical supervision quality. (2) Readers will be familiar with some existing tools for assessing the quality of clinical supervision. (3) Readers will be able to identify common problems in the development of instruments for assessing clinical supervision.

Play in social workers’ psychodynamic therapy supervision

ABSTRACT Various studies in the science and culture fields have long recognised the power of play in facilitating human development and therapeutic processes. This paper focuses on the developmental potential of play in psychodynamic therapy supervision for social workers who function as therapists, but its conclusions might be applied to supervision of other social work interventions. It is suggested that play is represented in supervision by an illusion shared by the supervisor and supervisee of their complete togetherness in the supervisee’s clinical struggles and clinical responsibility. This element of play temporarily reduces supervisees’ sense of loneliness in their responsibility for clients’ welfare and for the integrity of therapeutic processes. This illusion is healthy and growth promoting when supervisees acknowledge reality and when, by repeatedly experiencing this illusion, they assimilate it into their professional self. Through such a process, supervisees eventually internalise a professional community of supervisors, colleagues, and writers, who become symbolic representations that can be projected onto reality and facilitate professional interactions.

Model Control of Cupping Treatment Therapy for Patient Satisfaction at the Community Health Center in Langsa City, Indonesia.

BACKGROUND:Traditional medicine cupping therapy is so popular for the community in Langsa city; therefore, it needs to standardise and government control.AIM:To find out the supervision model of cupping therapy for patient satisfaction at the community health centre in Langsa City.METHODS:The design of this study is a quasi-experiment. The design used was a non-randomized pretest-posttest control group design. The sample was chosen as many as 45 people, using a purposive sampling technique for patients visiting with inclusion and exclusion criteria. Univariate and bivariate analysis was used to see the effect of traditional cupping therapy supervision models on patient satisfaction. Then test paired t-test and One-Way ANOVA.RESULTS:The paired t-test results showed a significant change in satisfaction with a value of p < 0.05. Group (SOP & supervision = 7.07) and (SOP = 3.13) each change with p-value = 0.0001. The group (control = 04) experienced a change in satisfaction with p-value = 0.02. ANOVA test results show there are differences between groups with a p-value of 0.0001. The difference in value includes SOP and supervision of the control of 7.46 with p = 0.0001. The SOP group for the control group was 3.53 with p 0.004. The SOP & supervision group towards the SOP group was 3.93 with p 0.001CONCLUSION:The SOP group supervision and supervision model is effective in increasing satisfaction scores cupping therapy patients in the community health centre of the city of Langsa, Aceh Province, Indonesia.

Limitations of Multicultural Supervision in Clinical Neuropsychology

Abstract Multicultural awareness, competency based clinical supervision, and the clinical neuropsychology subspecialties are areas of growing importance in the psychology field. Specific guidelines exist for multicultural practice, clinical supervision, as well as training in clinical neuropsychology. However, there are significantly fewer resources and training procedures that focus on multicultural supervision, very limited information regarding neuropsychology supervision, and almost non-existent resources that address multicultural considerations in clinical neuropsychology supervision. Objective: This Poster highlights the most important literature regarding general aspects of multicultural supervision in psychology, supervision in clinical neuropsychology, while also introducing ideas and considerations regarding the dire need of multicultural supervision in clinical neuropsychology. Method The authors reviewed the literature regarding general aspects of multicultural supervision in clinical psychology, supervision in clinical neuropsychology, and additionally highlighted the gaps related to supervision in multicultural neuropsychology. Finally, they introduced ideas to address some of the needs in the arena of supervision in multicultural neuropsychology. Discussion Available resources that explore, delineate, or evaluate competent multicultural supervision in clinical neuropsychology are absent. Partially, the limited understanding of - and research that focuses on - the influence of diversity in neuropsychological assessment and interventions might explain the lack of resources allotted to competent multicultural supervision in clinical neuropsychology. It is proposed that in clinical, neuropsychology supervisory process (as in therapy supervision) should include a culturally competent supervisor who can assist in the development of self-awareness, knowledge, and skills in order to provide interventions that understand, honor, and respect the clients’ multiple diversity dimensions.

PD-L1 expression on circulating tumor cells and prognosis of breast cancer patients.

e14028 Background: Nowadays programmed cell death (ligand) 1 (PD1/PD-L1) inhibitors in the clinic show benefit for appropriate patient. There are clinical trials for specific breast cancer patients. We all know that the prognosis of breast cancer is associated with CTC. However, PD-L1 expression on circulating tumor cells (CTC) is lack of research. It is crucial for the prediction and supervision of molecular-targeted therapy, while the predictive biomarker response to PD(-L)1 checkpoint inhibitors is lacking. So we tried to explore the relationship between overexpression of PD-L1 on CTCs and prognosis and clinicopathological features of breast cancer patients. Methods: We analyzed CTC and PD-L1 mRNA expression on CTC in 20 primary breast cancer patients, through mRNA probe hybridization. The relationship between clinicopathological features and PD-L1 expression on CTC was analyzed by chi square test. Kaplan-Meier and univariate Cox proportional hazards model analyses were used to compare the survival of patients with high PD-L1 expression and patients with low PD-L1 expression. Results: The median follow-up time was 40 months (range, 36-43 months). Of the 20 patients, 15 had more than 1 CTC in 7.5ml peripheral blood. Among the 15 patients, each one has at least 1 CTC showing PD-L1. The expression of PD-L1 on CTC was divided into low expression, medium expression and high expression, then we gave 1 score for low expression, 2 score for medium expression and 3 score for high expression. PD-L1 high expression was total score≥3, while PD-L1 low expression was total score ＜ 3. We found PD-L1 expression on CTC is related to the tumor size(P = 0.012) lymph node status (P = 0.001) and PR status (P = 0.037). There was significant difference between T2 and T3 in large tumor group(P = 0.003), while in node status group statistical difference can be found in N1 vs N3(P = 0.000) and N2 vs N3(P = 0.015). Our data indicated that patients with high PD-L1 expression on CTC had poor overall survival(P = 0.004) compared to low PD-L1 expression on CTC (Table). Univariate Cox proportional hazards model analysis showed that high PD-L1 expression on CTC was an independent prognostic factor. Conclusions: PD-L1 on CTC is indeed associated with some poor clinicopathological features. High expression of PD-L1 on CTC is an independent prognostic factor for shorter survival. [Table: see text]

Annotated Bibliography for Supervising Psychiatry Residents in Psychodynamic Psychotherapy.

This paper sought to compile an annotated bibliography for the outpatient year of adult psychiatry residents, providing resources for a foundation in psychodynamic theory which can be utilized in supervision to aid in ongoing psychotherapeutic work. In selecting the readings, the ACGME Milestones sub-competencies considered were (i) empathy and process, (ii) boundaries, (iii) alliance and provision of psychotherapies, (iv) seeking and providing supervision, and (v) knowledge of psychotherapy (theories, practice, and evidence base). Once the readings were selected, two authors independently reviewed the articles to determine which key sub-competencies each article addressed. Chance corrected agreement between the reviewers was assessed using the Cohen kappa statistic. The kappa for interrater agreement was 0.83. A list of 32 readings was compiled sequentially, allowing for theoretical concepts to be progressively built upon. The content of the papers aligned well with multiple sub-competencies in the medical knowledge (MK) and patient care (PC) domains. The bibliography allows for close examination of therapeutic frame; active listening and reflecting on the meaning of the therapist's interventions; transference and the use of countertransference as a diagnostic/therapeutic tool; defense mechanisms; patient pressures towards reenactment; theoretical viewpoints on therapeutic action (e.g., ego psychology, self-psychology, relational therapy, object relations, classical/modern Kleinian); and meaning of lateness, treatment breaks, and termination. This list serves as an ancillary resource which can augment discussions in therapy supervision, while also aiding in standardizing the minimal knowledge base achieved in psychodynamic theory.

Cognitive Behavioral Therapy in Choking Phobia: Case Report

Choking phobia (or swallowing phobia) is a disorder which defined as a fear and avoidance of swallowing food, drinks or pills. his study includes the process of the case formulation and cognitive behavioural therapy supervision which is addressed at the end of 27 sessions of a patient with choking phobia and panic attacks. Patient is 25 years old, university graduated, female with a profession. Patient recoursed with the complaints of choking thoughts while eating, panic attacks and trust issues she experiences in her romantic relationships. During the therapy process which has been composed within the framework of cognitive behavioral therapy; cognitive restructuring techniques, relaxation exercises, systematic desensitization, coping cards and psycho-education methods were utilized. At the end of the process, it was observed that the patient is able to consume food and drinks that she could not consume before the treatment, her choking anxiety while eating and drinking has disappeared. Moreover, she is able to eat in different social environments which was not possible before, her panic attacks did not repeate and in particular the cognitive distortions which are affected her romantic relationships decreased. In the follow-up interview it was observed that well-being has maintained. It is thought that this case study will contribute studies about choking phobia which are few in the literature. The findings should be strengthened by applying appropriate cognitive behavioral techniques to other cases.

미술치료 수퍼바이저의 수퍼비전 관계 경험에 관한 질적 연구

본 연구의 목적은 미술치료 수퍼비전에서의 미술치료 수퍼바이저의 관계경험을 살펴보는 것에 있다. 연구대상자는 미술치료 수퍼바이저이자 치료사로서 교육 경력 10년 이상인 7명의 미술치료 수퍼바이저이며 자료의 수집은 2016년 3월부터 2016년 9월까지 이루어졌다. 연구의 절차는 예비면접, 연구 참여자 선정, 심층 면접을 통한 자료 수집, 자료 분석 및 글쓰기의 순서로 진행되었다. 해석학적 현상학 연구 방법을 사용하여 미술치료 수퍼바이저 경험의 실재를 진솔하게 드러내도록 하였다. 그 결과, 미술치료 수퍼바이저들은 수퍼바이지와의 관계에서 한 명의 수퍼바이지를 성장시키는데 있어 어떤 순간에 성장을 독려하고 어떤 때 그저 지켜봐주어야 하는지를 안으로 냉정하게 숙고하고 있었다. 수퍼바이저들은 수퍼바이지의 성장에 가장 큰 관심을 두고 그 성장을 위해 매 순간 역할을 달리하는 모습을 보여주었다.

The Effects of Play Therapy Supervision Training Program Based on Developmental Supervision Model on the Competence of Novice Supervisor and Novice Supervisee

The Effects of Play Therapy Supervision Training Program Based on Developmental Supervision Model on the Competence of Novice Supervisor and Novice Supervisee

Introducing client feedback into marriage and family therapy supervision: a qualitative study examining the transition to empirically informed supervision

AbstractThe use of client feedback in clinical supervision provides a way for supervisors to access clients' experiences of the treatment process and monitor clinical progress of their trainees' cases. The present qualitative study investigated a marriage and family therapy training programme's early experience of introducing the Systemic Therapy Inventory of Change (STIC®; Pinsof et al., 2009) into clinical supervision. Supervisors (N = 8) and trainees (N = 14) were interviewed to elicit their experience using the STIC in supervision with a focus on understanding the frequency of use as well as the facilitators and constraints to implementation. The analysis of the narratives resulted in the development of five themes (time, supervisors' expectations, broader training system influences, client feedback training, and perceived helpfulness) that contributed to decreased usage over time. Recommendations to the field for integrating client feedback into empirically informed training and supervision are provided.Practitioner points Training programmes should consider the potential benefits of utilizing client feedback measures for outcome‐based training and supervision Training programmes adopting a client feedback measure need to be aware of the potential challenges of implementation The additional time needed to use a client feedback measure in the clinical supervision process must be considered as it is the most notable constraint to implementation

UHMS Guidelines for Credentialing, Privileging and Supervision of Hyperbaric Oxygen Therapy in the U.S.A.

UHMS Guidelines for Credentialing, Privileging and Supervision of Hyperbaric Oxygen Therapy in the U.S.A.

Best practices in supervising cognitive behavioral therapy with youth.

Clinical supervision of cognitive behavioral therapy (CBT) with youth ensures better patient care and fosters trainees' professional development. However, often insufficient attention is directed toward disseminating best practices in supervision of CBT with youth. This Therapeutic Advances contribution aims to communicate the core content of supervision. Additionally, the key supervisory practices associated with CBT with youth are described. Supervisory outcomes are summarized and recommendations for supervisory practices are made.

UHMS Guidelines for Credentialing, Privileging and Supervision of Hyperbaric Oxygen Therapy in the U.S.A.

This document provides health care professionals, hospitals, health care systems and non-hospital affiliated centers with credentialing and privileging guidelines for providers who attend hyperbaric oxygen (HBO2) treatments. The goal is to ensure optimal patient safety and the appropriate utilization of hyperbaric medicine.

An improved competence rating scale for CBT Supervision: Short-SAGE

AbstractRecent developments have led the UK government to deem clinical supervision ‘essential’ to a safe and effective national health service. Cognitive behavioural therapy (CBT) supervision has been increasingly operationalized and manualized, but there are few psychometrically sound observational instruments with which to measure CBT supervision. This paper reports the factor analysis of a promising 23-item instrument for observing competence in CBT supervision (Supervision: Adherence and Guidance Evaluation: SAGE).N=115 qualified mental health practitioners (supervisors and their supervisees) rated the same supervision session by completing SAGE. A principal components analysis indicated that a two-factor solution, identified as the ‘Supervision Cycle’ and the ‘Supervisee Cycle’ components, accounted for 52.8% of the scale variance and also demonstrated high internal reliability (α = .91 and α = .81, respectively). These findings provide the basis for a shorter, 14-item version of SAGE, clarify the factor structure of SAGE, ease implementation, and afford more succinct feedback. Short-SAGE also improves implementation yield, taking half the time to complete as the original 23-item scale. These conceptual and practical improvements strengthen the role of SAGE as a promising observational instrument for evaluating CBT supervision, complementing self-report assessments of competent CBT supervision with an instrument that can fulfil the distinctive functions that are provided through direct observation.

The Role of Intersectionality in Marriage and Family Therapy Multicultural Supervision

ABSTRACTThis paper offers a framework for understanding intersectionality and its role within marriage and family therapy multicultural supervision. An explanation of intersectionality, social identity relationships, multicultural supervision foundations and the influence of power through supervision will be discussed. Further, this paper will describe foundational concepts in the multicultural supervisory dyad and challenges integrating intersectionality within marriage and family therapy supervision. Implications for clinical supervision and research directions are discussed through cross cultural models, a randomized control design and conversation analysis.

Guided Imagery and Music (GIM): Reflections on supervision in training and therapy

Supervision is one of the scientifically neglected fields in music therapy and in GIM. One of the reasons for this is the different usage of the term in different countries. Clear definitions of supervision are needed. The author differentiates between supervision for training and job-related issues and reflects on a supervisor’s qualifications and competencies. Is an experienced GIM therapist sufficiently qualified as a supervisor or is a double qualification needed to be GIM therapist and professional supervisor? In order to give an orienting with a heuristic to be used by GIM supervisors the author refers to a multiperspective and metahermeneutic concept. Political, social, cultural, theoretical, ethical and practical dimensions are taken into consideration. An example of a supervision process is given in the form of a hermeneutic spiral including different states of consciousness and reflexivity. An example heuristic could contribute to developing a broader understanding of supervision and its goals and contents.

Supervisee Art-Based Disclosure in El Duende Process Painting

Although art-based supervision often leads to supervisee disclosure, little is known about the experience, process, or contributions of such disclosure. We investigated the phenomenon of supervisee disclosure during El Duende Process Painting art-based group supervision using a qualitative study. JoHari's Window was used as a grounding model to describe content and structural analysis of the phenomenon of disclosure. Participants were supervisees (N = 21) in art-based supervision groups at 2 universities. Findings indicate that supervisee disclosure occurs in the artwork prior to conscious knowledge of the supervisee, and 3 precursors to increased self-awareness arise just prior to a disclosure. This suggests that mechanisms leading to disclosure occur during art making. Disclosure mechanisms have relevance for art therapy supervision and practice.