Advertisement

Contemporary Family Therapy

, Volume 38, Issue 4, pp 361–372 | Cite as

Managing Emotional Responses in Therapy: An Adapted EFT Supervision Approach

  • Kristy L. SoloskiEmail author
  • Sharon L. Deitz
Original Paper
  • 498 Downloads

Abstract

Therapists often encounter experiences in therapy that elicit emotionality, this could be in the form of self-of-the-therapist issues, compassion fatigue, or professional burnout. Whereas approaches to supervision for self-of-the-therapist issues recognize the need for accessing the supervisee’s emotionality, approaches have not focused on how the clinical and professional system could also be part of the cycle. We propose an adapted emotionally focused supervision approach that employs steps one through six of the EFT model. To display how this approach would work, we provide the example of work with longer-term clients. Working with longer-term clients can be a challenge for many therapists, and both the professional and client system come with factors increasing emotional risk to the therapist. Engaging the therapist’s emotionality through supervision has the potential to improve therapeutic outcomes, as well as reduce loss of good therapists in the field to professional burnout.

Keywords

Compassion fatigue EFT Long-term therapy Self-care Self-of-the-therapist Supervision 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103–108. doi: 10.1037/0002-9432.76.1.103.PubMedPubMedCentralCrossRefGoogle Scholar
  2. American Association for Marriage and Family Therapy. (2015). AAMFT code of ethics. Alexandria, VA: Author. Retrieved from https://www.aamft.org/imis15/AAMFT/Content/Legal_Ethics/Code_of_Ethics.aspx.
  3. Becvar, D. S. (2003). The impact on the family therapist of a focus on death, dying, and bereavement. Journal of Marital and Family Therapy, 29, 469–477.PubMedCrossRefGoogle Scholar
  4. Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35, 155–163. doi: 10.1007/s10615-007-0091-7.CrossRefGoogle Scholar
  5. DeLeon, P. H., VandenBos, G. R., & Bulatao, E. Q. (1991). Managed mental health care: A history of the federal policy initiative. Professional Psychology: Research and Practice, 22(1), 15–25. doi: 10.1037/0735-7028.22.1.15.CrossRefGoogle Scholar
  6. de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York, NY: W W Norton & Co.Google Scholar
  7. de Shazer, S., Berg, I. K., Lipchik, E. V. E., Nunnally, E., Molnar, A., Gingerich, W., et al. (1986). Brief therapy: Focused solution development. Family Process, 25(2), 207–221. doi: 10.1111/j.1545-5300.1986.00207.x.PubMedCrossRefGoogle Scholar
  8. Doherty, W. L., & Simmons, D. S. (1996). Clinical practice patterns of marriage and family therapists: A national survey of therapists and their clients. Journal of Marital and Family Therapy, 22(1), 9–25. doi: 10.1111/j.1752-0606.1996.tb00183.x.CrossRefGoogle Scholar
  9. Emerson, S. (1996). Creating a safe place for growth in supervision. Contemporary Family Therapy, 18(3), 393–403. doi: 10.1007/BF02197050.CrossRefGoogle Scholar
  10. Figley, C. R. (Ed.). (2002a). Treating compassion fatigue. New York, NY: Routledge.Google Scholar
  11. Figley, C. R. (2002b). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58, 1433–1441. doi: 10.1002/jclp.10090.PubMedCrossRefGoogle Scholar
  12. Galatzer-Levy, I. R., Nickerson, A., Litz, B. T., & Marmar, C. R. (2013). Patterns of lifetime PTSD comorbidity: A latent class analysis. Depression and Anxiety, 30, 489–496. doi: 10.1002/da.22048.PubMedCrossRefGoogle Scholar
  13. Gelso, C. J., Latts, M. G., Gomez, M. J., & Fassinger, R. E. (2002). Countertransference management and therapy outcome: An initial evaluation. Journal of Clinical Psychology, 58, 861–867. doi: 10.10002/jclp.2010.PubMedCrossRefGoogle Scholar
  14. Gingerich, W. J., & Eisengart, S. (2000). Solution-focused brief therapy: A review of the outcome research. Family Process, 39, 477–498. doi: 10.1111/j.1545-5300.2000.39408.x.PubMedCrossRefGoogle Scholar
  15. Greenberg, L. S., & Johnson, S. M. (1988). Emotionally focused therapy for couples. New York, NY: The Guilford Press.Google Scholar
  16. Hersoug, A. G., Høglend, P., Havik, O., von der Lippe, A., & Monsen, J. (2009). Therapist characteristics influencing the quality of alliance in long-term psychotherapy. Clinical Psychology and Psychotherapy, 16, 100–110. doi: 10.1002/cpp.605.PubMedCrossRefGoogle Scholar
  17. Hill, E. W. (1992). Marital and family therapy supervision: A relational-attachment model. Contemporary Family Therapy, 14(2), 115–125. doi: 10.1007/BF00898080.CrossRefGoogle Scholar
  18. Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41(2), 159–164. doi: 10.1037/0003-066X.41.2.159.PubMedCrossRefGoogle Scholar
  19. Lakey, B., & Cohen, S. (2000). Social support theory and measurement. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 29–52). New York: Oxford University Press.CrossRefGoogle Scholar
  20. Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., et al. (1996). The reliability and validity of the Outcome Questionnaire. Clinical Psychology & Psychotherapy, 3(4), 249–258. doi: 10.1002/(SICI)1099-0879(199612)3:4<249:AID-CPP106>3.0.CO;2-S.CrossRefGoogle Scholar
  21. Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: Update of a meta-analysis. The British Journal of Psychiatry, 199, 15–22. doi: 10.1192/bjp.bp.110.082776.PubMedCrossRefGoogle Scholar
  22. Lerias, D., & Byrne, M. K. (2003). Vicarious traumatization: Symptoms and predictors. Stress and Health, 19, 129–138. doi: 10.1002/smi.969.CrossRefGoogle Scholar
  23. Lum, W. (2002). The use of self of the therapist. Contemporary Family Therapy, 24(1), 181–197. doi: 10.1023/A:1014385908625.CrossRefGoogle Scholar
  24. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2, 99–113.CrossRefGoogle Scholar
  25. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422. doi: 10.1146/annurev.psych.52.1.397.PubMedCrossRefGoogle Scholar
  26. McCann, L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131–147. doi: 10.1007/BF00975140.CrossRefGoogle Scholar
  27. McGoldrick, M. (1982). Through the looking glass: Supervision of a trainee’s “trigger” family. In R. Wiffen & J. Byng-Hall (Eds.), Family therapy supervision (pp. 17–37). London: Academic Press.Google Scholar
  28. Munroe, J. F., Shay, J., Fisher, L., Makary, C., Rapperport, K., & Zimering, R. (1995). Preventing compassion fatigue: A team treatment model. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 209–231). Philadelphia, PA: Brunner/Mazel.Google Scholar
  29. Negash, S., & Sahin, S. (2011). Compassion fatigue in marriage and family therapy: Implications for therapists and clients. Journal of Marital and Family Therapy, 37(1), 1–13. doi: 10.1111/j.1752-0606.2009.00147.x.PubMedCrossRefGoogle Scholar
  30. Newell, J. M., & MacNeil, G. A. (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue: A review of theoretical terms, risk factors, and preventative methods for clinicians and researchers. Best Practices in Mental Health, 6(2), 57–68. Retrieved from http://www.iupui.edu/~mswd/S501/multimedia/word_doc/burnoutarticle.pdf.
  31. O’Donnell, M. L., Creamer, M., & Pattison, P. (2004). Posttraumatic stress disorder and depression following trauma: Understanding comorbidity. The American Journal of Psychiatry, 161(8), 1390–1396. doi: 10.1176/appi.ajp.161.8.1390.PubMedCrossRefGoogle Scholar
  32. Pearlman, L. A., & Saakvitne, K. W. (1995). Treating therapists with vicarious traumatization and secondary traumatic stress disorders. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 150–177). London: Brunner Routledge.Google Scholar
  33. Ray, E. B., & Miller K. I. (1994). Social support, home/stress, and burnout: Who can help? Journal of Applied Behavioral Science, 30(3), 357–393.CrossRefGoogle Scholar
  34. Rosenberg, T., & Pace, M. (2006). Burnout among mental health professionals: Special considerations for the marriage and family therapist. Journal of Marital and Family Therapy, 32(1), 87–99. doi: 10.1111/j.1752-0606.2006.tb01590.x.PubMedCrossRefGoogle Scholar
  35. Scharff, D. (1992). Refinding the object and reclaiming the self. Northvale, NJ: Jason Aronson.Google Scholar
  36. Stamm, H. B. (1999). Secondary traumatic stress: Self-Care issues for clinicians, researchers, and educators. Baltimore, MD: Sidran Press.Google Scholar
  37. Timm, T. M., & Blow, A. J. (1999). Self-of-the-therapist work: A balance between removing restraints and identifying resources. Contemporary Family Therapy, 21(3), 331–351. doi: 10.1023/A:1021960315503.CrossRefGoogle Scholar
  38. Valenta, V., & Marotta, A. (2005). The impact of yoga on the professional and personal life of the psychotherapist. Contemporary Family Therapy, 27, 65–80.CrossRefGoogle Scholar
  39. Watson, M. F. (1993). Supervising the person of the therapist: Issues, challenges and dilemmas. Contemporary Family Therapy, 15(1), 21–31. doi: 10.1007/BF00903485.CrossRefGoogle Scholar
  40. Wetchler, J. L. (1998). The role of primary emotion in family therapy supervision. Journal of Systemic Therapies, 17(3), 70–80. Retrieved from http://search.proquest.com.er.lib.k-state.edu/docview/619361896?accountid=11789.
  41. Wetchler, J. L. (1999). Integrating primary emotion into family therapy supervision. Journal of Family Psychotherapy, 10(4), 71–76. doi: 10.1300/J085v10n04_06.CrossRefGoogle Scholar
  42. Yen, S., Shea, M. T., Battle, C. L., Johnson, D. M., Zlotnick, C., Dolan-Sewell, R., et al. (2002). Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: Findings from the Collaborative Longitudinal Personality Disorders Study. Journal of Nervous and Mental Disease, 190, 510–518. doi: 10.1097/01.NMD.0000026620.66764.78.PubMedCrossRefGoogle Scholar
  43. Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155(12), 1733–1739. Retrieved from http://search.proquest.com.er.lib.k-state.edu/docview/220480726?accountid=11789.

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Texas Tech UniversityLubbockUSA
  2. 2.Kansas State UniversityManhattanUSA
  3. 3.Miami UniversityOxfordUSA

Personalised recommendations