|Beyond the One-Way Mirror - Page 10|
Despite this auspicious beginning, it was still crucial to have the PLL model actually take root in the agency. In the past, after the initial, five-day, onsite training wrapped up, another PLL supervisor or I would maintain an arms-length relationship with an agency, consisting mostly of two-hour phone supervision about stuck cases once or twice a month. This time, I decided to experiment with regular onsite visits within the first three to four months after the training. Like the live presentation, these visits proved crucial in the joining and restructuring process. For example, when the agency was having trouble jump-starting referrals, I rolled up my sleeves and set up a meeting between the agency and local referral sources.
At the meeting, I suggested that a probation officer and a PLL therapist meet with client families together for the first intake appointment, thus diminishing the possibility that the family would play them off against each other. Through role-plays, I taught them how to do motivational interviewing. Both groups loved the idea of working together and started implementing the strategy immediately. Soon the splitting engendered by the families stopped, the relationship between the probation system and the agency was strengthened, and the referrals from the probation system nearly doubled.
These onsite visits have continued, changing the relationship from a formal consultation to a dynamic partnership with a high degree of mutual trust and respect. During the onsite visits with the PLL staff, we've covered everything from intensive case discussions to producing a mission statement, but what's taken the partnership to a higher level is our new approach to ongoing supervision.
In the old days, the PLL staff and I would do some form of typical case-management supervision: a therapist would present his or her best recollection of a stuck PLL session from case notes and we'd recommend a strategic family therapy intervention to get things moving. Neither we nor the therapist had any way of knowing whether the therapist was making tactical mistakes in sessions or using the model correctly. The result was low adherence to the PLL model and frustration among the therapists because their tougher clients weren't improving.
From my one-way-mirror supervision days, I knew that this supervision format was the answer, but didn't know how it could be adapted to an agency without one-way mirrors. To address this challenge, I investigated a relatively new method of supervision, known as interpersonal process recall (IPR), whereby the therapist videotapes a session of a stuck case on a DVD camcorder and the clinician's performance is rated using a five-point scale. I adapted the IPR method to focus on seven specific skills essential to the implementation of both the group and family therapy aspects of PLL. (Please go to www.gopll.com to view the IPR method.)