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Burns Lundgren, E., 2002. Long-distance Supervision and the Melbourne Project. Reformulation, Spring, p.8.
You may be aware that a research project involving CAT is currently underway in Melbourne, Australia. It is a randomised, controlled trial, an RCT no less! which compares CAT with standard treatment for adolescents and young adults at a health service centre in Melbourne. An attempt is being made to explore whether early intervention with CAT can help prevent the development, or reduce the severity, of borderline personality disorder in a vulnerable patient group. You will be able to hear more about this exciting project from Andrew Chanen, the psychiatrist in charge of the project, who will be doing a presentation at our 10th Annual Conference in March.
The therapists having had initial CAT teaching input provided in Tony Ryle's usual internet and airwave style and by Ian Kerr in person, I joined the project as the second supervisor after Tony Ryle about a year ago. My early trepidation was swiftly swept aside by the dedication and open-mindedness of the therapists, and by the impressive scope and versatility afforded for supervision via the combination of internet/e-mail input, fax and intermittent telephone calls.
The therapists tape every session, and the last five minutes are spent on summarising the themes of the session, especially as they relate to and can be located on the diagram. Of particular importance is the identification in this part of any in-session events between client and therapist which may have been missed or need to be highlighted. This five-minute excerpt is then uploaded in a password protected safe format via the internet, and down-loaded by us supervisors on our computers, to be listened to in conjunction with a written account of the full session. This is e-mailed in the usual manner, using initials. Imagine my amazement the first time I heard these clear Australian voices coming over the loudspeakers in my own study, saying things like 'no worries, mate' and using CAT-speak!
Using Tony Ryle's STIC (Short Therapist Intervention Coding), which is an abbreviated version of Dawn Bennett's TIC sheets, we score each taped summary and send these scores back as part of a more detailed feed-back, which is again sent via e-mail. For each case, one session is randomly selected for TIC-scoring of a full taped session. Draft reformulation letters are sent as attachments to be commented on, and diagrams are usually faxed, ideally as versions as they develop. In order to ensure consistency of supervision and of the inherent teaching aspect of the work, all feed-back has been copied to all the therapists involved and the supervisors, where we have now been joined by Dawn Bennett and Jackie Withers. Exposing or what!?
The purpose of this mini-report is to update on the supervision side of the project, and also to promote the potential for the use of the internet/e-mail in long-distance supervision. It is proving a most excellent and flexible tool, which could most profitably be of increasing use, as CAT trainings spread across the country, where trainees perhaps can see patients in their own settings, but where supervisors aren't necessarily available locally. It is possible to pick up the most delicate nuances on the tape via tone of voice, choice of words or topics avoided, which can then be expanded on in the e-mail feed-back. More sensitive counter-transference issues can be explored in individual telephone sessions. These also provide the opportunity for asking 'idiot's questions' and for learning how to name things in the transference, supervision components which are frequently spontaneously commented on as being very helpful. So don't be afraid of it, embrace the technology!
Eva Burns-Lundgren
Long-distance supervisor.