The Complete Systemic Supervisor: Context, Philosophy, and Pragmatics, Second Edition. Edited by Thomas C. Todd and Cheryl L. Storm.
© 2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, Ltd.
Implementing Technology in
Systemic Supervision
Kevin P. Lyness
As technology becomes more ubiquitous in our society, supervisors need to be more aware of the possibilities and pitfalls for utilizing technology in therapy and supervision. Supervisors’ use of technology ranges from the use of cellular tele-phones, texting, instant messaging, and email to the use of social media to the use of sophisticated videoconferencing, enabling the review of sessions and the ability to conduct “live” supervision.
One primary concern for supervisors is managing the use of technology in an eth-ical manner. The American Association for Marriage and Family Therapy (AAMFT) Code of Ethics (2012), a prominent professional code of conduct for systemic therapists, recognizes the need for therapists to have training in the use of technology prior to commencing therapy and the importance of ensuring that they conduct therapy in accordance with all relevant laws. This includes:
…Additionally, marriage and family therapists must: (a) determine that electronic therapy is appropriate for clients, taking into account the clients’ intellectual, emo-tional, and physical needs; (b) inform clients of the potential risks and benefits associ-ated with electronic therapy; (c) ensure the security of their communication medium; and (d) only commence electronic therapy after appropriate education, training, or supervised experience using the relevant technology. (1.14 Electronic Therapy)
For systemic therapists to abide by these ethical guidelines (which are similarly noted in other ethical codes used by systemic therapists and also covered in the
accompanying book in Chapter 2), they must understand the various types of technology and be trained in them. Supervisors can play a vital role in training systemic therapists via supervised experience; but to do so, they also need to understand the various types of technology and their applications, and be trained in the use of them.
Guidelines for Using Technology in Supervision
Following are guidelines for ethical best practices in utilizing technology in super-vision. (Interested readers can learn more about the best practice recommenda-tion of embracing technology in supervision and including relevant aspects in supervision agreements in Chapter 17 of the accompanying book and review a social media policy in this section of the resources.)
Be aware of legal climate
Before using any technology for supervision, the supervisor and therapist should be aware of the legal climate in their state, province, or locale. Different jurisdictions have different rules about what is acceptable for supervision and what is not. For example, the state of New Hampshire uses the term “face-to-face supervision” (New Hampshire Board of Mental Health Practice, 2011, Chapter Mhp 300, sec-tion 302.22) though the rules do not define further what “face-to-face” means. Supervisors should always check with their regulatory bodies if they have any ques-tions about whether a certain practice fits within the rules and regulaques-tions. This can be particularly troublesome when crossing state, provincial, or even national bound-aries, and supervisors need to understand what laws and regulations apply.
Clarify use and determine appropriateness of technology in
therapy and supervision
Supervisors have to clarify with supervisees both their use of technology in super-vision and their supervisees’ use of technology with their clients (Blumer & Hertlein, 2012; Wright & Griffiths, 2010). Supervisors and therapists must care-fully determine whether technology is appropriate for the situation and what technologies can be ethically used. For example, see Chapter 5 for the use of tech-nology within supervision in educational settings. All participants must be informed of the potential risks and benefits of the use of technology, whether for supervision, therapy, or both. Supervisors must be clear in the supervision contract what technology—everything from email and cell phone use to videoconfer-encing—will be used in supervision. Similarly, therapists must include information in their informed consent documents with clients that clearly spell out not only the therapist’s use of technology to communicate with clients but also what tech-nologies might be used in supervision.
Understand issues and limitations
Supervisors must understand specific issues associated with each type of tech-nology and the limitations of confidentiality, and supervisors must help supervis-ees understand this as well. Barnett (2011) summarizes well some of the challenges with email:
These include the possibility of not knowing the true identity of the client (or supervis-ees)…, the inability to guarantee confidentiality due to the use of the Internet, difficulty interpreting written text due to the absence of tone of voice and inflection, and the total absence of visual cues that are so essential for effective communication with clients (and supervisees). (p. 104, parentheses added)
Given these and other considerations, Barnett encourages therapists to only use email for administrative purposes, and the same recommendation is appro-priate for supervisors with therapists. In the current climate of government surveillance, it is clear that nothing on the Internet is fully secure. There are ways to make email more secure (using SSL encryption, for example) but supervisors, therapists, and clients need to understand the limitation of security when using email.
There are also some specific issues to consider with videoconferencing, a common way of using technology in supervision. Abbass et al. (2011) not only discuss consent issues for web-conferencing, but they also provide a sample con-sent for the use of video in web-conferencing. Videoconferencing programs may also vary in the level of security and encryption provided. Skype, which is very popular, may not be a secure means of communication, so alternatives like goto-meeting.com or Adobe Connect may be more appropriate (Hertlein, Henline, Blumer, & Winter, 2013). Some authors do recommend Skype (Abbass et al., 2011) and the Skype website does discuss encryption (see http://www.skype.com/ en/security/). Regardless of the service used, supervisors should be clear on the limitations. Abbass et al. offer helpful tips for using web-based videoconferencing for when supervisors use such a service, including basic issues like using up-to-date computers, broadband Internet connections, making sure other programs aren’t running on the computer, and so forth, and they discuss the trade offs in stream-ing versus sharstream-ing files.
Consider the effect on supervision relationship
Regardless of the technology used, supervisors still need to focus on developing a solid supervisory relationship (Perry, 2012). Technology can both hinder and facilitate this, and supervisors may need to develop creative ways to connect to supervisees when using primarily technological means of supervision (e.g., paying attention to joining issues, being explicit about sharing certain personal information between supervisor and supervisee, etc.).
Creative Applications of Technology
and Future Directions
There are a number of very creative applications of technology to supervision today. Nagel, Goss, and Anthony (2009) talk about using research software like NVivo (which is used for qualitative data analysis) to enhance the ability to analyze session transcripts or videos. Smith, Mead, and Kinsella (1998) pioneered the use of computer technology to provide direct supervision, using computer monitors in the therapy room. Given how pervasive technology is becoming, and how tech-nologically savvy many therapists and clients are, supervisors are encouraged to embrace technology while understanding its limits. Manring, Greenberg, Gregory, and Gallinger (2011) believe the most effective tool for engaging trainees in using technology is to see the behavior modeled.
The additional references listed in the following text, including some from beyond systemic therapy and supervision, include a great deal more information on creative uses of and guidelines for training and supervision utilizing technology. Supervisors interested in adding technology to their practices are encouraged to keep reading!
Additional Resources for Technology in Supervision
Blumer, M. L. C., Hertein, K. M., Smith, J. M., & Allen, H. (2013). How many bytes does it take? A content analysis of cyber issues in couple and family therapy journals. Journal of Marital and Family Therapy, 40(1), 34–48.
This article summarizes a recent content analysis of couple and family therapy journals on technology issues, including conclusions and recommendations drawn from the review. Brandoff, R., & Lombardi, R. (2012). Miles apart: Two art therapists’ experience of
dis-tance supervision. Art Therapy: Journal of the American Art Therapy Association, 29(2), 93–96.
The authors of this article present two views (supervisor and supervisee) on distance supervision in an art therapytraining program.
Byrne, A. M., & Hartley, M. T. (2010). Digital technology in the 21st century: Considerations for clinical supervision in rehabilitation education. Rehabilitation Education, 24,57–68.
This article has specific recommendations regarding the use of technology in clinical supervision in a rehabilitation counseling setting, including looking at recent small size technologies like tablet computers and small digital video recorders.
Coursol, D. (2004). Cybersupervision: Conducting supervision on the information super-highway. In G. R. Walz & C. Kirkman (Eds.), CyberBytes: Highlighting compelling uses of technology in counseling (pp. 82–85). Greensboro, NC: ERIC Clearinghouse on Counseling and Student Services.
This document introduced the term cybersupervision and discusses practical requirements as well as advantages and limitations of the model.
Olson, M. M., Russell, C. S., & White, M. B. (2001). Technological implications for clinical supervision and practice. The Clinical Supervisor, 20, 201–215.
This article was one of the first discussions of the use of technology in MFT supervision, and includes a rationale for using technology and a review of technologies available at the time of the article.
Stebnicki, M. A., & Glover, N. M. (2001). E-supervision as a complementary approach to traditional face-to-face clinical supervision in rehabilitation counseling: Problems and solutions. Rehabilitation Education, 15, 283–293.
The authors of this article argue for the use of technology in clinical supervision in a rehabilitation counseling program, and report on results of an exploratory study utilizing technology in supervision.
Vaccaro, N., & Lambie, G. W. (2007). Computer-based counselor-in-training supervi-sion: Ethical and practical implications for counselor educators and supervisors.
Counselor Education & Supervision, 47, 46–57.
This article discusses computer-based training and supervision, highlighting ethical and prac-tical implications in counselor education as well as providing reviews of specific applications. Wolf, A. W. (2011). Commentary: Internet and video technology in psychotherapy
super-vision and training. Psychotherapy, 48, 179–181.
This brief article serves as an introduction to a special section of the journal on technology in supervision.
Wood, J. A. V., Miller, T. W., & Hargrove, D. S. (2005). Clinical supervision in rural set-tings: A telehealth model. Professional Psychology: Research and Practice, 36, 173–179. This article discusses implications for supervision in rural settings, utilizing a telehealth model.
References
Abbass, A., Arthey, S., Elliot, J., Fedak, T., Nowoweiski, D., Markovski, J., & Nowoweiski, S. (2011). Web-conference supervision for advanced psychotherapy training: A practical guide. Psychotherapy,48, 109–118. American Association for Marriage and Family
Therapy. (2012). Code of ethics. Retrieved from http://www.aamft.org/imis15/Content/Legal_ Ethics/Code_of_Ethics.aspx
Barnett, J. E. (2011). Utilizing technological innova-tions to enhance psychotherapy supervision, training, and outcomes. Psychotherapy,48, 103–108.
Blumer, M. L. C., & Hertlein, K. M. (2012). Addressing ambiguity in e-practice management: Family therapy and supervision in a digital age.
Family Therapy Magazine, 11(6), 16–18.
Hertlein, K., Henline, B., Blumer, M., & Winter, G. (2013). Pros, cons, and tools for online supervision.
Paper presented at the AAMFT Annual Conference, Portland, OR.
Manring, J., Greenberg, R. P., Gregory, R., & Gallinger, L. (2011). Learning psychotherapy in the digital age. Psychotherapy, 48, 119–126.
Nagel, D. M., Goss, S., & Anthony, K. (2009). The use of technology in supervision. In N. Pelling, J. Barletta, & P. Armstrong (Eds.), Practice of clinical supervision (pp. 340–363). Bowen Hills, QLD: Australian Academic Press.
New Hampshire Board of Mental Health Practice. (2011). Chapter Mhp 300 License and registra-tion requirements, applicaregistra-tions and fees. Retrieved from http://www.gencourt.state.nh.us/rules/ state_agencies/mhp300.html
Perry, C. W. (2012). Constructing professional iden-tity in an online graduate clinical training program: Possibilities for online supervision. Journal of Systemic Therapies, 31(3), 53–67.
Smith, R. C., Mead, D. E., & Kinsella, J. A. (1998). Direct supervision: Adding computer-assisted feedback and data capture to live supervision.
Journal of Marital and Family Therapy, 24, 113–125.
Wright, J., & Griffiths, F. (2010). Reflective practice at a distance: Using technology in counselling supervision. Reflective Practice, 11, 693–703.
