Teleconferencing Supervision an Effective Clinician Training Technique

Clinician training is used to help clinicians broaden their methods of approach when treating clients. Training involves teaching clinicians how to develop higher levels of motivational interviewing (MI) using cues and feedback. These training sessions are usually conducted in workshop settings and involve role-playing. Another popular training technique that has been shown to provide positive skill enhancement for clinicians is the review of taped sessions. Clinicians tape sessions with clients and then have them reviewed by supervisors who provide suggestions on how to improve their MI skills and overall therapeutic technique. Although both workshop training and tape reviews offer the opportunity for therapists to hone their clinical skills, the effects are not usually sustained long-term. Advances made in workshops may not be wholly effective in real-life situations with clients, and tape reviews are conducted long after sessions have taken place, creating a missed opportunity to make changes to the therapeutic approach in real-time settings.

Jennifer L. Smith of the Department of Psychiatry at Columbia University recently led a study to test the effectiveness of more immediate clinician training. Teleconferencing supervision (TCS) involves remote supervision of therapy sessions while they occur. In this study, Smith evaluated 97 therapists who received training through workshops, tape reviews, or live TCS using an earpiece during substance abuse treatment sessions involving client actors. The participants conducted sessions over 5 weeks and were assessed for MI during the treatment and again 8 and 20 weeks after.

Smith found that the therapists in the TCS condition developed higher levels of MI, resulting in more empathy toward their clients than was achieved by the other groups of participants. The MI gains also reflected less argumentative engagements and negative confrontation during sessions and at follow-up. When Smith compared all three conditions, she found that TCS was the most effective, followed by taped reviews and then workshop training. However, Smith also noted that some of the clinicians in the TCS condition relied too heavily on the remote supervision and that more open-ended prompts should be used in place of direct suggestions to allow clinicians to strengthen their ability to select the appropriate course of action during therapy. She added, “The present findings suggest a longer duration of supervision, involving a combination of techniques embodied in TCS and tape, might be tested with the goal of bringing a greater proportion of community-based counselors to high levels of proficiency.”

Smith, J. L., Carpenter, K. M., Amrhein, P. C., Brooks, A. C., Levin, D., Schreiber, E. A., et al. (2012). Training substance abuse clinicians in motivational interviewing using live supervision via teleconferencing. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028176

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Rabon


    April 27th, 2012 at 3:04 PM

    This is much more of the hand on learning style that I personally prefer

  • Jayden B

    Jayden B

    April 27th, 2012 at 4:05 PM

    I for one think that I would be pretty distracted by getting suggestions made in my ear. This does not allow someone to see how a therapist would really handle the situation because obviously the suggestion that the remote narrator makes is what is most often going to be pursued. I think there is a lot of benefit from this, but I agree that maybe suggestions that are a little more open ended will offer therapists the best sort of training. This will kind of give them an idea of where to go from there, without overtly influencing the way that they handle the therapy session.

  • tricia


    April 28th, 2012 at 5:58 AM

    Real time suggestions are always FAR more effective than sitting and reading a chapter.
    It gives you things to think about right them and there, which is going to be more like the real world counseling situations that you will find yourself in.
    It is all about being in the moment, making decisions right then that will keep the patient engaged and contributing to his or her own treatment.

  • Rosie


    April 28th, 2012 at 11:53 PM

    I would hate it if my doc had some unseen person telling him how to talk to me.I want a human,not a human-controlled bot to talk to me.

    I prefer they have a combination of the workshop and tape method because the workshop serves as classroom for the clinicians and tapes are like their exam papers.Yes,you can’t score 100% in the exam but when you go back to class you can then better yourself and perform better the next time!And the patient is not being bothered by the ear-piece control during their conversation!

  • Amy


    April 29th, 2012 at 2:40 AM

    What the clinician says and how it is put across is very important and can form the basis of how the client’s perspective is formed..It is very important that it is put across in the bet possible way and if help is given to the clinician during a session and if it benefits the clients then why not!

  • Perez


    April 29th, 2012 at 4:27 AM

    especially favorable for any learner who needs hands on type training

  • Cora S

    Cora S

    April 30th, 2012 at 4:18 AM

    Would the “patients” be actors or if these are true patients would they have to give their consent to allowing them to be a study material?

  • Titanium Sword

    Titanium Sword

    May 1st, 2012 at 12:02 AM

    What a clinician has to say to a client cannot really be taught.It is a skill that needs to be developed.You cannot tach something like that wherein the situation varies with every client and the talk needs to be adjusted according to the client.

    While the live help may be beneficial to the clinicians,it will never replace a natural immediate answer from a well experienced clinician.

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