INTERNATIONAL JOURNAL OF BEHAVIORAL CONSULTATION AND THERAPY ©2012, ALL RIGHTS RESERVED 2012, VOL. 7, NO. 2–3 ISSN: 1555–7855 FAP Group Supervision: Reporting Educational Experiences at the University of São Paulo, Brazil Regina Christina Wielenska1 and Claudia Kami Bastos Oshiro2 1Institute of Psychiatry of the University of São Paulo and 2Institute of Psychology - University Hospital of the University of São Paulo Abstract The present article describes and analyzes educational experiences related to the teaching of FAP for psychology graduate students (cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:7)(cid:8)(cid:9)(cid:10)(cid:11)(cid:2)(cid:12)(cid:13)(cid:8)(cid:5)(cid:13)(cid:14)(cid:7)(cid:11)(cid:4)(cid:14)(cid:3)(cid:12)(cid:7)(cid:5)(cid:2)(cid:12)(cid:5)(cid:12)(cid:10)(cid:14)(cid:5)(cid:15)(cid:3)(cid:11)(cid:16)(cid:14)(cid:13)(cid:7)(cid:11)(cid:12)(cid:8)(cid:5)(cid:17)(cid:18)(cid:5)(cid:19)(cid:20)(cid:17)(cid:5)(cid:21)(cid:2)(cid:22)(cid:23)(cid:17)(cid:24)(cid:5)(cid:25)(cid:10)(cid:14)(cid:5)(cid:26)(cid:13)(cid:7)(cid:12)(cid:5)(cid:14)(cid:27)(cid:6)(cid:14)(cid:13)(cid:11)(cid:14)(cid:3)(cid:9)(cid:14)(cid:5)(cid:11)(cid:3)(cid:16)(cid:17)(cid:23)(cid:16)(cid:14)(cid:4)(cid:5)(cid:6)(cid:7)(cid:8)(cid:9)(cid:10)(cid:17)(cid:23)(cid:17)(cid:28)(cid:8)(cid:5)(cid:28)(cid:13)(cid:2)(cid:4)(cid:22)(cid:2)(cid:12)(cid:14)(cid:5)(cid:7)(cid:12)(cid:22)(cid:4)(cid:14)(cid:3)(cid:12)(cid:7)(cid:5)(cid:2)(cid:3)(cid:4)(cid:5)(cid:5)(cid:11)(cid:3)(cid:9)(cid:23)(cid:22)(cid:4)(cid:14)(cid:7)(cid:5)(cid:2)(cid:3)(cid:5) example of the shaping process occurring within the supervisor-supervisee relationship, the changes observed in the supervisees´ repertories and the impact this had in the way they would conduct therapy. The second experience involved Psychiatry residents (cid:12)(cid:13)(cid:2)(cid:11)(cid:3)(cid:11)(cid:3)(cid:28)(cid:5)(cid:12)(cid:10)(cid:2)(cid:12)(cid:5)(cid:11)(cid:3)(cid:16)(cid:17)(cid:23)(cid:16)(cid:14)(cid:4)(cid:5)(cid:2)(cid:5)(cid:13)(cid:17)(cid:23)(cid:14)(cid:29)(cid:6)(cid:23)(cid:2)(cid:8)(cid:11)(cid:3)(cid:28)(cid:5)(cid:6)(cid:13)(cid:17)(cid:9)(cid:14)(cid:4)(cid:22)(cid:13)(cid:14)(cid:5)(cid:12)(cid:17)(cid:5)(cid:6)(cid:13)(cid:14)(cid:7)(cid:14)(cid:3)(cid:12)(cid:5)(cid:12)(cid:10)(cid:14)(cid:5)(cid:26)(cid:16)(cid:14)(cid:5)(cid:13)(cid:22)(cid:23)(cid:14)(cid:7)(cid:5)(cid:17)(cid:18)(cid:5)(cid:30)(cid:31)(cid:21)(cid:5)(cid:2)(cid:3)(cid:4)(cid:5)(cid:7)(cid:10)(cid:2)(cid:6)(cid:14)(cid:5)(cid:12)(cid:10)(cid:14)(cid:13)(cid:2)(cid:6)(cid:11)(cid:7)(cid:12)!(cid:7)(cid:5)(cid:13)(cid:14)(cid:23)(cid:14)(cid:16)(cid:2)(cid:3)(cid:12)(cid:5)"(cid:14)(cid:10)(cid:2)(cid:16)(cid:11)(cid:17)(cid:13)(cid:7)#(cid:5)(cid:2)(cid:7)(cid:5)$(cid:14)(cid:23)(cid:23)(cid:5)(cid:2)(cid:7)(cid:5) (cid:12)(cid:10)(cid:14)(cid:5)(cid:2)(cid:4)(cid:17)(cid:6)(cid:12)(cid:11)(cid:17)(cid:3)(cid:5)(cid:17)(cid:18)(cid:5)(cid:2)(cid:5)(cid:7)(cid:6)(cid:14)(cid:9)(cid:11)(cid:26)(cid:9)(cid:5)(cid:30)(cid:31)(cid:21)(cid:5)"(cid:2)(cid:7)(cid:14)(cid:4)(cid:5)(cid:11)(cid:3)(cid:12)(cid:14)(cid:13)(cid:16)(cid:14)(cid:3)(cid:12)(cid:11)(cid:17)(cid:3)(cid:5)(cid:12)(cid:17)(cid:5)%(cid:17)(cid:4)(cid:11)(cid:18)(cid:8)(cid:5)(cid:12)(cid:10)(cid:14)(cid:5)(cid:7)(cid:22)(cid:6)(cid:14)(cid:13)(cid:16)(cid:11)(cid:7)(cid:14)(cid:14)(cid:7)!(cid:5)"(cid:14)(cid:10)(cid:2)(cid:16)(cid:11)(cid:17)(cid:13)(cid:5)(cid:4)(cid:22)(cid:13)(cid:11)(cid:3)(cid:28)(cid:5)(cid:7)(cid:22)(cid:6)(cid:14)(cid:13)(cid:16)(cid:11)(cid:7)(cid:11)(cid:17)(cid:3)(cid:5)(cid:2)(cid:3)(cid:4)(cid:5)$(cid:11)(cid:12)(cid:10)(cid:5)(cid:12)(cid:10)(cid:14)(cid:5)(cid:9)(cid:23)(cid:11)(cid:14)(cid:3)(cid:12)(cid:24) Keywords FAP supervision, supervisor-supervisee relationship, role-playing T wo FAP based educational experiences at the University supervisees and others members of the group (including the su- of São Paulo in Brazil will be described here. The results pervisor) will evoke some supervisees´ behaviors problems, giv- clearly illustrate and suggest that FAP can be converted into ing the supervisor the opportunity to respond to the student´s a significant experience of personal and professional growth for behavior, shaping more effective interpersonal behaviors. therapists. These reports are based on qualitative data and serve This article describes the process of FAP group supervision the goal of illustrating the FAP informed supervisory process that occurred at the University of São Paulo in 2010, including and lay the groundwork for future studies that involve gathering examples of the process of shaping the supervisees’ behaviors systematic data about the supervision of future groups of psy- during the process of supervision, the changes observed in the chology and psychiatry students. supervisees´ repertories and the impact in the way they would conduct therapy. GROUP SUPERVISION AT THE UNIVERSITY OF SÃO PAULO: TEACHING FAP FOR PSYCHOLOGY GRADUATE STUDENTS STRUCTURE OF THE COURSE AND GROUP SUPERVISION FOR PSYCHOLOGISTS FAP is an interpersonally‐oriented psychotherapy based on an- alytic behavior principles. It focuses on client change through The Institute of Psychology at the University of São Paulo of- contingent shaping of target behaviors and the application of fers a one-year course entitled “Behavior and Cognitive Ther- natural reinforcement during a therapy session. The therapeutic apy: theory and practice” to psychologists who have completed relationship is the primary vehicle for client growth (Kohlenberg an accredited undergraduate Psychology program. The course and Tsai, 1991). The same assumptions guide FAP group super- occurs once a week and it is divided into three activities: two vision that aims to teach to the supervisee: 1) essential thera- hours of clinical supervision, one hour of clinical practicing peutic skills, for example, to know when and how to respond (therapy) and four hours of theoretical classes (total duration of to clinically relevant behaviors (CRB1, in-session occurrences of 540 hours). The course has established a partnership with the client repertoires that have been specified as problems according University´s Hospital (UH) and the Department of Psychiatry to the client’s goals for therapy and the case conceptualization; who was responsible to refer clients for therapy with course en- and CRB2, in-session improvements in CRB1 repertoires and rollees. This partnership had a great impact on the therapists’ should increase in frequency over the course of successful FAP) training because they could work inside a hospital and learn how emitted in the context of the therapeutic relationship and, 2) to to communicate with others professionals. Every year the course be sensitive to the interpersonal contingencies while in session has about 60 students and they are divided into four clinical su- with the client, responding in an effective way to promote be- pervision groups. The sessions are conducted by pairs to facili- havior change. tate training needs within limited resources available; each client However, how is it possible to guarantee that the supervisees has two therapists at the same time. will follow the rules emitted in supervision without becoming in- During the year of 2010, one of the groups, conducted by sensitive while in session? Considering the assumption that the Claudia Oshiro, had 14 psychologists with different levels of interactions that occur in the supervision (as well as in therapy) clinical experience and theoretical knowledge (with 0-10 years happen in an interpersonal context, the interaction between the of experience). The supervisees knew a little bit of FAP but none 177 178 WIELENSKA & OSHIRO of them had a FAP supervision experience. Clients worked with and just answered that everything was okay and the supervisor two therapists in the same session making a total of seven clients continued: “Well, it is not okay. I can see that you are turning for this group. The clients had different diagnostics: two with red…Let me change the question: what are you avoiding ad- panic disorder, four with personality disorders (three border- dressing with your client? Probably we can make a parallel of lines and one narcissistic) and one with paranoid schizophrenia. what is happening here and what is happening with your cli- The first clinical supervision session started with an explana- ent. What do you think? Let me help you with this. Everybody tion about the way it would be conducted by the supervisor. The here wants to help you two thinking about the case”. After those supervisees were told that to analyze the client´s behavior, it was questions, the two therapists conveyed that they were worried necessary to consider two sets of data: 1) client´s report about about what the supervisor would think about them because the way he interacts with his significant others and his relation- they were not doing anything to stop those client´s behaviors. ship with people outside therapy and, 2) the way he interacts They shared with the group that they knew that the client was with the therapist in the here and now context of the therapeutic avoiding intimacy, but for them it was hard to feel close to him relationship. Considering the second set of data, it was empha- because if they did so, he would ask about their lives. One of sized for the supervisees that some therapists’ difficulties and the therapists said that she was feeling like she was a terrible problems could also be evoked in those situations and it would therapist and the entire group would notice that. The second be important to talk about that during the process of supervi- therapist noticed that she was mad at him (client) because “he sion. It was pointed out that one of the goals of FAP supervision, has not the right to invade me”. The supervisor reinforced this then, is to teach the supervisees to attend to what is actually oc- disclosure and interpersonal closeness by saying: “yeah, it was curring during the session and responding to changes and the nice to see that you two shared this with us. I can understand contingencies. Further, they would learn how to do this during what you are feeling. Sometimes we don´t know what to do with supervision through direct exposure to an intense interpersonal all the behaviors that are emitted in therapy with us…when that relationship with the supervisor, in which emitting and notic- happens it seems like we are doing something wrong. You know, ing important emotional responding could occurs. Addition- sometimes I have those feelings too… I feel better now and I feel ally, during the supervisory session, the supervisor could ask like helping you in a more effective way.” The supervisor also them some questions to evoke their problem behaviors and told them that they could use their feelings as hints about pos- shape improvements. After this discussion of the supervisory sible in-session contingencies. process, the first impact could be observed: the supervisees were After this episode, the two supervisees went back to the ses- surprised. It was possible to observe that some were excited to sion and were not avoiding interpersonal tension. As a result do that, whereas others were afraid and others were turning red of their experience during the supervisory session, they had a and anxious. model of effective conflict solving with the supervisor. Further, As the supervision continued along the weeks, the supervisor it was a model of being therapeutically intimate and effective. introduced the FAP assumptions and the five rules described Another important repertoire that was developed in this epi- as: 1) watch for CRBs (to develop client case conceptualization sode was the ability to discriminate one’s impact on others and skills in order to understand which client behavior would be vice versa. For example, even if they would say that everything CRB1s and CRB2s); 2) evoke CRBs; 3) reinforce CRB2s natu- was okay with the supervisor, they noticed that this kind of re- rally; 4) observe the potentially reinforcing effects of therapist port had a bad impact on supervisor if they were being avoid- behavior in relation to client CRBs and, 5) provide functional ant. Correspondingly, in the therapy session, the therapists analytically informed interpretations and implement general- were more effective in blocking avoidance. They also noticed ization strategies (Tsai, Kohlenberg, Kanter, & Waltz, 2009). that when they were avoiding interpersonal tension (they were During the teaching of the rules, important interactions be- distant), the client´s aggressive behavior increased in frequency. tween supervisees and supervisor occurred; the most relevant This first episode was very important for the group. Super- one will be described below. visees felt like they could trust in the supervisor and they could In session, one of the clients diagnosed with borderline per- develop some interpersonal skills in the service of personal/ sonality disorder, was saying many “theoretical talks”, he was professional growth in supervision. It was possible to observe, always changing subjects, increasing the volume of his voice, during one year of supervision, that the supervisees had learned asking about the therapists’ lives and avoiding saying anything to 1) name their feelings; 2) use them as tips of the possible con- about his feelings and interpersonal relationships. During the tingencies in session and, 3) identify, evoke and shape CRBs. supervisory session, both of the therapists began by presenting Their clinical skills had improved, hence, a decreasing in the fre- their analyses of the external contingencies that appear to be in- quency of CRB1s and an increasing of CRB2s could be observed fluencing the client, and that was the content of the supervision. in all others cases. The supervisor noticed that the therapists were avoiding talking Many other here and now interactions between supervisees about what was happening in session and on one of the occasion and supervisor occurred and all brought relevant changes in the said: “Girls, I have to tell you something. I´m not feeling com- way the supervisees conduct therapy. The supervision was a “sa- fortable with the way you two are reporting this case analysis to cred space” for them (Tsai, Callaghan, Kohlenberg, & Darrow, me and our colleagues. You know, it seems like you are avoid- 2009, p. 171). And they were able to create the same space with ing telling me what is happening during the session and I am their clients. wondering what kind of feelings do I bring up in you? Can we By the end of the course, one of the supervisees said: “It was talk about that for a moment?” The two therapists turned red an amazing experience. In the first class, I was resistant and not FAP GROUP SUPERVISION: REPORTING EDUCATIONAL EXPERIENCES 179 believing that we could do that. FAP changed my life and I am a the specific purpose of sharing with the therapists a little about better person, therapist, and friend”. the client’s private states, concerning what was going on dur- ing the session. The other teachers also made interruptions to THE TEACHING OF FAP TO PSYCHIATRY RESIDENTS IN THE ask the residents about their ideas, feelings, and private states CONTEXT OF A CLINICAL BEHAVIOR ANALYSIS PROGRAM that emerged while they were interacting with the client. Based The Department of Psychiatry at the University of São Paulo on this, they proceeded to establish the proper connections be- Medical School has approved the creation of a behavior analy- tween FAP theory and the here and now of the therapeutic in- sis program. Among its attributions, the program offers a basic teraction. training in clinical behavior therapy to third year Psychiatry The role-playing format of the class produced some intense residents. Classes started on February, 2011. This constituted a learning moments; two of them will be reported here. A signifi- challenge for the teaching staff because there was no established cant episode happened after the client was invited by the thera- model of such a program in Brazil. pist to enter the office and talk about herself, and she felt she The group of 12 third-year residents attended two weekly was being treated in a rather cold and distant way, with a hard hours of classes, emphasizing theoretical aspects, and lectures to understand vague professional jargon and lack of empathy. and discussion of relevant papers plus two hours of clinical su- The dramatization was interrupted and the supervisor (the one pervision in smaller groups, constituted of four residents and acting as the client) explicitly shared with the residents the feel- two supervisors, who worked together to discuss the case as- ings and thoughts of the client. They were instructed to identify signed to each supervisee. As part of their academic year, the parallels between their difficulties and the client’s characteristics residents had a one-month vacation and also had to engage and behaviors during their interaction and invited to modify in scientific exchange programs at worldwide acknowledged topographies, observing the different effects of them on the cli- psychiatric institutions. This required a significant amount of ent’s behavior. During the course of the exercise, the residents flexibility to accommodate unavoidable absences and interrup- were guided to keep the focus on building a connection with the tions of activities during the year. The teaching and supervising client, striving to recognize and value behaviors and feelings of team was constituted by two psychiatrists (with 30 and 10 years trust and intimacy as discussed by Kohlenberg, Kohlenberg and of experience) and four psychologists (with 8-29 years of ex- Tsai (2009). Particular attention was given to the importance perience). The residents described their vague familiarity with of therapist disclosure and interpersonal closeness (Tsai, Cal- cognitive-behavior therapy techniques, as exposure therapy laghan, Kohlenberg, & Darrow (2009). Alternative interactions and disputing irrational beliefs. They knew practically nothing were repeated with three other therapists, always with immedi- about behavior-analytical theory and its clinical applications. ate feedback from the client/supervisor and group discussion. Some of the residents had a clear identification with psychody- The session could only progress when the client and therapists namic theoretical approaches and didn’t seem to be especially agreed that they have effectively achieved an optimal level of open to the present experience being offered to them. mutual, positive connection, which would favor the therapeutic The description below focuses on reporting and analyzing the alliance and behavior change in the future. strategy adopted in the first class about FAP that involved nine This experience pinpointed how much the residents were dis- residents and also some specific FAP based highlights of the su- connected from the client at the start of role playing, and maybe pervision of one of the groups, conducted by Regina Wielenska during real life first sessions, and were not aware of the function and Carolina Perroni. of apparently minor, but relevant, therapist’s behaviors such as offering undivided attention, orienting their body towards the INTRODUCING THE FOUNDATIONS OF FAP IN A GROUP FORMAT: client when appropriate, or expressing empathy, which were ROLE-PLAYING OF A SESSION. probably decisive to influence a client’s decision of giving that After four months of general presentation of behavior-analytic young medical professional a chance of effectively helping her. principles and case supervision, it was time for the first class fo- The second relevant episode during the role playing session cusing on FAP and the therapeutic relationship. Four of the su- happened when the residents were trying to explain to the client pervisors planned the introduction of the basics of FAP to resi- what therapy consists of, and more than one therapist promised dents in an experiential way, alternating between the discussion that they would certainly be able to help her fight depression. At of the five rules (Tsai, Kohlenberg, Kanter, Walts, 2009) and the this point, the supervisor who was playing the role of the client role-playing of a first session to with the exam of any relevant decided to express her discomfort with what she felt as an ap- topic that would emerge. One of the supervisors played the role parently arrogant or naïve exhibition of self-confidence, which of a woman diagnosed with depression and the nine residents seemed to invalidate all her experience of emotional pain. Then present that day were instructed to interact with this 45 year old the supervisor/client decided to disclose to the therapists her client in her very first session, practicing application of the rules reason for depression: expressing a mix of sadness and anger, during the therapeutic encounter. The role-playing started from she told the story about her 19 year old son who tried to save a calling the client in from the waiting room, followed by mutual person who was victimized by urban violence and he was shot introduction. The residents were asked to act as though they and died before paramedics could arrive. Every supervisor wit- were a single therapist; all of them were encouraged by teachers nessed the strong impact of this information upon therapists. to participate. They practically froze, a behavior probably analogous to the way The supervisor in charge of acting as the client could inter- the client was reacting to the loss, her life has stopped as her rupt the dramatization anytime she felt it was convenient, with son’s heart stopped beating. Then one of the therapists said he 180 WIELENSKA & OSHIRO could pretty much imagine how she was feeling. The client re- started some weeks ago, on many occasions, I saw you texting plied: “Have you ever lost your son to criminals? It doesn’t seem and browsing, at least partially disconnected from the supervi- to me that you can feel a gram of what I feel; you are too young sion. You may say you are skilled enough to do two things at for this”. This threw the therapists out of their comfort zone and the same time, but research data about texting and driving, for they got lost, unsure of how to react to the client. The teachers example, says this doesn’t prove to be true. I bet the same apply then helped the residents to functionally analyze the complete to the art of fully being present at a session of therapy or super- episode, including private events as empathic or aversion feel- vision. We miss facial expressions and gestures while we focus ings and fears, always trying to be attentive to the functional on a machine. We indirectly tell the audience that what we need relations between therapists’ and client’s behaviors in session. to do with the phone is more important than interacting with Again, the clinical episode was extensively managed up to the the person sitting ahead of us with a painful story to tell. I would point that all participants were in agreement that they have feel better if you tell us that the inpatient unit is calling and you achieved a (re)connection between client and therapist. have to go. Otherwise, please, stay with us for real, contribute At the end of class, the group was asked about how they felt with your knowledge and feelings, be present”. having to dissect so many details of their relationship with the Then, specifically addressing the supervisee who was texting, depressed client. The experience was considered positive, al- the supervisor says, “Once, in elementary school, I was atten- though hard and sometimes painful, initially eliciting helpless- tively listening to my teacher and copying something that was ness feelings, but also resulting in a clear understanding of the on the board. She had told us to pay full attention and noticed therapeutic possibilities of FAP when the therapist behaves with I was writing and she called my attention, catching the pencil awareness and compassion, risking being fully present and shar- from my fingers and saying I was not doing what I was told to ing his/her own feelings with the client with authenticity. This do. I have never forgotten the moment of shame, mixed with a didactic role-playing strategy was considered by participants as sense of injustice, and I still feel I was right. Please tell me if I a motivating and effective way of learning how to identify the did something unfair, my purpose is not getting your uncondi- occurrences, during the session, of a client’s CRBs and actively tional compliance, but helping you to learn the art and science evoke and differentially reinforce them. The supervisors, in par- of therapy, of relating to others based on respectful and caring allel, were able to be contingent upon the therapists’ behaviors, attitudes. And what you have done today is just a sample of what in session, step by step. It was possible to establish a clear paral- seems to be a cultural practice of many groups of residents, and lel between the client‘s outside-the-session behaviors, the client’s that we, supervisors, are not accustomed to it and feel it does not and therapists’ behaviors in session and what happened between suit the mutually committed atmosphere we prefer to stimulate supervisors and residents during and after the role-playing. One here”. of the instances of this occurred when the client mentioned how The supervisees’ initial expression of surprise, maybe shock, her life has stopped with the death of her son, the therapists felt gradually faded out and was substituted by an attentive posture. immobilized, unable to act, and reacted in a kind of distant or They nodded, agreed that this was happening, and added they silent way. Then the supervisors interfered, discussing parallels were not aware of this type of impact of their behaviors on the between the client’s and therapists’ similar feelings and reac- interaction we were establishing during supervision. They as- tions. Unfortunately, the class was not videotaped, which would sured us they didn’t do that with the clients and then we formed a consensus that if replying a call was really mandatory they have allowed better descriptions and analyses. could excuse themselves and leave us for a moment. Then the INTERVENTION UPON RELEVANT SUPERVISEES’ BEHAVIORS: FAP other supervisor added other words of endorsement and the INFLUENCING CLINICAL SUPERVISION supervision of the case was restarted in an atmosphere of mu- One episode will illustrate how FAP also influenced the style of tual interest and support. After the case was fully discussed, the supervision provided to residents. This starts with the fact that group process was analyzed as a possible intervention inspired both supervisors have discussed between them that they were by FAP principles: we valued being fully present, functionally feeling annoyed with how frequently the supervisees used the analyzing interactions, promoting the courage of self-disclosure mobile phone for calls and texting/browsing during supervision and taking necessary risks, never neglecting a compassionate and classes, seeming to be detached from the colleague’s case and caring attitude. All this is compatible with Tsai, Callaghan, and the subject being discussed. The supervisors recognized Kohlenberg, and Darrow (2009) perspective about FAP based they were medical doctors on duty, had to deal with emergen- supervision. Initially, the supervisor expressed her needs con- cies and may need to make or receive occasional calls. Even so, tingently to the texting behavior (immediate natural conse- this didn’t seem to be the case. They seemed to be accustomed quence), trying to be responsive the effect of this on the group, to behave like this as a way of getting some distraction during a including her partner in supervision. She also managed the con- class which they don’t like during other academic activities. In flict listening to supervisees, proposing intermediate solutions. one of the recurrences of the behavior, during the discussion of Then she disclosed her feelings about a similar emotionally a case, one of the supervisors asked the permission to interrupt charged academic context that occurred decades ago in her own the activity. She addressed the students and said something that life and addressed everyone’s emotions and ideas. As the super- was pretty much similar to this: visor understood that the supervisee’s behavior needed to be the “I need to share with you a strong feeling of mine. We were focus of intervention, she approached the issue describing the in the middle of a case discussion, this means that a therapist impact of that behavioral pattern of the resident on herself and and his client are in need of our full attention and help. Since we the possible implications of that. That type of feedback has never FAP GROUP SUPERVISION: REPORTING EDUCATIONAL EXPERIENCES 181 been given to them before, and the interpersonal consequences pists. The present article is probably the first Brazilian report of texting and browsing could not be recognized and assessed of FAP being systematically presented to psychiatry residents, till that moment. It is also a FAP based intervention in the sense especially in a behavior analysis program, and more data will that the supervisor tried to connect with the resident’s possible be systematically collected during supervision sessions in the discomfort feelings and she reported her own childhood ex- following groups. perience as an analogue of the present interpersonal conflict. Additionally, some of the values pursued by FAP (Tsai, Kohlen- (cid:2) REFERENCES berg, Bolling & Terry, 2009), as a caring attitude of awareness in Kohlenberg, J. R., & Tsai, M. (1991). Functional Analytic Psychotherapy: Creating session and supervision, were emphasized as valid objectives. Intense and Curative Therapeutic Relationships. New York: Plenum. It is interesting to notice that the two psychologists (in this Kohlenberg, J. R., Kohlenberg B., & Tsai, M. (2009). Intimacy. In M. Tsai, R. case, the supervisors) and the four psychiatrists (supervisees), J.Kohlenberg, J. W. Kanter, B. Kohlenberg, W. C. Follete, & G. M. Callaghan (Eds.), A although having many points of common in their academic his- guide to functional analytic psychotherapy: awareness, courage, love and behavior- tory, could be viewed as different, “very unique micro-cultures”, ism. (pp. 131-144). New York: Springer. as analyzed by Vandenberghe et al. (2010), and this means that Tsai, M., Callaghan, G. M., Kohlenberg, J. R. & Darrow, S. M. (2009). Supervision certain differences between supervisors and supervisees, if not and therapist self-development. In M. Tsai, J. R. Kohlenberg, J. W. Kanter, B. acknowledged and dealt appropriately, would impair the quality Kohlenberg, W. C. Follete, & G. M. Callaghan (Eds.), A guide to functional analytic of the relationship in the supervision group and the progress of psychotherapy: awareness, courage, love and behaviorism. (pp. 167-198). New York: Springer. all participants. Initially, the supervisor needed to assume the Tsai, M., Kohlenberg, Bolling, M. Y., Terry, C. (2009). Values in therapy and green FAP. risk of confronting a cultural practice of that group of students In M. Tsai, J. R. Kohlenberg, J. W. Kanter, B. Kohlenberg, W. C. Follete, & G. M. and had to find a compassionate way of doing this. The solu- Callaghan (Eds.), A guide to functional analytic psychotherapy: awareness, courage, tion was describing her inner states and impressions concerning love and behaviorism. (pp. 199-212). New York: Springer. browsing and texting during case discussions, and functionally Tsai, M., Kohlenberg, J. R., Kanter, J. W., Waltz, J. (2009). Therapeutic technique: the analyzing the probable consequences of the lack of focus on dis- (cid:26)(cid:16)(cid:14)(cid:5)(cid:13)(cid:22)(cid:23)(cid:14)(cid:7)(cid:24)(cid:5)’(cid:3)(cid:5)*(cid:24)(cid:5)(cid:25)(cid:7)(cid:2)(cid:11)#(cid:5)+(cid:24)(cid:5)/(cid:24)(cid:5)5(cid:17)(cid:10)(cid:23)(cid:14)(cid:3)"(cid:14)(cid:13)(cid:28)#(cid:5)+(cid:24)(cid:5);(cid:24)(cid:5)5(cid:2)(cid:3)(cid:12)(cid:14)(cid:13)#(cid:5)<(cid:24)(cid:5)5(cid:17)(cid:10)(cid:23)(cid:14)(cid:3)"(cid:14)(cid:13)(cid:28)#(cid:5);(cid:24)(cid:5)=(cid:24)(cid:5)(cid:30)(cid:17)(cid:23)(cid:23)(cid:14)(cid:12)(cid:14)#(cid:5) cussion and of visual contact. The additional parallel between & G. M. Callaghan (Eds.), A guide to functional analytic psychotherapy: awareness, childhood experiences and the feelings of the student, as well as courage, love and behaviorism. (pp. 61- 102). New York: Springer. proposing a solution for emergency calls helped create a warm Vandenberghe, L., Tsai, M., Valero, L., Ferro, R., Kerbauy, R. R., Wielenska, R. C., atmosphere, rich in empathy. Learning theory research has ex- Helweg-Jorgensen, S., Schoendorff, B., Quayle, E., Hahl, J.A., Matsdumoto, A., tensively established that immediate consequences have more Takahashi, M., Okouchi, H., & Muto, T. (2010). Transcultural FAP. In J. W. Kanter, M. chances of affecting the probability of a certain response. This Tsai, & R. J. Kohlenberg (Eds.), The practice of functional analytic psychotherapy. also applies to FAP based interventions. Giving immediate, here (pp.173-184). New York: Springer. and now, feedback (e.g. reinforcement), right after the problem- atic texting behavior occurs, is much more powerful. It is in- (cid:2) AUTHOR CONTACT INFORMATION teresting to notice that the residents’ behavior while discussing REGINA CHRISTINA WIELENSKA cases changed from that intervention on; they tried, in a higher frequency, to keep the focus on each others’ reports and started [email protected] to contribute with empathic remarks and opinions, staring at Rua Itapeva, 202, conjunto 92, the colleagues, not at a screen. Another change was a reduction CEP 01332-000, Bela Vista, São Paulo, SP, Brazil in the occasions they had to reply the calls or browse the web. (55) (11) 32884740 What could be simply an interpersonal conflict was transmuted (55) (11) 99886984 into a rich interaction during clinical supervision with the deci- sive support of FAP. CLAUDIA KAMI BASTOS OSHIRO FINAL REMARKS [email protected] Av. Rouxinol, 1041, conjunto 1701, Concerning the supervision of psychologists, the challenge is Moema, São Paulo, SP, Brazil reconciling the differences in clinical and interpersonal reper- toires of supervisees, and this requires future research about the (55) (11) 9631-9500 teaching of FAP for such heterogeneous group of young thera- (55) (19) 3434-9597 (Piracicaba/SP)