This is a chapter about the status of training and supervision of family therapists. My decision to use the word “advancing” rather than “advances” in the chapter’s title is intentional. The word “advancing” suggests an active process of attempting to move forward with the possibility of various levels of success, whereas advances points toward outcomes that are superior to what had come before. In one of the seminal reviews of the literature on training and supervision in family therapy, Liddle (1991) remarked about this review: “It seeks to identify where we have been and where we are headed, and perhaps most important, where we need to go” (p. 639). As I will show, this ambitious goal has not been realized. Rather, the history of training and supervision of family therapists can be characterized as a struggle to move forward. In some ways, progress has been made, but in others, the state of the art is little changed from what it was twenty-five years ago and in some ways the present state of the art is inferior to the past. I think there is much to learn from this struggle because insights into it offer possible pathways for significant advances called for by Liddle (1991). While it is customary in the literature to cite articles no more than a decade old, for reasons that will become clear, I will cite earlier work in order to shed light on the nature of this process of advancing. To examine this process of advancing, I will focus on three interrelated snapshots of training. The first addresses efforts to define training and supervision by cataloguing components of this endeavor. The second is the research that explicates both best practices of these components as well as whether and how they produce significantly positive outcomes both for the trainee and for the trainees’ clinical outcomes. The third is important changes in how psychotherapy is practiced that have entered the field of family therapy and necessitate that they be addressed in training and supervision. Finally, I will make some modest proposals for how training can continue to advance. But first, it is important to distinguish between training and supervision. Training encompasses all of the practices essential to develop family therapists. Supervision is but one practice of training in which a supervisor and supervisee meet and use a variety of processes to enhance the development of the supervisee and to improve his or her clinical practice. Using an apprenticeship model, one can train a family therapist using only supervision; however, such apprenticeships are more characteristic of agencies or private practice wherein the supervisee seeks to learn family therapy. Supervision is also used to train family therapists in degree granting or postgraduate programs and to monitor and enhance the skills of a trained family therapist working in agencies and/or private practices. In the literature, the terms “training” and “supervision” are often used interchangeably and/or together. So far the literature has been mostly concerned with supervision. The majority of family therapy training now takes place in degree-granting programs whose training arsenal includes academic course work, supervision, clinical practice, mentoring and sometimes research and/or a thesis or dissertation. In this chapter, I will use the terms “training” and “trainee” within the context of a training program and reserve the terms “supervision” and “supervisee” to refer to the specific practice of supervision. Compared to supervision, far less attention has been given to training, particularly the respective contributions to outcome of each of its practices. We still do not know which training practices are best suited to a particular aspect of therapist development, or how the practices work together to synergistically produce a family therapist. This is unfortunate because training is expensive and cost could be contained if some practices were shown to be redundant and/or less efficient than others.
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