Getting out of one-way mirror – a more transparent, equal and interative approach in live clinical demonstration

Abstract

Abstract Early clinical training emphasized the importance of in-depth self-reflection with process recording as the core instructional media. After World War II, with the development of diversified psychotherapeutic models, various emerging psychotherapy schools had breakthroughs in live supervision models with varied characteristics. One-way mirror supervision gained its popularity in the 1980s and clinical supervision switched to the discussion of detailed clinical therapeutic techniques and process. Since both the work of supervisors and supervisees were exposed, the communication between supervisors and supervisees became more reciprocal. The one-way mirror method was greatly welcomed by students because they could observe and discuss therapy sessions in a much more realistic way. They can master applicable skills much faster. For supervisors, one-way mirror was both challenges and opportunities. They could continuously improve their clinical skills, as well as increase the efficacy of clinical supervision. However, there are also limitations of the one-way mirror method, for examples, this method can be not respectful to clients because behind the one-way mirror without validity checking by the clients, it can be hard to maintain a meaningful, well-disciplined discussion among the students. In view of the limitations of the traditional clinical supervision methods, we experimented getting out of one-way mirror and had the supervisors, clients and some 20 to 30 students with multidisciplinary background all in the same room, so that the helping process is conducted in a more transparent, equal, respectful and interactive manner. After a few trials, the benefits of this method quickly emerged: (1) Students showed much higher degree of respect to clients and saw them as real, whole persons. Students did not simply ‘analyze’ the ‘client’. Instead, the students, as appropriate, also used self-disclosure and shared their relevant experience with the ‘person’. Quite often, sharing could be more impactful than analyzing; (2) Discussion of client’s issues in the presence of the client is a great way of training in that it can prevent useless theoretical debates and irrelevant arguments/speculations because clients can easily be the final ‘judge’; (3) With multidisciplinary background, students can jointly come to a more comprehensive understanding of the clients ; (4) With the presence of the students and client together in the same room, we could flexibly apply some innovative therapeutic techniques, such as role play and enacting simulations of critical scenarios in real life by involving both the client and students. To conclude, with over 10 years of continued practice, we have conducted over 100 live clinical sessions in such format with more than 3000 students (headcounts), and we have finely polished the techniques of leading this type of live clinical session. In a nutshell, the effectiveness, adaptability and value of this transparent, interactive live clinical training format have been clearly demonstrated with the Chinese service users of Hong Kong. This method is worth trying in more diverse cultural contexts in the future.