Accelerated Experiential Dynamic Psychotherapy (AEDP) Supervision
For individuals in the U.S. & U.S. territories
In Accelerated Experiential Dynamic Psychotherapy (AEDP) Supervision, Dr. Diana Fosha demonstrates how the supervisory model for this healing-oriented transformational approach incorporates many of the key principles used in the therapy itself.
Aspects of AEDP supervision include creating safety for the therapist and supervisee, undoing the therapist and supervisee's aloneness, fostering a therapeutic alliance that helps both therapist and supervisee become skilled in detecting transformation, and using an affirmative orientation.
In this program, Dr. Fosha and her supervisee engage in a supervisory session, and host Dr. Hanna Levenson interviews them about their work together, discussing the supervision model with illustrative clips from the demonstration session.
AEDP has a psychotherapy model of supervision – the supervision practice has grown out of clinical practice and theory and practice of AEDP. What holds true for AEDP therapy holds true for the model of supervision: Many of the key concepts in AEDP Supervision are the same as those of AEDP itself.
The Centrality of Videotape to the AEDP Supervisory Process
Before going into the specifics, it is also important to state upfront that just as AEDP therapy is conducted and each session is videotaped, AEDP supervision is conducted from videotapes of the supervisee's therapy sessions. The supervision is conducted from a micro-analysis of the videotape, thus this being a deliberate practice.
In this way, therapists/supervisees get to learn the phenomenology of the transformational process by empirical evidence. The data of supervision sessions do not come from the memory and imagination of therapist/supervisees and their own construction of what happened, but rather from the evidence of the session itself, captured on videotape, which is used for the supervision session. That's how AEDP therapists self-monitor and how they teach and supervise AEDP.
As a result, AEDP supervisees become "super-shrinks" — excellence is built from having on organic baseline from which to proceed, and on which additional specific skills are built. AEDP work is guided, moment-to-moment, by a four state transformation model of the phenomenology of the transformational process. The therapist uses this model as a guide or as a map, to figure out where she or he is in moment-to-moment, and where he or she wants to go.
AEDP interventions are rooted in the 4 state transformational model.
The following are some features of AEDP supervision:
- creating safety for the therapist/supervisee
- undoing the therapist/supervisee's aloneness
- help therapist/supervisee become a skilled transformance detective
- building a strong alliance between the therapist/supervisee and the supervisor
- affirmative orientation: the focus of the supervision is on what the therapist/supervisee is doing well, rather than focusing on what they're doing badly
- affirmative and encouraging of exploration: the YES AND approach. celebrating and affirming and being explicit about what is good and the therapist/supervisee is doing well AND also pointing out the leading edge of the work, what needs work, gently over time
- what skills need to be developed (use of the AEDP Fidelity Scale)
- orientation to the new and emergent: the focus of the supervision is on new skills/achievements that are new aspects of the therapist/supervisee's repertoire and reflect her/his taking risks to put into practice new AEDP skills
- dyadic affect regulation of and with the therapist/supervisee by the supervisor especially when the client is dysregulated in the videotaped session being worked on
- anxiety-regulating supervisory stance and aim: the supervisor works to foster the regulation of the anxiety of the therapist/supervisee
- moment-to-moment tracking of the therapist/supervisee in relation both to the session work being supervised on the videotape (and at times in relation to the supervisor/supervisee dyad). Key AEDP representational schemas — The Triangle of Experience and The Four States and Three State transformations of the Transformational Process — are schemas that guide moment-to-moment tracking, both in AEDP therapy sessions and in AEDP supervision. Questions that guide this exploration are "Where do you think the client is right now?" and "Where do you think you are right now?"
- the teaching of
- co-constructing safety from a collaborative, affect facilitating, attachment-based stance
- being a transformance detective, and attuning to the positive affective-somatic affective markers, i.e., the vitality affects, associated with transformance phenomena
- experiential language
- entry points, clinical choice points and basis for decisions grounded in moment-to-moment tracking, and affective-somatic markers of the transformational process
- moment-to-moment tracking
- dyadic affect regulatory skills for working with dysregulated clients and dealing with overwhelming emotional experiences
- emotion-processing skills for experiential work with emotion and relatedness
- metaprocessing skills for experiential work with transformational experience
- uniqueness of supervisory dyad, matching uniqueness of each therapeutic dyad: the cocreation of transformation: whereas the Three State transformations of the Transformational Process capture the regularities and phenomenological features of the transformational process, AEDP believes that each dyad coconstructs its interactions and thus the manifestations of transformance and transformational process are unique in each therapeutic dyad. The same is true of the supervisory dyad: each dyad is unique is con-constructs its own transformational path.
- The supervisor as True Other to the therapist/client dyad: AEDP believes in the emergent cocreated uniqueness of each dyad. The supervisor as True Other to the therapist/client dyad does not wish to disrupt the unique attunement client and therapist have coconstructed, but rather to attune to that, and affirm all positive affects reflected in that coconstructed interpersonal therapeutic interaction and use that to help therapist/supervisee stretch if need. The supervisor does not introduce ways of working that are not organic to the client/therapist dyad being supervised.
- meta-processing success or breakthrough moments that happen in therapy
- use of the self-of-the-supervisor to model alternate reactions/approaches/lines of inquiry
- work with supervisor around therapist's edges in working with the self-of-the-therapist
- use of experiential self-disclosure from supervisor (sharing pride, being moved, touched, etc.) in witnessing therapist/supervisee's clinical work
- when at a crossroads, focus and privilege the positive
- challenge the therapist/supervisee to use both left and right brain approaches in therapy
- help therapist/supervisee develop greater receptive capacity and affect tolerance, especially for the positive effects that characterize transformational experience.
Standards of excellence and precision: For certification in AEDP, specific criteria have to be met, specific objectives that are to be reflected in the videotaped sessions that are to be submitted for certification.
Diana Fosha, PhD, is the developer of accelerated experiential dynamic psychotherapy (AEDP), and founder and current director of the AEDP Institute, an internationally recognized school that specializes in training therapists in a healing-oriented transformational approach to the treatment of attachment trauma.
A leader in the field of transformational studies in trauma treatment, Dr. Fosha's work on healing transformational processes focuses on integrating neuroplasticity, emotion theory, recognition science and developmental dyadic research into experiential clinical process work with patients.
She is the author of The Transforming Power of Affect: A Model for Accelerated Change (Basic Books, 2000) and senior editor, with Daniel Siegel and Marion Solomon, of The Healing Power of Emotion: Affective Neuroscience, Development and Clinical Practice (Norton, 2009) and numerous papers on healing transformational processes in experiential psychotherapy and trauma treatment.
With an interest in the phenomenology of experience, Dr. Fosha is on the cutting edge of transformational theory and practice. AEDP's transformational theory, a basis for putting neuroplasticity and attachment theory into clinical action, is similarly receiving increasing recognition. Dr. Fosha's live AEDP clinical work is featured in the APA Psychotherapy Video Series.
Dr. Fosha lives in New York where she practices. She is on the faculty of the Department of Psychiatry and Psychology of New York University and St. Luke's/Roosevelt Medical Centers in New York. Many of her papers can be found on the AEDP Institute website.
- Fosha D. (2009). Emotion and recognition at work: Energy, vitality, pleasure, truth, desire and the emergent phenomenology of transformational experience. In D. Fosha, D. J. Siegel, & M. F. Solomon (Eds.), The healing power of emotion: Affective neuroscience, development, clinical practice (pp. 172–203). New York: Norton.
- Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York: Basic Books.
- Fosha, D. (2008). Transformance, recognition of self by self, and effective action. In K. J. Schneider, (Ed.) Existential-integrative psychotherapy: Guideposts to the core of practice, pp. 290–320. New York: Routledge.
- Fosha, D. (2009). Healing attachment trauma with attachment (…And then some!). In M. Kerman (Ed.), Clinical pearls of wisdom: 21 leading therapists offer their key insights (pp. 43–56). New York: Norton.
- Fosha, D. (2009). Positive affects and the transformation of suffering into flourishing. W. C. Bushell, E. L. Olivo, & N. D. Theise (Eds.) Longevity, regeneration, and optimal health: Integrating eastern and western perspectives (pp. 252–261). New York: Annals of the New York Academy of Sciences.
- Fosha, D., Paivio, S. C., Gleiser, K., & Ford, J. (2009). Experiential and emotion-focused therapy. In C. Courtois & J. D. Ford (Eds.), Complex traumatic stress disorders: An evidence-based clinician's guide (Chapter 14, pp. 286–311). New York: Guilford Press.
- Fosha, D., Siegel, D. J., & Solomon, M. F. (Eds.). (2009). The healing power of emotion: Affective neuroscience, development and clinical practice. New York: Norton.
- Gleiser, K., Ford, J. D., & Fosha, D. (2008). Exposure and experiential therapies for complex posttraumatic stress disorder. Psychotherapy: Theory, research, practice, training, 45 (3), 340–360.
- Gold, J. (2011). Attachment theory and psychotherapy integration: An introduction and review of the literature. Journal of Psychotherapy Integration, 21 (3), 221–231.
- Prenn, N. (2009). I second that emotion! On self-disclosure and its metaprocessing. In A. Bloomgarden & R. B. Menutti, (Eds.), Psychotherapist revealed: Therapists speak about self-disclosure in psychotherapy (Chapter 6, pp. 85–99). New York: Routledge.
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In this comprehensive guide, Natasha Prenn and Diana Fosha offer a model of clinical supervision that is based on the Accelerated Experiential Dynamic Psychotherapy approach.