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At George Washington University, in Washington, D.C., graduate-level art therapy students are interacting with the local community on a regular basis. Part of the intensive master’s program includes providing art therapy to local residents at a low cost. The experience is key to the students’ future success as therapists and provides the university with a meaningful way to give back to the community.
Faculty members at the Columbian College of Arts and Sciences have found that high-definition video recording and playback is an extremely effective way to record, analyze and improve students’ clinical work. From observing visual cues that inexperienced students might miss to reviewing therapist–client interactions, the faculty relies on this technology to shape therapists into practiced experts by the time they graduate.
Faculty members have used video in student supervision since the clinic was started, about five years ago. Supervision and critique were originally done via Apple’s QuickTime streaming servers, with third-party recording and archiving. When Apple discontinued their platform, the faculty knew this gap couldn’t be left unfilled. The solution came in the form of HD video conferencing from LifeSize.
Now in the second year of using the LifeSize technology, high-definition video recording and playback is facilitating student learning more than ever for the art therapy program. Read on to learn how it works.
There are six case consultation groups in the clinic, with four supervisors reviewing student sessions. The clinic director also reviews sessions from time to time, both to supervise individual students as needed and to follow clinic practices overall.
Each student has a login identifier for the video system. Before each session with a client, the student authenticates his or her account and sets up the meeting room.
The clinic’s video system uses two wall-mounted cameras and a microphone that is suspended from the ceiling. The benefit of a multicamera approach is that it offers a variety of setups for session review: split screen, picture-in-picture and other configurations. When the student finishes the session and logs out, he or she can play back the recording to review what happened in therapy.
We ask students to review the recordings after each session. When the students go into supervision a week later, they are expected to show segments of their recordings to their supervisors and discuss what happened during the session.
This 5- to 10-minute review has proved incredibly useful. When students are learning to interact with clients, it’s not uncommon to miss things going on in the room. Video recording provides a second set of eyes, helping to hone students’ observational skills. Supervisors can offer a fresh perspective on the session and can integrate learning opportunities into the review. They can identify why things may not have proceeded as intended or why certain things worked particularly well.
In the beginning, of course, everyone has some anxiety about recording the therapy sessions. There is a period of adjustment, when both student and client are very aware that they are being recorded. Within a few sessions, however, faculty members have found that the anxiety diminishes to the point that the student is looking forward to reviewing the sessions, and the client becomes oblivious to the presence of the recording equipment.
A focus on microbehavior is vitally important in any type of therapy. In art therapy, when the client creates a picture, there is a lot of information therapists must consider. After a session, therapists look at the picture, analyze it and intellectually discuss it. What is particularly interesting, however, is observing how the client approached the materials in the process of creating the picture. This is one way that recording enables therapists to really examine what happened during a session.
For example, our therapists recently worked with a particularly dissociative client, who had experienced severe trauma in the past. Therapists noted that the client would “flatten out” at certain times during her therapy sessions. When the client was working with materials — whether emotional material or actual art materials — she could be triggered into a highly anxious PTSD (posttraumatic stress disorder) state. In one case, the client actually collapsed at the table and fell into a dissociative state.
The assigned student shared her concern that she did not know how to respond to the severe behavior in the session. Instructors were able to address her concerns while reviewing the video recording. Faculty members supervised the student by tracking the events on the recording and identifying what she had done well and how she might be able to notice cues that the client was going into a dissociative state, possibly catching the dissociation before it peaked.
Video review allows students to follow clients more carefully and to note when a client may be triggered emotionally. It also teaches students to be more self-aware. In the classroom, instructors can teach students how to work with someone who is dissociative, but with video to review, staff can point to incidents where the dissociation is beginning to happen. It’s an effective way to engage the students with real-world examples.
Members of the staff also see clients in the clinic, and their sessions are recorded as well. In order to use video as an effective teaching tool, it’s important that instructors understand how it feels to be recorded and how valuable the data can be.
Video is an unflinching eye yet it humanizes the experience of being a therapist. Therapy is not a matter of being smarter or faster than your client. Rather, it's a matter of analyzing clients and using clinical experience and classroom knowledge to address situations.