Reviewing Digital Session Recordings (DSRs) from actual treatment sessions provide invaluable information for the therapist and supervisor. Our belief is that this is the best way to train therapist and learn any new protocol. Therapists initially may feel threatened or embarrassed, but reviewing these tapes will provide a great opportunity for improving their skills.
The DSRs highlight the specific CRA/FT procedures that have been utilized and the level of effectiveness of each procedure. It is also just as important to discuss procedures that have been overlooked, or techniques that should have been used. Supervisors should look for common problems that a therapist is having in implementing CRA/FT treatment.
• Losing sight of the reinforcers;
• Failing to involve a significant other;
• Neglecting the importance of having a satisfying social/recreational life;
• Not stressing the necessity of participating in meaningful activities (school, job, church, self help meetings);
• Inadequately monitoring trigger to use;
• Not determining what are the positive reinforcers (motivation).
A specific form is available that describes the CRA/FT procedures and provides an opportunity for supervisors to note what CRA/FT procedures were used, as well as which ones could or should have been used. One should be filled out for each session by the therapist. The supervisor should then review the completed form. The supervisor may also use this form when listening to an audio tape to check on whether the procedures were actually done, and how well they were used. If tapes are not listened to, then the supervisor may use the checklist in supervision and ask the therapist to explain when and how it was used and how useful the therapist thought the procedure was.
There is no exact number of DSRs that needs to be turned in to be certified. Instead, we require demonstration of the mastery of specific CRA procedures. It is common for therapists to turn in tapes of therapy sessions that contain several of these procedures (i.e., you don't need a separate tape for each required procedure. Example: the Overview of CRA takes about 5 min, and thus may be easily be combined in sessions with other procedures). Often it takes 8-12 DSRs to get certified.
For each tape that's submitted a therapist receives: (a) a completed checklist, and (b) a written narrative describing both the therapist's strengths in doing CRA and the areas needing further attention.