Supervision Note

Supervision Note

Supervisor: Dr. Sarah Jenkins (Clinical Psychologist, PSY0001482910)

Supervisee: Liam O'Connor (Provisional Psychologist, PSY0002391044)

Date: 24/10/2023

Duration: 60 mins

Topics Discussed

• Caseload management and review of current clinical hours for AHPRA 5+1 internship logbook.
• Application of exposure and response prevention (ERP) for OCD.
• Managing therapeutic boundaries and termination planning.

Case Reviews

• Pt JT (MRN: 482-910-33): 28yo F with OCD (contamination subtype). Discussed hierarchy construction for ERP. Pt showing avoidance during in-session exposures. Explored strategies to grade tasks more gradually and address safety behaviours.
• Pt MK (MRN: 839-201-74): 42yo M with MDD and comorbid GAD, stable on escitalopram (Lexapro®) 20 mg PO mane. Approaching final session under Better Access MHTP (session 10/10). Reviewed relapse prevention plan and GP feedback letter requirements.

Feedback Provided

• Strong rapport building and thorough risk assessment noted with Pt MK.
• Watch pacing during ERP with Pt JT; ensure subjective units of distress (SUDS) are monitored until a 50% reduction is achieved before terminating the exposure task, rather than rescuing the client prematurely when distress peaks.

Action Items

• Re-adjust ERP hierarchy with Pt JT in next session; record video of the next in-vivo exposure for review.
• Draft GP Mental Health Treatment Plan closing letter for Pt MK for supervisor co-signature by 27/10/2023.
• Complete reading: Abramowitz (2018) chapter on inhibitory learning in ERP.

Reflection

• Supervisee recognised own anxiety regarding Pt JT's high distress levels during exposure tasks, leading to premature termination of exercises. Expressed increased confidence in applying the inhibitory learning model moving forward.

Additional Notes

• Mid-placement competency evaluation scheduled for next supervision session on 31/10/2023 at 14:00. Logbook hours are currently on track.