Because subtitles commenting on the therapist-patient conversation appear as the conversation is ongoing, the density of information contributed by the teacher can be much greater than when a video is repeatedly stopped and started. Stopping and starting disrupts the flow of patient-therapist conversation and wastes class time. In a group supervisory seminar, with unedited tape, considerable class time may be taken by waiting or hoping for something to happen. Uncertainty about what comes next and the risk of having an unproductive class may cause a teacher to prefer discussion to continued watching. The teacher who prepares a movie has the opportunity to observe the entire session and direct attention to what he or she thinks is important. With conventional individual or group supervision, both teaching and evaluation of trainee competence are based on samples.
Psychotherapy supervision addresses the therapist’s understanding of the patient, understanding of himself or herself, and the overall direction of treatment. Success as a psychotherapist, however, just as for the musician, athlete, surgeon, or pilot, involves technique. Understanding is not enough. Coaching and practice are time-tested strategies for mastering technique and improving skills. The edited, subtitled movie is an efficient way to provide answers to the question asked over and over by beginning psychotherapists: “What should I say?” Use of subtitles facilitates attention to choice of words, nuance, and reinforcement of what the trainee is doing right. When the focus is technique, it is often productive to study treatment of patients for whom psychotherapy is an adjunct to medication management or other patients who often do not attract supervisory attention.