Online ISTDP Supervision for Therapists

I offer online individual and small-group supervision for psychotherapists seeking to deepen their work in Intensive Short-Term Dynamic Psychotherapy (ISTDP) and related experiential dynamic therapies.

Supervision is grounded in careful review of video-recorded clinical material. Rather than reconstructing a session from memory or deciding what theoretically “should” have happened, we slow the process down and examine what actually occurred:

• What was the patient communicating?

• How was anxiety being experienced and discharged?

• Which defenses were active?

• What happened in the therapeutic relationship?

• How did the patient respond to the therapist’s intervention?

• What does that response suggest about the next clinical step?

The aim is to help you develop clearer psychodiagnostic thinking and increasingly precise, responsive interventions—not simply memorize techniques or imitate another therapist’s style.

Who Is ISTDP Supervision For?

Supervision may be useful for clinicians who are:

• Beginning to integrate ISTDP after introductory, Pre-Core, or Core Training

• Seeking consultation alongside formal ISTDP training

• Working to translate ISTDP theory into moment-to-moment clinical practice

• Interested in strengthening their assessment of anxiety, defenses, resistance, and affect tolerance

• Encountering cases in which the therapeutic process feels unclear, stuck, overly intellectualized, passive, or emotionally disconnected

• Wanting to understand their own reactions and participation in the therapeutic relationship more clearly

Supervision is adapted to the clinician’s experience, learning goals, and the needs of the patients being discussed.

Areas We May Explore

Depending upon the clinical material and your goals, supervision may focus on:

• Establishing a clear therapeutic focus

• Psychodiagnosis and response-to-intervention

• Anxiety assessment and regulation

• Identifying and restructuring defenses

• Differentiating feeling, anxiety, defense, and detachment

• Mobilizing the patient’s will and capacity for collaboration

• Resistance and the unconscious therapeutic alliance

• Transference and recurring relational patterns

• Affect tolerance

• Countertransference and therapist process

• Recognizing when the therapist is beginning to overfunction, rescue, push, withdraw, or assume responsibility for the patient’s work

• Translating clinical observations into clear, timely interventions

The Triangle of Conflict and Triangle of Persons provide useful maps, but they are not substitutes for inquiry. We continually test our understanding against the patient’s observable experience and response.

You can read more about this approach in my guide to the Triangle of Conflict in ISTDP.

How Supervision Works

Supervision is available online through Zoom in individual and small-group formats.

Video-recorded clinical material is a prerequisite. Reviewing the actual therapeutic exchange allows us to study verbal and nonverbal communication, anxiety, defenses, emotional contact, therapist interventions, and the patient’s responses with greater accuracy than retrospective description alone.

You remain responsible for obtaining appropriate patient consent and handling all clinical material in accordance with applicable legal, ethical, and organizational requirements.

We can begin with a particular clinical question, a segment that felt confusing or difficult, or a broader concern about the direction of treatment. At times, the most useful learning emerges from slowing down an interaction that initially seemed unremarkable and noticing what was happening between patient and therapist.

My Approach to Supervision

My approach is collaborative, active, and non-shaming. The goal is not to judge a performance after the fact. It is to become interested together in what the clinical material can teach us.

We will look closely at what you already recognized, what may not yet have been visible, and how your interventions affected the process. When a therapist feels pressure to explain, organize, rescue, reassure, push, or carry the session, we can treat that reaction as valuable clinical information rather than evidence of failure.

I place particular emphasis on helping clinicians:

• Remain emotionally present while thinking clearly

• Work at the patient’s current capacity

• Distinguish observation from assumption

• Learn from the patient’s response

• Preserve the patient’s agency and responsibility

• Develop a clinical voice that is precise, authentic, and their own

The purpose of supervision is not rigid adherence to a model. It is the development of thoughtful, responsive clinical practice.

About David Rudesill

David Rudesill, MSW, LCSW, is an IEDTA Certified Teacher, psychotherapist, clinical supervisor, educator, and author. He is licensed as a clinical social worker in Colorado and California and has worked in mental health since 2008 across community mental health, university counseling, integrated healthcare, academia, and private practice.

His teaching and supervision emphasize careful observation, anxiety and defense assessment, therapeutic alliance, affect tolerance, patient agency, and moment-to-moment clinical decision-making.

Clinicians who would benefit from a structured introduction to the model may also be interested in ISTDP Pre-Core Training.

Frequently Asked Questions

Do I need video-recorded clinical material?

Yes. Video review is essential to this form of supervision because it allows us to study the actual therapeutic process rather than relying exclusively on memory or retrospective description.

Do I need to have completed ISTDP Core Training?

No. I work with clinicians at different stages of ISTDP learning. The supervision will be adapted to your current experience and professional goals.

Is supervision available individually or in a group?

Both individual and small-group supervision may be available. Please contact me regarding current openings and group availability.

Is supervision conducted online?

Yes. Supervision is available online through Zoom.

How much does individual supervision cost?

Individual supervision is $200 per hour. Please contact me for current small-group availability and rates.

How do I get started?

Please tell me briefly about your clinical background, previous ISTDP training, and what you would most like to strengthen through supervision.

Contact me about ISTDP supervision