What's not being said? Recollections of nondisclosure in clinical supervision while in training

The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and data analysis drew on Consensual Qualitative Research. The findings revealed four categories relating to: (i) the nature of the difficulty; (ii) reasons for nondisclosure; (iii) the supervisory relationship; and (iv) facilitative factors. The quality of the supervisory relationship was a significant element in nondisclosure. A key recommendation was that role induction for supervisees should be incorporated into training programmes to assist supervisees in learning how to use supervision more effectively. Limitations of the study and further research are provided in light of current findings.     

When educational supervision meets clinical supervision: what can we learn from the discrepancies?

The authors question the taken-for-granted notion of supervision. Their concerns arose out of an attempt to introduce 'clinical' supervision into academia as a way of addressing an increasing number of the ethical issues which confront lecturers. They recognise that knowledge can impact adversely on students and that lecturers at times find themselves compromised. They settled on supervision as an organisational space in the domain of power in which to address the distress they observed. However, through their different experiences of supervision, they soon found themselves talking past each other. When clinical supervision meets educational supervision, several anomalies are brought to the fore. The authors draw on Foucault's notion of discourse, and of knowledge as power, in order to foreground these and conclude by cautioning against an uncritical acceptance of supervision as an ethical practice. They believe there is a benefit in bringing together the two discourses of clinical and educational supervision for further discussion.     

A Survey of Clinical Supervision in Genetic Counseling

Three hundred and thirty-five full members of the National Society of Genetic Counselors completed a survey concerning the nature of clinical supervision for genetic counseling students. Slightly over half (54.3%, n = 182) had provided clinical supervision within the past 5 years. Of those who supervised, 66.7% had 5 years or less supervision experience, and 55% had supervised 10 or fewer students. The majority became supervisors because they enjoy teaching and contributing to the profession. Common reasons for not supervising include no local graduate program, and had never been asked to supervise. Live supervision is the most prevalent student evaluation method: every supervisor reported providing one-on-one oral feedback, and 47.3% indicated that they always provide feedback immediately following a counseling session. The most frequent challenges involve students who lack technical knowledge and who fail to incorporate feedback. Training, policy, and research implications are discussed.     

A Qualitative Investigation of Student and Supervisor Perceptions of Live Supervision in Genetic Counseling

Live supervision of genetic counseling students is critical for ensuring quality client care and student clinical skill development. However, no research has investigated students' and supervisors' experience of this primary supervision method. In this study, separate focus groups of students and supervisors discussed their perceptions of the nature and impact of live supervision. A modified Consensual Qualitative Research method (Hill et al. (1997) Couns Psychol 25:517–572) was used to analyze the data. Results suggest that live supervision is an essential and effective method that promotes student skill development and professional development for both students and supervisors. There is a lack of formal training regarding supervision; most learning is trial and error. Students worry about being evaluated, and supervisors wonder if they are providing supervision effectively. Both samples emphasized that client care should not be compromised. Participant recommendations for improving live supervision are described, and suggestions are made for future research.     

Recording supervision: Educational,therapeutic, and enhances the supervisory working alliance?

Aims: To explore the impact of listening to an audio‐recording of their latest supervision session on supervisees. Method: Participants recorded a supervision session, listened to it and were interviewed about this experience of listening to it within seven days of listening to the recording. The phenomenological interviews informed by the researcher's knowledge were analysed using grounded theory. Participants: Fifteen participants with 0–20 years’ experience, representing person‐centred, CBT, psychodynamic and integrative approaches, and qualifications ranging from student to doctorate formed the theoretical sample. Findings: Listening to the audio‐recording allowed participants to re‐experience their thoughts and emotions. Participants recalled and re‐experienced events which had been forgotten, unnoticed or (arguably) repressed. This re‐experiencing was usually less emotive than in real‐time; but suppressed emotions could be more intense. As participants integrated both these noticed and unnoticed events, they were able to accept what had been unacceptable, gaining self‐awareness, which was potentially therapeutic. Noticing what had been unnoticed permitted insights into many aspects of therapy and supervision, which was more than just ‘reflection‐on‐action’. Conclusion: Listening to an audio‐recording of the latest supervision may be educational for any supervisee; it may be therapeutic by facilitating challenge of maladaptive beliefs and behaviours; and it also seems to strengthen the supervisory working alliance.     

Trainee nondisclosure in supervision: What are they not telling you?

Aims: The purposes of this study were to examine: (1) the content of and reasons for trainee nondisclosure in supervision, and (2) the influence of trainee anxiety and perception of the supervisory working alliance on amount of nondisclosure and willingness to disclose. Method: As the focus of the study was a single supervision session, qualitative and quantitative data were collected from 204 trainees about their most recent supervision session. Results: Within the single supervision session on which they reported, 84.3% of trainees withheld information from their supervisors. Trainees reported an average of 2.68 nondisclosures occurring in the session, with the most common nondisclosure involving a negative supervision experience. Trainee perception of a better supervisory working alliance was related to less nondisclosure and greater overall willingness to disclose in supervision. Higher trainee anxiety was related to greater nondisclosure and lower overall willingness to disclose in supervision. Implications: The implications of the findings for the practice of supervision are discussed and areas for further research are suggested.     

Supervisory styles index: Examining supervisees' perceptions of Supervisory Style

The goal of this research was to develop an instrument, the Supervisory Styles Index (SSI), that would examine supervisory style. Style has been described as the way in which the personality and convictions of the supervisor are demonstrated in the supervisory relationship (Leighton, 1991). This study focuses on the interplay between supervisory style and the influence of sex and gender. The findings of this study reveal that female supervisees discern their supervisors to be more self-disclosing than do male supervisees. Implications of the findings and utilization of the index are discussed.Portions of this paper were presented at the 52nd annual conference of the American Association for Marriage and Family Therapy, Chicago, Illinois, November, 1994.     

On psychoanalytic supervision

The author provides both a theoretical context for, and clinical illustrations of, the way in which he thinks and works as a psychoanalytic supervisor. The analytic supervisory experience is conceived of as a form of 'guided dreaming'. In the supervisory relationship, the supervisor helps the analyst to dream (to do conscious and unconscious psychological work with) aspects of the analytic relationship that the analyst is unable to dream or is only partially able to dream. It is the task of the supervisory pair to 'dream up' the patient, that is, to create a 'fi ction' that is true to the supervisee's emotional experience with the analysand. To carry out this work, the supervisor must provide a frame that ensures the supervisee's freedom to think and dream and be alive to what is occurring in the analytic and the supervisory relationship, as well as in the interplay between the two. In one of the clinical illustrations presented, the author illustrates his conception of the importance of the feeling on the part of supervisor and supervisee that (at least occasionally) they have 'time to waste'. Such a state of mind may provide an opportunity for a type of freely associative thinking that enhances the range and depth of what can be learned from the supervisory experience. In another clinical example, the author describes his own experience in supervision with Harold Searles, which contributed to his conception of the supervisory process.