Moments of Real Relationship in Psychoanalytic Supervision

What role does the real relationship play in psychoanalytic supervision? While the real relationship's role has long been and continues to be considered with regard to psychoanalysis, it has received virtually no attention in the supervision literature. In this paper, using Horney's construct of the real self as conceptual anchor, I attempt to: (1) situate the real relationship squarely within the borders of the psychoanalytic supervision relationship; (2) examine the relevance of real relationship phenomena for the supervision experience; (3) provide some simple, ordinary yet meaningful examples of case dialogue that illustrate moments of real relationship in supervision; and (4) introduce the concept of real relationship rupture and consider its potential ramifications for and impact upon the supervisor-supervisee relationship. Just as ruptures can occur in the supervisory alliance, I propose that ruptures can also transpire in the supervisory real relationship, have the potential to reverberate throughout the entirety of the supervision experience, and depending upon how they are handled, can prove either constructive and relationally energizing and enlivening or enervating and eviscerating to supervision process and outcome.     

How does psychoanalytic supervision work? A brief communication

In this brief communication, we offer one perspective – the contextual psychoanalytic supervision model (CPSM) – on how psychoanalytic supervision works. The CPSM, a supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, accentuates four psychoanalytic supervisor–supervisee relationship variables as crucial and change inducing: the learning alliance bond, supervisor–supervisee real relationship, creating supervision expectations/providing an expectation-consistent form of supervision, and the supervisee’s engagement in facilitative educational actions. The CPSM is presented in hopes of stimulating further discussion about what makes psychoanalytic supervision work.     

Dynamics of psychoanalytic supervision: a heuristic model

This paper presents a heuristic model for the dynamics of psychoanalytic supervision. It is not a manual for how to perform supervision, but a model for how to identify and think about the complex elements and forces influencing the supervisory process. The point of departure is that psychoanalysis is a composite craft in which seemingly contrary elements like strict rules and creative intuitions have their place and interact. Several aspects of supervision are discussed: aims, learning processes, teaching methods, relationship, emotional atmosphere and evaluation. Competence is given a pivotal place in the model. The main feature of the model is that these aspects of supervision are all seen as suspended in a field of dynamic tensions between phenomena in real or apparent opposition. One example of this is the tension in the supervisory relationship between supervisor as instructor acting as an authority for the candidate whilst being a mentor fostering autonomy in the candidate. It is argued that related kinds of dynamics characterize several aspects of psychoanalytic supervision and that these tensions are inherent in analytic work. In conclusion a key word picture of the model is presented.     

The Relationship Between Supervisee Stress,Coping Resources,the Working Alliance,and the Supervisory Working Alliance

The authors examined the relationship of perceived stress, specific types of coping resources, the working alliance, and the supervisory working alliance among 232 counselor supervisees. The working alliance and the supervisory working alliance were negatively related to perceived stress and positively related to multiple coping resources. Two regression models for predicting the working alliance and supervisory working alliance from perceived stress and specific coping resources were significant. Implications for practice and research are discussed.     

Supervision and Analysis at a Crossroad: The Development of the Analytic Therapist: Discussion of Papers by Joan Sarnat and Emanuel Berman

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered.     

Career counselor training and supervision: role of the supervisory working alliance

The importance of career counseling within our educational and professional systems is clearly recognized, yet little attention has been directed toward explicating the career counseling supervision process. Research on personal–emotional counseling supervision has stressed the critical importance of the supervisory relationship. The purpose of this study was to better understand the nature and effect of the supervisory working alliance in the supervision of career counselors, using case study methodology. Results point to the importance of explicitly addressing the working alliance early in the work, exploration of affect in supervision, and cognizance of the power differential inherent in a training relationship.     

The Supervisory Alliance as Quintessential Integrative Variable

The concept of alliance in psychotherapy supervision is now a half century old. But over the course of its first 50 years, how has the supervisory alliance come to generally be viewed by supervision scholars and practitioners? and What is its specific place now within different visions of supervision? In this paper, I would like to consider those two questions by: (a) describing the two enduring perspectives on the supervisory alliance that have dominated and continue to dominate the supervisory scene; and (b) examining the ways in which the alliance appears to currently be conceptualized and implemented across several distinct views of supervision. Each view of supervision is also presented as containing and actuating its own message and meaning about the role of alliance in supervision, and those messages and meanings are accordingly identified. The supervisory alliance appears to now be widely regarded as being a transtheoretical common factor that binds by means of: (a) bond/rapport; (b) supervision goals; and (c) supervision tasks. Much like the therapeutic alliance in psychotherapy, the supervisory alliance has increasingly come to be seen as the very heart and soul of supervision itself and may indeed be the quintessential integrative variable in psychotherapy supervision.     

The competent psychoanalytic supervisor: Some thoughts about supervision competences for accountable practice and training

What are the competences required to satisfactorily practice effective or “good enough” psychoanalytic supervision? In this paper, I would like to consider that question. Over the past approximate 15-year period, increasing attention has been directed toward more specifically identifying and defining the components of competent psychoanalytic practice. But any parallel attention toward identifying and defining the components of competent psychoanalytic supervision practice has, in comparison, been sorely limited if not virtually absent. If we are to best practice competent psychoanalytic supervision and best train future psychoanalytic supervisors for competent practice, effort needs to be made to concretely delineate the competences that are requisite for such practice. In what follows, I present and adapt six broad-based families of internationally relevant supervision competence areas for use in psychoanalytic supervision: (1) knowledge about/understanding of psychoanalytic supervision models, methods, and intervention; (2) knowledge about/skill in attending to matters of ethical, legal, and professional concern; (3) knowledge about/skill in managing psychoanalytic supervision relationship processes; (4) knowledge about/skill in conducting psychoanalytic supervisory assessment and evaluation; (5) knowledge about/skill in fostering attention to difference and diversity; and (6) openness to/utilization of a self-reflective, self-assessment stance in psychoanalytic supervision. Although by no means an exhaustive list, 30 supervision competences (five per family) are proposed as significant for guiding competent psychoanalytic supervision practice and supervisor training, and a brief explanatory comment is offered in support of each broad-based family of competences.     

Attachment theory within clinical supervision: application of the conceptual to the empirical

Attachment theory, which has demonstrated application in caregiver-child, romantic, and psychotherapeutic relationships, also appears to be supervision relevant. But bad blood between attachment theory and psychoanalysis may well have hampered considering the relevance of attachment theory for psychoanalytic supervision. This project sought to investigate the application of attachment theory to the supervision situation, with the potential implications of our findings for psychoanalytic supervision being considered. Attachment styles, leader–follower dynamics, and attachment-based expectations were explored as predictors of supervisor-trainee working alliance using a prospective, longitudinal study design. Findings revealed the importance of measuring supervision-specific attachment, the particularly problematic nature of supervisee avoidant attachment, and the potential contribution of a leader–follower framework for understanding supervisory attachment. These attachment concepts may well be useful in, and additive for, psychoanalytic supervision practice.     

Supervising Psychoanalytic Psychotherapy: Present Knowledge,Pressing Needs,Future Possibilities

Existing research from the fields of education, cognitive science, neuroscience, and psychoanalytic psychotherapy points us toward possibilities for the future of psychoanalytic supervision. This research suggests that we need to go beyond communicating abstract knowledge and make our supervisory relationships more experiential, participatory, relationship-focused, and personal in order to teach usable knowledge, develop complex psychotherapeutic skills, and facilitate emotional and relational development in our supervisees. The author concludes that a relational model of supervision fits this pedagogical profile. After grappling with our resistances to change, the author hopes that more psychoanalytic supervisors will make use of a relational model of supervision, as well as drawing upon new technologies and neuroscience-based teaching techniques.     

Supervisor social skill and supervision outcome

Background: The practice of clinical supervision is considered an effective procedure to achieve a variety of professional outcomes for supervisees. Supervisory alliance mediates many of the learning outcomes thought important for effective supervision. Therefore, it is important to identity supervisor characteristics that relate to the capacity to develop a positive supervisory alliance and achieve supervision outcome. Aim: Supervisor interpersonal skill was investigated as a characteristic involved with both supervisee assessment of supervisory alliance and learning outcomes of supervision. Method: Forty supervisors completed assessments for interpersonal skill and provided 8 sessions of supervision to 50 supervisees. Supervisees completed assessments for supervisory alliance and supervision evaluation. Findings: Supervisor interpersonal skill predicted supervisee rated supervisory alliance and supervision outcome. Implications: Supervisor interpersonal skill is important for the capacity to develop a positive supervisory alliance and manage the learning environment of supervision.     

The Relationship Between Counseling Trainee Perfectionism and the Working Alliance With Supervisor and Client

The relationships between perfectionism, counseling self‐efficacy, and the supervisory and client working alliance were investigated among 143 counseling trainees and 46 supervisor–trainee dyads. Maladaptive perfectionism was negatively correlated with the supervisory alliance and working alliance. Counseling self‐efficacy moderated the relationship between adaptive perfectionism and the supervisory alliance (perspective of the counseling trainee) and maladaptive perfectionism and the supervisory alliance (perspective of the supervisor). The authors conclude that supervisors should consider perfectionism and counseling self‐efficacy as important factors in supervision.     

The supervisory alliance: Comparison of measures and implications for a supervision toolkit

Background Clinical supervision lies at the core of the professional development of clinicians providing services within a range of service settings. The supervisory alliance is regarded as the most important construct in effective supervision which underlies the importance of metrics to assess this construct. Aims materials and Method A cross‐sectional self‐report questionnaire design was used to examine clinical supervision constructs. The study used two scales measuring the supervisory alliance (SRQ and SWAI‐T), a scale measuring supervision satisfaction (SSQ) and a scale measuring disclosure (TDS). The questionnaires were administered to 127 clinical psychology trainees who were undertaking a practicum placement. Results Both scales measuring the alliance were positively correlated with satisfaction with supervision and disclosure, with similar sizes of correlation for each alliance scale. There was also a large, positive correlation between the two scales of measuring the alliance. Discussion Both scales were designed for use in supervision and are related to supervision outcome measures in the expected directions. Conclusion The SRQ has some distinct advantages over the SWAI‐T that lend the SRQ to be potentially more useful in clinical and research settings.     

Relationship Between the Supervisory Working Alliance and Outcomes: A Meta‐Analysis

This study investigated the relationships between the supervisory working alliance and supervision outcome variables using meta‐analysis. The authors reviewed 27 articles, dissertations, and theses published between 1990 and 2018. The authors used the MIX program to calculate the meta‐analyses. The results indicate that the supervisory working alliance is positively related to supervision outcome variables. Supervisees’ perceived relationship with the supervisor was positively related to the relationship with the client. This shows that the phenomenon of isomorphism is a repeated pattern in the relationships in supervision and counseling. The authors discuss the limitations and implications.     

The peer supervisory group for psychoanalytic therapists

The recent interest in peer supervisory groups for psychoanalytic therapists raises important questions regarding both psychoanalytic training and group process. The present paper explores these issues and suggests that there exists a continuum from case-centered peer supervisory groups to process-centered peer supervisory groups. Transference and countertransference and the recognition of parallel processes in psychotherapy supervision are examined in their relation to the supervisory group experience. The authors suggest that the model a therapist employs regarding the role of countertransference will most likely influence the kind of peer supervisory group that s/he will choose. Further, there are specific techniques, as well as experiences, which may foster alteration of the group's psychic organization. Illustrative case examples are provided throughout.     

The Supervisory Working Alliance,Trainee Self-Efficacy,and Satisfaction

Theoretically, when the supervisory working alliance is strong, the trainee and supervisor share a strong emotional bond and agree on the goals and tasks of supervision. Tested was Bordin's (1983) proposition that changes in counselor trainees' perceptions of the supervisory alliance over the course of supervision would predict supervisory outcomes. A national sample of beginning practicum- to intern-level trainees were assessed at the beginning and end of an academic semester. Contrary to predictions, changes in the alliance were not predictive of changes in trainees' self-efficacy. However, improvements in the emotional bond between the trainees and supervisors were associated with greater satisfaction.     

The supervisory field and projective identification1

Taking as their starting point the Baranger and Baranger model of the ‘psychoanalytic field’, the authors extend the notion of intersubjectivity in the analytic relationship to the supervision process. They use a practical example of a supervision to show the development of what they term the ‘supervisory field’, formed from the superimposition of the two fields of analyst‐patient and supervisor‐supervisee. They emphasize the interplay of projective identifications with objects emanating from the inner world of the patient that are relived in the analytic relationship and transposed to the supervisory field. They believe that the concept of the ‘supervisory field’ contributes to a deeper understanding of the unconscious processes occurring in the mind of analysand, supervisee and supervisor during supervision, particularly regarding the identification, comprehension and resolution of persistent disturbances in the supervisory process.     

Convergence,commonality, and context in psychoanalytic supervision

ABSTRACT

What are the binding commonalities that demark and define any and all psychoanalytic supervision perspectives? What do we all do as psychoanalytic supervisors that practically matters? Furthermore, might there be a unifying model that anchors those binding commonalities together into a supervision meaning-making, explanatory framework? In this two-part paper, I take up those questions. In Part I, based on a century-spanning literature review, I identify 50 (non-exhaustive) common Support and Learning factors that appear present across the panoply of psychoanalytic supervision perspectives. Relational, educational, and interventional, these 50 factors reflect the very stuff of which psychoanalytic supervision is made. In Part II, I present and elaborate upon the Contextual Psychoanalytic Supervision Relationship Model (CPSRM) – a theoretically-grounded model that anchors and contextualizes those common Support and Learning factors. Because common factors can be seen as nothing more than atheoretical amalgamation (i.e., lists of desirable characteristics endlessly strung together), the CPSRM is proposed as a theoretically-based antidote. A supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, the CPSRM accentuates relational connection, expectations/goals, and educational action as preeminently supervisee change inducing and learner affecting.     

INTERFACING INFANT MENTAL HEALTH KNOWLEDGE: PERSPECTIVES OF SOUTH AFRICAN SUPERVISORS SUPPORTING LAY MOTHER–INFANT HOME VISITORS

This article is part of a project investigating the interfacing of clinically and research‐generated knowledge in the field of infant mental health (IMH) with local cultural models of child care and development. The article explores the experiences and challenges reported by psychology‐trained supervisors in supervision with local, lay, trained home visitors. Supervisors and supervisees were drawn from two early intervention programs which apply relational IMH mental health models in socioeconomically deprived townships in South Africa. Literature that considers supervisors’ experiences of conducting supervision with lay counselors has been limited, and even more so in settings where there are marked cultural and contextual differences between supervisors and supervisees. These differences pose particular challenges regarding the finding of a shared theoretical understanding of the work as well as to the establishment of a secure working alliance. While it was found that psychoanalytic and attachment‐informed theories of infant development are applicable in these South African settings, differences in race, language, education, socioeconomic status, and culture between supervisors and supervisees challenge the supervisor–supervisee relationship and require psychological processing and creative solutions to ensure integrity in the application of the model.     

Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.