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.     

Infant mental health home visiting therapists’ reflective supervision self-efficacy in community practice settings

In recent years, there has been an increase in the research on reflective supervision, including the development of tools designed to measure reflective practice in the context of reflective supervision. The Reflective Supervision Self-Efficacy Scale for Supervisees (RSSESS) is a self-report measure that has been used in previous evaluations and is designed to assess perceived reflective practice self-efficacy for Infant Mental Health-Home Visiting (IMH-HV) therapists. Properties of the RSSESS including factor structure and reliability are explored in a first study that lays the foundation for the use of the RSSESS in an IMH-HV evaluation in the State of Michigan. IMH-HV therapists completed the RSSESS at 4 time points over a 12-month period and also completed a Clinician Profile Form that included questions about their IMH background and their work experience, including job satisfaction and burnout. Results indicated that the RSSESS is a reliable tool to measure change in reflective practice skills. IMH-HV therapists demonstrated growth in their use of reflective practice skills with families and their observational skills over the 12-month period. In addition, results indicated correlations between reflective supervision self-efficacy and job satisfaction as well as burnout.     

Toward the science‐informed practice of clinical supervision: The Australian context

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature and suggests steps to advance the development of a mature science of clinical supervision. The main areas requiring attention include the identification of the mechanisms by which supervision produces change in supervisees and their patients, the refinement of measurement methods and instrumentation, and the need to pursue collaborative research that maximises the generalisability of research findings.     

Perspectives on supervision in cognitive therapy

Supervision is often a neglected clinical area. Frequently, supervisors view supervision as an epiphenomenon of clinical work rather than a central feature. This article emphasizes the importance of supervision in cognitive therapy. Teaching novice professionals to skillfully apply cognitive conceptualizations and interventions is a challenging and difficult task. It is argued that fostering a learning alliance in supervision forms the basis for acquisition of pivotal cognitive therapy competencies. Various impediments to productive learning alliances are discussed and ways to obviate these obstacles are suggested. Further, issues related to technical interventions, relationship processes, and case conceptualizations are discussed. Finally, ways to augment trainees' skills in these fundamental areas are delineated. He is also Co-director of the Pre-Doctoral Psychology Residency Training Program.     

Supervisory reactions: an important aspect of supervision

Anne Alonso was passionate about the practice of supervision. An excellent supervisor herself, she sought to identify and teach the ingredients of effective supervision throughout her career. Her first book, The Quiet Profession (1985), was about the supervisory relationship and the various influences on it from within and without the relationship, and she insisted that the Center for Psychoanalytic Studies training program that she directed for many years include a required course on supervision. While the usual focus in supervision is on the supervisee and the clinical material presented, supervisors often experience powerful emotional reactions. Sometimes this is parallel process, in which the dynamics of the psychotherapy are replayed in the supervisory relationship. However, many other sources can contribute to supervisory affect, including the personality, background, and developmental stage of the supervisor, the impact of the clinical material, and the setting in which the supervision takes place. Supervisory reactions can be informative about the psychotherapy being supervised, about the supervisory relationship, or about the supervisor. Supervisors need self-awareness in order to identify their own contribution to their affective responses in supervision. The use of a supervisor decision tree of 1) awareness of reaction, 2) identification of its source, 3) relevance to current supervision, and 4) appropriate use of the reaction in the current supervision is recommended.     

‘A preparation for practice?’ Students experiences of counselling training within departments of higher education

The literature has identified a gap between the education and practice in the education and training for the practice based professions based within traditional Departments of Higher Education. In the education and training in counselling it is suggested that this gap is primarily between those who view practice as the rigorous application of formal ‘science’ and those who see it as more holistically embedded in ‘tacit knowledge’ and artistry of the practitioner. This paper reports on a small scale qualitative study (Scanlon, 1993) which investigated the experience of students undertaking Counsellor training courses within Departments of Higher Education. Analysis of interview data revealed three main categories of concern. The first categoy describes the adverse effects of the theory-practice gap on the students. The second catego y describes the importance of clinical supervision in acquiring practice skills and the third catego y describes the participants' concerns about the quality of outcome for such training, particularly in relation to the perceived lack of ngour in the assessment of clinical competence. In the light of these findings a number of suggestions about how the professional education and training of counsellors could be better integrated into a more ‘practice led’ curriculum model are discussed.     

Population Health and Trauma‐Informed Practice: Implications for Programs,Systems, and Policies

Population studies indicate that trauma exposure is ubiquitous and has a significant impact on health. Trauma‐informed practice seeks to address the health consequences of trauma through integrative responses that incorporate an understanding of the effects of trauma, the multiple pathways to recovery, and the potential for re‐traumatization. Current trauma‐informed practice considers trauma exposure an individual clinical problem rather than a societal problem with population health consequences. Population health refers to the aggregated health status of individuals who share some characteristic, such as trauma exposure, and includes the study of determinants that shape the distribution of health outcomes in specific populations. In this paper, we describe a population health perspective for trauma‐informed practice that complements the current clinical perspective, and then discuss implications of that perspective for programs, systems, and policies. We summarize essential concepts about trauma over the life course and describe principles of population health science relevant to trauma‐informed practice. We then discuss implications of these principles by identifying four priorities for trauma‐informed practice from a population health perspective: (a) adopting trauma‐informed policies to prevent trauma exposure and to foster resilience in the aftermath of trauma; (b) infusing trauma‐informed practice into everyday activities so it is a routine part of interpersonal transactions; (c) incorporating trauma‐informed practices into existing service systems; and (d) adapting existing treatments to incorporate trauma‐informed principles for population health impact.     

Tuning into the psychotic wavelength: Psychoanalytic supervision for mental health professionals

In this paper, material is presented from supervision groups run for mental health professionals in different mental health settings. I will argue that a psychoanalytic framework, which puts the transference and countertransference at the centre of clinical practice, offers an important model for thinking about psychosis and psychotic means of communication. When staff are able to ‘tune in’ to their patients' communications it can help to change a patient's monologue about his/her delusional world into a meaningful dialogue about their emotional world.     

Systems-centered supervision

The systems-centered (SCT) approach to supervision frames the dynamics of both groups and individuals as isomorphic systems. In this chapter, the SCT supervisory experience, its goals, and its approach to transference and countertransference are addressed; the orientation of the seven questions that structure the SCT supervisory process are identified; and the thinking that is required to answer them is discussed. SCT supervisees locate their supervision issues in the context of the phases of system development; consider interventions as hypotheses that can be tested in the therapeutic context; and provide feedback to all parties about the validity of the theory of living human systems, the reliability of its systems-centered practice, and the accuracy of the therapist's hypotheses about the isomorphic dynamics of the systems of member, subgroup and group as a whole. Illustrations are taken from tape recordings of supervisory sessions.     

Mo(ve)ments in the academic supervision relationship: Ethics in practice

Context: The context of the article is a supervisory relationship between an academic supervisor and a student‐researcher and an ethic of risk within the research and supervision. Focus: The challenges for supervisor and student, and thus the supervisory relationship, and the strategies to move beyond the ethical dilemmas encountered in the research project, within an ethic of risk, form the focus of the article. Discussion: This article highlights the moments when a student counsellor/ researcher came to an impasse in transcribing and analysing data generated in an auto‐ethnography, and the author, the academic supervisor's responses to these difficulties. The use of specific knowledge, skills and strategies in the supervisory relationship opened space for agency and movement within these moments of impasse. Text work and researcher identity work was facilitated through the use of particular listening skills and narrative therapy informed questions.     

Parallel process in supervision

This paper addresses the concept of parallel process and its application in clinical supervision. Parallels between therapy and supervision are examined as well as some of the key issues surrounding the use of parallel process as a supervisory intervention. Although there is a need for more investigation to explain and support this concept further, the authors would argue that parallel process interventions in supervision can enhance the supervisory process and the task of teaching and learning for both the supervisee and supervisor. A case example is provided to demonstrate the parallel process in supervision and its potential as a facilitative intervention.     

Ethical considerations in the supervision of applied sport psychology graduate students

Abstract

Some of the most important relationships that a sport psychologist experiences in his or her career are between the supervisor and supervisee in applied practica and internships. These relationships may become models for future professional and ethical behavior with colleagues, students, and clients, and thus deserve careful examination. Ethics form a foundation for practice, and while classroom discussions of ethical issues help educate graduate students, the supervisor-supervisee relationship may provide a hands-on experience of ethical dilemmas and ethical problem solving. Ethics in supervisor-supervisee relationships cover at least two broad areas. First, there is the supervisor's monitoring and mentoring of ethical considerations in the supervisee's relationship with the athlete-client. Second, ethical questions arise in the relationship between the supervisor and the supervisee. The present paper includes discussion of general supervisory issues (e.g., modeling ethical behavior, helping develop counseling skills) and explores the specific ethical problems of referring for counseling, intimacy, and exploitation. Also, three case examples illustrate ethical concerns that may appear in the process of applied sport psychology supervision. Broadening education in ethical issues in supervision for both psychology and exercise science graduate programs may help future practitioners better serve their clients.     

A bridge of knowing: The scholar-practitioner of supervision

This essay is the text of a speech given on the connection between empirical and practice knowledge is supervision. It includes a framework for the conceptualization of the various factors that are relevant to the supervisory process and a series of brief stories that depict the speaker's involvement with supervision through her years of research and practice.     

“She was on my side,and grounded me when I needed it:” Research supervision in the field of therapy,based on counsellors’ and psychotherapists’ views on their engagement with research

Research‐supported practice is increasingly emphasised within counselling and psychotherapy at all stages of training. Guided by an interest in how to support therapists in their efforts to develop research knowledge during doctoral training, this paper focuses on research supervision. Research supervision is a surprisingly under‐researched area. Little is known to date about how supervisors “go about their supervision” (Bruce & Stoodley, 2013, p. 5), despite the fact that “high failure rates for research dissertations in the social sciences have been partly attributed to student dissatisfaction with supervision and poor student–supervisor relationships” (Armstrong, 2004, p. 134). Between 2016 and 2019, we explored accredited counsellors' and 'psychotherapists engagement with research during or after their doctoral training. This paper explores research supervision with these two previous studies serving as the backdrop (Bager‐Charleson et al., 2018; Bager‐Charleson et al., 2018b), together with a literature review into research supervision within social sciences and psychotherapy. Supervision is discussed as a crucial coping/support strategy to (a) link research with practice in therapy work, practically and epistemologically; (b) contain and make sense of the use of transformative learning; (c) balance “enculturation” with critical thinking and emancipation; and (d) support reflective and reflexive development. This paper discusses an adaptive research supervision model, akin to a “holding bond” (Stevens, 2016) which supports the student to reflexively position her/himself personally, intersubjectively, theoretically and socio‐culturally, whilst “negotiating the tension” (Lee, 2008) during a process of enculturation into the discipline, and also fostering critical thinking and emancipation to contribute to new knowledge.     

The patient's material as an aid to the disciplined working through of the countertransference and supervision

The author argues that the patient's largely unconscious observations of the analyst's functioning are, at times, communicated in the patient's material and that this can impart a sense of clinical relevance to the countertransference. The concept of 'understanding work' is used to provide a psychoanalytical model of this phenomenon. This is illustrated in a clinical case and it is argued that a selective consideration of the patient's material can provide a proper discipline which steers the analyst between the twin dangers of megalomania, on the one hand, and involvement in a symmetrical, self-disclosing relationship, on the other. The author then applies these ideas to supervision and uses them to distinguish psychoanalytic supervision from a practice that also derives from an intersubjective paradigm but which, to the author's mind, is not distinct enough from personal analysis.     

Psychoanalytic supervision in the new millennium: On pressing needs and impressing possibilities

Having now completed its first century, psychoanalytic supervision has been and continues to be regarded as the cornerstone of psychoanalytic education; it is the primary means by which (1) psychoanalytic ideology becomes translated into practical product, and (2) budding analytic practitioners develop and grow in their therapeutic skills and professional identity. The supreme significance of supervision in contributing to the “making” of the competent psychoanalytic practitioner now seems a widely accepted given, even axiomatic. But as its second century gets underway, what have we learned from psychoanalytic supervision's first 100 years? What are its most pressing needs and, in turn, impressing possibilities at this time? And what needs to most change if psychoanalytic supervision is to most profitably advance in the years and decades ahead? In this paper, I would like to consider those questions, giving focus to five needs that seem to most require attention now: (1) making the practice of psychoanalytic treatment an increasingly competency-based, concretized learning affair; (2) enhancing the efficacy of supervisors through competency-based practice and training in psychoanalytic supervision; (3) more effectively incorporating existing technology and emerging technological advances into supervision and using them to enhance the psychoanalytic learning process; (4) better attending to matters of difference and diversity, and striving to seamlessly integrate them into the conceptualization and conduct of the psychoanalytic supervision experience; and (5) vigorously researching the psychoanalytic supervision process and working to establish an evidence base for supervisory practice.     

动觉监督早期介入对动作技能形成的影响

通过人工动作技能项目和典型职业操作技能项目的训练活动,研究了动觉监督早期介入对动作技能形成的影响,结果表明早期进行动觉监督训练可以更为充分、有效地发挥动觉监督的作用,提高动作技能形成的成绩和效率。据此讨论了“视觉为主转化为动觉为主”监督机制观点的局限性,认为自觉的职业操作技能训练活动无须遵循这一结论;提出了含有动觉训练的职业操作技能训练模式。     

Informing supervision practice through research: A narrative inquiry

Intention: This study focused on questions of whether and how clients benefit from supervision. As practitioner research, the study was intended to shape the researchers’ own supervision practice. Method: The qualitative approach was based on interviews with a small number of experienced practitioners about their supervision experiences. The findings are presented in the form of reflexive stories, told by each researcher. Findings: In these stories the researchers tell how engagement with experienced practitioners’ accounts of their past supervision shaped the hopes and intentions the researchers hold for their future supervision. Implications forpractice: The stories suggest there are therapeutic benefits in an ethic of transparency that provides for practices that overtly carry stories in both directions between counselling and supervision.     

Dynamic accountability in clinical training and supervision: Three orienting ideals

Despite the growing interest on making clinical practice accountable, research on how specific components of professional competence are relevant in actual training/supervision practice is as yet unspecified. This study explores this dynamic aspect of professional supervision. Three supervisory dyads, composed by an experienced supervisor and a doctoral counseling psychology student were used in the study. A qualitative, ethnomethodology-informed design was used to discursively analyze 16 significant episodes (SEs) in actual supervision meetings. This was complemented by 16 follow-up interviews. Three interpretative repertoires – ‘ideals’ – influencing participants’ accounting practices were identified: efficacy, responsiveness, and authenticity. The article discusses how structural (competency-based) and dynamic (practice-based) approaches to accountability can be combined to guide the appraisal of relevant professional competencies.     

Deconstructing Agnes – externalization in systemic supervision

Externalization is seen in this paper as a valid and useful part of the process of clinical supervision in systemic family therapy training. We offer a discussion on the use of externalization based on an example from a supervision group on a London M.Sc. in Family Therapy. Externalizing practices are located in the context of a postmodern perspective and narrative ideas within systemic family therapy. We explore the use of narrative ideas and the recursive relationship between theory, practice and the subjective experience of the trainee, within the practice of systemic supervision.