Supervision and the 'reflective practitioner'
As all practitioners reading this will know, supervision is an important experience and activity for the reflective practitioner of counselling and psychotherapy. Many supervisees are happy and willing to attend and get support for the sometimes excruciating and difficult work they are exposed to - all by themselves, due to confidentiality reasons, if it wasn't for the space supervision can provide. So supervision is recognised as a useful, necessary, often helpful procedure.
Although for the beginning practitioner it often consumes a large part of their income, there is a general consensus that we cannot just let counselling and therapy trainees loose on the unsuspecting public without some kind of apprenticeship and monitoring. Fair enough.
The role of the supervisor and its power implications
However, for some people the term 'supervision' can be so tinged with hierarchical meanings of control and suspicious monitoring that the creative and developmental potential of supervision can be outweighed by the supervisee's fear and compliance. A sense of obedience in the supervisee and concern with textbook correctness, the assumed or perceived 'rules' of the profession and with anxiety about 'making mistakes' can all but wreck what supervision has to offer.
In some work situations there is, of course, an actual overlap between managerial and clinical supervision (generally NOT a good idea, in my opinion, if one wants to put the needs of the client first), but even without that overlap many supervisees initially behave as if the supervisor held that degree of imposing power (manager and supervisor rolled into one).
There is, of course, an element of power inherent in the supervisory position, as potentially the supervisor needs to be able to act as an advocate for the client/patient. If in the supervisor's judgement the supervisee's work falls short of what may be deemed as responsible or ethical practice, then possible sanctions and threats to the supervisee's sense of self both as a person and as a practitioner may enter the frame. The power of the supervisor is, of course, exacerbated in 'training supervision' where the supervisor's judgement of the supervisee does to some extent enter the assessment process, and the supervisor becomes a 'guardian at the gate' into the profession and thus having influence over the supervisee's future career.
However, those elements of reality in how the supervisor may be perceived as a 'controlling and critical parent' can sometimes blow out of all proportion and dominate what might be a profoundly supportive and influential apprenticeship and initiation into the profession. Even the word 'super'-vision lends itself to a one-sided emphasis of the hierarchical nature of supervision (which is why some people have reacted by proposing the term 'inter-vision').
Supervision: supporting the relational heart of the helping relationship
The more we see the helping relationship that is being supervised indeed as 'relational', the more it matters that the supervisee is supported in their own presence and way of working, rather than importing the supervisor's ideas, instructions, interventions (even in situations where these in themselves are 'better' or 'more appropriate'). It's the relationship between client/patient and practitioner that matters, not the practitioner's behaviour or thinking. Behaviour and thinking can be borrowed from the supervisor - therapeutic presence can't be.
Parallel process in supervision
Hawkins/Shohet: |
The supervisor's task is to support - in Bion's words - the relationship between the "two frightened people" in the room.
Traditionally it has not been uncommon for supervisors to pay a lot of attention to the verbatim interaction between client/patient and practitioner, as reported in supervision, and on that basis to suggest interventions and ways of working. This is now considered only a small slither of the whole spectrum of reflections and interactions which we may fruitfully engage in during supervision. The various levels of shared exploration which can legitimately constitute the focus of supervision have been set out in the comprehensive model by Hawkins/Shohet in "Supervision in the Helping Professions" and is known to include especially the idea of parallel process.
In simple terms, the concept of 'parallel process' captures the phenomenon that the dynamic in the helping relationship can at times be replicated in the supervisory relationship: key aspects of the relational pattern between client and therapist are repeated and paralleled between therapist and supervisor. If we include this as a valid aspect of supervision, we can follow Hawkins/Shohet in distinguishing six, and in the latest version of their model: seven, possible foci of supervision:
7. Observations and comments regarding the whole system |
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6. Focus on supervisor’s countertransference |
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5. Focus on supervisor-therapist here-and-now process as a mirror or parallel of therapist-client there-and-then process |
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4. Focus on therapist’s countertransference |
a. personal material re-stimulated |
b. transferential role projected onto therapist |
c. therapist’s attempt to ‘counter’ that role |
d. projected material taken in by therapist |
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3. Exploration of therapy process and client-therapist relationship |
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2. Exploration of strategies and interventions used by the therapist |
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1. Reflection on the content of therapy session |
Relational functions of supervision
Supervision helps to contain the work, allowing the practitioner to become fully involved, whilst relying on the support, challenge and reflective quality of the supervisory space (Patrick Casement compares it to the 'nursing triad' of infant, mother and the mother's intimate significant other). This becomes more necessary, the more we recognise and work with unconscious dynamics and the concomitant pressures and primitive feelings. A crucial aspect of supervision is containment, specifically of the enactments of relational patterns which necessarily occur between client and therapist.
Supervision - attending to both situational and habitual countertransference
Supervision engenders continuing professional development, by focussing both on the current work and the developing personal-professional capacities, qualities and resources of the practitioner. I use a simple distinction between 'situational countertransference' (which is specific to the particular dynamic between client and therapist) and 'habitual countertransference' (which occurs irrespective of the individual client and has more to do with the therapist's 'construction' - both conscious and unconscious - of their role).
As recognised since the 'countertransference revolution' (which started in the 1950's by re-defining countertransference and changing our perception from an obstruction to the work into one of its most precious avenues), 'situational countertransference' contains elements which give us information about and access to the client's inner world and its significant issues and struggles.
An extended model of 'parallel process'
I have developed an extended model of 'parallel process' which includes the established phenomenon that the client-therapist dynamic can be reflected and paralleled in the therapist-supervisor relationship, but goes beyond this into the client's and the therapist's inner world and body/mind reality (see my presentation for the UKCP Inaugural Conference on Supervision "The Fractal Self - 'parallel process' as an organising principle for psychotherapy".
Variety of arrangements and contracts
A variety of contracts are possible, ranging from clinical supervison on a consultancy basis to training supervision. I have many years' experience of both, working with counsellors and psychotherapists from across a variety of approaches.
Most supervision happens on a one-to-one basis, but occasionally spaces become available in small supervision groups of 2 to 4 supervisees.