A Supervision Guide

by Annie Sampson

This article is in answer to questions about the nature and practice of supervision. The article provides a flavour of the work but the experience of two people in the supervision room completes the whole.

My supervision practice reflects my training as a body orientated psychotherapist, with the addition of my life experiences, values and philosophy of supervision. It also incorporates the accepted elements of supervision. With that in mind,

The purpose or goal of supervision can be viewed as the creation of a good relational space by the supervisor and supervisee where the focus is on creative, joyous, collaborative learning and personal / professional growth which allows support and monitoring of the supervisees work for the welfare and safety of the client.

Inskipp and Proctor (2001) name the tasks of supervision as support (restorative) learning and growth (formative), and monitoring (normative) with one in the foreground at any time. These tasks are negotiated and agreed between supervisor and supervisee, so that both know the parameters of the work producing a degree of safety. This negotiation forms the contract which can be referred to or re-negotiated at any stage of the work. All these are held within a good supervisory relationship, which forms the frame or container allowing effective supervision to occur.

The importance of a good supervisory relationship cannot be underestimated and so like any other relationship it needs attention. Having an awareness of the conditions which foster a good relationship as well as those which are barriers to this relationship is essential. This is the foundation upon which the tasks and goals lie.

The person centred core conditions, (Rogers, 1977) facilitate the development of a good supervisory relationship. This relationship should allow for growth and autonomy of the supervisee, which are necessary to foster their sense of safety. This gives the supervisee permission to be him/her self, without fear or punishment so encouraging expression of their inner thoughts, feelings and experiences. The supervisory relationship founded on person centred attitudes creates learning directed towards personal self awareness and professional growth, enabling trust and respect to develop. The supervisee who experiences space to breathe and relax is also able to experiment and explore and bring their life experiences into the work. A supervisee who feels received, valued and understood (Proctor, 2004) can feel safe and open to the tasks and goals of supervision.

Duncan, Hubble & Scott (1997), referring to brief therapy, state that therapy begins as soon as the person contemplates beginning therapy. This can be the same in supervision, leading to the person developing expectations, projections, hopes and fears which are at work by the time we meet. This crowed space can present barriers to effective person to person work and needs addressing. As Berne (1968) states effective communication is adult to adult but when other ego states are present or triggered by the interaction, the communication and therefore the ability of the supervisee to be present to the work is hindered.

As in any relationship transference to the supervisor is often evoked. Transference, I believe, is one of the most potent tools within the therapeutic relationship, along with counter transference. This concept can be difficult for the novice therapist, grappling with the theory and practice. Supervision provides the space for a comprehensive practical understanding of transference and counter transference allowing the supervisee to experience their counter transference and experiment with the knowledge it provides.

Supervisees can come to the supervision room with their education, history and experience to the fore. From my observations many adults have carried a sense of fear, of ‘getting it wrong’, which limits their thinking, their expression and actions, taking the excitement out of exploration and learning. The learning that inspires me is the learning described by Rogers (1994) when he talks about learning driven by curiosity which has an insatiable appetite, leading to a sense of excitement. This I hope is the experience of our supervisory encounter.

Growth and learning has many facets and as a psychotherapist the work is to facilitate clients to achieve a sense of well being, self fulfilment and autonomy. This is also true of the work with supervisees, facilitating pride, pleasure and self directed development in them. So enabling the supervisee’s to become a good enough practitioner, in their own style of work.

The presentation of clients facilitates learning and growth of the supervisee. The techniques, skills, counter transference and other senses the supervisee uses to present, gives the supervisee the chance to practice and develop skills as well as being challenged to learn new ones, so learning their craft. It also highlights personal blocks which may be present for the supervisee in their ability to work with the client. The business of therapy is another formative task achieved through looking at referrals, working environment, advertising, enabling the supervisee to learn to run the business of therapy in the best possible manner.

As stated learning can be fun. The supervisee is encouraged to play fantasies and experiment, be spontaneous, while creating the client in the room. The ‘creation’ of the client enables both myself and the supervisee to have a better feel, sense and understanding of the clients reality in the hope that we are better able to facilitate the client. All the supervisees senses, as well as information supplied by the client are used in this creation of the client. The supervisees’ counter transference, as well as the supervisors, is a valuable source of knowing what is happening in the emotional world of the client. The theoretical training and cognitive abilities of the supervisee will give a hypothesis or framework, so guiding the work. The use of role play, art, dialoguing and other interventions and techniques, also promotes better empathy with the client as well as the supervisee practicing and developing the skills and craft of therapy.

Maclagan, in Shipton (ed., 2000) argues that fantasy is a valuable source of information and quotes Guggenbuhl-Craid, “to encounter a person creatively means to weave fantasies around him, to circle around his potential……using imaginative images to grasp the reality of the other person.” This suggests fantasy gives us an ability to expand knowledge and understanding of the client.

A further benefit of creating the client is the knowledge and learning both supervisor and supervisee gain of the client. Both can deepen and expand empathy, striving for relational depth (Mearns and Cooper, 2005) with the client, have a more intimate understanding of how it is to be the client, to understand his/her internal world and how the client relates to others. This can be understood through the supervisee and supervisor taking on the body postures, tensions of the client, so giving insight into the client’s experience of their internal world and how they have adapted and related to the external world. All this work is conducted in a supportive, encouraging environment aimed at enabling the supervisee to develop their competence and practice.

Many authors refer to the stages of supervisee development, moving from unconscious incompetence, where the supervisee’s inner critic is to the foreground, to unconscious competence, when the supervisee’s internal supervisor is guiding. This leads the supervisor to be a facilitator, encouraging the supervisee to move from one developmental stage to the next, but also provides the supervisee with a sense of safety by working with one who has experience and knowledge.

The final important and necessary goal, of supervision is monitoring the work of the supervisee for the welfare and safety of the client. The most important provision is that the supervisee needs the basics of being well trained, knowledgeable in theory, personally aware, professionally competent, ethically bound, (formative, normative, restorative,) as appropriate to their professional level of experience. They also need to have the means and willingness to develop in all these areas, with the supervisor encouraging and challenging as necessary. Page and Wosket (2001) state that it is the job of the training institutions to have laid these foundations and that supervision is the place where these are put into practice and developed. The monitoring happens through the presentation of the client in the supervision room.

It is important the supervisee is safe in the supervision relationship, so that they feel free to disclose their worst fears as well as their achievements, otherwise concealment may occur. Proctor refers to the client therapy relationship as a private relationship which the supervisor cannot demand access to but encourages the supervisee to be as courageous and honest in their presentation of the client. The supervisor needs to be aware that the fears and concerns of the supervisee are not always mirrored in practice behaviour that the supervisees speaks what they wish to be heard. This can lead to an idealised situation or client presented in the room. Ethically the supervisor’s role is the welfare of the client. The supervisor needs to challenge the supervisees about this hiding but in a manner that helps the supervisee come forward, learn and grow rather than triggering them back to judgemental learning experiences.

Another aspect of monitoring is the safety of the supervisees. If their skills and knowledge are tested before they are ready or with a client, who is out of their range of competence, this could undermine their confidence in their selves and their new abilities so impact on the client’s safety and welfare. Part of the role of supervisor is to monitor the supervisee’s interaction with this in mind.

There are other implications for the safety and welfare of the client. If the supervisory relationship feels unsafe and the supervisee is not held in her/his attempts to learn, grow, develop, and work with the client, the supervisee can mirror this lack of holding in their practice. As in the client / therapist relationship the supervisee learns not only form the supervisor but from the supervisory space and may mimic the worst as well as the best elements of their supervisory experience.

Conclusion

Supervision offers support to the supervisee in the form of a good supervisory relationship. It gives a sense of excitement for the potential for growth and development of the supervisee through a mutual learning alliance. The working alliance allows the supervisee and supervisor to work in a clear, negotiated and agreed manner for the welfare of the clients. Supervision should provide a safe, secure space with the necessary conditions for the supervisee, with their life experiences, to grow into a good enough therapist (practitioner).

Annie Sampson is a body orientated psychotherapist and supervisor and trainer working in private practice in Limerick.

References:

Berne, E. (1968) Games People Play. The Psychology of Human Relationships. London: Penguin

Duncan, B.L., Hubble, M.A., Miller, S.D. (1997). Psychotherapy with Impossible Cases: the Efficient Treatment of Therapy Veterans. London: Norton

Inskipp, F. and Proctor, B. (2001). Making the Most of Supervision. Part 1. Twickenham: Cascade.

Maclagan, D. (2000). ‘Fantasy Play and the Image in Supervision’, in G. Shipton, Supervision of Psychotherapy and Counselling. Making a Place to Think. (ed.). Buckingham: Open University Press.

Mearns, D. and Cooper, M. (2005). Working at Relational Depth in Counselling and Psychotherapy. London: Sage.

Page, S. and Wosket, V. (2001). Supervising the Counsellor. A Cyclical Model. Hove: Brunner-Routledge.

Proctor, B. ‘Supervision: A Co-operative Exercise in Accountability’, in Marken, M., & Payne, M. (eds), Enabling and Ensuring Supervision in Practice. Leicester: National Youth Bureau.

Proctor, B. (2004). Group Supervision. A Guide to Creative Practice. London: Sage.

Rogers, C.R. (1977). A Therapist’s View of Psychotherapy. On Becoming a Person. London: Constable.

Rogers, C.R., Freiberg, H.J. (1994). Freedom to Learn. Prentice Hall.