Extracts from the Diploma 2018-19 Moderation Report - September 2019
....The trainers are to be congratulated on further consolidating the requirements and assessment structures, and expertly tutoring and facilitating the development of participants in this fifth offering of the CST Diploma Course....
‘The participants’ unanimous feedback focused on the comprehensiveness and the extensiveness of course content, the initial review of the areas, and that despite the content-richness, seldom feeling rushed, because of the tutors’ depth of knowledge, sensitivity, and skill in meeting individual learning needs’....
....As I have noted in the past, the CST Diploma course remains a feather in the cap of accredited training monitored by the ASIIP, providing a unique opportunity for supervisors from a range of backgrounds and situations to develop, deepen and extend their practice of supervision. Long may it flourish!’
Dr Karen John - ASIIP External Moderator
Feedback from participants of 2018-19 Diploma:
‘…the course structure was useful in offering varying modes of learning from the more information based to the experiential’;
‘The pace was great with plenty of time to reflect – offering the course over weekends helped keep the energy going, but didn’t overwhelm us’;
‘The assignments built on each other so I felt able to track my own development and to see how far I had come since the beginning of the course’
‘Tutor support was always given in an encouraging way, with just the right pace for me’
‘The tutors modelled a kindness, non-judgemental and open approach to the work and to each of us which I felt was containing and provided an environment in which we could learn and play’
Supervision is a bit sneaky. We meet in private to talk about individuals who aren’t there. We’re constantly reporting, guessing, collating, imagining, putting two and two together. Some people would call this gossiping. And it is absolutely true that we often say things in supervision about a client that we wouldn’t say to their face. Imagine if one of your clients was sitting in your session with your supervisor and listening to you talking about them. How might that affect you? The degree of difference it would make to what you said, or the way you said it, could be very useful as a measure of your ethical hypocrisy.
Of course we’re not mere gossips, and we’re not sneaks either, but you take my point. It’s your well-tuned ethical sense that tells you why you’re describing a client in language you wouldn’t use if they were in the room with you. We need to know why we do this and we would be non-ethically hypocritical if we didn’t know.
Good supervision enables us to take a dispassionate and curious look not only at how ‘two-faced’ we may be, but also how we use our awareness of that duplicity. This reflective process can be awkward but it’s not agonising. We could start with the familiar notion that a hypocrite* is someone who doesn’t practise what they preach. So that’s already most of us, right? When you offer therapeutically wise and sensible ideas to your clients – about self-care and self-compassion, for example – do you genuinely apply these same things to your own daily life? Let’s not dishonour our subjective truths on this. For myself, I reckon the answer is ‘no’ about a third of the time. From discussions I’ve had with colleagues it seems that we do regularly practise some of the good stuff we preach, but we’re also quietly aware of ways we fail to ‘walk the talk’. Bringing that self-awareness into the supervisory frame is always beneficial, because where we are in some sense ‘lapsing’ or ‘falling short’ is precisely where we invigorate the natural impulse to grow and develop. In this respect, gently declaring our personal pieces of hypocrisy in supervision becomes self-motivating, not self-shaming.
We talk a lot about our clients in supervision sessions but how often do we talk about our supervision in client sessions? Hardly ever, it seems. In fact most clients probably know almost nothing about supervision other than what’s stated briefly in the counselling contract. In my experience, it’s extremely rare for anyone to ask about supervision. So in any given piece of work, it’s highly likely that both the practitioner and the client are totally silent on the matter – albeit for very different reasons. One professional rationale for the silence is that the content of supervision sessions is confidential between the parties undertaking the supervisory contract; the client is not a signatory to that specific contract, so what goes on in supervision is strictly speaking not their business. It makes sense in terms of strong containment, but the more I think about this set-up, the more intriguing it gets.
I wonder if the practice of supervision itself isn’t a discreetly specialised form of hypocrisy. The high level of confidentiality within the consultation process allows for, and even legitimises, the application of double standards. The therapy space and the supervision space are held to be distinct. Different dialogical rules apply in each. Whatever we do and say in one place is not witnessed in the other. Confidences can become confused with secrets. Dual relationships can result in clinical collusion. And who really knows what goes on behind closed doors anyway? Things can get weird. No wonder we have such a carefully crafted set of commitments to accountability within the Ethical Framework. We might have set ourselves a nice trap there: the greater the ethical language we use to describe our professional obligations in supervisory relationships, the more we lay ourselves open to the charge of hypocritical posturing.
The traditions and conventions of supervision have evolved primarily to minimise the risk of harm, mainly to clients and also to practitioners. As a profession we’re somewhat compromised in this regard since we have almost no research-based evidence that supervision is intrinsic to the achievement of that worthy aim. We feel that it helps more than we know that it does.
Engaging in supervisory work is not unlike an act of faith: we believe in its goodness without being able to prove it other than doing it steadfastly in the belief that it’s good. The reality is that as signed-up, card-carrying members of BACP we are required to believe in it. This potentially exposes us to two particular states of active hypocrisy: practising supervision while not believing in it (completely cynical), and practising supervision while never admitting our doubts about it (secretly sceptical).
If you know how it feels to embody the second type of hypocrisy, you’ll also know the best ethical move to make is to become openly doubtful. Actually, this applies to all of us: our least worst hypocritical position is frank and fearless scepticism. Then we can honestly call ourselves good ethical hypocrites.
*I like the fact that the word comes to us directly from hypokrites, the old Greek word for ‘actor’. It literally means ‘speaking from underneath’ – in ancient Greece actors wore masks to indicate the character they were portraying, and acted or spoke from underneath or behind the mask. This theatrical origin is still evident in the modern use of ‘hypocrite’ to mean someone who is not what they seem: they’re a ‘bad actor’ in the sense of a person apparently acting in good faith but in reality only pretending to.
Jim Holloway is a senior accredited counsellor and supervisor, a Cambridge Supervision Training Associate, and a co-author of Practical Supervision: How to become a supervisor for the helping professions (JKP 2014). He contributes to 3menwithablog.com, a collaborative blog about therapy.
Whilst training counsellors on a short course about supervision, my colleagues and I became interested in how to teach the trainee supervisors to take appropriate supervisory authority both under normal circumstances, which entails developing some interventionist skills and habits for good practice, and how to manage a relationship under threat because of a major difficulty, which requires a relationship- focused approach. Adlerian ideas about the importance of monitoring whether the superiority and inferiority dynamic is being expressed, and if so, how it is happening in the supervisory relationship have become useful to our teaching. Specifically we used Dreikurs’ (1953) and Sweeney’s (1981) explanations on the inter and intra-personal dynamics that arise from an individual’s feelings of superiority and inferiority. My colleagues, who call the preoccupation with success and failure (superiority and inferiority) “the slippery pole”, introduced me to these ideas and adapted Sweeney’smodel presented in the diagram on page 45.
What do I mean by taking supervisory authority under normal circumstances? It may include many ways to relate that require immediacy, may be uncomfortable, or simply take more initiative than is normal in counselling relationships, currently the major professional role of the trainee supervisors. It relates to the task of the supervisor and the expectations of the role to protect clients and uphold standards.
Examples of the relationship qualities normally required are subtle to convey, and trainees’ private logic (‘internal working models’, in the language of attachment theory) greatly affects how they hear the teaching. Specifically, and unhelpfully, trainee supervisors may conflate ‘taking authority’ with ‘being authoritarian’, a style they do not wish to implement because it would undermine some core Adlerian values about equality and encouragement, respect and regard. In the inevitably asymmetrical relationship that is supervision, the everyday challenge is to sustain these core values about relationship whilst undertaking the necessary tasks of supervision.
As trainers of supervisors, we need to explore the issues and model the skills involved. Especially when supervising trainee counsellors there is a real power differential arising from the tasks the supervisor has to undertake, and this can beneficially be openly acknowledged rather than denied. The Adlerian commitment to supporting clients to fulfil the tasks of their life through encouragement is paralleled in supervision, as assessment and giving feedback are core tasks for the supervisor. Furthermore, these tasks need to be done within honest exchanges and without attacking the self-worth of the supervisee. The concept of Social Interest is uniquely relevant to healthy supervisory relationships and indeed professional relationships ofall sorts, because of the emphasis on people’s “proclivity for being responsible, co- operative yet creative members of humankind” (Sweeney, 1981, p. 23).
Criteria for Best Practice
Making the contract sets the tone for the relationship. Is it a basis for a working alliance? Is it comprehensive or sloppy? What leeway is there for meeting the unique needs of this supervisee as well as this supervisor? Does the supervisor feel entitled to be clear about her or his own needs, such as adequate payment, or notice for missed sessions? Does the supervisee feel entitled to be clear too, to be able to request help without having to hide their vulnerability or their skill, to be understood at their developmental stage, and so on? Contracts are crucial at the start of the supervisory relationship, and also at the start of each session, especially when the supervisee has a big agenda. The contract conveys that this is a purposeful relationship that can be monitored and reviewed by both parties regularly enough to allow uncomfortable matters to be discussed before they become impossible to speak about. Contracting is useful in counselling, and essential in supervision.
Trainees on the supervision course came with habits and expectations from their experiences as supervisees that implied that contracting is a skill that many supervisors barely deploy. Training can usefully contradict this custom and practice. Trainee supervisors can use contracting to become aware of differing learning styles, and thus of the balance between theoretically-based interventions, intuition, and use of the senses that suits them, and that a different balance may suit each supervisee. The contract can spell these out, together with pragmatics about meetings, payments, cancellations, extra contact between supervisions, and so on.
It is helpful to see managing the time during sessions as a shared responsibility. If the agenda is big, supervisor and supervisee can decide the order of topics and renegotiate if some elements take longer than anticipated. Invitations to use creativity and to focus on a specific question for supervision under each heading can invite the supervisee into
healthy habits of preparation for supervision, and build their “internal supervisor” during the process (Casement, 1985).
Power and the Taking of Authority
Power issues do need to be explored during the training to be a supervisor, add comma in which ways to address supervisee expectations are identified. If the supervisee feels inferior, fears failure, and pervades the dialogue with anxiety and excuses, blaming or complaining, the power dynamic can be discussed, and the supervisee can be invited to express their concerns and to take responsibility for their part in the interaction. This situation and this interchange may thus form a paradigm for other relationships and model direct communication in ways the supervisee may take back to the relationships with their clients. Sensitivity is required, and sometimes it cannot be made all right. Either party needs to be able to say that the relationship is not working and propose an ending, but in particular the supervisor needs to be monitoring the efficacy of the relationship and the work coming out of supervision, and they both need to commit to having regular reviews of the supervision relationship. The Adlerian insight from the slippery pole is to bring encouragement into the situation through attending todescriptions in response to the thought, “What am I doing?” rather than preoccupationwith judgement by self or other.
14/8/2018 0 Comments
The encouraging supervisor helps supervisees remove some of their self-imposed attitudinal roadblocks and supports them to aim for their highest possible level of competence.
The word ‘supervision’ has oppressive connotations to some people. So before going any further, we need to emphasise the importance of establishing an equal, collaborative relationship between supervisor and supervisee that also has the potential to be mutually enjoyable. This is an essential value at the heart of our book Practical Supervision: How to Become a Supervisor for the Helping Professions1 and the Cambridge Supervision Training courses. Although we draw on diverse resources, our main approach rests on Adlerian ideas and values, focusing on awareness of interpersonal relating, the importance of empathy, equality, and co-operation, and the central need for, and specific skills of, encouragement.
‘En-courage-ment’, with courage at its heart, develops the person’s inner resources and courage and enables the building and maintenance of a constructive working relationship. The encouraging supervisor helps supervisees remove some of their self-imposed attitudinal road blocks and supports them to aim for their highest possible level of professional competence.
The theory and practice of encouragement was described by Alfred Adler nearly one hundred years ago, and these ideas are now extensively shared by ‘strengths based’ supervision approaches2 and ‘appreciative enquiry’3 where the supervisor and/or organisation respects, values, and positively acknowledges the ability and potential of their supervisees. As most management texts now agree, people perform best when they feel appreciated, understood, encouraged, and accepted ‘warts and all’. We can all feel shame when we make mistakes. The encouraging supervisory relationship provides a space where learning from mistakes, coping with uncertainty, and processing our emotions, are valued as normal and actually essential elements of our professional development. An encouraging supervisor does not ignore these mistakes or uncertainties, but provides an appropriate balance between support and challenge, ensuring that the supervisory role also carries authority. This involves knowing how to be authoritative without being authoritarian.
Before exploring some of the encouraging ways to put this support and challenge into practice, here are what we understand to be the three supervision tasks to be met:
1. To support and give courage to people engaged in emotionally demanding tasks.
2. To make sure they know how to do what is expected.
3. To uphold agreed standards and support the supervisee to work to them.
In our experience, the successful achievement of the core tasks requires the supervisor to ground their practice in these definitive essentials of supervision:
• Creating a carefully negotiated working agreement between supervisor and supervisee(s).
• Developing a supervisory relationship that has mutual trust and safety as its basis.
• Talking openly about personal and professional values and ethics in relation to the work that is being supervised.
The working agreement
Effective supervision is a collaborative process. The co-creation of a clear contract through exploring both explicit and implicit hopes, fears, and requirements of supervisor and supervisee, lays the foundation for an encouraging, respectful and equal relationship.
The explicit contract includes such issues as organizational arrangements, codes of conduct and ethics, general practicalities such as venue, time, payment, and structures within supervision such as review processes:
The psychological or ‘implicit’ contract in supervision prevents unspoken misunderstandings bubbling away beneath the surface, such as clarifying training level, expectations, issues of difference, learning style, ensuring boundaries, and maintenance of the supervisory alliance.
Contracting for each session
To reduce a power imbalance, it will also be important for the supervisor and supervisee to work together to clarify the agenda for each new session, so that the needs of supervisees are freshly accommodated. Some possible open questions include:
“What is your key supervisory question?”
“What do you most want to achieve in this session and how can we work together best to achieve that?”
To maintain the encouraging equality of the relationship, supervisors can actively invite feedback from supervisees at the end of each session with such questions as:
“What are you taking away with you today?”
“What was useful about this session and what was less helpful?”
A supervisory relationship based on mutual trust and safety
Even where there is a difference in experience and expertise it is possible for supervisors to create a climate of equality and collegiality with their supervisees. This provides a potent foundation that helps supervisees have the courage to be imperfect5. Making mistakes and ‘not knowing’ are essential prerequisites for learning. Yet, as was identified in some USA based research6, trainee supervisees often avoided bringing material that could have been central to their learning; this included personal issues raised by clinical work, perceived clinical mistakes, and negative reactions to clients. This non-disclosure, which is particularly relevant with trainees, can be prevented by the supervisor at the outset of the contract saying something like:
“In supervision it is important to bring me things you are worried about, or feel you have not done quite right, or that you need to know more about. This can provide really valuable material that will invariably be useful as a base for further learning. If you avoid bringing any of these worries, I shall be concerned that you are not telling me essentials. I will be clear with you as we go along if I have any concerns about your ability to pass this course, and will discuss this with you long before I write any report.”
Part of what is involved in being an encouraging supervisor is to be able to name uncomfortable issues and offer clear feedback about the supervisee’s practice. Effective encouraging feedback is about enabling growth and learning and improved practice. It can be seen as an interaction, or a meeting-point between the supervisor and supervisees, rather than something that the supervisor ‘gives out’ to them. The feedback channel works best when it is two-way. One-sided feedback in supervision invariably increases a power imbalance, even when the supervisor shares positive comments.
Encouraging feedback is different from traditional praise or rewards, as it focuses on enabling both supervisor and supervisee to develop an inner sense of satisfaction and motivation. This involves much more than expressing positives7. Different from praise, encouragement focuses on what the person is doing, rather than how the person compares with others. Verbal encouragement can be achieved by avoiding the use of adjectival labels such as ‘good’, ‘unethical’, ‘clever’, ‘non-empathic’, and by keeping in mind the assets and intentions of the supervisee.
By using descriptive language and paying particular attention to verbs, the supervisor can offer feedback that is very specific, identifying what the supervisee has actually been doing, without needing to evaluate it. For example, an evaluative label: “You’re hopeless with boundaries and get far too involved with your patients” becomes: “I notice that instead of the allotted half-hour, you regularly stay for one hour with your patient, and that you made an additional home visit out of work hours when it was this patient’s birthday.”
From this non-attacking base, the supervisor can invite the supervisee’s own views, and then share any concerns, providing educative information and supportive challenge as appropriate.
Here respectful use of ‘signposting’ is helpful. Just as it is crucial on a motorway to be prepared for a side turning a good mile before, we can signpost our feedback in advance so it is less startling and enables a more collaborative meeting-point.
For example: “I’d like to discuss the ethical issue that may be involved in this situation – can we look at this now?” Further space can then be given for two-way discussion with the supervisee.
The use of Socratic questions can also help supervisees focus more deeply on their work, thus keeping a two-way flow of communication. This type of questioning invites the supervisee to gain insight into their own perceptions and then, ultimately, their own wisdom. For example:
“When you say you find this young person difficult, what specifically do you mean?”
“What do you appreciate about the way you handled that?”
“How might you do things differently in future?”
Being able to receive feedback in a constructive way is a skill in itself, and is far from a passive process. Whether in the role of supervisor or supervisee, some form of defensiveness is likely when receiving feedback. Maybe because this triggers old feelings of shame, from which we may defend ourselves by shrinking and losing our sense of capability, or perhaps we overcompensate for our feelings of inferiority by becoming aggressive. Either way this inhibits potential learning and growth. The challenge for both supervisee and supervisor is to be able to listen openly to the feedback, and identify how, if at all, this might support future practice.
Supervisees will feel more able to share their mistakes and vulnerabilities if supervisors take risks to speak directly and honestly, and not put themselves on a pedestal. In addition, the supervisee must know the steps to take if they wish to make a complaint about the supervisor (this information can be clearly indicated in the initial contract). Supervisees seldom say what the supervisor has done that was unhelpful, and so it is important that the supervisor routinely asks such questions as: “What were the most and least useful parts of today’s meeting?”
Ethics and authority
Part of the supervisor’s role is to act as a gate-keeper for the profession. Trainee practitioners are especially aware of this when coming for supervision, as the report the supervisor writes about their work could directly affect their entry into their chosen professional field. Whether a supervisee is in training or fully qualified, if there are concerns about their competence and resilience, the supervisor has an ethical responsibility to address the concerns, in the interests of protecting clients/patients from possible harm. The ethical position as supervisor is also one of support and care for the supervisee. So is an encouraging attitude compatible with the supervisory authority essential for effective supervisory practice?
At the start of this article we defined the encouraging supervisor as someone who helps supervisees remove some of their self-imposed attitudinal road blocks and supports them to aim for their highest possible level of professional competence – so yes, authority and encouragement go hand in hand. Authoritative interventions include advice-giving, providing information, and confronting. Feedback can be particularly useful when the other person has a ‘blind spot’, and is totally unaware of their motivation for what they have done or the impact of it. Often trainees fail to recognise minor ethical difficulties. When supervision can offer an encouraging and authoritative space for the supervisee to explore, ‘not know’, and ‘feel stuck’, there can be rich learning from mistakes.
It is important to distinguish between mistakes, malpractice, and poor practice. Minor mistakes are normal unintended slips in normally good practice. Malpractice arises when the practitioner meets their own needs at the expense of the workplace or people in it, and if it continues, this must be addressed as part of the ‘giving of courage’ or encouragement. Whether mistake or malpractice, the supervisor needs to address the issues with encouraging authority, and in turn, the supervisee will be more open to the feedback and guidance.
The supervisor also needs to be open to stuckness, not knowing and learning from mistakes. Saying ‘I don’t know’ can be hard as a supervisor, if you feel you ought to know. It is beneficial to tolerate the discomforts of not knowing while still thinking together about an issue: this models the reflective process and demonstrates the value of reflection to the supervisee in an encouraging way.
Encouragement is a many-faceted process, and we see it as a vital ingredient for effective supervision. However, this fine balance between support and challenge, empathy and authority is by no means easy. We all have tendencies to move into judging and defensive positions at times, and we all make mistakes. When we can embrace these moments with compassion, it is gratifying to realize that they offer great opportunities for professional growth.
1. Henderson, P., Holloway, J. and Millar, A. (2014) Practical Supervision: How to Become a Supervisor for the Helping Professions. London: Jessica Kingsley Publishers.
2. Edwards, J.K. (2012) Strengths-based Supervision in Clinical Practice. London: Sage.
3. Cooperrider, D. et al (2000) Appreciative Enquiry: Rethinking Human Organization Towards a Positive View of Change. Champaign, IL: Stripes Publishing.
4. Burnham, J. (2012) ‘Developments in social GRAAACCEEESS: Visible and invisible, voiced and unvoiced.’ In Krause, B. (ed.) Mutual Perspectives: Culture & Reflexivity in Systemic Psychotherapy (pp 139-162). London: Karnac Books.
5. Dreikurs, R. (1970) ‘The Courage to be Imperfect’. In Articles of Supplementary Readings. Chicago: Alfred Adler Institute.
6. Ladany, N., Hill, C.E., Corbett, M.M., and Nutt, E.A. (1996) ‘Nature, extent and importance of what psychotherapy trainees do not disclose to their supervisors’. Journal of Counseling Psychology, 43, 10-24.
7. Millar, A. (2007) ‘Encouragement and Other Es’. Therapy Today (18)2, 40-42.
Why is it that some clients find their way into supervision from the beginning, while others barely get a look in?
How do you decide which clients to take to supervision? That sounds like a straightforward question for any of us to ask, as part of good reflective practice. However, scrutinising a question can often be more productive than replying to it – so, instead of giving an answer, let’s look at some of the basic premises underlying this one. I reckon four key assumptions are made.
The first assumption is that deciding which clients to take to supervision must be a conscious, deliberative process. Really? If you say you consciously decide, does this mean they are never unconsciously selected as well? We could get clever (or pretentious) on this point by engaging with neuroscientific findings about the reality of ‘free will’ and so on – but let’s work instead with an ordinary notion we’re all familiar with: the hunch.
They say a hunch is stronger than a guess but not as strong as an intuition. Although we employ ‘the professional hunch’ a lot of the time, we tend to underestimate its true value. Of course, we make carefully considered decisions too, but let’s not overlook the sudden wisdom of our hunches. For example, when it ‘comes to mind’ that I need to take a particular client to supervision, even if I then wonder about what’s going on with me and that person, I’m still not ‘choosing’ to take them for any obvious reason – but this does become clear later in supervision. When a piece of client work is seriously baffling or disturbing, I am very likely to take it, but other clients arrive in the supervisory space without any conscious intention on my part.
The second assumption is that choosing is necessary and unavoidable because it would be practically unworkable to take all your clients. This depends on what kind of supervisory arrangements you’ve devised for yourself. I know someone who runs six to eight therapy sessions a week. She has one-hour fortnightly supervision with me and two-hour monthly co-supervision with a colleague. This set-up means she can fulfil her self-imposed requirement to ensure all her client work is supervised. I admire her commitment, but some therapists might feel over-supervised in that situation.
One of my past supervisees had 15 appointments per week and saw me for one-and- a-half hours every month – ie the recommended absolute minimum* – so several of her clients were never mentioned, let alone discussed. I asked her to write a caseload summary every other month, with a thumbnail description of the work with each client, plus brief queries. With this ongoing information about all her clients, I could request we give some time to certain cases that caught my eye, but which she did not choose or intend to bring. Preparing in advance for clinical presentations of clients is often essential, but I believe it’s just as productive sometimes to bring them ‘unrehearsed’ and ‘unrefined’ – not so time efficient, perhaps, but still valuable for therapeutic insight and learning.
The third assumption is that supervision is always for the benefit of clients, therefore as many clients as possible should be taken to supervision. We assume supervision can benefit clients, and very often we feel it to be the case. In fact, we’re in the peculiar position of believing it’s beneficial, while knowing there is hardly any research evidence to support our belief. It would be more accurate to state that supervision is primarily for the benefit of supervisees. To put it in plain terms: we trust that whatever good stuff a supervisee derives from their supervision sessions, one way or another, it really does get passed on to their clients.
I hope that what you get mostly from supervision is support, understanding, challenge, development and encouragement for yourself, so that you are then well resourced, refreshed and ready to maintain the same or similar beneficence for your clients. If clients do benefit from supervision, it is mostly through a subtle, indirect transmission. The point is this: in order to gain the benefit of the supervisory space for yourself, it’s not a good idea to squeeze as many clients as you can into the room.
The fourth assumption is that clients themselves have no say in the matter. In principle, if they’ve read in your contract that you consult confidentially with a supervisor, any client could ask if you talk about them in supervision. A few practitioners tell some of their clients about their supervisory discussions anyway, and the remote supervisor can become a useful transferential figure. So, in some cases, the client’s own intentional input into the supervision process is central to the work.
What intrigues me is how certain clients leap straight into supervision from their first encounter and settle themselves there for a long time. They may be welcome, but who actually invited them? And then there are clients who suddenly ‘pop in’ while you’re presenting another case. I’m sure some clients unconsciously let the counsellor know they need to be supervised. In this sense, clients ‘bring themselves’ to supervision.
In contrast, people you conscientiously put on your ‘take to supervision’ list may never show up. They ‘get lost in transit’, or you always run out of time. Or, if you do introduce them, you soon find yourself trailing off. In this instance, it’s important to ‘hear’ what that individual’s psyche could be telling you about their absence from supervision. Perhaps some clients unconsciously instruct us not to share anything of their story with anyone. With this in mind, we can invigorate our sense of choosing who we take to supervision – reluctantly or otherwise.
In BACP documents, the figure of one-and-a-half hours per month is always stated as the minimum for accreditation purposes. I’ve met many practitioners who wrongly take this to mean a ‘sufficient’ or ‘correct’ amount.
1. Wheeler S, Richards K. The impact of clinical supervision on counsellors and therapists, their practice and their clients: a systematic review of the literature. Counselling and Psychotherapy Research 2011; 7(1): 54–65.
2. Davies N. Research and literature overview of supervision within the counselling professions. Good Practice in Action 043. BACP 2016.
Jim Holloway is a senior accredited counsellor and supervisor, a partner in Cambridge Supervision Training, and a co-author of Practical supervision: how to become a supervisor for the helping professions (JKP 2014).
Summer 2017 Private Practice 25
Jim Holloway considers what we might learn from the apocryphal tale of the colleague who dozes off when in the supervisor’s chair
Over the years I’ve been in practice I’ve heard several therapists say they once had a supervisor who fell asleep in a session. You might have heard this a few times yourself and perhaps wonder, like me, if it’s really true. I’ve never experienced it myself, in almost 25 years as a supervisee with many different supervisors, but I suppose it might yet happen. (From the other side, in the supervisor’s chair, I would like to point out that I’ve never nodded off when supervising – as far as I know. Seriously, I’m pretty sure I would remember if one of my supervisees ever had to wake me up in the course of a session.)
One of the best measures to take against compassion fatigue is to get right away from the world of work fairly regularly
Whether told with gentle good humour, fierce indignation or a combination of both, the story of the sleeping supervisor is worth probing. It’s a subtly potent little tale that seems to have a life of its own in our professional circles, rather like a piece of folklore. This sort of micro-myth must exist for a purpose, surely, so it could be useful to take a closer look at it and explore what kinds of meaning it might carry. One very direct approach, as a purely personal experiment, is to take a few minutes to imagine seeing your current supervisor fall asleep during one of your sessions, and then observe as vividly as you can what you think and feel as the scene unfolds in your imagination. This exercise might seem a bit weird, but I did it myself and found the effect surprisingly moving and productive. If you try it for yourself, I think you’ll find the thoughts and feelings that arise may yield some unexpected information about the current state of your relationship with your supervisor.
As you create the scene in your mind, you might be aware of tender and concerned feelings towards him or her. Is she unwell, or distressed, or just extremely tired for some reason? If you feel the urge to help, what can you say or do? Alternatively, you might get primitive sensations of being lost and abandoned, and start to feel anxious, scared or angry. Notice where your thoughts take you. Maybe you begin to wonder about what kind of parallel process might be taking place. Most of us are familiar with the phenomenally sleepy way in which we sometimes react to clients, and we know this embodied effect can be unconsciously transferred into the supervisory relationship. Might that help to explain why the supervisor has apparently drifted off? Sitting silently for a minute or two while she dozes is not what you expected from the session, no doubt, but something constructive could emerge from the strangeness of the experience, if you let it develop with full awareness in your imagination.
You might take the view that almost everything that occurs in supervision is potentially relevant data to be used in the service of the client, in which case you can probably find it quite easy to stay curious and reflective. But perhaps you’re simply not in the mood for a sensitive reverie and instead you get busy exercising your sharply critical mind with immediate contractual concerns about professional ethics and fitness to practise: your supervisor is seriously letting you down and is probably over-working or suffering from an undisclosed illness. That may or may not be the case, but either way it could still miss the point, which is the plain fact that you’re totally pissed off with your supervisor for falling asleep in front of you. How dare she? You tell yourself this situation is absolutely not your responsibility and you’re not going to rescue her or somehow make excuses for her. The session feels like a waste of valuable time and is definitely not what you’re paying for.
Now, there are many angles we could take here, but let’s talk about money. What difference does the fee make? If you imagine a colleague dropping off drowsily in a peer group or co-supervision session, I guess your response would be strongly affected by the greater equality in the collegial relationship because no money changes hands. The true significance of your ethical commitment to care for colleagues is heightened in this sense, because no one is in charge and no one is paid to take control. When you pay your supervisor for their professional service (whether one to one or in a group) the equation is different. The way I see it, a proportion of the fee I’m paying my supervisor is for their self-care. At a basic level, the supervisor needs to charge enough for each session so they can make a good living without having to run so many weekly sessions that they become over-stretched and exhausted, and also so they can afford planned time off from working, whether just an occasional half-day or a whole week or two.
This is about organised resilience. One of the best measures to take against compassion fatigue as a therapist or supervisor is to get right away from the world of work fairly regularly. For me, a daily break is essential too. I’m a firm believer in the benefit of taking an afternoon nap for half an hour – a wonderfully simple luxury for which I feel grateful every day – but of course I must make sure it’s affordable. It may sound odd to state that my supervisees (and therapy clients) are paying me to switch off in my own time, not theirs. But in relation to the mysterious tale of the sleeping supervisor, this reality is exactly what the supervisor must wake up to.
Encouragement: An Essential ingredient of Supervision - Anthea Millar
Supervision comes in many shapes and sizes, inspired by numerous models and theoretical orientations. Yet when ‘unpeeled’, it seems there is a common ingredient at the heart of all effective supervision practice: encouragement. This is also an essential value at the heart of our Cambridge Supervision Training courses and the book Practical Supervision: How to Become a Supervisor for the Helping Professions co-authored with my colleagues Penny Henderson and Jim Holloway.
Adler, over 80 years ago, took an optimistic view of human nature, believing that a need to belong and contribute to the group is inborn in each individual. However, humiliation and shame, disconnection and disgrace, inferiority and deficiency are deeply threatening dangers to us all, and prompt us to lose courage (feel discouraged) in making positive connections and contributions. So we may resort to patterns of self-destructive behaviours if, in our family of origin, we experienced these forms of discouragement. Adler also suggested that neither heredity nor environment is the ultimate determiner of personality. Instead he believed that this desire for pro-social behaviour is embedded in us, and we all have the capacity for constructive change (Ansbacher and Ansbacher 1956). And crucially, this change is most likely to occur in a relationship with a person who is encouraging.
Encouragement has been described as: ‘…the process of facilitating the development of the person’s inner resources and courage towards positive movement. The encouraging person helps the discouraged person remove some of the self-imposed attitudinal road blocks.’ (Dinkmeyer and Losoncy 1980 p 16). Looking more specifically at supervision, Lemberger and Dollarhide (2006) state that the process of encouragement can ‘..assist the supervisee to aspire to the highest possible level of professional competence. Encouragement is literally “entering the courage” and assets possessed by the supervisee….(it) can further buttress the working relationship between the supervisor and supervisee and open up new meaning-making opportunities for both…’ (p119).
In a bid to identify the many forms that encouragement can take, and having a bit of fun with alliteration, I have created a diagram that aims to illustrate my thoughts about the main Elements (or ‘E’s) of supervision. These elements are ordered to echo key phases in the supervision process, and are framed by encouragement.
Where there is a clearly contracted working alliance that is underpinned by a strong ethical framework, such as that provided by the BACP, both supervisor and counsellor can work more courageously. The increased courage comes from being supported by a set of principles that are not there to ‘police’ but to encourage mature reflection. Without the encouragement of an ethical frame, dilemmas can seem insurmountable; or of much greater concern, we may miss the dilemma altogether, and unwittingly enter into unethical practice, becoming both discourager and discouraged.
The Essential ‘E’s
Equality and Empathy‘To be human means to have inferiority feelings’(Adler 1964 p54). Adler suggested that the development of inferiority feelings result in large part from subjective childhood comparisons with other family members. As these feelings are so uncomfortable, we compensate by striving to overcome them through such patterns as superiority and perfectionism. Here’s where problems can arise in the supervisory relationship. This ‘slippery pole’ dynamic of inferiority and superiority will show itself as a discouraging power imbalance, that destroys a sense of equality.
Equality does not mean that the supervisor and supervisee need to have the same level of experience, values or theoretical orientation – what it does mean is that there is a cooperative partnership that acknowledges and honours difference. By not getting caught into ‘How am I doing in comparison to others’, and reflecting instead on: ‘What am I doing?’, we then offer a supervision space based on equality that encourages supervisees to risk disclosure of problematic issues much more readily.
Most counselling and supervision approaches have empathy as a fundamental basis to the relationship and I certainly see this as essential to offering an encouraging frame for the supervision work. However encouragement is always about authenticity, where a willingness to be honest (congruent) with a supervisee is as important as offering of empathic understanding.
Exploration and Enabling InsightEnabling the supervisee to present and explore what is going on, whilst keeping a careful eye on the client’s well being, is a complex task. As supervisors, we may be tempted to come in too early with our theories, interpretations and answers. Equally, with the aim of being empathic, we may delay intervention, listen attentively, but offer no focused input to the supervisee. One example of very many interventions that can encourage supervisees to explore and gain insight is the process of Socratic questioning (Millar 1999).
Using Socratic questions, the supervisor does not play the role of expert or authority. The skill of the supervisor is in having an idea of what direction would elicit the most useful information, clarification, or insight. Each new question is based on the supervisee’s previous answer or statement. Gradually, the supervisees are led to their own insight, and make their own conclusions as to what they are doing, and what they could be doing more effectively.
Education and ExtensionWhether in the role of supervisor or supervisee, taking risks and extending our skills is often deeply encouraging. Our learning can be particularly rapid after making mistakes or discovering gaps in our knowledge. However it is at exactly these moments that we can feel most vulnerable to inferiority feelings. By protecting ourselves from this discomfort, we are not protecting the client, and poor practice may be perpetuated. Supporting the supervisee to have ‘the courage to be imperfect’ (Dreikurs 1970) through feedback that will educate and extend, is an essential aspect of taking supervisory authority (Henderson 2006). So how can this verbal feedback be offered encouragingly so that it is neither punitive nor unhelpfully praising? (Dreikurs 1958, Dweck 1999, Kohn 1993).
Adlerian practice puts the emphasis on first identifying a person’s strengths, before presenting areas for development and change. This provides a firm base from which we can be more receptive to other forms of feedback. A similar process can be used both for identifying strengths and challenging areas for growth, as verbal encouragement, differentiated from praise, focuses on what the person is doing, rather than how the person compares with others. This is achieved by avoiding the use of single adjectival labels such as ‘good’ ‘unethical’, ‘clever’, ‘non empathic’, and also by keeping in mind the assets and positive intentions of the supervisee. By using descriptive language, paying particular attention to verbs, feedback offered is very specific, identifying what the supervisee has actually been doing. From this base, the supervisor may add their view, or provide educative information as appropriate.
EffectivenessLast, but not least, is the need to assess not only the supervisee’s competence, but our own effectiveness as a supervisor. Some crucial ways for the supervisor to ensure this include regular opportunities for mutual feedback between supervisor and supervisee, supervision for the supervision work, ongoing professional development and further supervision training.
Encouragement is a many faceted process that is the essential ingredient for supervision. But it is not easy. I have continually to deal with my own tendency to move into a superior and judgmental mode, but have discovered, gratifyingly, that when I am more encouraging, I actually feel more encouraged. So I would invite all supervisors to reflect on what they might develop further to ensure encouragement is at the heart of their supervisory practice. This practice will in turn encourage and enable the most important person of all: the client.
ReferencesAdler, A. (1964) Social Interest: A Challenge to Mankind. New York: Capricorn. (Original work published 1933)
Ansbacher, H.L. & Ansbacher, R.R. (Eds). (1956) The Individual Psychology of Alfred Adler. New York: Harper & Row
Dweck, C (2000) Self Theories: Their role in Motivation, Personality, and Development. Philadephia: Psychology Press.
Dinkmeyer, D. & Losoncy, L.E. (1980) The Encouragement Book. New Jersey: Prentice Hall
Dreikurs, R. (1958) The Cultural Implications of Rewards and Punishment. The International Journal of Social Psychiatry. Vol IV, No 3, Winter 1958
Dreikurs, R. (1970) The Courage to be Imperfect. In Articles of Supplementary Readings (Chicago: Alfred Adler Institute 1970)
Henderson, P. (2006) Learning to take Supervisory Authority. In P.Prina, K.John, C.Shelley, A.Millar (Eds). UK Adlerian Year Book 2006. London:ASIIP pp 40-49
Henderson, P., Holloway, J. and Millar, A. (2014) Practical Supervision: How to Become a Supervisor for the Helping Professions. London: Jessica Kingsley Publishers.
Kohn, A. (1993) Punished by Rewards New York: Houghton Mifflin.
Lemberger, M.E. & Dollarhide, C.T. (2006) Encouraging the Supervisee’s Style of Counseling: An Adlerian model for Counseling Supervision. The Journal of Individual Psychology. Vol. 62:2, pp106-125
Millar, A. (1999) The Use of Socratic Questioning in Classical Adlerian Therapy. In P.Prina, C.Shelley, C.Thompson (Eds). UK Adlerian Year Book1999. London:ASIIP