October 23rd, 2019

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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.

 

23/10/2018 0 COMMENTS
Penny Henderson remembers...​​Offering Supervision Training: 2004-2012 

Supervision of counsellors is professionally required, but unregulated.  In the early 2000s relatively few counsellors trained specifically to be supervisors, but for many it was the next step after a few years of Practice.  Yet as younger people entered the profession, many were taking up supervisor roles after just a couple of years as a counsellor, which gave them an insufficient basis in experience.  In addition, recognition was increasing that the role was distinctly different from that of counsellor, and an approach where people did what had been done to them was unsatisfactory. A supervisor has to have the capacity to take a view of the work of the counsellor that encompasses an analysis of what ails the client, a review of the developing relationship between counsellor and client, and an understanding of the impact of the work on the personal / professional work of the counsellor.  Good supervision is restorative of the counsellor, developmental of their professional ability in the role, and serves as a professional monitoring of the quality of the work. 

My beginning as a trainer of supervisors all began serendipitously, and responsively in 2003. My old friend and ex-tutor Brigid Proctor, who was a high profile supervision trainer decided she didn’t want to do a day she’d been asked to do about creative supervision for the BPS counselling psychologists in the Midlands, so she gave them my name as a substitute.  I was interested, and asked my Cambridge colleague and friend, Anthea Millar, to co-tutor the day.  We discovered we worked well together and had a lot of creative fun designing and implementing the day with a challenging group in Birmingham. We were happy to survive the experience and get good enough feedback. 

In the next year, Anthea was asked to set up and offer a supervision training for Adlerian counsellors to do supervision associated with their developing course in Wales.  She asked me with two Adlerian colleagues if we would like to design a course that would prepare counsellors for their new role, and our quartet formed. It soon became apparent that the other two only wanted to be involved in one x 2 day module out of the four we proposed, so Anthea and I became the core tutors, planned the course in detail, did the other three weekends, and managed the assessments so we could give participants a Certificate. We were all very experienced supervisors, and I was fully up to date, at that point, with current writing and research about the topic, as a result of writing a couple of chapters, doing some research, and my 2 years as editor of the supervision column of our professional journal.  Anthea was ready as she had done a Masters degree on the topic at Birmingham university. But I was not trained as an Adlerian, and so there were some new concepts to grasp that Anthea felt were essential for people who would supervise students on an Adlerian course. We wrestled a bit with the course structure, fitting what each considered essential into 8 brief days of training.
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Each module felt like rather a marathon, as it entailed taking train journeys to west Wales, as well as the teaching, which was not easy to fit in with an existing busy schedule. Our train journeys were wonderful planning and reviewing spaces, however, and as we got to know each other better, and trust each other as trainers with very very different styles and pace, our enjoyment and friendship deepened. 

As that enterprise came to an end Anthea proposed that as we had done so much work in designing the course, we should set one up here in Cambridge. She was always the visionary one, though I was the enthusiastic first mate.  So we tweaked our plan, and began to advertise and recruit for the first Certificate. Once more her contacts were helpful in the initial run, as she had been tutor of the Cambridge Adlerian course, and was loved and respected by her ex-students. We enrolled a full course. 

After the first course, we decided that we two would be the only full time tutors, and one of the other two, Julia Herrick,  would be the practice tutor coming in for a half day each weekend to support the students as they took turns to supervise each other, and get intensive review and feedback about their efforts. This gave us a tutor-participant ratio of 1-4, almost unheard of in CPD courses run by academic or private institutions.  We never made much money as a result, and were much too conscientious in our feedback to participants about their written and practice assignments. Two perfectionists working together each admiring the other made for an excellent service to our participants, but ridiculous hours of work for us. Happily, we decided we would meet weekly, swim at 8.00 am, and then go upstairs to the café at the Chesterton school pool for breakfast and a working meeting. This was highly enjoyable, professionally and personally productive, and kept us fit too.  We did this till Council cuts closed the early morning swimming option. 

Soon, we began to feel that although we were offering a sound base, some less experienced participants were not really ready to call themselves a supervisor by the end of four weekends, as they may have only supervised each other.  This is a complex moment of professional development. Does a counsellor begin to offer supervision to get some experience, and then do the training? This often means they have a very limited analytical basis for their work, and generally they do what was done to them. If they had a good model from their own supervision, all is well, but if they have had sloppy supervision, they are unlikely to provide a good quality service.   Or should they do some training and then begin to supervise?  This means that they may talk the talk, but not be so effective in walking the walk. The professional body was unhelpful in this decision.  It has failed to make their professional accreditation for supervisors attractive, and very few people did it, though I had in 2001. They make great play of the importance of supervision, making it a monthly requirement throughout a counsellor’s professional life, but fail to set standards.  

So we set up an arrangement for any of our graduates who wanted to, to meet monthly for a year with one of us for group supervision of supervision. This gave the participants plenty of opportunity to practice supervising each other’s actual work with supervisees, and get guidance from one of us too. Our learning from this then formed the basis for the Diploma we designed, which had a quarter of the time in such groups. Once more we had a four-weekend model, though this included two days with external trainers who were a big crowd draw for other supervisors working in the area, who could take the day as a part of their CPD. This proved a helpful financial model, as these days could accommodate up to 20-25 people, so this subsidised the core training a bit.  We were still doing all the course admin, assessment and marketing in our own time. However we employed a highly experienced colleague, Karen John, who had taken the Wales training herself,  to be an external assessor for the course, and we registered it for accreditation with the Adlerian Society of Great Britain. We were very pleased when our assessor returned a glowing review, although the participants’ reviews of each training day had kept us tuned in to what was working and what needed further tweaking. We were inveterate tweakers. 

We spread our wings, again as a result of Anthea’s contacts, to do a 2-day supervision training in Riga, Latvia, on a very cold February weekend in 2010. This was my first experience of teaching through an interpreter, and I thoroughly enjoyed it, though the dynamics in the group between the Russian speakers and the Latvians were tricky.  
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Sadly my health deteriorated after a virus in September 2010, which gave me a winter with 5 chest infections, and barely a week of good health. I struggled on with a variety of associated health difficulties, until 2012, but then insisted that Anthea find another core trainer. We chose one of our graduates, Jim Holloway, who joined us as a partner as he already had a good local reputation.  He only did a year as co-tutor, before deciding it didn’t fit with his other work, and she had to begin again with a third partner, though he continued skilful work as administrator and designer for publicity materials for some years more. Our steady practice teacher, Julia Herrick,  has continued throughout, and brings sustained observation and valuable feedback with a quiet presence. 

So my decision to end, like the decision to start, had arisen without my intending it.  The bit in the middle was hugely satisfying. 

14/8/2018

Embrace your inner Idiot.. by Jim Holloway

What your Clients say about you...  by Jim Holloway
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Learning to take supervisory authority - Penny Henderson

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 include:

1. making contracts for the work;
2. taking and sharing responsibility for allocating time during the supervision;
3. coping with ethical dilemmas;
4. giving feedback about the skills or approach of the supervisee;
5. writing reports or references;
6. assessing ‘fitness to practise’ together when the supervisee is facing difficult life
7. events or health problems;
8. setting up regular reviews of the supervisory relationship and its efficacy, and​ preparing well for them in advance so each person gives feedback to the other.

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

1. I have tried to develop criteria for best practice in relation to supervisory authority in both normal and difficult circumstances, and I think these include five distinct elements for trainee supervisors to consider:They need to encourage their supervisees to learn to take responsibility for preparation and for focus, so that they do not abdicate control and initiative totally to the supervisor. Often they become aware during the training of the value of this for themselves as supervisees.
2. They need to understand about ‘slippery pole’ dynamics, and how to sustain a commitment to equality and mutual respect, especially when difficult things are to be said. Social influence, leadership, mentoring and responsibility, all come within this criterion, and getting the relationship right creates safety and an enabling working alliance.T
3. They need to develop their views about the purpose of supervision, issues of power and authority, the development of an ethical stance, and an awareness of the importance of ethical principles and frameworks to approach supervisory dilemmas.
4. They need to become aware of the bases for legitimate authority. These may include expertise, role, and the professional bodies’ expectation that supervisors will keep a watchful eye on practice for the sake of the profession. There is ‘institutional power’ attached to this role even when the relationship is entirely between private practitioners: the supervisor carries responsibility for the promotion of good practice and the protection of clients.
5. They need to accept that the person undertaking the supervisory role has a right and a duty as part of the role to challenge bad or inadequate practice, and enquire about ‘fitness to practise’. Fitness to practise concerns the practitioner’s resilienceto undertake the role without doing harm to the recipient or becoming more vulnerable to fall into ethical traps because of their own life circumstances or health. With this criterion comes the expectation that the supervisor develop the skills to exercise this right whilst minimising the assault on the sense of worth of the recipient. As trainers, our role is to model and explore the skills involved, and also to engage in equally respectful relationships, even when offering feedback that we could predict would be painful or disappointing to receive. For instance, we aim to model putting the relationship first, not ducking the responsibility to be clear about standards or expectations, and being willing to share our own struggles to practise professionally. Of course as humans, we sometimes get this wrong too.

Contracting: 
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.

Becoming an Encouraging Supervisor
Anthea Millar, Jim Holloway and Penny Henderson


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.
 

Who's in and Who's out? - Jim Holloway
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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.
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Reference
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.
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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

The Case of the Sleeping Supervisor - Jim Holloway
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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.
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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.

Saying the Real thing - Jim Holloway

Bullshit in supervision shows up when we say the ‘right thing’ instead of the real thing.

I first came across the idea of a bullshit detector in a rather unexpected context, namely Michael Carroll’s scintillating chapter on spirituality in Integrative Approaches to Supervision, where he says he got the idea from the American philosopher Sam Keen. Adapting Keen’s concept of a spiritual bullshit detector for use in the field of professional supervision, Carroll identifies five things to beware of:

    1. Highly charismatic supervisors who are seen as unquestioned authorities.
    2. Supervisors with double standards: they ask from you what they do not do themselves.
    3. Superior supervisors who set themselves apart and avoid collaborative peer relationships.
    4. Supervisors who neither encourage difference of opinion nor invite challenge and criticism.
    5.Deadly serious supervisors who have no sense of humour and are never playful.

So, here’s an immediate health warning: if you recognise your supervisor in this list, you could be exposing yourself to harmful levels of bullshit. Obviously, I want to believe nobody reading this column currently has a supervisor who is anything like that. In private practice, we usually select our supervisor using our own initiative, according to our particular requirements, but many practitioners in other work settings are allocated a supervisor, and do not have a choice. However, even if you seek out your own supervisor independently, you might still encounter a significant amount of bullshit. Our detectors, I would argue, need to be well tuned at all times, in all professional circumstances.

In a world full of bullshit, each of us can do our profession a favour by minimising our own production of it. Reflecting on its occurrence within the supervisory frame, what comes to mind? For me, it describes the quality of what is spoken when the speaker doesn’t really know what they’re talking about but believes they mustor should know. What’s behind this might be a fear of seeming stupid or incompetent – the dark edges of shame, perhaps. If I bullshit regularly in order to hide my secret feelings of inadequacy, I might never find out whether those feelings are justified in the first place, and so I learn nothing new. When, for some reason, I pretend to be something I’m not, bullshit seems to provide an effective disguise.
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Bullshit in supervision can be a type of dissimulation (making one thing appear to be another), which sounds more polite but is just as obstructive to genuine dialogue. It also shows up subtly when a supervisee or supervisor says theright thing instead of the real thing. That kind of convenient bullshit is probably something we all come up with occasionally in the ordinary flow of interpersonal relating, but keeping it out of the professional supervisory space as much as possible strikes me as a practical and ethical necessity.

The trouble is this: in highly verbal and inventive individuals, as many therapists evidently tend to be, bullshit (whether spoken or written) can be marvellously distracting, often seductive, sometimes almost hypnotic. I know this partly because I’ve been on the receiving end of it (I guess we all have, in one kind of relationship or another) and also because I’m perfectly capable of delivering it. Let’s not overlook our own little bits of bullshit. If you’ve constructed a bullshit detector and decided on the calibration markers (like the handful in the list above) that make sense for you personally, then be prepared to apply the detector not only to others but also to yourself.

As a practical anti-bullshit device in supervision, I like the simplicity of a brief personal story told ‘against myself’. Like a teaching tale, it paints a picture and attaches some real emotion to the learning point. Take the following example of me being a bullshitter while supervising – or ‘poopervising’, if you like. This happened several years ago when I was a novice in the role, a fact that offers a partial explanation, perhaps, if not
a full excuse.

A new supervisee, an integrative therapist who had recently qualified, talked about The Therapeutic Relationship by Petrūska Clarkson.
I owned this important book without having done more than skim it but – bullshit alert! – I immediately reacted as if I knew the text, since I was at least aware it contained Clarkson’s seminal and much-quoted stuff about the five relationship modalities, and a close colleague had only recently told me he couldn’t imagine working effectively in therapy without fully appreciating her five-level model. All this added up to a major bullshit-manufacturing opportunity in my head, and it extended for several long minutes as the supervisee, apparently encouraged by my sage-like nods as she spoke candidly about her struggle with the book, suddenly asked a really well-formed and very pertinent question about it. I wince to recall the crap I offered in response. Regrettably, my reply could only be expressed in the false language of bullshit due to my having already taken a phoney position.
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Thanks to that experience, one small but vital calibration point on my internal supervisor bullshit detector became firmly set: never give the impression of being familiar with something (a text, theory, author, research study, even just an acronym) that you’re really not. It’s disrespectful to myself and others not to simply state my lack of knowledge at any given point. As it happens, there is a bit of a twist in the tale too: I still haven’t read the whole book.
References
1. Carroll M, Tholstrup M (eds). Integrative approaches to supervision. London: Jessica Kingsley Publisher

Trauma & Grief in the Covid-19 Pandemic. Presented by Anthea Millar

 

​Practical Supervision: How to Become a Supervisor for the Helping Professions 
The original, comprehensive, concise and jargon-free text by CST partners Penny Henderson, Jim Holloway and Anthea Millar
Introduction by Francesca Inskipp and Brigid Proctor|
Jessica Kingsley Publishers 2014

“This excellent book will be especially useful for anyone thinking of becoming a supervisor, or for those who have already started out on that journey ... I can see it becoming a classic text for supervision training courses.”
James Rye,|BACP Private Practice Journal Spring 2015
“An invaluable reference tool for all supervisors ... it contains gems of useful general guidance ... so packed with goodies that taking it all in is daunting in one go! ... I recommend it without reservation to all those undertaking supervision.”
Prof. Martin Johnson,|University of Cambridge
“I enjoyed this book. It is well structured, very accessible and, as the title suggests, practical, both for new and experienced supervisors. I particularly valued the frequent reflection points which encourage and challenge the reader to apply the text to their own practices.”
Robin Shohet,|co-author of Supervision in the Helping Professions
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Articles

A Different Wisdom: Reflections on Supervision Practice
by Penny Henderson (Karnac 2009) • Full details

"In a warm and personally revealing style Penny offers illuminating reflections on supervision ... The essence of this book lies in the successful balance of authority, which has its foundation in Penny's comprehension of her experience and knowledge of the literature, with her vulnerability as a reflective learner: wisdom indeed." 
(Steve Page, co-author of Supervising the Counsellor)


Supervisor Training: Issues and Approaches
Edited by Penny Henderson (Karnac 2009) • Full details

Contains chapters by Caro Bailey, Valerie Batts, Rose Battye, Roger Casemore, Suzanne Dennis, Christine Driver, Anna Gilchrist, Alec Grant, Penny Henderson, Julie Hewson, Francesca Inskipp, Anthea Millar, Antonia Murphy, Brigid Proctor, Charlotte Sills, Michael Townend, Carole Waskett, Wendy Wood
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Jim Holloway 
Jim Holloway is a BACP senior accredited counsellor and supervisor. He is an Associate of Cambridge Supervision Training, and co-author of practical Supervision: How to become a supervisor for the helping professions (JKP 2014)
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Jim's supervision columns published in BACP's Private Practice journal from 2016 to date.
The BACP In My Head 
Figuring Out The Framework
The Case of the Sleeping Supervisor' 
 Saying The Real Thing
'Resistance and Resilience' 
Who's In and Who's Out?'
Pressure of Time
Professing and Confessing

​Links

• Adlerian Society UK and Institute for Individual Psychology (ASIIP)

• British Association for Counselling and Psychotherapy (BACP)​

• British Association for Psychoanalytic and Psychodynamic Supervision (BPPS)

• British Psychological Society (BPS)

• Bucks Adlerian Training (BAT)

• Cambridge Adlerian Society (CAS)
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• United Kingdom Council for Psychotherapy (UKCP)