Section 6: Psychotherapy-Based Supervision Models of Supervision

In the early days of supervision, when Freudian and Jungian forms of therapy were the predominant models, supervision often consisted of entering into a kind of combined therapy-supervisory relationship. The concept behind this model was that the supervisee needed to experience the process of therapy from the role of the patient, while simultaneously learning how to build the complex cognitive and emotional competencies necessary to become a skilled clinician.

While this model has largely fallen out of favor and poses difficult questions these days about professional boundaries, there are still supervisors who practice these models of supervision with intent and purpose.  Additionally, there are supervisors who train supervisees to become specialists in a certain model of therapy, as opposed to becoming generalists who utilize approaches and techniques from a variety of theoretical approaches. This latter model might be considered to fall into the general category of a competency-based supervisory model, but with a very focused goal of enhancing competencies within a very defined school of thought. 

While most Masters level clinicians who are seeking to become supervisors may elect to choose a developmental or integrative model of supervision as the primary theoretical orientation, it is not inconceivable that some supervisors will choose to specialize in a specific arena of practice in which there will be a heightened relevance to knowing and applying best practices within a practice based model. Towards that end, this section will provide a brief overview of the practice based models, with references for those clinicians who may wish to seek additional information in this area.

 

Psychodynamic Approach to Supervision

For more information, see: Rock, MH, Psychodynamic Supervision: Perspectives for the Supervisor and the Supervisee, 1997, Plymouth, UK: Rowman and Littlefield Publishers

Key understandings:

 

1. Interpersonal dynamics between the supervisee and the client may be instructive in understanding the dynamics between the supervisee and the supervisor
2. These dynamics address the central themes of psychodynamic therapy: affect, defenses, transference/countertransference
3. In processing the dynamics on an experiential level with the supervisor, the supervisee understands the client’s experience and learns techniques on addressing the dynamics through the actions of the supervisor
4. There is a focus on situations when supervisees have been drawn into enactments with clients

 

Key tasks:

1. Educate supervisee on how to understand and apply psychodynamic theory and knowledge, and develop techniques
2. Develop skills in assessment and case formulation within a psychodynamic framework
3. Build and strengthen the capacity to recognize and understand significant patterns in the clinical material within a psychodynamic framework
4. Learn how to turn psychodynamic theory and case material into appropriate and effective therapeutic strategies and techniques
5. Learn how to recognize, understand, and address the transference and countertransference processes occurring in the relationship between the supervisee and the client
6. Develop the ability of the supervisee to recognize and control his own emotional experience within the therapeutic relationship

There are three categories of psychodynamic supervision:

1) patient-centered

2) supervisee-centered

3) supervisory-matrix-centered.

Patient centered supervision focuses more intently on the relationship between the supervisee and the client, supervisee centered supervision focuses more on the relationship between the supervisee and the supervisor, and supervisory matrix centered is more oriented towards a balanced focus on both sets of relationships and parallel processes.

 

Cognitive-Behavioral Supervision

For more information, see: Schmidt, J. P. (1979). Psychotherapy supervision: A cognitive–behavioral model. Professional Psychology, 10(3), 278-284.

http://dx.doi.org/10.1037/0735-7028.10.3.278

Key understandings:

1. Focus of supervision will be on the development of core cognitive-behavioral knowledge, skills and techniques, including case conceptualization from a CBT perspective
2. Experiential processes will be more focused on having the supervisee understand his/her own cognitive biases and distortions and learning how to keep those separate from the relationship with the client

Key tasks:

1. Understand how to develop a therapeutic relationship in order to set the framework for successful cognitive work: building trust through positive regard, attunement, empathy and accurate understanding
2. Comprehend the etiologies of maladaptive cognitions, emotions and behaviors.
3. Teach the key techniques and tools of the theoretical orientation: using observable cognitive material and behaviors, cognitive distortions, and approaches to restructure the cognitive material and direct the client to more adaptive cognitions, emotions and behaviors, including the use of role play, guided discovery, direct instruction
4. Learn how to structure client sessions, create useful between session homework, and create meaningful summarizations of the material from the sessions and homework

 

Person-Centered Supervision

For more information, see: Bryant-Jefferies, R, Person-Centred Counselling Supervision: Personal and Professional, 2005, Boca Raton, FL: CRC Press

Key understandings:

1. Focus of supervision will be on the development of the supervisee’s skills through a collaborative process, enhancing the supervisee’s capacity to utilize his/her resources for effective clinical work
2. The role of the supervisor is to provide an environment in which the supervisee is supported in being aware of his/her own experience and fully engaged with the client. 

Key tasks:

1. Understand how to develop a therapeutic relationship in order to set the framework for successful person centered work: genuineness, attunement, empathy and unconditional positive regard
2. Comprehend how to establish a clinical environment in which the client can be open to his/her own experience and utilize his/her own resources to find solutions to problems
3. Teach the key techniques and tools of the theoretical orientation: focus on the present, listening, accepting, understanding, and sharing in a collaborative manner

 

Solution Oriented Model of Supervision

For more information, see: Dewane, CJ, Solution-Focused Supervision: A Go-To Approach, 2015, Social Work Today, Vol. 15 No. 5 P. 24

Key understandings: 

1. Focus of supervision will be on the development of the supervisee’s skills through defining and pursuing clear, incremental developmental goals, defining problems for which solutions are being sought, improving and enhancing the solution creating skills of the supervisee
2. The role of the supervisor is to provide an environment in which the supervisee’s competence and resources are validated, and capacity for the creation of increasingly effective solutions is supported and enhanced
3. The supervisor will attempt to find out the best way of collaborating with the supervisee to move towards goals, including understanding the preferred learning style of the supervisee, stage of development, attributes of the supervisee, circumstances in which the clinical work is occurring, language and values of the supervisee

Key tasks:

1. Understand how to develop a therapeutic relationship in order to set the framework for successful solution focused work: concern, empathy, confidence, optimism, establishment of a collaborative relationship
2. Comprehend how to establish a clinical environment in which the client can utilize his/her own resources, skills and abilities to identify key problems, establish realistic goals for addressing the problems, and develop and implement solutions to problems
3. Teach the key techniques and tools of the theoretical orientation: focus on the problems identified by the client, facilitate the setting of goals and solutions, encouragement and support for the implementation of solutions, examination of the effectiveness of solution attempts

 

Bowenian Family Therapy Supervision 

For more information, see: Everett, CA and Koerpel, BJ, Family therapy supervision: A review and critique of the literature, Contemporary Family Therapy, March 1986, Volume 8, Issue 1

Key understandings:

1. Focus of supervision will be on helping the supervisee differentiate successfully from his/her own family system
2. The role of the supervisor is to serve as a coach to the supervisee, using genograms, modeling successful differentiation, and working with the supervisee to define actions and activities that will help the differentiation process

Key tasks:

1. Understand how to develop a therapeutic relationship in order to set the framework for successful family system work: trust, concern, empathy, confidence, optimism,
2. Comprehend how to establish a clinical environment in which the client can begin the process of differentiation of self from the family system
3. Teach the key techniques and tools of the theoretical orientation: use of genograms, psychoeducation on family system, use of actions and activities for differentiation of self

Post-modern Supervision

For more information, see: Shurts, WM, Infusing Postmodernism Into Counseling

Supervision: Challenges and Recommendations, 2015, The Journal of Counselor Preparation and Supervision, Vol 7, No. 3 

Key understandings:

1. Focus of supervision will be on helping the supervisee identify, expand, and learn to use in clinical work their multiple possible role identities and narratives
2. The supervisor remains flexible in his/her own role identities and narratives in order to participate with the supervisee in a co-construction of supervisees’ capacity to operate competently as a clinician
3. The supervisor may move fluidly and flexibly through six major roles or identities: the supporter, the supervisor, the case consultant, the trainer or teacher, the colleague, or the advocate.

Key tasks:

1. Understand how to develop a therapeutic relationship in order to set the framework for successful family system work: support and acceptance for the client within their own roles, identities and narratives, trust for the co-creation process
2. Comprehend how to work with the client to transform roles, identities and narratives in ways that move towards the key purposes of the client
3. Teach the key techniques and tools of the theoretical orientation: clarification of roles, identities and narratives, facilitation and co-creation of alternative and preferable roles, identities and narratives

This completes the material for this module. The link for the post-test may be found at the bottom of the bibliography section.

 

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