The Contemporary Relational Supervisor

Robert E. Lee, Thorana S. Nelson

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135008604
• Edition: 1
• Topic: Psicología
• Subtopic: Asesoramiento psicoterapéutico

The Contemporary Relational Supervisor is an empirically based, academically sophisticated, and learner-friendly book on the cutting edge of couple and family therapy supervision. Appropriate for master's and doctoral level students, as well as experienced clinicians who wish to learn about supervision, it emphasizes system and relational thinking and intervention, while privileging the diversity of training system members, their realities, experiences, and interpretations of life.
The authors are attuned throughout the text to how and where clinical training and services are provided, and to whom, and provide detailed literature reviews for readers. These factors assist their discussion of the socio-historic development of the AAMFT supervision designation, and the fundamentals, contexts, philosophy, relationships, and pragmatics ofCFT supervision. They also discuss major models and approaches, evaluation, ethical and legal issues, and therapist development. Perhaps most important is their presentation of methods that help tailor and extend supervision practices to meet the clinical, institutional, and economic realities thatCF therapists navigate.
Readers are engaged by the discussions and exercises at the end of each chapter, which help them to feel more grounded in a topic, to have their own voices heard, and to be granted insight through experiencing multiple realities. This valuable reference prepares the next wave of cutting-edge CFT supervisors–those who are knowledgeable, skilled, and realistically confident.

Part I

Understanding the Supervisory Process

An Overview

1

Basic Ingredients in the Supervisory Process

Supervision is

an intervention provided by a more senior member of a profession to a more junior member or members of that same profession. The relationship is evaluative and hierarchical, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s), monitoring the quality of professional services offered to the clients that she, he, or they see, and serving as a gatekeeper for those who are to enter the particular profession.

(Bernard & Goodyear, 2009, p. 7)

This chapter is meant to be foundational to all that follows. It intends to result in a clear understanding of those things that characterize effective couple and family therapy (CFT) or relational supervision. It is based on the distinction between education and training (Lee & Nichols, 2010; Nichols & Everett, 1986). Education in CFT is acquiring a knowledge base; training in CFT is acquiring skill in the application of this knowledge base to therapeutic situations. Couple and family therapy supervision is a training endeavor; it follows some amount of CFT education and is dependent on a working alliance between the trainee and the supervisor in pursuit of the trainee’s professional goals while education can occur without such an alliance.

Training in supervision is similar: it includes education (acquiring knowledge) and skill-building. Professionals in CFT believe that supervision is a different activity from doing therapy and thus requires specialized training. This book is intended to be a part of that training—the educational part.

We view training in CFT supervision as different from both training in therapy and from training in supervision in other mental health approaches, although more like the latter than the former. There are important differences, however, as described by Storm (2007). First, supervisors in CFT are more likely to attend to the values and beliefs that trainees hold about couples and couples in therapy, including same-sex couples. Second, the therapeutic alliance in couple and family therapy is systemic and complex, requiring supervision that discourages alliances that can be detrimental to the couple relationship. Finally, therapists and supervisors of CFT must be comfortable with complex emotional expressions that emerge in CFT.

In this book, we refer to therapists who are learning systemic therapy as trainees, regardless of their backgrounds or developmental levels. This includes students in graduate programs, postgraduate trainees, and anyone else who is in a learning position with a systemic, relational, or CFT supervisor. This training also occurs in many settings that include university or other training clinics for graduate students as well as agencies and other places that provide settings for training. These contexts are multifaceted, and we have attempted to provide ideas that apply to all as well as some ideas that apply to specific contexts. We also refer to client systems as including individuals, couples, families, and other groupings that seek services from a couple and family therapist.

This text is based on a systemic conceptual model perhaps first introduced by Liddle in 1988. Supervision focuses on the acquisition of skills more than education. The full training system includes many entities and sub-systems: clients and their systems, therapists, therapists in training, supervisors, supervisor candidates, supervisor mentors, clinics and other agencies that provide mental health services, educational institutions, and other entities that may interact with other parts of the training system. These other entities may include courts and academic departments as well as textbook authors. From a systemic perspective, training settings also include the relationships among the various parts and subsystems. Not all training systems include all parts (supervisor mentors, for example) and not all parts are housed in the same place.

As you can see, the training system is a complex environment of subsystems “with reciprocally influencing domains of conceptualization and action” (Liddle, 1988, p. 154). Interactional dynamics occur within, between, and among these subsystems. Moreover, these dynamics are frequently related to each other, indicating multiple lines of interaction and the potential for many nonsupportive triangles (Alderfer, 2007). The hypothesis of “isomorphism” (or parallel processes; see White & Russell, 1995, and also Chapters 2 and 3 of this text) is that interactional patterns in the overall training system and across subsystems are replicated, each reflecting others. That is, dynamics in the trainee/client system may be replicated in the trainee/ supervisor subsystem and vice versa. We mention this because it is a central concept in the conduct and particularly the troubleshooting of difficulties in the training context. Therefore, if supervisors are able to step back and observe themselves as living parts of the training system, they may gain important insights into and leverage within these training systems (cf. Lee, 1999b). Indeed, looking at the training system from “the top down,” it becomes clear that the manner in which supervisors construct “supervision” and “therapy” in terms of their processes and goals greatly influences trainees, clients, and supervisors, and the process of both therapy and supervision. Supervisors’ constructions greatly influence “everyone’s ideas about what therapy is and how it is done, how people in relationships should be, what constitutes a ‘problem,’ and how important it should be considered relative to other matters” (Lee & Everett, 2004, p. 12). That is why we, the authors of this text, suggest beginning supervision with discussions with trainees, being alert to the fit between prospective therapists’ and supervisors’ ideas about the content and process of supervision (see below). This discussion, which we might call an appreciative interview, entails listening carefully and co-constructing understandings about each other, the supervision process, and the work together.

An essential construction in this book is the paradigm of system thinking (von Bertalanffy, 1968). As system thinkers, we see the world as a complex of individuals and their relationships with each other that are visible through interactions. Within a system, which may be a subsystem of a larger system, change that occurs in one part reciprocally affects all other parts and is, in turn, affected by those other parts. A system is made up of ever-changing dynamics, roles, interactions, and meanings. We will discuss system ideas in more detail later in the text.

System thinking in therapy and supervision includes awareness of differences of values, attitudes, and ways of understanding the world, and the influence these have in professional work. Increasing awareness of differences should inform assessment and other interventions and result in personal commitment to enhancing services to diverse client families in diverse settings. This is a matter that goes beyond “cultural competency” (see Chapter 9) and which must pervade CFT education and training, and be attended to on a continual basis. Using common parlance, individual differences should be a “dashboard” issue. The eyes of CFTs and relational supervisors should always be on it, and their professional thinking and conduct guided by it.

The training system is situated within a systemic understanding of the supervisory process. Training occurs in a large, multi-layered context that involves simultaneous responsibilities not only to trainees and client systems, but also to institutions and communities in which the training is being provided. Thus, one supervisory role is to facilitate the growth of trainees as professionals. However, there are at least two other supervisory roles, namely, teachers and gatekeepers (Goldenthal, 2000; Grant, 2000; Lee & Everett, 2004). Therefore, supervisors oversee the treatment process so that client families are well served and trainees learn the craft of therapy. They also monitor the administrative needs of institutions such as communities, accreditation and other regulatory bodies, and the professional fields of mental health therapy to ensure that the community is protected from harm.

Getting the Training Process Started

This book is meant to be solidly based in empirical and conceptual literature and readers will note that approach. However, this is first a pragmatic text and second, a beginning for students of CFT supervision. Doctoral students and others who are studying supervision as a field may note some deficits and will want to further engage with literature.

Pragmatically, supervisor candidates’ first steps should be to recognize their own philosophies of supervision, that is, their ideas about what they, as supervisors, believe about supervision and intend to do. These visions in turn must be attuned to those to whom they have obligations: their trainees, of course, but also to the units of the larger training system in which they and their trainees are situated. Rober (2010) suggested a process whereby new trainees attend to their “polyphony of inner voices” (pp. 158–159). Through an exercise of self-awareness, trainees become more conversant with themselves, particularly in four areas of concern: their ideas about clients’ process (listening), processing what they hear (making sense of the client’s story), focusing on their own experiences related to the clients’ stories, and then managing the therapeutic process. We suggest that a similar process for supervisors could be quite beneficial in terms of their relationships with their trainees.

Only at this point are supervisor candidates ready to engage trainees in a supervisory process. After reflecting upon one’s ideas about the purpose and goals of supervision as well as what you think is important in a supervisory process (your basic philosophy), a good next step is to begin to interview trainees, being careful to privilege that which trainees “know” about therapy, supervision, and themselves as therapists. New trainees may protest that they have no clinical experience and therefore “know” nothing about therapy. However, they have ideas about the purpose of therapy; they have had experience with work supervisors and professors, and they therefore have a sense of what can be helpful or detrimental in a supervisory process; and they have some ideas about who they might become as therapists. Some of these matters involve attitudes and style, and others, the mechanisms of the work as well as expectations for both supervisors and trainees.

Experienced trainees have been consumers of supervision and have clear ideas about what they have experienced as very helpful or less so (cf. Anderson, Schlossberg, & Rigazio-DiGilio, 2000). All—beginners and experienced trainees—have expectations of the training context, some good, some not so good, based on previous experiences with supervision. Beginning with an appreciative interview about lessons learned from life to date, especially in learning situations, is meant to safely elicit and address the anxiety most trainees feel at the inception of the first or a new episode of supervision. Such an approach involves common sense: increase the probability of desirable things happening, decrease the probability of undesirable things happening. This approach cultivates a sense of safety in the face of vulnerability, openness of the supervisor to the person of the trainee and self, reciprocal respect between the trainee and supervisor, and the importance of the working relationship. Where supervisors and trainees are not in agreement, the differences can be explored as stylistic or expectation differences, or for “baggage” that is relevant to the current setting and needs to be considered (barriers to effective supervision are addressed more in Chapter 14).

Responses from a national survey of trainees’ best and worst supervisory experiences (Anderson et al., 2000) suggest that most trainees might be reasonable in their expectations and their concerns quite valid, although some might attempt to use negative experiences to defend against anxieties and to tie supervisors’ hands (Menninger, 1968) or triangulate others. According to Anderson and colleagues, beneficial experiences reported by trainees involved an open supervisory environment characterized by positive communication and encouragement in which supervisors attended both to the personal growth of trainees and provided conceptual and technical guidance. Negative experiences with supervisors included continual interruptions and distractions, emphasis on weaknesses and shortcomings accompanied by negative evaluative comments, indirect and avoidant personal styles, and intolerance of divergent viewpoints. Explicitly understanding trainees’ past experiences through the appreciative interview facilitates beneficial opening conversations by cutting to the chase while reminding supervisors of the importance of interpersonal skills and helping the trainee understand and co-create a necessary level of safety in the current supervisory relationship.

An exercise taken from Cliff Sager (1994) can be very illuminating for trainees and supervisors alike and can be used in both individual and group supervision. Supervisors and trainees each take pieces of paper and fold them vertically in half. In the first column the supervisors list “all the things I expect from myself as a supervisor.” In the second column, supervisors list “all the things I expect from trainees.” Trainees concurrently make two lists: “all the things I expect of myself as a trainee” and “all the things I expect from a supervisor.” The trainees’ and supervisors’ lists are then compared. Sager observed that what one sees is a set of implicit contracts: “If I do this, I ought to get that.” An individual supervisor may feel that “if I do this as a supervisor (column 1), I ought to get that (column 2) from my trainees.” Trainees will expect that, if they do their own from column 1, they will receive from their own column 2. At issue is the extent to which the contracts of the supervisors and trainees are explicit and compatible. Are the supervisors’ expectations of self congruent with the trainees’ expectations of the supervisors? Are the supervisors’ expectations of the trainees harmonious with what they expect of themselves? Differences between these expectations need to be recognized and appreciatively explored.

To be sure, the constructive coming together of supervisors and trainees is a process that is not always easy, depending on a number of factors including how much choice is involved in the relationship. Supervisortrainee relatedness can be expected to range from immediate bonding to substantial reticence or even discord. Both extremes may prove challenging to the training relationship (see Chapter 14, Troubleshooting and Pragmatics in the Relational Training System). Chronic idealization on the part of the supervisor or the trainee, and a trainee’s dependency on the supervisor or excessive control by the supervisor may inhibit the trainee’s professional growth and autonomy. Trainees who do not trust the supervisor or supervisory process may not seek and accept direction, taking chances in therapy. Supervisors who do not trust the trainee or the supervisory context will likely lead to unhappy encounters that undermine the trainee’s self-confidence. However, after goals and expectations have been discussed and agreed on in a good-enough way, the supervisor’s next goal is to integrate his or her own ways of working and desired goals with those the trainees have expressed. We then encourage both supervisors and trainees to revisit these goals and expectations during the course of supervision, making adjustments and corrections as needed.

Paradoxically, in the midst of this process, a blending occurs even when the process is not collaborative and supervisors unilaterally indicate that the success of the training system is a product of non-negotiable, supervisor-established ground rules. However, some ground rules provide a contextual structure necessary for the trainee’s learning and growth: It is both safe and task-oriented. The transcendent rationale for ground rules is that effective supervision requires shared goals and enough of a relationship to support work on these goals as well as structure. Even in situations where supervisors’ philosophies place them in higher hierarchical positions, supervision succeeds when a structural coupling (Becvar & Becvar, 1999) or fit evolves. For example, one of the ground rules might be that trainees are responsible for managing difficulties, bringing them up in supervision as necessary. When the trainee complies, goals and processes are co-constructed; if the trainee does not comply, a new process ensues whereby the rule is explicitly or implicitly adjusted or the supervision relationship ends. Either way, a new system has been co-created. Similarly, there is the possibility that some of the trainee’s expectations are not negotiable and may be incompatible with the supervisor’s and vice versa. If such incompatibility exists where the relationship is dictated by the context (e.g., graduate program or postgraduate limitations), and the parties cannot agree on good-enough goals and rules, thus no fit, effective training cannot ensue without some intervention. Some ideas for this difficulty are presented later in this text.

Interdependent Fundamentals of Supervision of Relational Therapies

The context required for positive learning is comprised of a consistent and reasonable structure of which all members of the training system are fully aware and to which they freely commit, even when mandated. Although hierarchical to one degree or another, we believe that as much as possible, clinical training is best accomplished through an overt collaborative process, even when there are times the supervisor must be directive. There is ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Foreword
• Preface
• About the Authors
• Part I: Understanding the Supervisory Process: An Overview
• Part II: Relational Supervision Practices
• Part III: Contextual Considerations
• Part IV: Troubleshooting and Writing a Personal Philosophy of Supervision Paper
• Appendix
• References
• Author index
• Subject index