Are there parallel processes in psychotherapy supervision? An empirical examination.

Abstract

Parallel processes in supervision occur when (1) the therapist brings the interaction pattern that occurs between the therapist and client into supervision and enacts the same pattern but with the therapist trainee in the client's role, or (2) the trainee takes the interaction pattern in supervision back into the therapy session as the therapist, now enacting the supervisor's role. We examined these processes in the interactions of 17 therapy/supervision triads (i.e., supervisor, therapist/trainee, and client). Each session was rated for dominance and affiliation, and the similarity of these dimensions across equal status pairs (supervisor-therapist and trainee-client) was examined. It was hypothesized that if parallel process existed, there would be more similarity in dominance and affiliation between equal status pairs in contiguous sessions than would be true relative to general responses; the dominance and affiliation would be more closely matched than would be expected given general response tendencies. This was examined separately for each supervision triad using single-case randomization tests. Significant results were obtained for each dyad indicating the presence of parallel processes in each supervision triad. Additionally, the relation between parallel processes over the course of treatment and client outcome was examined using hierarchical Bayesian modeling. Results indicate that a positive client outcome was associated with increasing similarity of therapist behavior to the supervisor over time on both affiliation and dominance (increasing parallel process) and an inverted U pattern of high-low-high similarity of client behavior to trainee behavior over time. This study provides support for the existence of bidirectional parallel processes at the level of interpersonal interaction. Implications for therapist training and supervision are discussed.