Caractéristiques et limites de la supervision psychodynamique des thérapies du fonctionnement traumatique

Abstract

IntroductionPsychotherapy with traumatized people presents huge challenges for therapists that put them at risk for severe deleterious effects such as vicarious traumatization. Supervision is generally recommended to help them cope with these challenges and to prevent harmful effects for them and for their patients. However, few studies have investigated the specificities that would allow psychodynamic supervision of psychotherapy with traumatized people to achieve these aims. ObjectiveThis study sought to identify the distinctive features of this type of supervision and its potential protective effects. MethodSemi-structured interviews were conducted with six highly experienced supervisors in that field (M=25,8±7,2 years). ResultsA thematic analysis of the interviews suggests that the distinctive features of supervision derive directly from the particularities of patients’ traumatic functioning, i.e. their interpersonal rapport marked by hostility, and the horrific nature of the stories they tell. Supervisors thus identified as central to their work with their supervisees: paying close attention to the effects of trauma therapy on the supervisee; supporting the analysis of countertransference; distinguishing between supervising and treating the supervisee; encouraging personal therapy for the supervisee; and supporting their supervisee's clinical stance. They suggest that the supervisor's continuous concern for the supervisee's state could act as a protective factor, though ideally in conjunction with adjustments to the latter's professional and personal life. DiscussionExpanding on the results, we offer recommendations in the hope of better preparing supervisors and supervisees for this type of clinical work.