Empathy, Ethics, and Empowerment: Supervising the Transpersonal Therapist

Supervision is typically mandatory for therapists in training and plays an important role in their professional development. A number of qualitative studies have considered specific aspects of supervision. This systematic review aimed to synthesize these studies' findings and explore the experience and impact of supervision for trainee therapists. A systematic search of the literature was conducted, and inclusion/exclusion criteria were applied. This led to a sample of 15 qualitative studies, with which a meta-synthesis was conducted. The meta-synthesis led to four key concepts: supervision as a learning opportunity, the supervisory relationship, power in supervision and the impact of supervision. These themes explored helpful and unhelpful aspects of supervision, including some concerns regarding the evaluation of supervision. Supervision can effectively support trainee therapists in their personal and professional development. However, it can also lead to feelings of distress and self-doubt. Supervisors need to consider the power differential within supervision and attend to different factors within the supervisory relationship. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Supervision can encourage personal and professional development, but it can also have a detrimental impact on trainee therapists' well-being, and consequently their clinical work and clients' experiences. Supervisees may not disclose unhelpful events or impacts from supervision, for fear of negative evaluation. Evaluation of supervisors should be facilitated and encouraged, to maintain good practice.

The present article examines conflicts in the supervisory relationship from the supervisee's perspective. One hundred and fifty-eight graduate students in clinical psychology were surveyed concerning the occurrence, handling, and outcome of conflicts in their supervisory experiences. Thirty-eight percent of the students with supervised experience reported a major conflict with a supervisor, which made it difficult to learn from supervision. Trainees described three areas of conflict—theoretical orientation or therapeutic approach, style of supervision, or personality issues. The degree to which conflicts were discussed and successfully resolved seemed to depend partly on the type of conflict; it was easier to resolve conflicts that centered on style of supervision than on personality issues. When conflicts were not resolved, students often sought support from others, altered their behavior to conceal difficulties, or appeared to comply with the supervisor. The implications of these findings for the process in supervision are discussed. One of the most important elements in the training of a psychotherapist is the direct supervision of his or her clinical work. The knowledge acquired through books and classes provides the basis for therapeutic work, but the critical element is the more intensive, personal training provided by experienced supervisors. Supervision is more than simply a didactic experience in which the supervisor teaches the trainee. It is a complex interpersonal interaction subject to the vicissitudes of all human relationships. The importance of these interpersonal or relationship aspects of supervision to the quality of the experience has repeatedly been emphasized throughout the supervision literature. For example, Cohen and DeBetz (1977) stated that success in supervision depends on the quality of the relationship between supervisor and trainee, and Fleming and Benedek (1966) stressed the importance of establishing a learning alliance with the trainee, which they view as analogous to the therapeutic alliance. Indeed, one study found that trainees' perceptions of the quality of supervision were more strongly related to the interpersonal aspects of the relationship than to the content emphasized by the supervisor (Nash, 1975). A positive supervisory relationship characterized by good rapport, empathy, and respect appears to facilitate the trainee's receptivity to from the supervisor. Sources of tension in the, supervisory relationship have been discussed by numerous authors. For the most part, these discussions have highlighted problems that relate to personality dynamics and role definition, for example, personal issues or anxieties of the therapist in training (Fleming & Benedek, 1966; Langs, 1980; Mueller & Kell, 1972), need for dominance on the part of the supervisor (Robiner, 1982), and the dual role of supervisor as teacher and evaluator (Cohen & DeBetz, 1977; Hassenfeld & Sarris, 1978;,Kadushin, 1968; Robiner, 1982; Wolberg, 1977). Wolberg (1977) has also noted th^t conflicts may center around differences in orientation; that is, supervisor and supervisee may differ in theoretical orientation used in case conceptualization and treatment planning, in clinical methods and techniques, in use of terminology, and in the setting of psychotherapeutic goals. Numerous authors have stressed the importance of discussing conflicts in the su

Students bring skills gleaned from academic learning and any previous university clinic internship experiences to externship clinical placements. Speech-language pathologists (SLPs) in their personal work settings share their caseload, supervise, and guide these novice professionals as they advance their clinical skills in preparation for independent practice. Supervisors and student clinicians with varying skills, goals, and previous supervision experiences have expectations for these final placements that can impact the effectiveness of the supervisory relationship and experience. Educational theories indicate that a strong supervisory relationship is built on practices of modeling, active listening, and facilitative learning as students mature toward independent evidence-based practices and decisions, with supervisors that offer constructive feedback and encouragement. Supervisors should work to create an atmosphere that fosters trust and openness to promote the most effective supervisory relationship with their supervisees. An important component of an effective working relationship is to be aware of expectations and a willingness to adapt to varying and/or changing expectations. Increasing understanding of expectations will create an opportunity to exchange information and build a strong, effective supervisory relationship. An awareness of students' expectations and perceptions allows supervisors to target the students' needs and personalize guidance to facilitate maximum growth in clinical skills.

ObjectiveThe ability to form multiple learning relationships is a key element of the doctoral learning environment in the biomedical sciences. Of these relationships, that between student and supervisor has long been viewed as key. There are, however, limited data to describe the student perspective on what makes this relationship valuable. In the present study, we discuss the findings of semi-structured interviews with biomedical Ph.D. students from the United Kingdom and the United States to: i) determine if the learning relationships identified in an Australian biomedical Ph.D. cohort are also important in a larger international student cohort; and ii) improve our understanding of student perceptions of value in their supervisory relationships.Study Design32 students from two research intensive universities, one in the United Kingdom (n = 17), and one in the United States (n = 15) were recruited to participate in a semi-structured interview. Verbatim transcripts were transcribed, validated and analysed using a Miles and Huberman method for thematic analysis.ResultsStudents reported that relationships with other Ph.D. students, post-doctoral scientists and supervisors were all essential to their learning. Effective supervisory relationships were perceived as the primary source of high-level project guidance, intellectual support and confidence. Relationships with fellow students were viewed as essential for the provision of empathetic emotional support. Technical learning was facilitated, almost exclusively, by relationships with postdoctoral staff.ConclusionsThese data make two important contributions to the scholarship of doctoral education in the biomedical sciences. Firstly, they provide further evidence for the importance of multiple learning relationships in the biomedical doctorate. Secondly, they clarify the form of a ‘valued’ supervisory relationship from a student perspective. We conclude that biomedical doctoral programs should be designed to contain a minimum level of formalised structure to promote the development of multiple learning relationships that are perceived as key to student learning.

The supervisory relationship is one of the most important components in training therapists' professional development, and it is a frequent area of training-focused research. The current study explored how 57 training therapists' adult romantic attachments relate to the attachment to the supervisor and the supervisory working alliance. Additionally, we explored how both adult attachment and supervisory attachment relate to trainees' perceptions of their counseling self-efficacy (CSE). Results revealed that therapists with higher levels of fearful attachment to the supervisors and avoidant attachment in adult romantic relationships had less perceived CSE. Hierarchical regression revealed that it was the avoidant adult romantic attachment and the supervisory working alliance that accounted for the most significant variance in CSE, not the attachment to the supervisor. Path analysis using structural equation modeling was used to explore both the direct and indirect paths to CSE. When all variables were explored together, only the path from romantic attachment avoidance to fearful attachment to the supervisor was significant. Adult romantic attachment no longer directly related to CSE when including all the variables in the model. Implications of the findings will be discussed with regard to future research that is needed, the use of attachment-based supervisory interventions, and the application of the findings in clinical training.

While the interpersonal nature of the supervisory relationship in research degree supervision has been recognised and different models of supervisory styles have been developed, the research supervision literature has yet to acknowledge the relational individual differences and the relational dynamics that are at play within the supervisor-supervisee relationship. This paper draws on literature from the higher education, clinical supervision, and leadership fields and utilises attachment theory as a conceptual framework in an attempt to shed some light on the attachment processes and dynamics of the research supervisory relationship. The review of the evidence presented here clearly indicates the usefulness and applicability of attachment theory in the research supervision practice. This paper makes a contribution to the higher education and research supervision literature by offering new directions for research and by providing practical guidelines for the training of postgraduate research supervisors.

Evidence has shown that effective supervision is facilitated by a “safe” supervisory relationship. This fifth dimension of the IMS is also underpinned by developing knowledge about the neurobiology of relationship, which highlights the need to build trust between the supervisor and supervisee, and minimise perceived or actual threat. The guiding principle is that safety within an effective supervisory relationship is co-created and maintained by supervisor and supervisee. Proactive responses to address the emotional impact of the work are further developed in this chapter.

Feminist Supervision: Oxymoron or Redefinition of Power Many feminists working for feminist agencies that are hierarchically structured struggle with the issue of how to create an equitable workplace where power differentials between workers are minimised. Feminism in its very essence is about a redistribution of power. In their relationships with their supervisors, however, these workers often find themselves in a subordinate role. Much has been written about how feminist principles can be applied to the supervision process. No studies have been done, however, on how a hierarchical structure affects the supervisory relationship. This qualitative research looks at women's experience of such relationships within a hierarchical context. For this purpose I interviewed six women who identified themselves as feminists and who were employed by hierarchically structured agencies that saw themselves as subscribing to a feminist ideology. I also include my own experience in this area, since it is pertinent to the study and is one of the reasons I became interested in this issue. My Feminist Supervision: Oxymoron or Redefinition of Power By: Anne Spilker page ii September 2000 findings suggest that these workers' experiences varied greatly. What stood out most strongly was their desire for meaningful and effective relationships. Three main themes were developed from these interviews, each of which divided into a number of sub-themes. The main themes this study uncovered were (1) The varied ways these women experienced their supervisory relationships; (2) How they experienced the role of the supervisory relationship within the context of a hierarchical structure; and (3) What their experience revealed about what is needed to make such relationships function in more meaningful and constructive ways. This study attempts to begin a conversation about how supervisory relationships affect us as workers. I feel that this information is important to the field of Social Work, for how we are supervised impacts our effectiveness with our clients. Listening to the ones that have less power, I believe, makes a good beginning place. Feminist Supervision: Oxymoron or Redefinition of Power By: Anne Spilker page iii September 2000

In this case study research, we examine online supervision and engagements in a blended education doctorate (EdD) programme through a lens of relational trust. Interviews with supervisors and EdD graduates enabled us to examine practices and strategies used to cultivate relationships and learning alliances that supported doctoral candidates in conducting research and dissertation writing. We explored opportunities and challenges in fostering effective supervisory relationships online. Five enabling factors for cultivating effective online supervisory relationships address programme design, supervisors’ roles and responsibilities, and doctoral students’ experiences. Establishing relational trust and learning alliances in early and ongoing engagements in programme through to culminating milestones was vital for effective student-supervisor relationships.

This article seeks to demonstrage how self psychological concepts can be applied to the process of training psychotherapists in a variety of clinical and community settings. The author examines the role of clinical supervision in the development, consolidation, and maintenance of a cohesive professional self. The role of selfobject experience, needs, transference, and countertransference as manifested in the supervisory relationship is elaborated. Supervisor and supervisee form a self-selfobject unit, through which the trainee's anxieties and vulnerabilities can be managed. This selfobject matrix enables maintenance of self-esteem, expansion of cognitive understanding, and structure building in the arena of the professional self. To achieve these ends, the supervisor forms an empathic alliance with the internal, subjective experience of the therapist. The importance of focusing on the self experience and selfobject needs of the therapist in training via an empathic mode of observation is illustrated by several examples and vignettes. The application of theory to practice is emphasized, with examples chosen from a variety of clinical settings and modalities.

For family therapists in training, a key learning outcome is the development of reflexive abilities. This study explores the experience of three experienced training supervisors as they address this learning outcome with students. Transcripts of semi-structured interviews were analyzed using interpretative phenomenological analysis. The Supervisory Relationship emerged as a single overarching theme that contained and contextualized three further themes: Promoting Learning, Dimensions of Power, and The Self of the Supervisor. One theme is reported here, Promoting Learning, with an illustrative example of experiential learning in a student that demonstrates the overriding significance of The Supervisory Relationship. The findings are discussed in the context of current literature and research regarding supervision and training. This study adds richness and detail to material published on supervisory experience, and documents supervisory "micro-skills" relevant to the development of reflexive abilities in students.

In contrast to psychopharmacology and other predominantly biologically based treatment approaches in psychiatry, where testable hypotheses can, with relative ease, be generated and validated, (verbal) psychotherapy remains more art than science. The number of relevant variables is staggering in both patient and therapist alike. The privacy demanded in the psychotherapeutic setting contraindicates all but the rarest of intrusions by a third party. Psychotherapy, itself an experience of intimacy, can be taught only by analogy — in the supervisory situation, itself a variety of intimate encounter. Therapists in training are occasionally required to permit a supervisor to be present at a session, or perhaps to carry out a diagnostic or prognostic evaluation, in his/her role as consultant. No supervisor has ever been present, even sitting quietly in the background, throughout the length and breadth of an extensive psychotherapy. Even the videotaping of a ten- or fifteen-session-long “brief psychotherapy” does not create a record of the customary unwitnessed therapeutic encounter. The Heisenberg principle of the observer affecting the observed is nowhere more in operation than in the realm of psychotherapy supervision. Psychotherapy and observed psychotherapy are comparable — but they are not the same. Similarly, supervision in the one-to-one situation and supervision where two or more trainees are present in the supervisor’s office are also comparable, but they can never be the same.

Supervision of Psychotherapy and Counselling: Making a Place to Think • More Than a Mirror: How Clients Influence Therapists' Lives

This paper presents two original conceptual models to explain the triple transitions ofinternational doctoral students and how these can be facilitated better through effective supervisory relationships. These models are based on primary data collected by authors and well known theories, namely the ABC model, Emotional Intelligence and Resilience. The data suggest that when international doctoral students moved to the UK,they had to deal with not only a new educational system and different level of studies; they also had to deal with the daily life issues of being in a new country. These educational and daily life issues were not mutually exclusive and had an impact on each other. However, if one was going exceptionally well,it could act as a buffer for any problems in the other area. Transparent supervisory relationships, where mutual expectations were clear, were seen tobe an effective way of enhancing the transition experience of international doctoral students. This study is the first to explore the triple transitions ofinternational students. The Educational and Life Transitions (ELT) andSupervision Remit Compatibility (SuReCom) models are significant in ensuring successful transition and well-being of international doctoral students.

This chapter examines the key stages and associated issues in the development of a learning relationship that will provide the student with a supportive but challenging organisational context. The supervisory relationship is at the heart of field education. Supervision within fieldwork is a structured, interactive and collaborative process that involves monitoring, facilitating, coaching and supporting students during their fieldwork experience. Effective supervision of students involves a number of core tasks. While some of these fall outside any discussion of the supervisory relationship, a failure to attend to these activities impacts on an effective learning relationship. The student–educator relationship is embedded in a very complex context. Participants manage each other’s expectations alongside those of the agency, colleagues, management, clients and personnel from the teaching institution. The supervision session should be a time for open reflection in which the field educator facilitates the student’s journey through the learning cycle as they process the experiences encountered during fieldwork.