The Need for Safety in Clinical Supervision

Abstract

The Need for Safety in Clinical Supervision Robert S. Pepper1 issn 0362-4021 © 2018 Eastern Group Psychotherapy Society group, Vol. 42, No. 1, Spring 2018 55 1 Director of Training, Long Island Institute of Mental Health. Correspondence should be addressed to Robert S. Pepper, LCSW, CGP, PhD, 110-50 71st Road, #1E, Forest Hills, NY 11375. E-mail: DrRobertSPepper@aol.com. In preparation for my workshop at the Adelphi Conference on Clinical Supervision , I decided to focus most of the short session on my research (Pepper, 2014). This decision was based partly on the fact that I didn’t know beforehand the level of experience of workshop attendees, what their goals were for our workshop, or even how many participants had registered. I wanted all of us to be on the same page, so to speak, and thought that a brief lecture on my findings would be a good place to begin. My basic thesis is that, at many group training institutes across the country, there exists a conflict of interest between the organizations’ need to treat and their need to train. Independent of theoretical orientation, and the personalities of leaders , abuses of power often occur when the boundary is blurred between therapy and not-therapy. The need to treat is clinical, and the need to teach is educational. To combine both under the same roof contaminates both. Training institutes can’t have it both ways, because there are both ethical and clinical consequences to this blurring of boundaries. While this axiom applies to analytic institutes for individual psychotherapy as well as to institutes for analytic group therapy, the probability of treatment contamination is exponentially greater for analytic group institutes because of the increased likelihood of many different types of combinations and permutations of blurred boundaries in the group setting. But when some of the participants were incredulous that such things existed, finding it difficult to believe that teaching and training actually took place under one roof at some training institutes, I decided I had to change course and focused instead on the more general issue of the need for safety in the supervisory relationship . There was a consensus among the attendees that this would be a better place 56 pepper to start. While the audience consisted of a mix of clinicians with varying work experiences and levels of training, all were eager, bright, and inquisitive about the issue of secure boundaries. Despite their differences, the members were closely matched in their psychological sophistication. As a result, we were able to make a smooth conversational segue, since the keynote speaker of the conference’s opening plenary, Dr. Rebecca Shahmoon-Shanok, emphasized the importance of safety in the supervisor–supervisee relationship. I believe this a point well taken. I remember hearing Harville Hendrix say the same thing during a talk on couple therapy. He said that, more than anything else, couples report that they most value feeling safe in a relationship (Hendrix, 2013). Several attendees picked up on this thread and gave examples of instances where supervisors paid lip service to the need for safety but didn’t abide by it in their work. I supported this point and said that it never ceases to amaze me how bright, psychologically minded clinicians miss the obvious when it comes to examining their own behavior. There seems to be a blind spot in self-awareness. I’ll recount some excerpts from our workshop where participants shared their experiences with blurred boundaries in supervision. My role naturally evolved into an organic opportunity to link their examples to the eight dangers of blurred boundaries, which I describe in my book. For instance, Melinda2 gave an example of her supervisor, who, in the spirit of openness, shared a story of his own countertransference toward an intrusive patient, not realizing that he may have been part of the problem, inadvertently perhaps. Nonetheless, in the process of telling her the story, he may have revealed more about his dark side than he had consciously intended. The supervisor told Melinda that his practice was in his posh home, a Fifth Avenue brownstone. Sam, a workshop participant, said, “It sounds like he was bragging.” Would he have told Melinda where...