Psychotherapy Supervisors Research Articles

When one became four: A systemic approach to supervision

This article describes the respective and shared experiences of a systemic psychotherapy supervisor and three final year clinical psychology trainees.

Gabbard Explains Dos and Don'ts Of Teaching Psychotherapy

Gabbard Explains Dos and Don'ts Of Teaching Psychotherapy

The Making of A Psychiatrist

The Making of A Psychiatrist

Experiences of Group Culture and Patterns of Interaction in Psychotherapy Supervision Groups

Beginner supervisees (n = 84) and their psychotherapy supervisors who worked in 28 supervision groups in an academic training context participated in this study. SYMLOG self-ratings of actual and ideal experiences of the group interactions were collected at three measurement points: the beginning, middle, and end of the supervision. The main purpose was to examine group members' (supervisees and supervisors) experiences of patterns of polarization in terms of development of subgroups within the supervision group, and group culture in terms of flexibility. The results showed that, for the majority of groups, experiences of patterns of interaction, as measured at the three measurement points, involved changes in role functions or degree of polarization among group members. The group members tended to become slightly more satisfied with their informal roles and the group culture over time. Group members who experienced that the group interactions did not become more flexible also experienced that subgroups, characterized by Nurture or Dependency, had emerged in their groups. In conclusion, the significance of polarization patterns and flexibility was emphasized. A certain degree of opposition and conflict in the supervision group seemed to further development and flexibility in the group.

Boundaries in psychotherapy supervision.

This study examines the perceptions of trainees and supervisors on the boundaries of the supervisory relationship. A 19-item questionnaire about the appropriateness of the actions of a psychotherapy supervisor was completed by 43 supervisors and 52 trainees. It was distributed at Grand Rounds and mailed out to psychotherapy supervisors in the community. Generally, trainees and supervisors agreed about the boundaries of supervision. Only one item indicated a significant difference between trainees and supervisors. Trainees considered the discussion of sexual fantasies as less appropriate than did supervisors. Using factor analysis, two scales accounted for 66% of the common variance. Supervisors scored higher than trainees on scale 1 (F = 5.14, df = 1.92, p = .03) and women scored lower than men on scale 2 (F = 9.88, df = 1.92, p = .002). Scale 1, a set of items related to sexual topics, revealed a significant difference in supervisor/trainee response with supervisors considering discussion of sexual items as appropriate compared to trainees. Scale 2, a set of items related to self-disclosure, revealed a significant difference with male respondents favoring looser boundaries and more self-disclosure than female respondents. The boundaries of the supervisory relationship are important concerns for our profession. This is the first study to provide an empirical evaluation of perceptions of trainees and supervisors on aspects of boundaries in the supervisory relationship. If the findings are replicated, they could contribute to future analysis of trainee/supervisor relationships. The maintenance of good boundaries between trainees and supervisors is crucial to the integrity of the supervisory relationship.

The Developmental Process of Clinical Supervisors in Training: An Investigation of the Supervisor Complexity Model

The authors investigated C. E. Watkins's (1994) supervisor complexity model (SCM). The Psychotherapy Supervisor Development Scale (PSDS; C. E. Watkins, L. J. Schneider, J. Haynes, & R. Nieberding, 1995) was used to ascertain development over a 15‐week supervision practicum for 12 doctoral students and to compare their development with 7 doctoral students who had not yet begun their practicums. A set of retrospective interview questions produced responses that were used to investigate the viability of the 4 proposed discrete developmental stages in the SCM. The PSDS findings are congruent with theory. The retrospective interview findings, although interesting, are less definitive. Recommendations for research and training are presented.

The Group in Psychotherapy Supervision

The present study was carried out with the aim of exploring the dynamics and significance of the group in psychotherapy supervision. Students in four supervision groups, representing extreme group climates, were interviewed in the first sub-study. In the second sub-study a questionnaire was used to ask ten psychotherapy supervisors in the training programme about their experiences of the group climates presented. Both students and supervisors reported that factors related to the individual and group constellation exerted a decisive influence on the group climate. The importance of group interventions which affected the group climate was also emphasised. The group dynamics were central to the supervision experience and remained as an intensive experience long after the conclusion of supervision.

Psychotherapy Supervisor Training: Differences Between Psychiatry and Other Mental Health Disciplines

Supervisors and residents spend a significant amount of time and effort in psychotherapy supervision, yet receive little or no training in how to supervise. No specific requirements for supervision training exist in psychiatry or social work programs. Accredited graduate programs in professional psychology are required to expose students to supervision. The field of psychoanalysis has some requirements for being a supervisor, but not any specific training for supervisors. In contrast, the American Association of Marital and Family Therapy (AAMFT) requires extensive training for its supervisors, which is described. The authors explore the reasons for the absence of requirements in psychiatry. Regardless of the number of requirements, all disciplines show a striking paucity of empirically-based research in supervision training. Authors discuss the deleterious consequences of the lack of both research and supervisory training requirements and propose critical elements for supervision training and research.

The Necessity of Continuing Education for Psychotherapy Supervisors

Over the past decade, the practice of neurobiology has come to dominate hospital-based psychotherapy, and the teaching of psychotherapy has become marginalized in psychiatry residency programs across the country. As a result, psychotherapy supervisors must play an increasingly important role in maintaining the viability of this discipline. Moreover, because the supervisory relationship is the main way that trainees develop their identity as psychotherapists, supervisors’ development of knowledge and skill is critical to their role as mentor. The authors describe a symposium and lecture series for trainee supervisors that enabled them to come together and offer a forum for a lively exchange of ideas and information.

Supervisor countertransference: A qualitative investigation into its identification and description.

Interviews were conducted with 11 psychotherapy supervisors about an experience of supervisor countertransference with a predoctoral intern. On the basis of a qualitative analysis, results revealed that supervisor countertransference manifestations consisted of affective (e.g., emotional distress), cognitive (e.g., questioning one's own competence), and behavioral (e.g., disengagement) components. Sources of supervisor countertransference always included both the intern's interpersonal style and the supervisor's unresolved personal issues and at times pertained to intern-supervision environment interactions, problematic client-intern interactions, intern-supervisor interactions, and supervisor-supervision environment interactions. Supervisors typically believed their supervisor countertransference initially weakened but eventually strengthened the supervisory relationship. Most supervisors managed their supervisor countertransference reaction by talking with colleagues, and most acknowledged they had received little or no training in addressing supervisor countertransference issues with trainees.

The Beginning Psychotherapy Supervisor

Learning to become an effective psychotherapy supervisor has been recognized as a difficult, trying task. Because the role is demanding and challenging, those new to it can have particular problems, crises, and concerns with which to cope. As a means of helping new supervisors make yet another professional transition, three issues are subsequently discussed as being important: (a) training institute or programmatic hold; (b) the training institute or program as gatekeeper; and (c) the provision of supervision for new supervisors. Those issues are discussed as being vital to the care and optimal development of the new psychotherapy supervisor.

Sexual Excitement in Therapeutic Relationships

All therapists at some point struggle with sexual and loving feelings in therapy relationships. Due to the absence of core curriculum on the resultant treatment issues, the psychotherapy supervisor or consultant may be the primary clinical teacher around these complex clinical situations. A safe, shame-free, trustworthy supervisory relationship provides the arena for open dialogue, self-revelation, and deep clinical exploration of these issues.

PSYCHOTHERAPY SUPERVISION FACE‐TO‐FACE AND BY VIDEO CONFERENCING: A COMPARATIVE STUDY

ABSTRACT A shortage in qualified psychotherapy supervisors in rural Norway motivated a study evaluating the quality of the supervision process when supervisors and trainees communicated by interactive audiovisual videoconferencing (VC). Six trainee and supervisor pairs participated in five alternating VC based and face‐to‐face sessions. The pairs had previously established a good face‐to‐face relationship. Self‐report data of the quality of communication, the alliance and disturbing elements in the supervision sessions were collected from specially designed questionnaires completed after each session. Independent ratings of the videotaped sessions and qualitative interviews conducted at the end of the study were also conducted. The only significant difference between the two conditions was that trainees scored higher on disturbing factors under VC conditions. Recommendations for use of VC are provided in light of the findings.

Further Validation of the Psychotherapy Supervisor Development Scale

ABSTRACT Clinical supervisors “oversee” client care and transmit skills and knowledge of the profession to the next generation of psychologists. Given the large impact that supervisors have on trainees and clients, it seems practical to expand our knowledge about supervisor development. The purpose of this study was to estimate temporal stability, internal consistency, interrater reliability, and concurrent validity of the Psychotherapy Supervisor Development Scale (PSDS), a theory-driven measure of supervisor development. Findings support the PSDS as a general assessment of supervisor development with highly homogenous items capable of yielding stable scores across a four week time period. A moderate relation was found between supervision theory complexity and complexity level as reflected in overall PSDS scores.

Contemporary Approaches to the Supervision of Psychotherapy

ABSTRACT The last two decades in the history of psychotherapy supervision are briefly described, placing the contributions in historical context. The issues raised by the authors are discussed, followed by an agenda for the development of psychotherapy supervision. The first agenda item concerns the preeminence of the root metaphor of the relationship in developing a theory of psychotherapy supervision. Then the need for empiricll foundations is discussed in terms of measuring supervisee and supervisor performance, determining the nature of the supervisory process, and assessing whether the patient is better served by the psychotherapist who has been supervised. Finally, the advantages and problems with the certification of psychotherapy supervisors are considered.

Psychotherapy Supervision

Psychotherapy supervision remains a crucial element in psychiatric residency training. The rapidly changing health care system is forcing supervisors to explore new methods of psychotherapy training. Supervisors must contend with decreased time for supervision, increased numbers of patients per resident, and patient cases that turn over more quickly. All of these changes require a more efficient and effective method of psychotherapy supervision. The authors propose a method that provides the psychiatry resident two supervisors for the price of one, that is, the psychotherapy supervisor and the resident himself or herself The authors detail the use of this method and present its potential advantages and difficulties.

On the Future of Psychotherapy Supervision in Psychiatry

Because psychotherapy supervision skills are learned primarily through experience as a psychotherapy supervisee, today's diminished training in psychodynamic psychotherapy can negatively influence future instruction in this important treatment modality. The author discusses role preparation for psychotherapy supervisors, suggests minimum standards for supervisor proficiency, and recommends ongoing instructional skills training.

Researching Psychotherapy Supervisor Development:

Preview: [Previous research and analysis in clinical supervision (i.e., the psychotherapy supervisee/supervisor dyad) can be used to inform our thinking about psychotherapy supervisor development and the supervision of psychotherapy supervisors (i.e., the supervisor trainee/supervisor dyad). In this paper, four issues are discussed: developmental level, methodology and methods, multi-factor, interactional designs and self-criticality. Each of these concerns is considered vital to address if understanding of the research into psychotherapy supervisor development is to most fruitfully advance.

Measuring Psychotherapy Supervisor Development:

As a topic of inquiry, supervisor development (i.e., the process of growth that supervisors experience in actually becoming a supervisor) has received limited research attention. The absence of a theory-driven instrument, designed to assess supervisor can be seen as one reason for this. In this paper, we describe an initial effort to generate and validate a theory-driven scale-the Psychotherapy Supervisor Development Scale (PSDS)- that could be used to assess supervisor development. The results of our study led to an 18-item scale (a) that provided a total score (but no subscale scores) reflecting psychotherapy supervisor development, (b) that had good (alpha) reliability (.90), and (c) that discriminated between supervisors at different levels of experience. While further validation work on the PSDS is needed, our initial findings suggest that the scale possessed adequate (alpha) reliability, (content) validity, and could be used for research purposes (in stud...

Experiences and Issues in the Professional Development of Psychiatrists for Supervising Psychotherapy

This study explores the role preparation and the professional development of psychiatrists who supervise psychotherapy. Three groups of psychiatrist psychotherapy supervisors were asked about stressors in supervising, their preparation for their role, their familiarity with supervision principles, supervisee developmental stages, and psychotherapy supervision literature, differences between new and experienced supervisors, continuing education interests, and the benefits of the course on instruction in psychotherapy in which they all participated. The usable response rate was 33%. Findings included new supervisor insecurity about technique and knowledge, ongoing concern about knowledge, and limited awareness of instructional components of the supervisory process among all respondents. Enthusiasm for psychotherapy supervision as an instructional mode was palpable, however. Supervisor preparation was based primarily on experience as a supervisee. Because of the diminishing resident exposure to psychodynamic...