A Different Wisdom: Reflections on Supervision Practice: Guide to Supervision

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Britain has a fine tradition of writing about supervision practice. This book connects to this by organising reflection around the practice taken from the author's sixteen years experience as a practitioner. Taking three broad sets of tasks of supervision as an organising frame, the book weaves examples of professional experience with current research and other reflective writing. From a broadly humanistic perspective, it examines the developmental journey of a supervisor interested in the overlap of the personal and the professional.

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CHAPTER ONE: Building a strong foundation

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“What we think we are coming for is not always what we need”

(Hewson, 1999, p. 77)

Contracts for supervision involve negotiation. Negotiated contracts create and sustain working agreements to suit both parties as they begin a relationship, or as they begin a session, and even as they change tack in the midst of a piece of work. For each eventuality the aim is to clarify whatever is necessary in connection with expectations, roles, and responsibilities, preferred methodology and desired outcomes. A new working relationship involves getting to know each other, to begin to build the trusting base for safety.

If the parties are willing to discuss their prior assumptions and hopes or fears, this can reduce the arena of undeclared expectations. Discovering how a supervisee chose me or was allocated to me, who made a recommendation, or in what other environments we may have met, sometimes hinted at items for further exploration about our hopes or fears as we began.

As the years go by and practitioners work with a series of supervisors, each may become more and more clear about what they do or do not want, and therefore more confident in negotiating about it. Flexibility is desirable, and, as the need for focus changes in a session, the existence of an explicit agenda and agreement for what the supervisee wants makes this more obvious. A review at the end of a session about what were the most and least helpful exchanges in the session highlights differing perceptions and gives feedback to the supervisor, and performs a really valuable shared monitoring function. A report of supervision research that made this enquiry (West & Clark, 2004) so impressed me that I arranged to include this in my future sessions as supervisor and supervisee.

 

CHAPTER TWO: Beginning as a supervisor

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“Practice prepares the mind, but suffering prepares the heart”

(Remen, 2000)

Ibegan supervising when requested by a local voluntary agency with only a day's training for the role, occasional attendance at conference workshops, and a little reading under my belt. My own supervisors were my models, and yet I made many naïve assumptions. I read early work by Inskipp and Proctor (a tapes and booklet resource now unavailable) and began confidently to negotiate administrative contracts about how we would work together: where, when, how often, and for what fee. We explored whether I was to be the only supervisor, and, if so, what my responsibilities were. We agreed other normative elements such as whether reports would be necessary, which ethical code or framework we each used, and what I would do if I became concerned about the supervisee's practice. I learned to negotiate a more psychological contract by experience that was sometimes difficult for myself or my supervisees, or both of us. Some lessons were about my own style and personality and the way these affected my supervisory style. In particular, there were hard lessons about the skills necessary for creating a safe, boundaried relationship in which I could take authority without slipping into oppressive behaviour.

 

CHAPTER THREE: Relationship climates

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“See how the golden groves around me smile,_
That shun the coast of Britain's stormy isle,
Or, when transplanted and preserved with care,
Curse the cold clime and starve in northern air.
Here kindly warmth their mounting juice ferments
To nobler tastes and more exalted scents”

(Addison, 1704)

Iam interested in the emotional tone of supervision, what the chemistry might be between people with different emotional styles in order to achieve an enabling supervisory environment. I describe these simply as warmth or coolness, though more complex analyses are available and discussed briefly below. I am curious about how the matches between the supervisor's and supervisee's styles make different supervision relationships work, and use ideas from Myers-Briggs and attachment theory to think about the issues.

A supervisory alliance may be built from, and work within, a comfort zone of shared style, or function as a bridge between different styles. Bonding with someone similar may initially seem easier, but bridging could be more productive in the end. Bridging skills include immediacy so either can make comments to check out the intentions or meaning of the other, and a curious interest in difference. I make my personal preference for warmth explicit, and I hope that does not wholly distort this discussion, as I am interested in all the variations of relationship, and, in particular, in the opportunities which arise from differences in professional style and theoretical modality, class, race, age, sexuality, and so on. Here, I focus on emotional temperature, but this intertwines with cultural norms and differences and the developmental stage of the supervisee. I am also conscious that differences can, unhelpfully, lead to abuse of power by either party.

 

CHAPTER FOUR: Encouraging resilience

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“Life isn't about how to survive the storm, but how to dance in the rain”

(Anon)

Resilience is all about positive engagement with adversity and sustaining competence with consistency when under stress. It is about accessing the range of emotions being experienced, rather than denial. It is about learning to put attention on to positive emotions and to buffer the self from being overwhelmed by painful ones. Counsellors and supervisors take it for granted that they will be working in a context of high, even occasionally overwhelming, emotional demands. These demands can have an overwhelming quality because it is difficult to control the quantity of approaches from clients or supervisees on any one day in work settings designed to be responsive to needs. But that is not all. The quality of the interaction is very often draining, as people who are stuck, scared, angry, sad, or in pain come for aid. It is a truism that those of us who are drawn to work as therapists have our own shadow and pain to address as an important part of becoming and remaining able to do this work. I am interested in describing the supervisor's role with counsellors who are vulnerable, or might become stressed. I call on the wounded healer archetype explored further in the next chapter while discussing how to support and sustain maximum resilience through supervision that enables counsellors to stay in touch with self-esteem and make good use of this external social support.

 

CHAPTER FIVE: Vulnerability

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“It's not ‘if, it's ‘when’ and ‘how bad'!”

(Mountaineers’ T-shirt slogan)

It is essential to be able to speak about fear about vulnerability as a practitioner, while also noticing one's resources, capabilities, and potential. Vulnerability arises from personal life events and the meaning we attribute to them, and thus needs to be mentioned in supervision, to discuss what is “really” happening in relation to the counsellor's resilience. It is useful to routinely ask: Is s/he blooming or wilting?

Shohet (2008) quotes Carroll (2001a, p. 77):

It is possible that a supervisory attitude, viewing supervision as a reflective process that allows participants to think deeply and vulnerably about life and values, work and career, relationship and connections, might make an immense difference to how participants live.

Good supervision does this, and values that attitude. It also attends to the social and cultural context in relation to mental health so that it does not pathologize the individual supervisee or client. In 2009, most counsellors, especially female trainees, are “time poor”. If employed elsewhere while training, they might be subject to the fears of short-term contracts, work intensification, redundancy or job losses, working in institutions where counselling values are not shared, and training for a profession where more people are trained than there are jobs available. Doing triple shifts as a working parent who is also training creates practical, financial, and emotional demands and hurdles. Trainees and newly qualified counsellors face a long period of volunteering to “get hours”, sometimes in highly exploitative contexts that do not employ them once they have become accredited, because organizational structures are based on volunteering. Some will also be preoccupied with global warming and the future of the planet, and Weaver (2005) describes how denial and splitting at many different levels can be explored in supervision in relation to engagement with interdependence and sustainable living.

 

CHAPTER SIX: Learning from supervision

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One reason to have supervision throughout a professional working life is that it feeds the practitioners involved. Some supervision sessions are three-course meals, others a smorgasbord of possibilities. Some are too rich to digest immediately, and require a period of quiet reflection, or journal writing, or further work to assimilate. Some, inevitably, do not suit the digestion of the recipient, and go the way of all flesh. The possibility is there at every stage of improving the practitioner's understanding and offering a different perspective that frees the work. Both the supervisor and the supervisee should—in an ideal world—come away from each session having chewed over some dilemma, thought something new, or said something different, or understood something more clearly, or felt something more authentically. That is, they are changed, and can grow from the space to reflect and learn. This requires time for preparation beforehand, and time to consolidate afterwards, and the courage to meet, being willing to go where the process takes us.

 

CHAPTER SEVEN: Developing a supervisory style

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“It is not possible to be intimate without also relinquishing the desire to control or being controlled—yet issues of control and power dominate our inner and outer lives—and are configured at the heart of our individuality. If control is more important than the desire for connection, you may only connect with those to whom you feel superior”

(Dowrick, 1992, p. 196)

The components of a supervisory style are complex in origin and subtle in expression. Most people are highly influenced by the style of their early supervisors, and if these people were helpful and encouraging, this can provide powerful modelling of how to be as a supervisor. When the relationship is damaging, the supervisee might make reactive resolutions about how not to be. Trainers and colleagues on counsellor or supervisor training courses may also be taken as models, so students who are treated ethically and with respect learn by this experience. It is particularly useful to observe others offering “live supervision” at conferences or during group supervision. DVD and video resources are rare, but, where they exist, also hold opportunities to see how others do the work.

 

CHAPTER EIGHT: Developing the “internal supervisor”

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“We don't see things as they are, we see them as we are”

(Nin, quoted in Epstein, 1999, p. 834)

The phrase “internal supervisor” is Patrick Casement's (1985). However, there are roots and connections to the ideas of Shon (1983, 1987), Bolton (2001), and many others who have developed the ideas of reflective practice. There is a value in monitoring our experience during the counselling session, taking time to reflect afterwards, using a variety of methods to increase personal sensitivity in the work. The supervisor's role is to assist supervisees to develop, with awareness, an internal encouraging voice that is also disciplined and rigorous about looking at practice.

It is essential to recall that many, if not most, counselling sessions are never discussed in supervision after training is complete, except where people have tiny caseloads. Thus, the development of the “internal supervisor” of the counsellor is essential for ethical work. Reflective practice is at the heart of our profession, and it behoves us all to take time to think about every client for ourselves. I find early morning swimming useful, as I sink into the rhythmical activity and my mind is free to process the work of the previous day. Others speak of walking the dog, watering the garden, and cycling to work as offering a similar space. Working lives are so pressured these days that the discipline of protecting a reflective space can be very hard to sustain, especially in the early years of work when building a practice.

 

CHAPTER NINE: Creative supervision

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“After all, Creativity is the flame of life”

(Lahad, 2000, p. 119)

This chapter is a marker of a major journey for me as a counsellor and supervisor. I nearly did not include it in this book, because I had a view of myself as handicapped in expressing my creativity in artistic ways by my education and personal style. My confidence increased as I understood that creative issues and approaches relate to ideas about the right side of the brain, and affect many processes, such as understanding metaphors, reading faces, expressing and reading emotions, music, and global holistic processing. These approaches free the juices. They bring liveliness and enjoyment to supervision. They create opportunities to engage imaginatively with the client. They also facilitate the therapeutic task within supervision, as many creative methods focus primarily on the reactions of the supervisee. A bedrock of careful contracting and respectful awareness of the supervisee's privacy and safety are the core to this way of working.

 

CHAPTER TEN: Taking supervisory authority

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“On the one hand the supervisor is working within a process that enables discovery, and on the other, is needing to maintain their own observing ego and hold an authority that emanates from experience and expertise. As in all balancing acts there is a danger of collapse to either extreme….. A working alliance, therefore depends as much on the internal attitude of the supervisor as it does on the supervisee.”

(Driver & Martin, 2002, pp. 54–55)

The central value of supervision is about creating a trusting working alliance. It requires courage and skill to take an authoritative stance. “Taking supervisory authority” involves learning to take authority without being authoritarian. This applies normally in relation to boundaries and a frame for the work, and in the more unusual, emotionally charged experiences when something is going wrong.

Challenge can create feelings of shame and exposure for the supervisee, or anxiety for the supervisor. The exploration of unconscious processes can mean that the supervisee feels that they lack control over what is seen by the supervisor, even when they are intending to take control over what they bring.

 

CHAPTER ELEVEN: Coping with ethical dilemmas

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“Our duty is to do what is right; but as a practical matter, we would just as soon have things turn out as well as possible”

(www.friesian.com/dilemma.html)

We do not speak often enough about how counselling can do harm. It can, and Lambert's research (2005) suggested that 8% of clients in his USA study got worse as a result of a counselling experience. Whatever the actual number in an individual's workload, engaging with the possibility of doing harm means that the supervisor has a role to help with this issue. This can occur through discussions about assessment to help identify clients at risk, and through reflection on practice to share the monitoring of the counsellor's work and resilience, and the client's process and outcome, as far as these can be reasonably known without ever meeting the client.

The normative function of supervision (Inskipp & Proctor, 1995) derives from these ethical or managerial responsibilities. The aim is to protect the client from malpractice and poor practice, to protect the reputation of the profession, and to aid the supervisee in processes of reflection and self-care. This might sound dull and dutiful, but in many ways it is the most interesting and challenging part of the work of a supervisor, as each party wrestles with ethical dilemmas without obvious or easy solutions.

 

CHAPTER TWELVE: Mistakes and complaints

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“Mistakes and failures are integral to the practice of psychotherapy and counselling because they are integral to life. In both life and therapy, mistakes are invaluable because they bring us up against reality—force us to recognise what is real rather than what we imagine, fear or hope for”

(Totton, 1997, p. 319)

This chapter has understanding of shame and fear at the core, and encourages both counsellors and supervisors to explore mistakes in supervision, whether these are made intentionally, unintentionally, or unconsciously. The uncomfortable work required to rebuild a working alliance after the exploration of a major mistake asks a lot from both parties. Fear of complaint has an impact on practice, and the consequent risks of defensive practice can affect every practitioner at some moments. Some useful fear is instilled by training, which sets out boundaries and appropriate behaviour, and during the transition from a trainee status to taking full responsibility for our own practice. We tread the line between being rule bounded and, therefore, sometimes being less genuine in our relationships to avoid risk of offence, or doing our best at the time, and trusting inner wisdom with awareness that it could lead us astray.

 

CHAPTER THIRTEEN: Giving references and writing reports

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“It takes a diplomatic use of language to indicate that a strength may also be a weakness, and an intuitive ability is absolutely essential to foresee the development of potential into actuality, or what is commonly called the blossoming factor”

(Mander, 2002, p. 43)

It is not easy to form a fair view of an individual that takes into account interactions of their confidence and competence, and the standards required of them at each stage of their development and working practice. Some issues of power and collegiality, transparency and integrity are implicit in the processes of writing about supervisees. A report writer can choose to be either explicit or ambiguous. Putting pen to paper on behalf of another is an opportunity to endorse their work wholeheartedly, or face moral dilemmas about how honest and specific to be about reservations. Supervisors complete many references and reports for trainees, or those about to undertake further training, seek a job, or apply for accreditation or, until recently, re-accreditation. In reality, referring clients to a supervisee is also an active form of reference, reflecting a good opinion of their practice. Some organizations involve supervisors in annual appraisals of supervisees that are then used within the organization for planning training or considering the future of the counsellor and the organization. Writing a letter of support when a supervisee has been complained against is also an invitation to contribute to accountability in the profession. I have been surprised to discover that some supervisors charge for many of these reports. It seems to me to be part of the core role of the supervisor to supply such written feedback to and about the supervisee when requested.

 

CHAPTER FOURTEEN: Becoming more experienced as a supervisor

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“Then she began to tell me a story about an old man who is walking along a beach at low tide, picking up starfish drying in the sun and gently throwing them back into the ocean. He has been doing this for some time when a jogger overtakes him and asks him what he is doing. The old man explains that the starfish will die in the sun and so he is throwing them back into the ocean. Astounded, the young man begins to laugh: ‘Why, old fellow, don't waste your time. Can't you see there are hundreds and hundreds of starfish on this beach? And thousands of beaches in this world? And another low tide tomorrow? What makes you think you can make a difference?’ And still laughing, he runs on down the beach.

The old man looks after him for a long while. Then he walks on and before long passes another starfish. Stooping, he picks it up and looks at it thoughtfully. Then, gently, he throws it back into the ocean. ‘Made a difference to that one,’ he says to himself”

(Remen, 2000, pp. 273–274)

Supervisors advertise themselves as experienced after supervising for between three years and twenty, according to experienced supervisors participating in a workshop about the topic. Many people survive a critical incident, and at this point claim to be experienced because they have learnt from it. Within this span of years, some common career developments occur. The balance of time spent on supervising may change, as more people seek supervision with a supervisor who develops a reputation. There may be extensions of experience from one-to-one to group supervision, or between supervising, training, or consulting. Special interests and expertise may emerge, about a context, a client group, a problem, or a modality. With experience and confidence might come more clarity about role, task, functions, and boundaries. Increasingly, as more post-graduate courses have become available, some experienced practitioners will now decide to take a further degree, and do some research in the process. Invitations to be part of working groups in a professional body or a local context might increase.

 

CHAPTER FIFTEEN: Bereavement and the supervisory relationship: working in the landscape of loss

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“Your joy is your sorrow unmasked.
And the selfsame well from which your laughter
Rises was oftentimes filled with your tears.
And how else can it be?
The deeper that sorrow carves into your being, the more joy you can contain …
Some of you say, ‘joy is greater than sorrow’ and others say, ‘Nay, sorrow is the greater.’
But I say unto you, they are inseparable.
Together they come, and when one sits alone with
You at your board, remember the other is asleep
Upon your bed.”

(Gibran, 1926)

Bereavement and loss play a notable part in supervision not only because it is often a factor in a client's story but also because it is a part of life and therefore it can be relevant to any or all of the three parties involved. As soon as there is bereavement in the room, death is also there, and it reminds us that we all must die, and that all lives contain many losses. Each individual survivor finds unique solutions. I think of it like a kite in the air with a tail on which each bow is another loss. Some people's kites have long tails. Some supervisees are private about their stories and do not wish to examine them much in supervision, yet these tails will influence their reactions to both personal and professional losses. This reveals a classic boundary between supervision and therapy, where the supervisor has to find a way to acknowledge difficulties, explore necessary issues in relation to clients without prying. My experience is that some supervisees may connect with their strong feelings when treated empathically. My underlying general belief is that personal growth and gain do occur through suffering, through heightened existential awareness. Bereavement is known to act as a catalyst, and to be one way in to awareness of underlying psychological issues and attachment patterns. Sharing a narrative of loss, with its associated constructs and feelings offers opportunities to understand and make sense of grief, and of life, and also to ease the loneliness of the experience. When these issues are triggered by the work, or by a major loss for the supervisor or the supervisee, supervision should attend to it.

 

CHAPTER SIXTEEN: Supervision of brief counselling

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“Nothing in my twelve years of supervising long-term psychodynamic work, in groups and individually, prepared me for the task of supervising counsellors doing brief and time limited work”

(Mander, 2002a)

Ibegan supervising brief, time-limited work in the 1990s, though from a different theoretical orientation from Mander, having developed interests in solution-focused counselling and then supervision. At this time brief work was new to a majority of practitioners, and often seen as second best by those trained to do open-ended and long-term counselling, and supervise this. We had to develop ideas and practice to fit the new potential and limits of brief work. Some earlier workers (Talmon [1990], for instance) had advocated single session therapy as the only reliable way to work, since many clients only come for one session.

Brief work has become a norm for counsellors who work in settings where someone other than the client pays for the service. The dominant counselling contracts in primary care and universities, employee assistance programmes (EAPs), and some voluntary contexts are often for up to six sessions, sometimes only four. Mander (1998, 2002a) usefully reminds us of the likelihood, given funding pressures, that clients from deprived backgrounds and other cultures will find their way into counselling within brief contracts, even when their needs are complex. Multi-cultural sensitivity in supervisor and supervisee is a crucial prerequisite for this work. A shared interest in public service and organizational dynamics will create a more encouraging environment for supervision than one where the supervisor undermines counsellor confidence by over-emphasis on the negative potential of limited time.

 

CHAPTER SEVENTEEN: Endings and retirement

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In private practice supervision, external pressures to end with a I particular supervisee are absent unless one party or the other is completing a course or placement, or changing work or moving, or is dissatisfied. Long-term supervisory relationships can become significant emotional attachments for both parties. A change of supervisor may be a time to acknowledge the relationship, and also has to include thought about any potential impact on clients, some feedback or review of the development of the supervisee, and attention to any necessary administrative tasks associated with training, or membership of or accreditation by a professional body.

Any professional ending may be usefully viewed through ideas about attachment and loss, and Worden's “tasks of mourning” can be adapted to professional endings (Worden, 1983). Thus, the supervisor and supervisee can expect to acknowledge the specific reality of the ending of their unique relationship, articulate feelings and work through them, come to terms with the responsibilities, roles, or tasks in moving to a new supervisor, and the supervisee can then invest emotionally in the new relationship.

 

CHAPTER EIGHTEEN: Consultative supervision for supervisors

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“Experienced practitioners never lose their doubts, but learn to work with them and despite them”

(Jacobs, 2000, p. 202)

Supervision of supervision is a consultancy process. It supports an experienced colleague or group of colleagues to develop and reflect on supervisory styles, and monitor work, especially any parts that create anxiety. For simplicity, and to clarify that no responsibility is taken for direct work with clients, I will call it consultative supervision. Clinical governance and a baseline legal knowledge form an essential foundation, and facilitative skills and expert knowledge both play a part.

Group consultative supervision is particularly useful because it provides multiple perspectives for problem solving and for feedback. Often the focus is about themes and general principles or professional or ethical issues. Because group members are all experienced practitioners, any variety in their responses can be particularly useful to identify parallel process or to debate complicated and multi-faceted dilemmas.

 

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