A Research Report: A Qualitative Investigation into Pre Accredited Supervisees Reasons for Choosing Their Supervisor

by Annie Sampson

As a trainer of psychotherapists I have a particular interest in the development of the newly graduated, pre accredited psychotherapist. As a supervisor I am involved in the ongoing development and learning of this group of psychotherapists. When meeting a pre accredited supervisee for the first time, I always asked, “why choose me as your supervisor”? The answer invariably was “you’re available, accessible and it’s really hard to get a supervisor”. During 2007, as part of a Masters course, I had the opportunity to carry out a small scale qualitative research project so I decided to pursue this question of why pre accredited supervisees choose their supervisor. The answers to the question are more complex than being available and accessible and show the needs pre accredited supervisees have of supervision and their supervisor.

The research project.

To begin to address the question of why pre accredited supervisees choose their supervisors I selected six participants, all recently graduated from professional training courses who were interviewed about their reasons for choosing their supervisors. Analysis of the resulting interview transcripts were not conclusive but point to a number of factors which affect the choosing of a supervisor for this group of supervisees.

Supervision is vitally important for any practicing therapists, in fact Holloway and Neufeldt (1995) state that supervised practice is more important than academic understanding in informing a psychotherapist’s performance. A supervisor who creates a good supervisory relationship sets the stage for exploration and experiments (Worthen and McNeill, 1996) which enables the supervisee to work in a competent and ethical manner. There is literature which helps the supervisee to think about the type of characteristics of the supervisor and the supervision they require, (Carroll and Gilbert, 2005) as well as literature which states what supervisee’s don’t want in their supervision (Gray et al, 2001; Ladnay et al, 1996). But what is the process and factors which influence Irish pre accredited supervisees?

The participants identified several factors involved in choosing their supervisor. During their training, pre accredited supervisees have experienced supervision, either ‘in house’ or with supervisors external to the course. From these experiences supervisees either de-selected supervisors due to negative experiences or they selected supervisors whom they thought and felt could provide similar supervision experiences as before. Supervisees were aware of the criteria for attaining accreditation with their professional body and therefore looked for supervisors who met this criteria.

As well as the criteria for accreditation supervisees looked for supervisors who were available to offer supervision as frequently as the supervisee needed. Participants in this study were aware that supervisors had full practices and at the time this project was conducted it was difficult to find a supervisor who would meet their needs. For this reason supervisees were willing to travel reasonable distances if necessary.

All interviewees referred to their continued learning and development as psychotherapists which they saw as an important aspect of their supervision. To this end they sought supervisors who were trained in a similar orientation to the supervisee allowing for their continued learning and development in the theory and practice which the training course had begun.  The guiding and instruction enabled the supervisee to feel minded and they believed this would ensure their client came to no harm.

The manner in which a supervisee wished to learn and develop was key to their choice of supervisor. The participants all spoke of ‘learning from their mistakes’ and the supervisor encouraging the supervisee to bring their ‘mistakes’ to the supervision sessions. Although interviewees did not speak of reflective practice they were asking supervisors to use this experiential learning method to develop their competence. (Holloway and Neufeldt, 1995).  As part of learning the supervisee wished for a supervisor who encouraged exploration and discussion about their client and the issues the clients brought to therapy rather than the supervisor being dogmatic about the manner in which the supervisee worked with clients.  This supports the Worthen and NcNeill, (1996) study that good supervisors need to be good educators, in terms of theory and practice, which in turn facilitates their supervisees to work more effectively with their clients.

Interviewees agreed that a good working relationship between supervisee and supervisor was essential for their learning, growth and development. It also allowed the supervisee to feel supported helping them to work with the client in the most effective way. The relationship affected what work supervisees brought from their client sessions as well as their own exploration of transference and counter transference within their work with the client. The exploration of transferences between supervisor and supervisee was also affected by the strength of the supervisory working relationship. This concurs with Ladnay, et al., (1996).  Supervisees wanted an adult to adult (Berne, 1965) relationship which would support the work of supervision as well as providing a strength, depth and connection which allowed exploration of difficulties, ruptures or breaks (Bordin, 1979) in the relationship between supervisor and supervisee. This relationship would also mirror the quality of relationship supervisees hoped to achieve with their clients, hence there was a learning of ‘how to do therapy’ through supervision.

Interviewees were aware of the skills and qualities they wanted from supervisors. Supervisors needed to be empathic and listen to the supervisee, in fact some interviewees had experienced supervisors whom they felt did not listen to them, or were non empathic towards them and this left the supervisee feeling isolated and unsupported. To achieve the relationship the supervisee desired, the supervisor had to have the qualities which are described as person centred or to provide “facilitative conditions” (Lambert in Carifio and Hess, 1987). The supervisee then felt supported by the supervisor rather than blamed or humiliated when they had made a ‘mistake’. This led to the supervisee’s confidence in their ability and skills to grow while being available to learn new therapeutic skills or develop existing skills from their supervisor.

All supervisees felt it essential for the supervisor to have great capacity for self awareness, enabling the supervisor to better monitor their own prejudices and transferences to the supervisee. This helped maintain a healthy relationship. Supervisees wanted a supervisor to  be interested and dedicated in their personal and professional development which involved providing time and space to enquire into the well being of the supervisee (Grube and Painton, 1990). Supervisors who acknowledged and addressed any issues the supervisee were dealing with, in their lives, and which might prevent them from availing of the work of supervision or interfere in their client work, were experienced as supportive.

As all interviewees had engaged in supervision during their professional training course, their previous experience of supervision impacted to a greater or lesser degree on their choice of supervisor. Some interviewees spoke of difficult supervision experiences, where they felt shamed, humiliated, exposed, vulnerable or unsafe. In these cases interviewees knew what they didn’t want from supervision and sought supervisors who could provide a different experience. When the supervision experience was good, there were feelings of sadness and loss at leaving this supervisor and supervisees felt this needed acknowledging for the relationship with the new supervisor to flourish.

As interviewees were aware of the importance of supervision in their development they wanted to find the right supervisor first time, rather than have to repeat the process several times. They used various means to identify possible supervisors.

To help the process of choosing a supervisor, interviewees used one or a combination of the following. They increased their academic knowledge and understanding of supervision. They asked other psychotherapists whom they respected and trusted for recommendations. Some interviewees referred to ‘using their nose’ to root out and absorb information which was available in the psychotherapeutic community about individual supervisors. Interviewees asked for recommendations for future supervisors from their existing supervisors.  Contact with supervisors through workshops or lectures gave interviewees a sense of both the personal and professional qualities of a supervisor, giving the interviewee a glimpse of how a supervisor worked. All this led to a short list of possible supervisors.

All the interviewees wanted the best supervisor but when asking for recommendations they did not inquire from the recommender what made this supervisor the best. Weaks, (2002) suggests experienced psychotherapists look for equality, challenge and safety rather than the formative function (Carroll, 1998) of supervision.  The pre accredited supervisees interviewed did want safety as well as challenge which they saw as supporting their learning and development. Equality was not spoken of directly but feeling valued was. It might be said that both experienced and pre accredited psychotherapists look for similar qualities in their supervisor.

Interviewees talked of the supervisor being professional, which conveyed a sense of the supervisor having status or being seen as an authority within the psychotherapeutic community. Being a professional supervisor is seen by interviewees as a supervisor who has experience as a psychotherapist and supervisor. Experience is assessed by how long the supervisor has worked as a psychotherapist. It was not seen as necessary for a supervisor to have specific supervision training.

That a professional fulltime supervisor is dedicated, focused and interested in their profession  gives permission to the supervisee to embrace their excitement and commitment to psychotherapy. Consulting rooms which conveyed professionalism, dedication, interest and commitment were more acceptable than a supervisor’s living space which was adapted to the work. A too familiar phone manner was seen as undesirable. A possibility for the importance of ‘professionalism’ is that supervisees were looking for a supervisor who modelled how to run a successful psychotherapy service. For those supervisees who planned to practice as full time psychotherapists this may have been important.

The maintenance of confidentially of both client and supervisees was spoken of but there was no reference to supervision working with and addressing ethical dilemmas. Interviewees felt the client’s welfare would be addressed by the supervisee engaging in a good supervisory relationship and therefore the client would be ‘minded’.

Discussion

The analysis of these interviews raised several points. The first is that this group of supervisees were looking for the restorative and formative functions of supervision rather than the normative. This may be due to the development stage of the supervisee rather than any other factors. In my supervision practice supervisees often talk about the loneliness of working in private practice and this can be keenly felt after graduation from the professional training course and leaving their training group. The restorative activity of supervision may be to the fore due to this sudden loss of colleges and friends.

The formative aspect was often referred to, the supervisees wanting to develop into more competent professionals. This may point to supervisees seeing their training as the beginning of the road with good supervision being the main focus of continuing their learning and development. Supervisees discussed the process of choosing a supervisor. What was interesting was the supervisees need to find a supervisor who was seen by the therapeutic community as being well thought of and as having a successful and thriving practice. Newly graduated therapists leave training with the skills and qualities which enable them to practice as psychotherapists but they may be lacking in the skills which help them set up and maintain a financially self supporting thriving practice. The running of a successful business may have to be addressed in a more formal manner than at present.

It does appear that pre accredited supervisees choose their supervisor to help them develop into competent professional psychotherapists. To do this they choose supervisors for their personal and professional qualities, their facilitative skills, their experience as psychotherapists, their professional standing in the community, their orientation and model of psychotherapy and their ability to teach their craft in a humanistic manner. They may also choose a supervisor whom they believe can help them set up and run a successful practice.

Annie Sampson MSC Supervision and Reflective Practice, maintains a private practice in Limerick, supervising therapists and non-therapists, as well as running a professional training in supervision.

References:

Berne, E. (1968). The Games People Play. The Psychology of Human Relationships. London: Penguin

Bordin, E.S. (1979). The Generalizability of the Psychoanalytic Concept of the Working Alliance. Psychotherapy: Theory, Research and Practice. Volume 16

Carifio, M., and Hess, K. (1987). Who is the Ideal Supervisor? Professional Psychology: Research and Practice.

Carroll, M. (1998). Counselling Supervision Theory, Skill and Practice. London: Cassell

Carroll, M., and Gilbert, M.C. (2005). On Becoming a Supervisee: Creative Learning Partnerships. London: Vukani Publishing.

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Grube, M.M., and Painton, S.W. (July 1990;8,4). Effective and ineffective college clinical supervisors: Looking back. The Health Care Supervisor. ProQuest Nursing Journals: Aspen Publishers Inc.

Holloway, E., and Neufeldt, S.A. (1995) Supervision: Its Contributions to Treatment Efficacy. Journal of Consulting and Clinical Psychology.

Weaks, D. (2002). Unlocking the secrets of ‘good supervision’: a phenomenological exploration of experienced counsellors’ perceptions of good supervison. Counselling and Psychotherapy Research, 2(1)

Worthen, V., McNeill, B.W. (1996). A Phenomenological Investigation of “Good” Supervision Events. Journal of Counselling Psychology.