A Question of Supervision – What’s Happening?

By Colm O’Doherty, M. Phil.

Introduction

This article is based on the results of a survey carried out at the beginning of 1995 by an IAHIP subcommittee: Barbara Fitzgerald, Alison Hunter and myself. The survey is a serious attempt, through a questionnaire, to gather up and listen to the experiences and expectations of the membership about supervision. It does not claim to be a scientific piece of research and the focus of this article, therefore, will be on general trends rather than on exact percentages.

Responses

Overall, those who responded had plenty to say, with most people anxious to squeeze as much as they could into the confines of a page. There were returns from almost half the membership, which I gather is above average for postal surveys. In terms of experience the largest group represented were therapists who have worked for between 5 and 10 years, with a further con­siderable number having worked for more than 10 years. The survey,therefore, draws on probably over 300 years of therapeutic experience!

Forms of Supervision

By far the most common form of supervision was one to one, with many of these therapists also attending either group or peer supervision, and in some cases both. It appears that the length of one’s experience as a therapist is a factor that influences the choice of form of supervision, with one to one supervision peaking with therapists of between 5 and 10 years experience. Those with over 15 years experience availed in equal measure of the three forms of supervision: one to one, group and peer.

Goals

It was most interesting to read in the survey what people said they wanted from supervision. It would appear from the responses that the members were clear as to their needs and how they wanted to use supervision. I have clustered what they perceived as the goals of supervision under four head­ings, with the first three being named in one form or another by almost everyone, and the fourth by just under half of those who responded:

1. Case Management
2. Self-Awareness 3. Support 4. Training and Information  

Obviously these are not discrete categories and in fact attention to one of these will usually affect some, or all, of the other aspects. Because this is a central issue and also because of the very interesting nature of the responses, I would like to give a flavour of the replies to this part of the survey. In response to the question, “From your experience as a therapist what do you see as appropriate goals of supervision?” people said they wanted a space where they could talk easily about their clients; where they could get help to look at difficulties they were having with clients. They would like to be able to check out their hypotheses with the supervisor and, in general, use super­vision as a sounding board, helping them to look at interventions they made. I categorised these sorts of responses under the heading of Case Management.

Regarding the second category, Self-Awareness, many people mentioned quite explicitly that they wished to be able to discuss in supervision, issues around transference and countertransference. Others, without using these terms had similar aims: to look at how the therapist might be blocking the client because of the therapist’s own inner process: to develop a watch­fulness which would help the therapist be aware of occasions when they might be attending to their own agenda rather than to that of the client. In general under this heading therapists wanted help in supervision so that they could better understand how they were with each of their clients.

Under Support I clustered responses which indicated that people were very glad of skilled professional company in the strainful and often lonely work of therapy. People appreciated reassurance, company in their isolation and encouragement. They wanted, supervision to be a place where the therapist could take a breather, or lay down the burden for a while.

Quite a few members saw supervision as a place where their skills could be developed and where they could have access to relevant professional information. The sorts of practical help that people wanted were information about legal implications where they were seeing clients who had been abused and information on other ethical issues such as suicide. Nobody was specific about the skills they felt they could learn in supervision and most often when skills were mentioned people wrote in very general terms.

It is interesting to note that the wishes of the members, as revealed in the survey, are consonant with the goals of supervision that are outlined in the literature. Kadushin¹, in his classic work, “Supervision in Social Work”, highlights the following aspects of supervision, all of which are touched on by the survey responses:

1. The Administrative Component
2. The Educational Component
3. The Supportive Component

Peter Hawkins² writing on supervision from a humanistic perspective offers a framework for supervision which accommodates different modes of working. Within the same supervisory session the focus can be on the content of the therapy session – offering scope to the therapist concerned with case management – and can then move to an exploration of the behaviour, feelings and processes of the therapist – attending to issues of transference and countertransference, and to the desire of the therapist to develop self-awareness. Both of these modes are supportive in a professional way to the therapist.

Effectiveness

In terms of effectiveness there was a wide range of responses from poor to very good, with just under 90% evaluating their experience between adequate to very good and just over 10% saying it was poor. The impression I get from the responses – and this is an impression – is that while most people were positive about the quality of supervision they were receiving they would also be glad enough if steps were taken to improve matters. A further analysis of these effectiveness figures reveals that those who felt their supervision was poor to adequate were mainly those with between 1 and 10 years experience of therapy. Within that group, those with between 5 and 10 years of experience are almost evenly divided between those who find supervision either poor or adequate and those who rate it good to very good. Those with over 10 years experience all responded within the reasonably good, good and very good categories.

It is important to caution here against drawing too many or too firm conclusions from these figures, yet there is ground for some concern when we note that the group most unhappy about their supervision is a group of experienced therapists (those with between 5 and 10 years experience) and who form the largest group who responded to the survey. Lastly, it appears that supervision is seen to be less helpful when it is most needed,i.e. during the early years of practising as a therapist. Apart from whatever this might point to regarding the training of supervisors, it would appear that it is important during the therapist’s training to consider how best the beginning therapist might avail of supervision and work beneficially within the super­visory relationship.

For Attention

When people were asked what needs most urgent attention in the whole area of supervision they gave a wide variety of suggestions, together with a few cautions. Just under half felt the priority should be training for supervisors. It was noted that there is a need to build up a pool of competent supervisors and that the prerequisite is appropriate training. Most people who are working as supervisors at present within the field of humanistic therapy come to that work on the strength of their experience as therapists. While such experience is recognised as being very important it is also acknowledged that it cannot remain the sole criteria. Questions were raised as to who should sponsor this training and what role IAHIP might have in this regard.

To date the Executive has taken no responsibility for setting up training in any area connected with therapy but it is obvious that someone, somewhere needs to give consideration to how supervision training could be made available to those who are interested.

Next to training – and closely linked to it in the responses – came accredi­tation i.e. criteria and procedures whereby people became recognised as supervisors.

When we looked at the responses to this question of what needs attention and correlate them with the responses to the last question in the survey -“Do you work as a Supervisor?” – we see both supervisors and non-super­visors have the same priorities, with supervisors even more clearly asking for training and accreditation criteria and procedures than those who are not supervisors.

As I said, there was a wide variety of interesting suggestions as to what was the most needed, for instance, a code of ethics and practice for super­visors, special attention to supervision of trainees, a requirement that super­visors be experienced therapists and be currently seeing clients, clarification on what differentiates a humanistic and integrative approach to supervision from other approaches, and finally a think tank cum support group for supervisors.

I mentioned that a few cautions were also included e.g. the dangers implicit in setting up a group of “experts”, and a query about the necessity of regular, mandatory supervision as opposed to when the need arises.

Conclusion

Overall it would appear from answers to this question that many people have a lot to say about the topic and where we might go from here, and that was confirmed by the very free flowing discussion at the AGM of the IAHIP when the results of this survey were outlined to the members. During that discussion the issue of accreditation again figured very prominently and in the light of this, the Executive agreed that priority now be given to working on criteria and procedures for accrediting supervisors within the organ­isation. This is no simple task, as other bodies have discovered, particularly if attempts are made to incorporate qualitative as well as quantitative criteria, and also to involve people with a range of experience. It is hoped that the survey has made some contribution to that process which is now underway.

Colm O’Doherty is a psychotherapist, who also works in training and supervision and is a member of IAHIP. He is Director of Dundalk Counselling Centre, 3 Seatown Place, Dundalk, Telephone (042) 38333.

References

1. Kadushin, A. (1976) Supervision in Social Work, Columbia University Press, New York.

2. Hawkins, P. (1985) Humanistic Psychotherapy Supervision: a conceptual framework, Self and Society: European Journal of Humanistic Psychology, 13(2) pp. 69-77 and Hawkins, P. and Shohet, R. (1989) Supervision in the Helping Professions, Open University Press, Buckingham.