Psychotherapy Supervision and Attachment Theory: Review,Reflections, and Recommendations

Mental health professionals (N = 110) were surveyed about their experiences in supervision with clinical, administrative, and dual-roled supervisors (supervisors who serve in both clinical and administrative roles). The effects of supervisor training, supervisor disclosure, and supervisor role on supervisee disclosure were examined using a multiple hierarchical regression. Supervisor disclosure explained level of supervisee disclosure regardless of supervisee role (p < .0001). Clinical implications of these findings are discussed.     

Investigating the impact of supervisee attachment system activation on the supervisory relationship

Using a quasi-experimental design, the authors explored how supervisee attachment to supervisor predicted the supervisory relationship after recalling critical feedback from a supervisor. To examine effects of supervisee attachment system activation, participants were randomly assigned either to recall critical feedback from a supervisor (experimental condition) or to list objects in the room (control condition). Anxious and avoidant attachment to supervisor significantly predicted the supervisory relationship, but there were no significant differences among participants in either condition in predicting the supervisory relationship. Results are discussed in light of attachment theory, and implications for further investigating attachment dynamics in supervision are presented.     

Learning and Supervisory Styles in the Training of Social Workers

This research investigated the learning and supervisory styles among a population of supervisors (N = 133) and social work trainees (N = 333). Using Kolb's Learning Style Index, the study looked at the ways learning styles change over the course of a three-year BSW program, distribution of supervisory styles among the fieldwork supervisors, and similarities and differences in styles between the two respective groups. The approaches used by supervisors to adjust their style to accommodate the learning needs of individual supervisees were also investigated. The findings allow us to infer that the learning styles of the students are more varied among themselves upon the commencement of studies than upon completion of the social work degree. The supervisees tend to move toward the styles that are prevalent among social workers. Almost all of the supervisors exhibit styles congruent with the styles typically found among social workers. In addition, supervisors tend to stick to their “natural” supervision style irregardless of the learning style of the specific supervisee. However, in the instances in which adjustments were made, the supervisors favored a certain degree of contrast between their supervisory style and the learning style of the supervisee in the supervisory dyad. The limitations of the study as well as the implications of its results for future research are discussed.     

Disclosure—and Lack Thereof—in Individual Supervision

Disclosure is a central component of the supervision process for supervisees and may, at times, also be a vital intervention for supervisors. I review the theoretical and empirical literature on disclosure and nondisclosure in individual clinical supervision, from both supervisees’ and supervisors’ perspectives. The review is focused primarily on supervisee nondisclosure, supervisor disclosure, and supervisor nondisclosure, and concludes with implications and recommendations for practice and research.     

Beginning Supervisees' Identity

Abstract

Masters level beginning supervisee practicum students (N = 98) from a western university were asked to identify what supervisor variables were most important for supervisees in their early developmental phase of becoming a therapist. The findings of the study indicated that supervisor care and concern as well as their clinical and supervisory experience were more important than supervisor-supervisee gender matches. The variables “supervisor care and concern” and “supervisor experience” were also indicators of supervisees' willingness to take risks in supervision.     

Putting on the face: A qualitative study of power dynamics in clinical supervision

Nine master’s-level counselors (recently graduated) were interviewed about their experiences with power in clinical supervision. Using the consensual qualitative research (CQR) method (Hill, Thompson, & Nutt Williams, 1997), the authors derived five general categories: power resides in the supervisor’s expertise, supervisor error erodes his or her power, misuse of power elicits self-preservation, supervisor demonstrating trust in the supervisee’s abilities empowers the supervisee, and supervisor transparency reduces power. Power dynamics appeared to be most salient in situations where the supervisee experienced a negative supervisory event. Implications for training and research are discussed.     

An autoethnography of broaching in supervision: Joining supervisee and supervisor perspectives on addressing identity,power, and difference

Broaching race, ethnicity, and other cultural factors within supervision can spark growth in supervisor and supervisee cultural responsiveness, enhance client care, and strengthen the supervisory relationship. Despite this promise, supervisorsunderutilize broaching. In the current study, we used autoethnography to explore the broaching process, including supervisor hesitation, supervisee expectations for supervision, and the relational and educational functions of broaching in supervision. The narratives of supervisor and supervisee were analyzed alongside empirical and conceptual work on broaching. Considerations for approaching broaching dialogues and implications for supervision practice are described.     

Exploring supervisees’ in-session experiences of utilizing intentional nondisclosure

ABSTRACT

Investigations of supervisee intentional nondisclosure can only occur after the incident has happened. Thus, prior studies of the phenomenon have been limited in the ability to encourage rich participant recall. In the current study, we reviewed a video-recorded supervision session with ten participants and used an Interpersonal Process Recall-informed interview procedure to understand their in-session experiences of utilizing intentional nondisclosure. Using transcendental phenomenological analysis, we identified three themes: (a) impressions of the supervisory relationship, (b) reactions to the structure or process of supervision, and (c) experiences of balancing professional and evaluative relationships. Implications for supervisors and training programs are discussed.     

Relationship Development in Supervisory Conferences:

An important component of supervision is the supervisory conference and the relationship that is developed between the supervisor and supervisee is critical in evaluating the success of the conference. Because relationships that are developed during the Entry Phase (first 5 minutes) are generally maintained for the duration of the conference, it is imperative that the conference begin in the best way possible. This paper discusses three aspects of relationship development about which a supervisor should be knowledgeable in order to establish effective, efficient relationships within supervisory conferences: (1) assumptions about change; (2) assumptions about learning; and, (3) assumptions about communication styles.     

The Fifth International Interdisciplinary Conference on Clinical Supervision

Doctoral students in counselor education and supervision programs take a course specific to clinical supervision as part of their doctoral course work. The transition from supervisee to supervisor occurring during this course can be challenging, as it is frequently the first time that students are asked to provide supervision to counselors in training. The purpose of this qualitative research was to gain information about the process of doctoral students' development from supervisees into supervisors. Significant themes emerged from the data related to the transition of becoming supervisors: the importance of creating the supervisory relationship and the need for further supervisory skills.     

A Model for Evaluating Supervisory Interactions in Family Therapy Training

While it is assumed in family therapy supervision that the relationship between supervisor and supervisee changes over time, the characteristics of this change have received little analysis. A model to explore this change was developed using audiotapes of supervisory planning sessions. Participants were marriage and family therapy trainees and three supervisors at Northern Illinois University Family Center. Fifteen categories of interaction were identified for analysis. Over a four month period, changes in frequency of kinds of interactions were recorded. The interactions during this period generally moved from a cordial, trusting, almost peer relationship to a more director-apprentice relationship as actual client families were encountered. These changes are compared to developmental models of supervision. Applications for use of the system are suggested.     

Supervision Characteristics Related to the Supervisory Working Alliance as Rated by Doctoral-Level Supervisees

Supervision is an essential element in developing well-trained and competent psychologists. The present study identifies strengths and weaknesses in supervisor characteristics that contribute to the supervisee's clinical training experience and professional development. Data gathered from doctoral psychology students indicate that supervisees rated their supervisors as having the following strengths: above-average intelligence, a positive attitude toward themselves, ethical integrity, and strong listening skills. Data from this study indicate the following areas may have room for improvement for clinical supervisors: awareness of countertransference in supervision, the ability to stay focused, the ability to meet time constraints, commitment to the supervisory alliance, and an ability to challenge the supervisee effectively. In summary, 68% of the participants rate their supervisor as outstanding, 5% rate their supervisor as acceptable, and 12% rate their supervisor as poor.     

Humility in clinical supervision: Fundamental,foundational, and transformational

We propose that supervisor humility is a critical variable for effective supervisory practice, fundamental, foundational, and potentially transformational in its impact. We examine humility, and the different types of humility (e.g., intellectual humility), that can impact supervision practice. Supervisor humility is considered to be supportive of supervision best practices by (a) enhancing multicultural competence, (b) fortifying the supervisory alliance, (c) rendering receptivity to supervisee feedback more likely, and (d) fostering engagement in peer consultation. Brief case examples are used to show humility in action.     

4/ Growth in Supervision:

This essay reviews the status of supervisory models, presents an overarching schemata of stage models of supervisee development, and finally, describes a three stage model of supervisor development. The terms "counseling" and "psychotherapy" are used synonymously, as are "trainee", "supervisee", "student", and "psychotherapist."     

The Relationship Between Counseling Supervisee Attachment Orientation and Perceived Bond with Supervisor

Clinical supervisors are often at a loss to explain why some supervision relationships promote change while others are fraught with conflict. Supervisee attachment may help supervisors understand supervision relationships. This qualitative study used The Working Alliance Inventory and a modified Relationship Questionnaire to investigate the relationship between supervisee attachment orientation and perceived bond with supervisor over time and within and between experience levels. The participants were 117 Master's level counseling students receiving supervision. The results indicated no difference of attachment orientation for level of supervisee but did indicate a relationship between attachment orientation and perceived bond with the supervisor.     

The Clinical Supervisor-Practitioner Working Alliance

Abstract

The focus of my presentation this morning is the core dynamics and skills of the supervisor-practitioner working alliance, or what I will refer to as the working relationship. I will present a model that suggests that the use of certain communication, relationship and problem-solving skills by the supervisor can influence the development of a positive working relationship with the supervisee, and that this working relationship is the medium through which the supervisor influences the practitioner. I stress the words “influence” because a central assumption of this approach is that both supervision and direct practice are interactional in nature. The supervisor and the supervisee each play a part in the process. The outcome of supervision is the result of how well each contributes to the process. This morning's presentation focuses on the supervisor's role. One of the discussions is the concept of the “parallel process.” While the role of the supervisor and the purpose of supervision are quite different from counseling and therapy, nevertheless there are striking parallels in the dynamics and skills. There is a suggestion that “more is caught than taught” and that our supervisees watch us very closely. Whether we like it or not, whether we are aware of it or not, our supervisees learn more about practice from the way we work with them than from what we say about their actual practice. Supervision is not therapy. In fact, supervisors who are seduced into a therapeutic relationship with their supervisees actually model poor practice since they lose sight of the true purpose of clinical supervision and their role in the process.     

Transference,Counter-Transference,Projective Identification and Role Responsiveness in the Supervisory Process

The psychoanalytic concepts of transference, counter-transference, projective identification and role-responsiveness are elucidated an discussed in light of the supervisory process. It is our feeling that because of the strong Freudian influence on therapy and on social work theory, it is essential that supervisors be able to recognize the interplay in the parallel process of supervison between supervisor and supervisee, on all levels.     

Advancing our understanding of sibling supervision and injury risk for young children

Sibling supervision has been shown to increase the risk of supervisee's unintentional injury in the home. Both poorer supervision by the older sibling and noncompliance by the younger sibling have been shown to contribute to this risk. Previous studies have shown that informing older siblings that they are responsible for the behavior of their younger sibling improves their supervision. The present study, conducted in Canada, examined whether informing both children the older child is in charge would improve both older sibling supervisory practices and compliance by the younger child. Younger and older siblings were initially placed in a room containing contrived hazards, and their interactions were unobtrusively recorded. In a second contrived hazards room, both children were then informed that the older sibling was in charge, and the supervisor was privately told not to let the supervisee touch hazardous objects. Results revealed that sibling supervisors showed improved supervision but supervisee behavior did not vary across conditions. Implications for injury prevention and future research directions are discussed.