Providing Clinical Supervision for Home-Based Family Therapists Module

Module Sections:

Scope of the Issue

 Importance of the Supervisory Relationship

The quality of the relationship between supervisor and trainee is probably the single most important factor for effective supervision. The supervision relationship should begin with discussion about structure, systematic review, planning time to cover all areas, deciding who is responsible for raising each topic and how and when the supervision process will be reviewed. Supervisors should have ground rules, be flexible, have learning objectives, and include record keeping and liaison with the program director. Training for supervisors is valuable and necessary.

Relationship is at the heart of an intense interpersonal process like therapy or supervision. It seems tempting and all too easy to focus on supervisory techniques, teaching psychotherapeutic skills, concrete details such as contracting, and philosophies of supervision, rather than the risky and uncharted territory of the supervisory relationship. Supervisees think of little else until a positive supervisory relationship is assured, then and only then can they turn their attention to some of these topics. Two other issues in the supervisory relationship is power and dual relationship.

It is hard to reassure supervisees that there is no hierarchy, or that blurred relationship boundaries are safe, unless they experience safety and security in the supervisory relationship.

Collaborative supervision involves,

“face to face ongoing dialogues between a supervisor and therapist where goodwill prevails; the learning is mutual and intense; the power relations are transparent; and the emphasis is on meeting standards of the profession, ensuring the well-being of clients served by the supervisory participants.”

Supervision promotes standardization within the profession; ensuring conformity to the goals and ethical practices; and transmitting skills, knowledge, and attitudes of the profession to the therapist. Goodwill and collaboration cannot develop unless all participants feel relatively free and willing to voice their ideas and opinions. The extent to which an individual expresses an opinion is mediated by the amount of power located within the context and by the sense of trust the therapist and supervisor each have in the words and actions of the other. A hallmark of a collaborative stance to supervision is the ongoing discussion with therapists about the supervision process, including revisiting past supervision experiences, examining the present, planning the future, and paradoxically, attempting to ensure that our enthusiasm for collaboration is not imposed.

The supervisor is the master therapist – the person with the answers, with the vision, and with the rightful power to normalize and discipline. Collaborative supervision has led us to pay particular attention to issues of leveling hierarchy and making the power relations between supervisor and therapist transparent. Collaboration means to work with. Power is an ever-present ingredient of all relationships, whether they are collaborative or non-collaborative.

Supervisors in administrative and clinical roles are in dual relationships with their supervisees. These supervisors, wearing two hats, need to be very clear which hat they are wearing. If this is left unclear, supervisees may end up relating only to supervisors as administrators, or clinical supervisors may become stuck in their administrative role. Supervisees may feel constrained in their degree of openness with each other and the material each feels comfortable bringing to supervision sessions. Supervisees may be concerned about the ability of a supervisor/administrator to fire them or recommend raises and promotions. Supervisors in administrative roles may also have access to considerable information from outside the supervision process and may feel unsure what and/or how much information to share with supervisees.