Supervision in the Real World: Understanding what makes an effective supervisory alliance
Curt and Katie chat about the relationship between supervisor and supervisee in clinical supervision. We explore what makes up a good supervisory alliance, what the research says (and why it is problematic), as well the practicalities of how to create a good relationship and set up a strong supervision meeting. We also look at the challenges in the real world, especially related to addressing business or administrative needs.
This is a continuing education podcourse.
Click here to scroll to the podcast transcript.Transcript
In this podcast episode we explore the clinical supervisory alliance for therapists
We know that the relationship is very important in therapy, but what about supervision? We dig into what makes an effective supervisory alliance (and what can hurt it).
What makes up a good clinical supervision relationship for therapists?
- Teaching within a learning alliance
- Having a shared view of what is being worked on
- Rapport, shared supervisory goals, shared tasks by which those goals are pursued
Research on clinical supervision is problematic
- Mechanisms by which efficacy is measured
- Poor timing of research (developmental stage of the supervisee as well as after supervision is done)
What does an effective clinical supervisory alliance look like, practically?
“One of the biggest problems is: I hear a lot of [newer] supervisors who tend to supervise in the way that they were supervised. And it’s just kind of being passed down as, alright, we’re going to come in and ‘what do you want to talk about today?’ And it kind of vaguely talks about some cases for a while, and it peters out until they’re not able to get to these important topics [e.g., the supervisory alliance] with any intentionality.” – Curt Widhalm, LMFT
- Strong relationship that holds space for an assessment of what the supervisee needs at their particular developmental stage
- Supervisory Alliance measures can help to identify how well this relationship is developing
- Using feedback to inform the conversations in supervision
- Cultural and gender impacts on the supervisory alliance
- Supervisor humility and openness
- Intentionality with how the relationship is developed
- Regular evaluations for supervisees, including the FASIT (Functional Assessment of Skills for Interpersonal Therapists) system from Behavioral Analysts to assess their skills
Setting up an effective supervisory session
“We feel like clinical work is so much more special than it actually is.” – Curt Widhalm, LMFT
- Navigating the business and clinical needs within the supervisory relationship
- Creating an agenda and goals
- Balancing case presentation with other supervisory needs
- Clear about expectations at every stage, especially relevant at hiring
- Pulling administrative conversations out of clinical supervision meetings
- Finding agreed upon path to address clinical work
- Cultural humility within the supervisory relationship
Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!
Once you’ve listened to this episode, to get CE credit you just need to go to moderntherapistcommunity.com/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed – you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com.
You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/courses/supervision-in-the-real-world-understanding-what-makes-an-effective-supervisory-alliance
Continuing Education Approvals:
When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information
CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Sign up to get on the list for Curt’s supervision workshop
Saving Psychotherapy by Dr. Ben Caldwell
A Few Thoughts on Impostor Syndrome by Dr. Jordan Harris
References mentioned in this continuing education podcast:
Callaghan, G. M. (2006). Functional Assessment of Skills for Interpersonal Therapists: The FASIT system: For the assessment of therapist behavior for interpersonally-based interventions including Functional Analytic Psychotherapy or FAP-enhanced treatments.The Behavior Analyst Today, 7(3), 399–433. https://doi.org/10.1037/h0100158
Callahan, J. L., & Love, P. K. (2020). Introduction to the special issue: Supervisee perspectives of supervision processes. Journal of Psychotherapy Integration, 30(1).
Enlow, P. T., McWhorter, L. G., Genuario, K., & Davis, A. (2019). Supervisor–supervisee interactions: The importance of the supervisory working alliance. Training and Education in Professional Psychology, 13(3), 206.
Fleming, J., & Benedek, T. (1964). Supervision. A method of teaching psychoanalysis: preliminary report. The Psychoanalytic Quarterly, 33(1), 71-96.
Patton, M. J. (1992). The Supervisory Working Alliance Inventory: A Validity Study.
Roscoe, J. (2021). Conceptualising and managing supervisory drift. The Cognitive Behaviour Therapist, 14, E37. doi:10.1017/S1754470X21000350
Watkins Jr, C. E. (2014). The supervisory alliance: A half century of theory, practice, and research in critical perspective. American journal of psychotherapy, 68(1), 19-55.
Watkins, C. E., Hook, J. N., Mosher, D. K., & Callahan, J. L. (2018): Humility in clinical supervision: Fundamental, foundational, and transformational, The Clinical Supervisor https://doi.org/10.1080/07325223.2018.1487355
*The full reference list can be found in the course on our learning platform.
Relevant Episodes of MTSG Podcast:
Bilingual Supervision: An interview with Adriana Rodriguez, LMFT
The Person of the Therapist: An interview with Dr. Harry Aponte
The Clinical Supervision Crisis: an interview with Dr. Amy Parks
Getting the Supervision You Want
Giving and Getting Good Supervision
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 00:00
Opening Advertisement
Announcer 00:00
You’re listening to the Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 00:00
Hey, modern therapists, we’re so excited to offer the opportunity for one unit of continuing education for this podcast episode. Once you’ve listened to this episode, to get CE credit, you just need to go to moderntherapistcommunity.com, register for your free profile, purchase this course, pass the post test and complete the evaluation. Once that’s all completed, you’ll get a CE certificate in your profile, or you can download it for your records. For a current list of our CE approvals, check out moderntherapistcommunity.com.
Katie Vernoy 00:48
Once again, hop over to moderntherapistcommunity.com for one CE once you’ve listened.
Curt Widhalm 00:53
Well, welcome back modern therapists. This is The Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is another one of our CE eligible podcast episodes. Make sure that you listen to the intro and outro for how to get CE credits. And we are going in on supervisory alliance today. It has been a long time since we have talked about supervision and just a little bit of a preview, I’ve got like a big supervision course coming up here in a couple of months that if you follow us, you’ll get information on how to attend and access. That we do have plans to record that and put it out. So just continue to follow us and support us in all of the various ways that you want to. But we are focusing this hour just on supervisory alliances. And Katie as we’ve talked about supervision in the past, what does the supervisory alliance sound like to you? The supervisory
Katie Vernoy 01:58
The supervisory alliance, I think, for me has shifted over time. I think like most folks, when I first became a supervisor, I was trying to determine how it was different from therapy. It became more I think, in my mind about different elements, there’s training, there’s mentorship, and I know that one of the topics that we’ll probably get into there, when I was doing a lot of supervision and supervision of supervisors, a lot of what ended up happening in in the supervisory relationship in community mental health ended up being administrative. And so it was teaching about the administrative parts of the job, which I think in traditional views of what the supervisory alliance this is kind of not appropriate. And so for me, I think my my supervision and the supervision I did for other supervisors really was around how to make all of those things mesh, how to do the clinical, how to do the kind of the professional development and then how to kind of take care of the quote unquote, business needs and how to put those things together. I’m excited about the conversation today, because I think that there is well I guess there are probably many different reasons why supervision is really important. There’s consumer protections, there’s training, there’s, you know, kind of the business needs. And I think for me, there’s confusion maybe about what really, really good supervision could look like in the real world, and what a really good supervisory alliance could look like in the real world. Because I think my impression and I could be wrong is that ideal clinical supervision is really around the clinical elements, and maybe a little bit of the professional development, but not necessarily what real supervision has to grapple with, which is the business needs.
Curt Widhalm 03:52
So you are mostly right. I will give you credit.
Katie Vernoy 03:58
Right about what?
Curt Widhalm 03:59
Well, so I think it helps to get into the definitions of supervisory alliance, where us as a field have been in this time and kind of where some things like supervisory drift end up happening. So there was kind of the Freudian, you know, alliance sort of things that led up to where the first descriptions of what a learning alliance was. And this was described in the mid 60s by Fleming and Benedek. We’re going to list all of our references over on our show notes at mtsgpodcast.com. And also along with the course that you’ll be able to get your CEs with. So you can look for all of these references over there. Fleming and Benedek readily acknowledged Freud’s contributions in what they came up with as their learning alliance or what ultimately became out as the supervisory alliance. And this is from their writings in the 60s. The structure of both the analytic and supervisory situations is determined primarily by the goal which each participant expects to accomplish in their work together. These ultimate expectations whether therapeutic or educational, orient the behavior of each member and guide their interactions through many vicissitudes.
Katie Vernoy 05:19
Vicissitudes? What does that mean?
Katie Vernoy 05:22
I’m in the middle of reading this. So…
Katie Vernoy 05:24
You’re like, I don’t know.
Curt Widhalm 05:27
…expectations of giving and receiving help initiate a bond of trust and confidence between an analyst and patient without which analytic work cannot proceed. In supervision, there exists the same necessity for acceptance of a mutually shared educational goal, and the same need for confidence that the expectations of teacher and learner can be satisfied. The term learning alliance describes the essential characteristic of this relationship.
Katie Vernoy 05:52
Okay.
Curt Widhalm 05:54
In other words, teaching people, helping them along, helping do this in a way where much like the therapeutic alliance, there’s a shared view of what we’re here to work on, and how well both parties feel that they’re working on it. And so Fleming and Benedek kind of boiled this down into there’s three components. There’s the rapport or bond between the supervisor and the supervisee, their shared supervisory goals, and the shared tasks by which those supervisory goals are pursued. So if the big long quote from the 60s, is too big and long, those three things are what we’re going to be focusing on here.
Katie Vernoy 06:34
Got it. So rapport or bond, shared supervisory goals, and the shared tasks by which those supervisory goals are pursued.
Curt Widhalm 06:43
Correct.
Katie Vernoy 06:44
All right.
Curt Widhalm 06:45
Now, I’ll admit, when I first started preparing for this episode, and was looking at a lot of the supervisory research, and believe me, there’s not as much supervisory research out there as we probably should have at this point. And I think that that’s very problematic for a couple of reasons. Number one is most of the supervisory research that’s out there is based on supervisees perceptions of things. And well, I would admit my own process in this is a little bit of I can hear community mental health supervisors, I can hear private practice supervisors, I can hear educators all from their own vantage points of being like, Yeah, but supervisees don’t know what they don’t know. Like, there’s going to be things that they need to have done in supervision, taught in supervision, taught how to operate within the workplace, that they are going to have problems being taught this stuff, and only listening to their opinions on this in the research is going to very much bias where the supervisory research is.
Katie Vernoy 07:53
Well, and I think another angle is the point. And maybe maybe I’m wrong. But one of the points of clinical supervision, if we’re looking at the consumer protection angle, is client outcomes. So is there any research on improvement in client outcomes based on supervision?
Curt Widhalm 08:13
None.
Katie Vernoy 08:14
Okay, so it’s…
Curt Widhalm 08:16
None that…
Katie Vernoy 08:17
…mostly from the supervisees, not on the supervisors and not on the clients, just on the people who are receiving this supervision. Okay.
Curt Widhalm 08:22
So I mean, there is research out there, I maybe I’m over exaggerating this, but supervision as a variable factor in client outcomes is not as robust as we would like it to be. It’s a little bit outside of today’s discussion here. But you can go to, you know, Ben Caldwell’s ‘Saving Psychotherapy’ book that we tend to meet our obligations of referencing every few episodes here. You know, because part of what you’re talking about is, you know, some of the problems of the implementation of supervision. And this ends up becoming something that can get in the way of those three things that Fleming and Benedek laid out. That if the shared supervisory goals are in competition with each other, we are left with supervisees who feel that supervision is not worthwhile. And guess what? They’re probably right.
Katie Vernoy 08:36
Sure.
Curt Widhalm 08:57
And if we don’t have the same goals, then the tasks by which we get there are probably not going to be right. And that can affect the rapport between supervisor and supervisee. It can then just end up making it to where here’s a checkbox that we are doing because it is obligated by the government by an agency that this is meeting time that needs to happen.
Katie Vernoy 09:42
Well, it’s interesting when you’re talking about shared supervisory goals. I think the biggest thing that I have had on either side of the Supervisory relationship is this difference around productivity. And oftentimes supervisees especially are wanting help around on clinical, and some supervisees supervisors whether it’s, and actually it’s either community mental health or even in private practice, you know, productivity in private practice is seeing enough clients and charging enough money.
Curt Widhalm 10:16
Sure.
Katie Vernoy 10:17
But it’s it’s something where that disconnect in what the goal is, I mean, I think that most supervisors and supervisees both want high quality clinical work. But I think there’s a difference around how many cases are being seen and kind of the that that business case that productivity case that I think that’s where a real conflict comes in.
Curt Widhalm 10:42
And that is going to show up a little bit later in the episode as far as some of the why of that becoming problematic, because there are other pieces that good supervisory alliance relies on in order to more effectively do that.
Katie Vernoy 10:59
But I think you’d also mentioned supervisory drift as a problem here, too.
Curt Widhalm 11:04
Sure. Before we get into that, there is other problems within supervisory research. Most supervisory research is done on graduate students, trainees who are actively involved in university settings. And…
Katie Vernoy 11:20
Okay
Curt Widhalm 11:20
…not all, you know, supervision research is there, but the vast majority of it is. Some of the meta analyses that I looked at, were pointing to things like 80% to 90% of supervisory research is based on graduate students and kind of ignores postgraduate prelicensed supervision. And that affects things like being able to properly implement develop mental models as a conceptualization from a supervisor as far as how effective and what to do in supervision is going back to the shared tasks by how supervisory goals are pursued, ends up becoming something that there’s not a lot of research on, and doesn’t seem to be a basis to really start some research on, because it’s kind of starting from the ground up.
Katie Vernoy 11:21
Well, and the the role of a trainee versus a prelicensed associate is very, very different. The case loads are very different. The expectation is different. Most trainees, not all, but most are not paid. Whereas hopefully all prelicensed associates, at least should be paid. And so there’s just there’s, there’s complete differences in what supervision looks like, when you’re a student versus what it looks like once you’re out in the world and working a job.
Curt Widhalm 12:40
And it should be. And that gets into…
Katie Vernoy 12:42
Of course.
Curt Widhalm 12:43
…you know, the conceptualizations of developmental models. And now we’re seeing, you know, different approaches to this. You know, we had somebody in our Facebook group shared an article with us where they had talked to Tony Rousmaniere over at Sentio Counseling Center about ways that working with the first six weeks of supervision and supervisors and what they’re allowed to do is something that is appropriate to that developmental stage of supervision, but is not necessarily something that is applicable across all of supervision. It’s a little outside the scope of this particular episode to continue to talk about it, but you did bring up supervisory drift. And here’s a preview for next month’s CE episode where we’re talking about therapeutic drift. But supervisory drift ends up becoming a problem when the goals of supervision are not being met. And this is where supervisory time ends up becoming just kind of a alright, what are we here talking about? We’re not here, you know, doing this for the benefit of the client, or we’re not doing this, you know, here dedicated time towards developing better skills. And a lot of what the body of literature on that we haven’t yet talked about, is the development of the person of the therapist of the supervisee that may go beyond clinical skills. It goes into being able to manage things like burnout and being able to manage the openness of here’s things going on in my personal life that may be affecting or clouding the way that I’m talking about this. Where supervisees don’t feel safe or don’t feel able to talk about those kinds of things, because the first part of what Fleming and Benedek talked about is the rapport or the bond between the supervisor and supervisee.
… 14:37
Advertisement Break
Katie Vernoy 14:38
So we’ve said a lot but I feel like it’s still very theoretical. And so when I’m, when I’m thinking through the experience that I have around supervision and and people I’ve talked to in different roles, it feels like there’s there’s always going to be a negotiation around the the goals, to me, it seems like anyway. Because I think when folks are coming into supervision, depending on their developmental level, I think there’s there’s an element of wanting to learn the job, the being a therapist, you know, and of course, I love the person of the therapist stuff. And we’ll we’ll link to a couple episodes that we have on that. But I think there’s this this element of, of just wanting to be in the room and understand who am I as a clinician, and what what is clinical work, like, look like? What should I do with the client? And yet, I feel like that’s not the whole job. I mean, some of the stuff, even though it’s administrative is: how do I document and the clinical loop and that those are things that some of it is more like, well, this is what we have to do to get paid. And some of it is this is how you actually understand your case, and all of those things. And then there’s also who do I want to be as a professional? And so, you know, going back to the professional development ideas, I think, if we remove because it sounds like this is to be discussed later, and some of the drift ideas, but like if we remove the administrative stuff, the productivity, the business stuff, and we really just look at the therapist, it seems like we’re talking about something that seems actually very similar to a therapeutic relationship, except it’s more directive once you get down to the learning, right? Like, there’s the rapport, there’s a, there seems to be some professional distance, although maybe I’m wrong. Because I’m your supervisor, you’re my supervisee, like, I’m not going to tell you all of my deep, dark secrets, I’m not going to become your friend, like it feels like there’s a similar boundary, maybe not the same. And then there’s also so much that, that supervisors and supervisees can teach each other that I just I feel like I need to have a better sense practically what this actually looks like what you’re talking about, because in practice, it feels like it feels like it flows for me. But I think that that you’re you have some specific ways that you’re trying to describe this, that I feel like I’m I’m trying to attach it to what I know, and I’m having trouble doing that.
Curt Widhalm 17:09
I will give maybe a stereotyped version here. And there’s always going to be exceptions of where people supervisory experience is. But picture a a trainee who’s in grad school, who goes into supervision their in their first couple of months of, you know, being at the site. They’ve got a handful of clients, they’ve figured out more or less how to write their SOAP notes and get it done on time. They may be struggling with, you know, being able to keep up their caseload, but they’re looking for maybe that confidence point of I think I’ve got this going right. I, you know, have a sense of I’ve developed a treatment plan. I maybe need some help with some therapeutic skills. I don’t know if my personality necessarily fits with being directive, like, you know, my, my supervisor is a very directive type person. And so I bring up a case in supervision. And I say, you know, I have an idea of what this client needs to do, their goal is to be more active, you know, go exercise or go, you know, do things outside of the house to combat their major depressive episode. And the supervisor says something to the effect of, well, you know, they’re not doing it, tell them that they’re not doing it. And that that’s, you know, why they’re depressed. I’m exaggerating here. Put your pitchforks down.
Katie Vernoy 18:35
Exaggerating for effect everyone.
Curt Widhalm 18:38
If the supervisee is left with the feeling of like, I don’t get how I can do that as a person. I understand that that is a CBT oriented thing that fits within our contract of what we’re supposed to be doing. If the supervisee is not able to voice like, I don’t know if I can do that effectively. And they can go and then try to ineffectively do that with the client, then that is ineffective supervision. On paper, it’s right, it’s the right intervention for that particular situation. But if it’s not processed as far as like, Okay, what’s getting in the way of you being able to do this? What’s getting in…
Katie Vernoy 19:23
And what would you do differently? I mean, you’re talking about like telling someone do a CBT intervention?
Curt Widhalm 19:29
Sure.
Katie Vernoy 19:29
And they’re saying they don’t think they can do it? I mean, are you wanting to get to the place of helping the supervisee to be able to do it? Or trying to have the supervisor be better able to advise them?
Curt Widhalm 19:40
Get, well, I mean, this episode is about getting the supervisor better able to do that. Because…
Katie Vernoy 19:45
Oh.
Curt Widhalm 19:45
…it’s a lot different if the person coming into supervision. That first example that I just gave is somebody in their first couple of months. They probably, from a developmental model, need more instructions of here’s how to do this. Here’s how to do this better. Let’s go to the tapes and review you trying to implement this and we can break down. It’s a lot different if it’s somebody who’s 50 hours away from being able to complete their licensure requirements. If the supervisor saying Go go do this intervention, that misses the point of where developmentally that supervisee is. Those supervision should look different. They should be, you know, where are you thinking of going with this? You know, how do you fit within our contractual model of being able to get this client to meet their therapeutic goals? With you as a person, like, how do you see this being a better way to address this that teaches more of that independent thinking and is acknowledging of where the supervisee is at that point in their development.
Katie Vernoy 20:51
So we’re talking about a lot of things all at once. But I do want to just comment on the article that we had talked about earlier was from Jordan Harris, and we’ll link to that in the show notes as well over at mtsgpodcast.com. It’s about how supervisors can harm impostor syndrome by being too reassuring and not directive enough. So this is kind of kind of irrelevant here. But I’m trying to kind of get to the point that you’re trying to get to Curt was, which is if the supervisor does not have a strong enough relationship with a supervisee, and doesn’t see the supervisee as someone that is going to have to, to work on these things and just gives direction that’s misaligned.
Curt Widhalm 21:34
Yes.
Katie Vernoy 21:36
If they’re if developmentally, they’re early on. Later, giving a direction, when someone is ready to get licensed, is very ready to be autonomous, that would be misaligned. And so we’re really the point we’re getting to is about the relationship needing to have that assessment in it. It needs to be able to see the supervisee where they are, understand, understand them well enough that you can then inquire and explore what’s getting in the way of them being able to do a particular particular directive, or helping them in scaffolding their ability to problem solve and identify how they might handle it themselves.
Curt Widhalm 22:16
Yeah.
Katie Vernoy 22:17
Okay.
Curt Widhalm 22:19
And so one of the ways of getting to this is doing a supervisory alliance measure. And this is, you know, out of feedback informed treatment-esque principles of some of the best ways of measuring what you’re talking about is by asking.
Katie Vernoy 22:36
Yes, yes, it is.
Curt Widhalm 22:39
Doing it in a way that ends up helping to better get to some of the, you know, the core of being able to address this. And there’s a 2014 meta analysis by Watkins that I’m pulling some of this from here in this next portion. But the meta analysis pointed out that part of the problem with supervisory alliance research is that most of it was done after the fact. And so there’s, you know, potentially the bias of, well, I had a bad supervision experience, and therefore, I’m going to have rated it badly, or I had a good supervision experience, and I was going to rate it well. And as Watkins points out, a lot of that just makes it to where there’s not a good opportunity to then do something with that information. And out of the the studies that Watkins had looked at most had only done one questionnaire, a Likert type scale questionnaire after the fact. Some…
Katie Vernoy 23:48
So just not nuanced enough, like not nuanced, the kind of up and down that can happen, or the arc of the supervisory relationship.
Curt Widhalm 23:55
The more robust of the articles that Watkins looked at had three questionnaires that were set. And the the one singular one had kind of 10 as the most robust thing, and that was done partially looking at people who were actively working and provides the most data. But the research behind effectively using supervisory alliance measures is just not deep enough. And the ones at the time that meta the meta analysis were done, the supervisory alliance measures. Were things like the supervisory working alliance inventory. This came out in the early 90s. It’s about 30 questions, again, Likert type scale things, some deal with the educational components of supervision, the abilities to put things in place to help clients and some of it was about the rapport with the supervisor. There has been some more recent articles that validate a shorter version of this Sabella, Schultz and Landon have a 2020 article that validates a brief form of the supervisory working alliance inventory. That’s only five questions. And that’s similar to the leads alliance and supervision scale that a lot of the feedback informed treatment people does. Scott Miller pushes this as when I have done Scott Miller workshops, that’s what was in effect there. So there is the basis of being able to do briefer versions of these things. But they should be done during the supervisory work together. So that way, it can be better able to be, here’s how well we feel like we’re working on goals together, here’s how well we feel that we can be open with each other. And to be able to have that feedback kind of addressed.
Katie Vernoy 25:55
I like the idea of being able to do some sort of feedback informed supervision and be able to do that with, with looking at these these different measures. Is there, is there a way to open a conversation about the stuff that just sucks? Because you have to do it? You know, like some people hate paperwork, for example. I’m not even gonna go to productivity, because that’s, that’s a whole other can of worms. But but timely documentation, complete documentation, like when that’s the, the potentially the focus of a supervision session, the supervisee, theoretically, might really hate it. So that type of feedback, does it, does it provide space to kind of look at like, you’re not going to love everything about the job, you’re not going to love everything about supervision. But did the supervisor address it well with you?
Curt Widhalm 26:51
Yes. And that’s the kind of stuff that comes out in especially the longer version of the supervisory working alliance inventory is, Hey, I see that you’re rating this down at like a three, instead of a seven. You know, I hear you, this aspect of the job sucks, or this part of the productivity. And good supervisors are able to ask the follow up question of like, Is there support that you need in being able to address these parts of your jobs that are going to make it to where you’re able to do this better? And I think, good supervisors do this kind of naturally.
Katie Vernoy 27:31
Of course.
Curt Widhalm 27:33
But there are people who are interviewed in some of these studies that are like, No, I was just told that it sucks and to deal with it. And…
Katie Vernoy 27:44
Well, I think I think it’s hard though to because, you know, supervisees, like supervisors, all have different personalities, different capacities and styles. And so I think it’s something where sometimes I think when we’re having these conversations, I feel like there’s there’s an overbalance toward supervisee, get have it rough versus it’s tough being a supervisor too. I mean, there are folks that don’t take feedback well, or don’t want to do the job that as it’s described, or those types of things. And so I just wanted to kind of identify the nuance of what’s actually being measured, versus, you know, these these conversations are. The fodder for, you know, kind of supervisory discussion, that makes sense, of course, you know, like, Hey, I saw that you hated this, you know, what’s going on? I think it provides an opportunity, not only to say, like, hey, was I not teaching you well? Or was it something that you’re not set up, you don’t have the appropriate resources for? Or is there some sort of philosophical difference or cultural difference around what this means and how this is operating? Because there are so many different elements of all of this, that I think if supervisors aren’t aware of it become pretty, pretty gnarly and, and definitely an opportunity for misalignment, if there’s not a real look at what’s going on there. Right?
Curt Widhalm 29:05
And you are making a great case for getting supervision on supervision.
Katie Vernoy 29:11
Oh, absolutely.
Curt Widhalm 29:11
Because you whether it’s, you know, going towards a certification or not, and you know, I’m a CAMFT certified supervisor. I do provide supervision of supervision to people. And this is something where, kind of in that parallel process of what supervisees go with with their clients comes up in supervision. Part of what I hear from supervisors is a then parallel process of what happens in supervision and feeling invalidated sometimes or needing to do the role shift of wearing multiple hats in order to shift from Okay, here’s the managerial side of productivity and meeting standards too. And I also want to help you develop as a person and to be able to meet your personal goals and you’ll be taken care of and explored Like what is best for you? So that way we don’t run into people just getting to licensure and being so fed up and burnt out with the field that they look at doing anything other than working with clients.
Katie Vernoy 29:15
Yeah. Oh, for sure.
Curt Widhalm 29:30
What can meta analysis boiled down just kind of some of the things that could be good predictors of supervisory alliance and could be links to things like higher supervisee self efficacy, higher supervisee well being, a greater willingness to self disclosed during supervision. And I’m going to majorly come back to that point.
Katie Vernoy 30:41
Sure.
Curt Widhalm 30:41
Leads to more satisfaction with supervision, more job satisfaction, greater perception of the effectiveness of supervision, more secure attachment style by supervisees tends to be a predictor of good supervision. An interpersonally sensitive supervisor’s style, a higher interactional complementarity between supervisee and supervisor. A lot of operational words that talk about good rapport and more frequent, yet appropriate supervisor self disclosures. Watkins goes on to say weak or unfavorably rated supervisory alliance was related to variables such as supervisee avoidant attachment style, higher degree of perceived stress, more exhaustion and burnout, greater amount of role conflict and role ambiguity, and more frequently perceived occurrences of negative supervision events. And while some of those can be measured in the supervisory alliance, this is also again, being culturally aware as a supervisor of knowing how to ask about things or knowing about how one is coming across in supervision. One article that I read and I’ll put it in the show notes here, talks about even just the way that gender events end up happening in supervision as perceived by female therapists, female supervisees that regardless of the gender of the supervisor, female supervisees end up being a lot more aware of how gender is talked about in supervision, whether it’s with the client, or even in the ways that female supervisees or female presenting supervisees end up being able to talk within group supervision. That as compared to their male counterparts, they tend to defer speaking first to male counterparts, the male supervisees tend to speak up more. And this can be things that contribute to rifts within the supervisory alliance as well. You can add intersectionality, on top of all of this, and this is all getting into multicultural aspects.
Katie Vernoy 31:05
Well and we had a conversation with Adriana and we’ll put that in the show notes as well, just as well as on language or cultural heritage and, and just there’s, there’s a lot of opportunities, person to person to miss each other. And there’s and all of the cultural dynamics that are in any other scenario, are going to end up happening within the supervision. And I think folks don’t think about it as much there’s. There’s less or or in the past have not thought about it as much. Not recognizing that cultural differences between cultural and racial racial differences between supervisor and supervisee gender differences, etc, that they will have an impact. And they may not be thought about or because it’s such a focus in clinical work doesn’t mean it’s necessarily a focus in supervision, because I think the workplace is still trying to figure out how to address it, and that this is more of a workplace relationship versus a quote unquote, clinical relationship. So just just an observation from my part.
Curt Widhalm 32:55
And speaking of Adriana, she’s going to be co presenting with me at the April workshop. So…
Katie Vernoy 34:07
Yay.
Curt Widhalm 34:09
Part of what really goes to serve well within the supervisory relationship; building rapport and practical skills that we can give supervisors here, or practical skills for those who are receiving supervision right now to ask of your supervisor, is a thing that Watkins in a 2018 article talks about as supervisor humility, Watkins et all, there was some co authors on this paper. They define supervisor humility as supervisor openness, supervisor willingness and ability to accurately assess her or his own supervisory characteristics and achievements, supervisory ability to recognize his or her own supervisory imperfections, mistakes and limitations, and other focused orientation. In other words, being oriented towards the supervisee, and the client rather than the self. And I will add in my own two cents on this: and other than focusing on agency or business model, but focusing on the supervisees experience. And they go on to say it is important to note that humility in supervision does not entail false humility by downplaying or unfairly criticizing one’s abilities or skills. But openness appears to be the cornerstone of supervisory humility.
Katie Vernoy 35:31
So there’s a lot in there that I’d like to talk about. I think the the first one, the most obvious one is just kind of the idea of humility. I agree with everything that’s said there. I think the idea around false humility, I agree, that’s ridiculous. And I believe that being open and willing to assess yourself and take feedback and learn from your supervisee, all of those things sound really good. I, I’ve worked with supervisors and have had to, you know, kind of correct or fire supervisors for being too open, too disclosing, too personal with supervisees and where it wasn’t reciprocated. I think that there’s, there’s an assessment here of how that relationship plays out. In some situations, I would imagine supervisees may want a little bit, you know, like, the the amount of authenticity and humility from the supervisor may be different depending on the person seeking supervision. And I think that would be collaboratively developed. I think that there’s individually what we need to be able to do, but I think it’s also how do we show up in the relationship that needs to be co-created to a certain extent.
Curt Widhalm 35:33
And it needs to be done with a certain level of intention.
Katie Vernoy 36:44
Sure.
Curt Widhalm 36:45
And one of the things that I’ve heard from supervisees, kind of throughout my career as an educator, you know, with students, is being able to talk about mistakes that I’ve made during my own therapy sessions as examples of like, even just coming back to things like repairing therapeutic relationships after a mistake has been made.
Katie Vernoy 37:05
Sure. Well, I think I think when we’re talking about kind of that, that humility around personal life, I think, the self disclosure part, maybe that’s that’s outside of this part, but it just, it, it feels like there’s like with self disclosure with clients and how we’ve we’ve opened up more of that, I think there still needs to be a lot of intentionality. So maybe that’s enough with around that topic. But I wanted to dig into to this other focus orientation. I certainly believe that if I’m the supervisor, I’m not the focus of supervision except where I need to correct or learn or self, you know, those pieces self disclose those pieces. But I think, when you’re talking about that supervision, that doesn’t have a focus on agency, or business or those types of things. I agree and with an asterisk, because I think that the reality is, there need to be conversations around the business, whatever that looks like. Because if money is not made, the business closes. And the supervisory relationship theoretically ends unless everybody’s willing to work for free. And so I think the way that we handled it in the agency I was working at, and I think some of the folks in private practices, if they’re big enough, can have more of an administrative supervisor and a clinical supervisor. But it was either having different folks addressing those two things, and/or having two different meetings with the same supervisor where one was focused on the business elements, and one was focused on more of the clinical elements. But even separating the functions or you know, I guess separating between two people, I think really helps that, that clinical supervision…
Curt Widhalm 38:53
Sure. Yeah.
Katie Vernoy 38:54
…be safer. But I private practice therapists who are bringing on a few supervisees can’t do that. And so when we’re looking at how do you navigate the business needs and the clinical supervision needs, because it’s still within that same relationship. It’s still within that, that alliance, that I have to also tell you about the fact that you’re not charging enough or that you’re keeping clients on too long when they are not showing up or you’re not seeing enough clients or you’re not making yourself available for enough clients. And so, there is a business case that that in most supervision relationships are there just as a practical measure.
Curt Widhalm 39:40
One of the best ways of doing this is setting goals for supervision.
Katie Vernoy 39:45
Okay.
Curt Widhalm 39:46
Even on a week by week basis, it can be as formal as here’s an agenda for how we’re going to spend supervision today. And if it’s something where you’d need a structure for it, to be able to follow it, either as a supervisor or as a supervisee. Here’s the topics that we want to hit today.
Katie Vernoy 40:06
Sure.
Curt Widhalm 40:07
Here’s the follow up that we have from last week. And if part of that is then just consciously dedicated to, and we need to talk about this part of being within the agency or being within the business and its effects on continued employment or continued role there. Then that is something that helps to make sure that those things are talked about in a more structured way. One of the biggest problems is, I hear a lot of earlier supervisors who tend to supervise in the way that they were supervised, and it’s just kind of being passed down as, alright, we’re gonna come in and what do you want to talk about today? And it kind of vaguely talks about some cases for a while, and it peters out until there’s not able to be able to get to these important topics without any intentionality.
Katie Vernoy 40:55
Sure, no, I completely agree that there needs to be agendas and goals, because I think that you know, whether they’re small goals for the supervision session, or larger term goal, longer term goals for the whole practice. But I, I still want to push back a little bit, because if you’re saying, goals, I’ve seen a lot of therapists who would not agree to the goal related to productivity. They would see it as unreasonable, they would they, they wouldn’t want to necessarily work on it, they would see it as as exploitative, which at times it was. And then there’s also folks around in private practice where I don’t want to see more clients, but you have to see more clients. And so when when one of the things is a is shared goals, that isn’t a shared goal. Like, I need you for the business or the organization or whatever, to see a number of clients or I need you to do things a certain way. That is very directive, it’s oftentimes very hard for folks to do, and they don’t do it well, but it also isn’t a shared goal. And it isn’t clinical. I mean, it can be, you know, certainly, you know, keeping your clients, you know, appropriately closing cases, all that stuff, you know, client retention is a clinical matter.
Curt Widhalm 42:10
Yes.
Katie Vernoy 42:11
So there’s there are clinical things. But that may not be a shared goal. The goals that sometimes supervisors have, because it is their business or because the organization says they have to address it are not things that supervisees want to talk about.
Katie Vernoy 42:29
And one of the ways that supervisors can best set that up for success, whether it’s agency, whether it’s private practice type situations, is being clear about the expectations and about the way that the business runs before ever hiring somebody or putting somebody into that position in the first place. Not every agency is going to get just perfectly matched supervisees and supervisees, are not always going to end up in the most perfectly matched places. But if here’s what it’s like to work here, is very clear up front, it minimizes the number of times that having different goals from the very beginning ends up becoming a problem. And so kind of in the way that we talk about, you know, working with clients of like, here’s what therapy with me is like. If you want to come in and you want to do psychoanalytic therapy and lay on the couch, that’s not me. You know, if you want to have a, you don’t have to go out and market or you don’t have to go out and create content, or you don’t have to develop yourself as a person of a therapists, that you work with the types of clients that we get at this practice, supportively, go someplace else. Like that’s…
Katie Vernoy 43:50
Yeah.
Curt Widhalm 43:50
And I have not been perfect about it. I’ve had supervisees, even in my own group practice that, I’ve liked them as people, I continue to like them as people, that the fit just was not explicitly said early enough. And I think that this is a supervisory skill, it’s a hiring skill of…
Katie Vernoy 44:12
Sure.
Curt Widhalm 44:12
…being able to make sure that those goals are aligned before the W-2 paperwork is signed.
Katie Vernoy 44:19
Sure. Well, and I agree with all of that. But no matter what, no matter how well aligned, there are still there’s still going to be the tension around those types of goals. And I think some of that’s required, right?
Curt Widhalm 44:35
Yeah.
Katie Vernoy 44:35
Especially for very successful practices or very busy organizations. The supervisor is going to want the, the supervisee to take more clients than they want to take.
Curt Widhalm 44:46
Right.
Katie Vernoy 44:47
And so there’s there’s, I guess it’s and maybe I’m belaboring this point we can we can talk about handling conflict another time, but I think that there’s this element of there has to be a mechanism by which the relationship can still be strong, even though there are competing or competing goals or even just attention on what the goals are. Because it’s it is a reality.
Katie Vernoy 45:11
Well, and this is where the reality goes against the research. Because one of the things that Watkins et all talked about is that other focused orientation, and at least during supervision, the other focus is keeping the supervisors feelings and pride and arrogance in check. It’s being invested in the whole of supervision, and it’s betterment. And these are maybe the administrative conversations that need to happen outside of supervision. I’m not saying that they don’t exist. I’m saying that for supervision to meet supervision goals, there have to be: I’m consciously taking off my supervisor hat, I’m setting it down, I’m putting on my employer hat.
Katie Vernoy 46:03
Okay.
Curt Widhalm 46:04
And parts of being able to do this and I, it’s in at least California has laws of regularly doing employee evaluations and supervisee evaluations with your supervisees. It’s part of our ethics codes.
Katie Vernoy 46:21
Sure. Sure.
Curt Widhalm 46:22
And we see people who have complaints against their supervisors, where this has never been done. And this ends up becoming problematic. If we don’t talk about the supervisory relationship, that’s problematic. And that needs to be able to be led in a graceful way by the supervisor as, hey, I know that you don’t want more cases. As an employee, I hear you, let’s talk about ways that you can balance the three more cases that we need to assign to you right now.
… 46:55
Advertisement Break
Katie Vernoy 46:57
So the different hat model, I agree with that. I think it’s the closest we have to something that works for someone that is a, you know, a group practice owner that has their own supervisees, right? Like they can’t divide it. I think this is in the best of situation where where agencies might do this better, where they have a clinical supervisor that can completely focus on clinical and then they have an administrative supervisor who can focus on that, and it’s keeps it separate. And so the clinical conversations in supervision can be richer. But in those situations, whether it’s an agency that doesn’t have two different supervisors or a private practice that doesn’t have two different supervisors/managers, I think that that has to be described, that there are these different hats, because I think that it’s hard for supervisees, unless they’ve been in a situation where there, where there are these different roles that are played out, I think it’s hard to distinguish that. Especially because business and clinical intersect a lot like client retention, like sufficient caseload like, you know, termination and closing cases, quickly, and paperwork like all of those things, which that traverse these different lines, I think, make it very hard to stick with this, you know, kind of ivory tower, definition of what supervision is to really get to the highest level, because I think that it can’t be completely separated. And I think it needs to be really explained if you’re going to have these this different hats of, of, you know, like, here’s the supervisor hat, here’s the mentor hat. And here’s the employer hat, because I think all three of those could have conflicting goals at any particular time.
Curt Widhalm 48:37
I think that part of where the supervisory research is that makes it into this ivory tower that you’re talking about is the ways in which we are measuring supervision and supervisory alliances, just historically.
Curt Widhalm 48:53
You know, it we this is my my criticism of kind of the publish or perish parts of academia right now is that a lot of research just gets focused on what’s already there and validating what’s already there just to be able to publish stuff. And so we’re a lot less likely to try new things within the research that show effective things. And when we do get something out there, we’re going to have problems with Okay, here’s trying something new or something that we haven’t done within our field before. And we bristle because now we have to do things different as supervisors. I have a master’s degree and a decent amount of training in behavior analysis, not talking about the application of it to any particular clients population here, but one of the things that I believe that behavior analysts do really well is the functional assessment of skills for interpersonal therapists. It’s called the FASIT system. And what it does is it starts to incorporate a lot of the problems that you’re talking about in a multi-directional way between the supervisor and the supervisee. That something like a Likert type scale, doesn’t end up getting into why these things were problems. The FASIT system is more labor intensive, it’s more qualitative, it gets into looking at the functioning of how both the supervisees, but also the supervisors address problems. And the article that I’m going to share in here is a 2006 article from Callaghan, Functional Assessment of Skills for Interpersonal Therapists: The FASIT system, and it does get into a lot of like, is there problems like identifying the specific needs from the supervisor. And I, is there problems with being able to have the appropriate contextual control for how these things are brought up. So it’s not just supervisees who are walking out of supervision being like, I didn’t get heard at all. But it helps to address some of the things like Is this something that deals with that aforementioned anxious attachment style of the of the supervisee? I’ve always been a big proponent of I want my supervisees to speak up. I want, I want them to openly be able to bring things up. Not everybody comes to that naturally. And if they don’t come to that naturally, that’s a great skill to learn. Because if you can’t do it within the safety of supervision, how do I trust that you’re going to be able to call out clients?
Katie Vernoy 48:53
Yeah.
Katie Vernoy 48:54
Yeah.
Curt Widhalm 48:54
And so there is aspects of this that goes into both ways. And part of the evaluation looks at what the what Callaghan calls, the response repertoire, is the way that the supervisee is handling things. Is it done through escape or avoidance? Or is it done through ineffective or unclear assertions of needs? You know, the some of the supervisory disruptions that I’ve had to work through before is people who said, Well, I did bring something up. And I go back through my supervision notes. And I said, you made one comment about this six months ago, and you never brought it up again. That’s, that’s an ineffective type of approach, at least within our supervisory relationship. Part of what Callaghan also talks about is, you know, being able to evaluate our supervisees rejecting that a need is present. I can picture some of our listeners who provide us feedback with, you know, well, what about supervisees who just don’t know what they don’t know. Okay, that falls under categories of rejecting that needs are, are there. Part B of Callaghan’s model here is then also looking at how the feedback is received on this. And this is all stuff that ends up, you know, I’m not going to go through every aspect of this, because we’ll include it in our show notes. But what this does, is helps to really get in at a deeper level of here’s what’s going on with our relationship and the relationship and its effects on the ability to go to clients with this. Or the way that you’re walking out of supervision with something to do about it, and be able to better shape the goals of supervision, you know. Alright, are we trying to, you know, talk about cases the entire time. So that way, we don’t have to talk about the administrative stuff of not getting notes done on time or being overwhelmed, because we just know that our supervisor is going to dismiss whatever it is about our assignments. Or on the other end of things, not being able to get enough clients to fulfill their hours obligations. So I really liked this because it gets more granular. Because it does lead to a better place of being able to look at how we can provide more constructive and evaluative feedback. This doesn’t need to be done in every single supervision, but it should be done more often. And it’s something that as a bi-directional approach, allows for the supervisor to then also be able to shape how supervision is to get better supervisory responses.
Katie Vernoy 54:26
So just trying to clarify. So the functional assessment of skills for interpersonal therapist is a tool that supervisors and supervisees can do to assess supervisees.
Curt Widhalm 54:36
Yes. I’m hoping that some of the research that comes out of this and the ways that I use this within my management style and within my group practice, I’ll interchangeably use management and supervision because it all fits within a larger umbrella like you’ve been talking about. I encourage this kind of a reflective skill from my supervisees and employees to be able to reflect back on, hey, Curt, it seems like this is, you know, lack of follow through at your end. Is this because you’re avoiding this? Is it because you’re just too busy with other things? And it helps me to even be able to break back down to them. And this is, again, how all of this stuff fits together within the humility of like, you know what, you’re right. This is something that’s falling through on my end. I’m open about this got pushed to the wayside because of XY and Z. And fitting it all together is something where Callaghan’s model here does not get into ways for supervisees to provide that feedback. But if that is something that’s coming up within the supervisory relationship, in conjunction with even some of these shorter form supervisory scales that say, Hey, I didn’t get out of supervision, what I needed today. These are assessments that can be used in conjunction with each other.
Katie Vernoy 56:02
That makes sense. I think on a theoretical level, and even getting a little bit more practical; I feel like we’re getting somewhere that’s really helpful. But I still really want to get more applied. Because to me, again, it’s it, you know, I’ll say the ivory tower phrase, again, I feel like that there’s for folks who are who are actually supervisors in an agency, supervisors in a group practice, or are thinking about starting their own group practice, or have their own group practice and are doing supervision. I feel like this, this, what we need, where we need to get with this conversation is how do folks approach it? Because what you’re talking about a lot of this stuff, I’m like, Okay, well, that’s just good management. And that’s good supervision in any field, right?
Curt Widhalm 56:45
Sure.
Katie Vernoy 56:46
It’s having humility. It’s being able to come together and try to figure out what’s going on.
Curt Widhalm 56:53
Yep.
Katie Vernoy 56:53
Have a relationship and talk to each other. And, and have it be collaborative versus someone that gets so frustrated and overwhelmed or, you know, rigid in how they view things that the supervisee is a robot that they’re just telling what to do. Right?
Curt Widhalm 57:07
Mmhmm.
Katie Vernoy 57:07
So I think that there’s there’s a lot of this that I feel like there’s there’s a huge amount of information. I would imagine, maybe I shouldn’t say this, but it seems like there’s a lot of information about how to manage people well. And it seems like this falls along the same thing. And there’s something different about supervising clinical work. And so when we’re looking at supervising clinical work, where does this fall in? Like how do we best supervise clinical work versus how do we best supervise employees? Because I think what you’ve described a lot of it speaks to everything else that the employment literature says. So what’s special about clinical supervision?
Curt Widhalm 57:55
Honestly, from my perspective, it’s: we feel like clinical work is so much more special than it actually is.
Katie Vernoy 58:07
That’s gonna be the pullquote.
Curt Widhalm 58:13
We want it to be something more than it actually is. Because my anecdotal experiences, the research on this is the single biggest waste of supervisory time is going around the room and just reporting on cases. And there are so many of us who have been supervised in that way. That there, there isn’t even a goal to what we’re talking about. That it’s just, and it allows for kind of that escapism of, okay, I’m a trainee, my, I want to look good for the supervisor. So I’m only going to report on cases that are going well, and that I have an idea of what’s going with. That, you know, again, harkening back to Scott Miller feedback informed treatment kinds of things and the mentor aspect of that that can apply to supervision is: better supervision skills use is here is a client and I have any specific question of what’s going wrong and that I need help with.
Katie Vernoy 59:16
Yeah, that’s that’s, that’s my experience with supervision is it’s only like we sit there and it feels like it’s all the cases that are super, super hard, in group supervision. And so it’s just this onslaught of like, lots of creative thinking, and just like, oh my gosh, our job is so hard. And then I always had to make sure that we were getting out of that like, oh my gosh, the job’s so, and how do we hold on to hope for these families that are having such a hard time. But…
Curt Widhalm 59:43
And what you’re demonstrating there is you’re recognizing supervisee needs in those situations. That you’re, you’re more a effective supervisor than maybe the ones that we’re painting here. But the there are a lot of supervisors and a lot of supervisee experiences that I hear where it’s just kind of like, okay, come in, you’ve talked about your cases, we can stamp off that you’ve done your 15 minutes of talking, and now seven other people are going to get 15 minutes of talking each. And, you know, we’re way too small of an office and just all sitting on top of each other, and it’s hot and…
Katie Vernoy 1:00:22
Well, I guess my experience was very different. It was a gigantic boardroom, and all of us were, you know, put off to one side of the table. And, and just digging in. I mean, I think the thing that group supervision is a whole other conversation.
Katie Vernoy 1:00:36
Sure.
Curt Widhalm 1:00:36
Right. Yeah, a lot of what we’re talking about here is individual supervision, because…
Curt Widhalm 1:00:38
…research and variables of other people within the group…
Katie Vernoy 1:00:43
Yeah.
Curt Widhalm 1:00:43
…and all of that kind of stuff.
Katie Vernoy 1:00:44
That’s a thing.
Curt Widhalm 1:00:45
Yeah.
Katie Vernoy 1:00:47
But I think, I think when we’re, when we’re really looking at it, the clinical elements of it, I mean, I think the clinical supervisors should have technical knowledge, they should be able to provide direction, whether it’s a CBT specific directive, or, you know, up at up to an including, like, the whole DBT supervision and how they’re doing DBT on each other. But I think there’s that element of, at a certain point, I mean, I’ve supervised people who were doing evidence based practices that I didn’t know. And it was because that was what was available. And so it was about accessing the supervisees experience, and being able to help them understand and identify how they can take this on, and how they can do it and those types of things. And so, to me, when I think about really good clinical supervision, I mean, sometimes maybe I am thinking about the DBT model of doing DBT on each other, but, but it feels like there’s people that talk about this, this experience that feels more clinical than maybe what you and I do, which is a little bit more directive, a little bit more supervisor supervisee employee management.
Curt Widhalm 1:01:57
Sure.
Katie Vernoy 1:01:58
And so, so are we missing something here? Maybe this is a question to our audience. Is there, is there some type of supervision that theoretically, would be more amenable to really high quality clinical work?
Curt Widhalm 1:02:10
I mean, this being a podcast episode on supervisory alliances, part of what you’re asking is a much deeper conversation that goes within the other aspects of the workshop that I’ll be recording in April.
Katie Vernoy 1:02:22
Sure, sure. But the reason I brought it up in a supervisory alliance one is because there are times when supervisory alliance looks more like therapeutic alliance, because of how they’re addressing the clinical work. And I just want to say, I don’t think, across the board, that that is what is wanted on on both both sides of that relationship.
Curt Widhalm 1:02:43
Correct. Yeah. And you poopoo DBT, you know, supervision…
Katie Vernoy 1:02:48
I didn’t. It’s great!
Curt Widhalm 1:02:50
It is great. And, and…
Katie Vernoy 1:02:52
I didn’t poopoo it.
Curt Widhalm 1:02:53
And I, I hear people poopoo DBT, and, you know, doing DBT on each other, it’s not doing therapy on each other, it’s, it’s living the principles of DBT, consistently. And within that is the agreement of yes, this is how we’re going to approach things.
Katie Vernoy 1:03:16
So it comes back to kind of basic principles, which is, be humble, I was gonna say, Don’t be an asshole, be humble, be willing to learn. And this is for supervisors, really make sure that you are consciously talking about what it is that you’re going to be working on. And going to the foundational principles that you were talking about rapport or bond, shared supervisory goals and the shared tasks by which those supervisory goals are pursued. But in looking at that, there are going to be other practical considerations. And as much as you can, try to separate out the stuff that is other focused, business focused, you focused whatever, from the kind of traditional supervision our so to speak. But recognize that those things are going to intersect and and there’s going to be things that that are harder to navigate, because there might be at least tension, if not conflicting goals. And part of the relationship is actually addressing those goals. And why they are there. I mean, sure, try to hire well, make sure people are aligned from the beginning. But as you said, there’s there are folks that don’t know what they don’t know. And so they might be saying, like, sure, I want to see 27 clients a week. And then when they actually start doing it, they recognize that no, in my traineeship, I had 10. And I felt like I could do twice that. But 27 is almost three times that and I just I don’t have it. And now what do we do? Right? So I think that there are, there are things that are going to come down and I think it’s important as a supervisor to continue to come back to the the position of humility, but humility, like a therapist has humility, not humility, like, you know, your drunk best friend might have.
Katie Vernoy 1:04:55
And so I think it’s something where it’s looking at: How do you keep navigating this relationship? Because it is more challenging than a therapeutic relationship, I think because of these additional tasks that are directive that are non negotiable and are not supervisee driven, that that hang in the outskirts at the very least.
Curt Widhalm 1:04:55
Sure.
Curt Widhalm 1:05:16
Sure, are going to build on that point with something that we haven’t talked about in here yet. And this goes back to that Watkins et all 2018 article is the role that that humility also brings up when it comes to multicultural competencies as a supervisor. Because you’re right, it is a lot different skill set while holding many of the same skills of being a therapist. But Watkins et all say that the humility may well be the foundational building block for the development and enhancement of multicultural supervision competencies because it A: fully opens the supervisor to the possibility the reality of multicultural differences, B: makes increasingly likely the seeing of any such possible multicultural differences, C: makes increasingly likely action to assess how to best address those identified multicultural differences and needs in supervision, and D: makes increasingly likely action to then multiculturally customize the supervision situation to best meet those identified needs. Our audience being wonderful, having multicultural humility. This makes sense. And I think for a lot of being able to address multicultural issues better in the last few years. If we just take that same approach and apply it to supervision, it’s the same thing. We don’t have to go in with the expertise of everything. And the more open that we are to other people’s experiences of the supervision, of the workplace, of how they apply their skills. This applies to supervision as well, both in a multicultural way and just about the supervision process, in and of itself.
Katie Vernoy 1:07:06
I think that’s amazing.
Katie Vernoy 1:07:09
You can find our show notes over at mtsgpodcast.com. You can buy this course at moderntherapistcommunity.com along with any of the other CE stuff that we’ve put out there. And follow us on our social media, become a patron if that’s a way that you want to support us. In another way, it definitely helps us keep putting out greater content and knowing that we’ve got some support on our end. And thank you for being a listener. And until next time, I’m Curt Widhalm with Katie Vernoy.
… 1:07:41
Advertisement Break
Katie Vernoy 1:07:42
Just a quick reminder, if you’d like one unit of continuing education for listening to this episode, go to moderntherapistcommunity.com, purchase this course and pass the post test. A CE certificate will appear in your profile once you’ve successfully completed the steps.
Katie Vernoy 1:07:57
Once again, that’s modern therapistcommunity.com.
Announcer 1:08:00
Thank you for listening to the Modern Therapist’s Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don’t forget to subscribe so you don’t miss any of our episodes.
SPEAK YOUR MIND