The Contemporary Relational Supervisor 2nd edition

Robert E. Lee, Thorana S. Nelson, Toni S. Zimmerman

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000414783
• Edition: 2
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The Contemporary Relational Supervisor, 2nd edition, is an empirically based, academically sophisticated, and learner-friendly text on the cutting edge of couple and family therapy supervision.

This extensively revised second edition provides emerging supervisors with the conceptual and pragmatic tools to engage a new wave of therapists, helping them move forward together into a world of highly systemic, empirically derived, relational, developmental, and integrative supervision and clinical practice. The authors discuss major supervision models and approaches, evaluation, ethical and legal issues, and therapist development. They present methods that help tailor and extend supervision practices to meet the clinical, institutional, economic, and cultural realities that CFT therapists navigate. Filled with discussions and exercises to engage readers throughout, as well as updates surrounding telehealth and social justice, this practical text helps emerging therapists feel more grounded in their knowledge and develop their own personal voice.

The book is intended for developing and experienced clinicians and supervisors intent on acquiring up-to-date and forward-looking, systemic, CFT supervisory mastery.

Part 1

Understanding the Supervisory Process

DOI: 10.4324/9781003099833-1

An Overview

• 1 Basic Ingredients in the Supervisory Process
• 2 Systemic Supervisory Relationships, Roles, and Goals
• 3 Getting Started: Readiness and Procedures
• 4 Screening, Contracts, Core Competencies, Evaluation, and Feedback-Centered Supervision

1 Basic Ingredients in the Supervisory Process

DOI: 10.4324/9781003099833-2

Supervision is an intervention provided by a more senior member of a profession to a more junior member or colleagues who typically (but not always) are members of that same profession. This relationship is evaluative and hierarchical, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; and serving as a gatekeeper for the particular profession the supervisee seeks to enter.

(Bernard & Goodyear, 2019, p. 9)

Relational/Systemic Supervision is the practice of developing the clinical competencies and professional growth of the student as a supervisee, consistent with the relational/systemic philosophy, ethics, and practices of the marriage and family therapy profession. Supervision is distinguishable from psychotherapy or teaching. Relational/Systemic Supervision may be provided though virtual supervision.

(Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE, 2017, pp. 2 & 3)

This chapter is meant to be foundational to all that follows. It intends to result in a clear understanding of those things that characterize effective couple and family therapy (CFT) or relational supervision. It is based on the distinction between education and training (Bernard & Goodyear, 2019; Lee & Nichols, 2010). Education in CFT is about acquiring a knowledge base. Training in CFT is about acquiring skill in the application of this knowledge base to therapeutic situations. Couple and family therapy supervision is a training endeavor. It follows some amount of CFT education and is dependent on a working alliance between the trainee and the supervisor in pursuit of the trainee’s professional goals. In contrast, education can occur without such an alliance. Of course, supervision includes overseeing quality of care of clients as well as the development of the trainee as a therapist. Therefore, competent therapists seek collegial input when necessary or desired. This activity, however, is not considered supervision; rather, it is consultation. Supervision has an element of responsibility and liability for the conduct of a trainee.

Training of supervisors is similar. It includes education (acquiring knowledge) and skill-building. Professionals in CFT believe that supervision is a different activity from doing therapy and thus requires specialized training. This text is intended to be a part of that training—the educational part. In it, we emphasize the recursivity of the training system: clients, therapists, supervisors, supervision mentors (supervisors of supervision), administrators, and so forth. We also emphasize that training and supervision are about the growth of the trainee as a therapist rather than merely consultation about cases. But unlike our peers who also are advocating for integrative, systems-based supervision (see chapters in Todd & Storm, 2014), our conceptualization of the training system explicitly denotes an overarching time or developmental factor (see below). We view training in CFT supervision as different from both training in therapy and training in supervision in other mental health approaches, although more like the latter than the former. There are important differences, however, as described by Storm (2007). First, supervisors in CFT are more likely to attend to the values and beliefs that trainees hold about couples, and couples in therapy, including same-sex couples. Second, the therapeutic alliance in couple and family therapy is systemic and complex, requiring supervision that discourages alliances that can be detrimental to the couple relationship. Finally, therapists and supervisors of CFT must be comfortable with complex emotional expressions that emerge in CFT.

In this text, we consider therapists who are learning systemic therapy as trainees regardless of their backgrounds, developmental levels, or the unique ecosystems in which they exist. This includes students in graduate programs, postgraduate trainees, and anyone else who is in a learning position with a systemic, relational, or CFT supervisor. We also recognize that training occurs in diverse settings, to wit, university or other training clinics for graduate students, behavioral science institutes, public and private agencies, and individual and group private practices, among others. These contexts are multifaceted, and we have attempted to provide ideas that apply to all as well as some ideas that apply to specific contexts. We also refer to client systems as including individuals, couples, families, and other groupings that seek services from a couple and family therapist. Training systems, in turn, include clients, therapists, supervisors, supervision mentors (supervisors of supervisors), administrative individuals, and so on, as well as the unique ecosystem in which each exists, and the developmental level of each unit. A relational supervisor ideally considers all of these systemic features while supervising therapists.

This text is based on a systemic conceptual model that includes a developmental component throughout (see Lerner, Agans, DeSouza, & Hershberg, 2014). Supervision focuses on the acquisition of skills more than education. The full training system includes many entities and subsystems: clients and their systems, therapists, therapists in training, supervisors, supervisor candidates, supervisor mentors, clinics and other agencies that provide mental health services, educational institutions, and other entities that may interact with other parts of the training system. These other entities may include courts and academic departments as well as textbook authors. From a systemic perspective, training settings also include relationships among various parts and subsystems. Not all training systems include the same parts (supervisor mentors, for example) and not all parts are housed in the same place and at the same level of developmental sophistication.

Why this developmental component? Contemporary supervision experts no longer focus primarily on the dyadic relationship that exists between trainer and trainee. Instead, they contemplate the entire training system, and this includes the contexts in which all the participants are situated. However, the most prominent of these do not include the dimension of time, that is, the developmental maturity of each part of the training system. We recommend that you consider this view because we think it is reasonable to assume that the adaptive performance of any system—in this instance, a training system—cannot rise above the capacities (level/predispositions) of its least sophisticated/mature/capable member/unit/participants. This idea has been manifest over time in interpersonal constructs such as “differentiation of self” as well as the directives by some that CFTs meet jointly with all members of a client family.

In today’s parlance, one member of a system may be aware and sensitive to other parts but this awareness may not produce compatible responses from members who are not.

We suggest that a best-case scenario would have you attempt to bring discordant parties on board with your epistemology or at least help them understand it. At the very least, however, it is advisable to take the developmental capacities of the participants and their unique contexts into account when planning interventions and setting goals.

We would like the reader to perceive a training system to be a complex environment of subsystems wherein interactional dynamics occur within, between, and among those subsystems and in which these dynamics frequently are related to each other. For example, there may be multiple lines of interaction and the potential for many dysfunctional triangles (Alderfer, 2007), and the processes and patterns in one part of a system may be isomorphs of those in other parts (see Koltz, Odegard, Feit, Provost, & Smith, 2012; Chapters 2 and 3 of this text). For us that suggests that interactional patterns in the overall training system and across subsystems are replicated, each reflecting the others. That is, dynamics in the trainee/client system may be replicated in the trainee/supervisor subsystem and vice versa. We emphasize this because isomorphism is a central concept when troubleshooting difficulties in the training context.

We believe the foregoing conceptualizations are vital to supervisor training and supervision of supervision (mentoring). If supervisors are able to step back and observe themselves as living parts of the training system, they may gain important insights into and leverage within these training systems (see Lee, 1999). Indeed, looking at the training system from “the top down,” it becomes clear that the manner in which supervisors construct “supervision” and “therapy” in terms of their processes and goals greatly influences trainees, clients, and supervisors, and the process of both therapy and supervision. Supervisors’ constructions greatly influence “everyone’s ideas about what therapy is and how it is done, how people in relationships should be, what constitutes a ‘problem,’ and how important it should be considered relative to other matters” (Lee & Everett, 2004, p. 12). Similarly, training therapists’ ideas about these things influence processes in supervision. That is why we, the authors of this text, suggest beginning the supervisory process with discussions with trainees that alert both parties to the fit among their respective ideas about the content and process of therapy and supervision (see below). This discussion, which we might call “an appreciative interview,” entails listening carefully and co-constructing understandings about each other, the supervision process, and the work together.

An essential construction in this text is the paradigm of system thinking (von Bertalanffy, 1968). As system thinkers, we see the world as a complex network of individuals and their relationships with each other that become visible through interactions. Within a system, which may be a subsystem of a larger system, change that occurs in one part reciprocally affects all other parts and is, in turn, affected by those other parts. A system is made up of ever-changing dynamics, roles, interactions, and meanings. We will discuss system ideas in more detail later in the text.

System thinking in therapy and supervision includes awareness of differences of values, attitudes, and ways of understanding the world, and the influence these have in professional work. Increasing awareness of differences should inform assessment and other interventions and result in personal commitment to enhancing services to diverse client families in diverse settings. This is a matter that goes beyond “cultural competency” (see Chapter 10). Couple and Family Therapy education and training must be infused with this matter and be attended to on a continual basis. Using common parlance, these individual differences should be a “dashboard” item. CFTs and relational supervisors should always be alert to multiple realities and their professional thinking and conduct guided by it.

The training system is situated within a systemic understanding of the supervisory process. Training occurs in a large, multilayered context that involves simultaneous responsibilities not only to trainees and client systems, but also to institutions and communities in which the training is being provided. Thus, one supervisory role is to facilitate the growth of trainees as professionals. However, there are other supervisory roles, namely, teachers, coaches, mentors, and administrators (Morgan & Sprenkle, 2007), gatekeepers (Baldwin, 2018; Lee & Everett, 2004), and supporter, supervisor, consultant, colleague, and socio-emotional regulator (Jethwa, Glorney, Adhyaru, & Lawson, 2019).

Therefore, supervisors oversee the treatment process so that client families are well served and trainees learn the craft of therapy. They also monitor the administrative needs of institutions such as communities, accreditation and other regulatory bodies, and the professional fields of mental health therapy to ensure that the community, if not ensured of best practices, at least is protected from harm.

Getting the Training Process Started

This text is meant to be solidly based in empirical and conceptual literature and readers will note that approach. However, this is first a pragmatic text and second, a beginning for students of CFT supervision. Doctoral students and others who are studying supervision as a discipline may note some deficits and will want to further engage with the literature.

Pragmatically, supervisor candidates’ first steps should be to recognize their own philosophies of supervision, that is, their ideas about what they, as supervisors, believe about supervision, what they intend to do, its purpose, and their responsibilities and actions. These visions in turn must be attuned to those to whom they have obligations: their trainees, of course, but also to the units of the larger training system and communities in which they and their trainees are situated.

Rober (2010) suggested a process whereby new trainees attend to their “polyphony of inner voices” (pp. 158–159). Through an exercise of self-awareness, trainees become more conversant with themselves, particularly in four areas of concern: their ideas about clients’ processes (listening), processing what they hear (making sense of the client’s story), focusing on their own experiences related to the clients’ stories, and then managing the therapeutic process. We suggest that a similar process for supervisors is quite beneficial in terms of their relationships with their trainees.

Only at this point are supervisor candidates ready to engage trainees in a supervisory process. After reflecting upon one’s ideas about the purpose and goals of supervision as well as what one thinks is important in a supervisory process (the supervisor’s basic philosophy), a good next step is to begin to interview trainees, being careful to privilege that which trainees “know” about therapy, supervision, and themselves as therapists. New trainees may protest that they have no clinical experience and therefore “know” nothing about therapy. However, they have ideas about the purpose of therapy, and they have had experience with work supervisors and professors. Therefore, they have a sense of what can be helpful or detrimental in a supervisory process, and they have some ideas about who they might become as therapists. Some of these matters involve attitudes and style, and others, the mechanisms of the work as well as expectations for both supervisors and trainees. Some training settings identify with a specific theoretical model of CFT. Consequently, supervision mostly is about helping trainees learn the approach specific to that theoretical model. In other settings, a supervisor helps a trainee develop his or her own approach, regardless of the supervisor’s own orientation to therapy.

Experienced trainees have been consumers of supervision and have clear ideas about what they have experienced as very helpful or less so (see Anderson, Schlossberg, & Rigazio-DiGilio, 2000; Drake Wallace, Wilcoxon, & Satcher, 2010; Hildebrandt, 2009; Johnson, 2017), depending on their current level training and clinical experience (e.g., Stoltenberg & McNeill, 2010). Moreover, the authors have learned that all trainees have expectations of the training context, some good and some not so good, based on previous experiences with supervisors, teachers, coaches, parents, and other authority figures. Therefore, we recommend that a course of supervision begin with:

An Appreciative Interview

The goal of an appreciative interview is to make explicit trainees’ lessons learned from their lives to date, especially in learning situations. In this way, supervisors can safely elicit and address the anxiety most trainees feel at the inception of the first or a new episode of supervision. Such an approach invokes common sense. One’s transcendental goal is to increase the probability of desirable things happening and decrease the probability of undesirable things happening. This approach, co-constructed by the supervisor and trainee, is intended to cultivate a sense of safety in the face of vulnerability, openness of the supervisor to the person of the trainee and self, and reciprocal respect between the trainee and supervisor, and to emphasize the importance of the working relationship.

An Investigation of Both Supervisors' and Trainees' Expectations of Each Other

Where supervisors and trainees are not in agreement, the differences can be explored as stylistic or expectation differences, or for “baggage” that is relevant to the current setting. These may be barriers to positive growth and need to be considered. (Barriers to effective supervision are addressed more in Chapter 14, Troubleshooting and Pragmatics in the Relational Training System, and also in Chapter 4, wherein feedback-centered supervision is discussed.) At issue is the extent to which the supervisors’ and the trainees’ expectations of each other in the training setting are explicit and compatible. That is, are the supervisors’ expectations of themselves compatible with those the trainees expect of the supervisors? Are the supervisors’ expectations of the...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• About the Authors
• Foreword
• Preface
• Part 1: Understanding the Supervisory Process
• Part 2: Relational Supervision Practices
• Part 3: ontextual Considerations
• Part 4: Troubleshooting and Writing a Personal Philosophy of Supervision Paper
• Appendix A Major Marriage and Family Therapy Models
• Appendix B AAMFT Core Competencies
• References
• Subject Index
• Author Index