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Supervision for Therapists – A Critique
I have wanted to write this article for a long time, but the contract has often prevented me from putting pen to paper. Intelligence in science is difficult to change; every new paradigm is always met with skepticism and contemptuous attitudes. But now I’m independent of those who can make life difficult for a single voice, so I think it’s time to make a case against supervising therapists.
Like many therapists and psychologists, I have had to submit myself to the task of observing and observing others for years. In order to clarify my objections to the process, I must first mention the existing conventions and wisdoms of the last 100 years.
What is surveillance and what is it for?
Therapy is seen as a difficult task where we have to listen to other people’s pain and difficulties by living their stories. Often difficult and stressed clients tell us what is going on in their lives now or in the past that is preventing them from moving forward from past traumas or current life struggles. Most professionals who listen can certainly empathize with the client and help the person deal with their problems and deal with the future in whatever form of therapy they have. It is the main point of the healing process.
For many less stable therapists they face the burden of objectifying the client’s situation and often shift the burden of the problems, themselves, from the client onto themselves. After a while they face personal failure and misery – not because of their own problems but because they cannot mentally remove themselves from the client.
The case for supervision is then largely directive, with the supervisor (usually a very experienced counselor) listening to the therapist to help that person put the client’s problems and their own into perspective. I think for a new trainee therapist and someone with low personal confidence this can help them to continue and help prevent personal failures. Most organizations insist on one hour of supervision for every six hours of customer contact.
So why stated above, a reasonable case for observation, I am so against the practice? Well, I will stop at the following points:
1. Most surveillance is ineffective
2. The questions themselves are a problem
3.It is a money turning exercise for profitability
4.Most famous therapists were never supervised in the modern sense.
5. It is a power play and an egotistical parent-child role play
6.It can be easily changed.
On my first point, most surveillance is ineffective; I state this from personal experience of observation and from anecdotal evidence of other therapists. When you submit to observation, most counselors and therapists report that they feel it is a critical experience rather than a supportive one. Many people feel that they are tempted to justify what they have said and done in individual therapy sessions. So many in these sessions are not honest and forward but in fact as any psychologist knows they will show themselves in the best possible light. This immediately defeats the whole concept of support and guidance. If the therapist feels judged they cannot benefit from the exercise and therefore do not feel able to grow from their current position as a counselor.
The second point is the observers themselves. Most are not experienced observers but are skilled in their particular field of theory. They take on the burden of supervision because they are asked to. However, this is not the most important aspect and I will look at it in the next point. My experience and that of other observers is that they hear cases second hand, try to make judgments outside of their personal experience, try to see the mind of the therapist in front of them and worse put a time limit on the relationship. Overall they have very little stake in the client and very little in the therapist in front of them.
My last and third point is – money! Supervisors are paid by therapists. They know every new consultant to need many hours of customer contact and hours of supervision compared to the theoretical requirements of the skill. This is the real challenge of supervision – the money made from new consultants (most of whom never become) is a high income business. Then the motivation of supervision is not a feeling of valuable support, but a simple commercial exercise that uses counselors and therapists for money. If it looks dry – too bad. The truth often burns.
I guess the best way is to invent your own theory of therapy and observe yourself as the most famous psychologist of the past actually did, Freud, Jung and many other historical figures had to draw observation but in fact the assembly self defense. The method they used was different from the heavy method we use for observation today. If you are confident in your ability and feel that you are successful with your clients (and only you and your client can judge that) then you don’t need anyone else to tell you.
My fifth point might be a tribute to Eric Berne, the creator of Conversation Analysis (personally one of the best theories in psychological thought). In the state of TA Berne’s beautiful concept of the PAC model, parents, adults and children as mental states. I don’t want to dwell on theory here and we don’t have the space. As an observer you act as a Parent to the child’s ego state of the counselor. This means that the supervisor is not in the position of a coach or mentor but is actually a supervisor and is often judgmental and parental in guidance. It doesn’t matter whether the supervisor takes the role of a critical parent or a great parent – the power play is the same. Counselors refer to parental symbiosis with their supervisor through childhood experience. This is unhealthy and limiting and most counselors will assume the role of the Adaptive Child in that they will submit to supervision as a way to please their parent (supervisor). As Berne explained, we all have a Little Professor in our heads who is constantly trying to get the best out of a situation and in the case of a child love and affection. If you can’t get love, then attention will – even critical attention.
My last point then is that it can easily be changed. Many years ago a group of like minded counselors decided to form a community away from the mainstream organizations that are trying to dominate the mental health regime through rules and doctrine of control. They met once a month as a large group, sometimes up to 60 people. They will have a speaker on some interesting topic, who was not allowed to speak for more than 30 minutes, as most psychologists know, the peak of our personal attention time to listen and stop. After people joined and chatted. Nothing serious, books read, clients seen, talking money and other general aspects of consulting. But more importantly they formed smaller groups that lived close together. These groups of five or six therapists will meet every two weeks in one person’s home and this will be transferred. These meetings were relaxed and informal. You can bring case history or clinical problems. Each in turn got a chance to talk about what was bothering them and in return received advice, wisdom or just general conversation from the other group members. The group didn’t have to solve any problems and you could just listen if you wanted. The idea was support and a non-judgmental group feeling. (Do not confuse this with a Group Therapy session). These colleagues and your friends are not your judge. The atmosphere of these groups was, I think, ten times more stimulating than any single supervised session. Of course some basic rules should be followed, be non-judgmental, respect for other people’s theoretical points, (you can all have different schools of thought) this often leads to a clash of ideas. You should not tell, just discuss, this leads to an atmosphere of information, not dictation. Finally, drink tea and biscuits, joke, have fun – this is a time to feel good and the fact that you are part of a community of people who care about others and are working towards a better mental health world.
I personally get to supervise new consulting students as they meet their first clients. I try to give a supportive and coaching approach to the process. I encourage my students to form peer groups and count their hours in these groups as observation time. I think once you have the talent then a group of friends should be all the support you need. Current supervisors can replace their lost income by giving open lectures or talks to groups (thirty minutes). If they are really as good as they think they are then they can demonstrate it in front of a group. Tough decision – to be judged – isn’t it?
I repeat, I am against surveillance. It should be stopped except for initial training purposes. Only therapists and their clients can do therapy. I know that this article will have many critics and those who will criticize my views. So be it. As I explained in the beginning, every new paradigm deviates from convention in the beginning. I just hope that in time we can figure out how sick the current system really is.
Professor Stephen F. Myler PhD (Psych)
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