During graduate school, my cohort was often posed with the question of how to respond to various ethical dilemmas. It became a running joke to always answer with one of the following: “It depends,” or “Ask your supervisor.” Before I began to see patients, “ask your supervisor” seemed easy enough to do. In reality, supervision can be a complicated process. At the same time, supervision is an amazing resource that can elevate your professional development. Read on for some considerations for getting the most out of supervision from start to finish.

Meeting your supervisor

Similar to establishing a foundation to your therapeutic relationship with patients, it is important to establish a strong foundation with your supervisor. The following guidelines can help accomplish this and set supervision in a positive direction.

  • What supervision framework (e.g., developmental) will your supervisor use? Knowing this at the start can help you understand your supervisor’s method of supervision and how he or she will conceptualize your development.
  • How will your supervisor evaluate you? Establishing clear objectives the supervisor expects you to meet throughout the training experience will help prevent misunderstandings that could negatively impact your progress in your training or potentially need remediation.
  • Clearly establish with your supervisor when you will need to consult immediately (e.g., patient reports suicidal ideation) and how to do so. This will help insure the safety of your patients and limit negative legal or ethical ramifications.
  • Be aware of some of the ethical considerations in supervision, and familiarize yourself with the ethical guidelines pertaining to supervision outlined in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct [1]. Equipping yourself with this information can help you advocate for and protect yourself if anything goes awry.
  • Talk with your supervisor about your training goals. Throughout your rotation, your supervisor can be on the lookout for opportunities to gain experiences in line with your goals, such as administering certain assessments or conducting therapy with a certain population. Ensuring your supervisor knows your training goals will enable the supervisor to, where possible, tailor the training experience to your needs.
  • Also let your supervisor know your theoretical orientation, but remain open to learning new ways of working. If your supervisor knows the framework you work from, he or she can promote your development within this framework by prompting you to conceptualize patients and provide interventions consistent with this orientation.
  • Finally, be honest with your supervisor about what experience you have already, and what skills you feel competent utilizing. It is better to be honest about any skills-related growth edges you have rather than covering them up and risk harming a patient.

If your supervisor does not already offer this, consider asking to create a supervision contract that addresses all of these considerations. Having the expectations and goals in writing can prevent misunderstandings further down the road, and also protect both parties in the event of a conflict.

Supervision throughout the year

After building a good foundation with a supervisor, the supervisor-supervisee relationship can grow and serve as a valuable resource to enhance your training. Here are some suggestions for how to utilize this resource:

  • Supervision does not necessarily need to be limited to talking about patients. Your supervisor can facilitate your growth by discussing various topics related to professional development, such as discussing how to work on an interdisciplinary team, participate in workshops, attend conferences, apply for postdoctoral fellowships/employment, prepare for licensure, and network with other professionals. Collaborate with your supervisor to determine when it is best to have these discussions, however, as immediate concerns about patients may need to be the first priority in supervision.
  • As a supervisee, it can be intimidating to open up about concerns or difficulties you are having for fear of receiving a bad evaluation. While this feeling is natural, it is also natural, and expected, for supervisees to experience challenges and need to discuss them with their supervisors. Therefore, try to be willing to open up to your supervisor about struggles you may be having in your training. You may feel vulnerable to criticism, but this also creates an opportunity for you to get assistance and learn how to change a shortcoming into a strength.
  • Continuously be aware of boundaries within your supervision relationship. Personal topics are likely to come up, such as while discussing burnout or feelings of countertransference with a patient, and some self-disclosure by both parties can strengthen the supervisor-supervisee relationship. However, there can be a fine line between what is professionally appropriate and inappropriate to discuss. A good rule of thumb is to only discuss personal matters as they are impacting your professional performance or development.
  • If you and your supervisor discussed your goals at the start of supervision, hopefully your supervisor has attempted to provide you with opportunities to gain your desired training experiences. However, if you find you are not getting the experiences you hoped for or were told you would have, it is appropriate to follow up with your supervisor about getting those experiences. This is especially important if you are trying to accrue experience with certain populations or assessments for your applications to internships or postdoctoral fellowships.

What you won’t learn about supervision in school

Our training programs do the best they can to prepare us for successful supervision experiences. At the same time, direct experience can be the best teacher. Here are some lessons I have learned so far outside of the classroom:

  • Our supervisors are people, too, and are not perfect. At the start of my training, I envisioned all my supervisors as oracles of psychological knowledge. I have learned so much from each of my supervisors, and there have also been instances when they did not know the answer. This is okay, as nobody will know everything. I have appreciated when, in these instances, my supervisor joined me in looking for an answer and made it a learning experience for her, too.
  • At other times, I found myself disagreeing with my supervisor’s opinions. Initially I worried I was being disobedient or I questioned my competence. However, I learned this can also be a sign of developing into an increasingly independent professional. I was shocked when a supervisor told me, “I want you to challenge me. Not just follow me blindly.” This statement validated what I was experiencing and encouraged me to stick to my guns while also remembering there is always more to learn and it is beneficial to consider other perspectives.
  • Even within my few years of providing therapy, I found supervisors can vary greatly in their supervision style. In particular, how they provide feedback. Some supervisors were eager to provide assurance, encouragement, and appreciation. With other supervisors, I did not receive these but learned I was in good standing if I did not receive any critiques. Personally, the latter was more difficult to deal with. From that, I learned to engage in self-appreciation for the work I was doing and keep in mind the progress I was helping my patients achieve. Furthermore, this is also a concern supervisees can discuss with their supervisor, as the supervisor may not be aware of how he or she is coming off.

Overall, supervision is a complex process with many factors impacting how beneficial the experience is. While we may not always be able to choose who our supervisor will be, as supervisees, we can follow some of the guidelines described above to get the most out of any supervision experience. What’s more, before long, most of us will be out practicing independently and will call upon the knowledge we acquired during supervision to enhance our competence as clinicans.

 

References

[1] American Psychological Association. (2010). Ethical principles of psychologists and code of conduct (2002, Amended June 1, 2010). Retrieved from http://www.apa.org/ethics/code/index.aspx

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Claire McDonough

Claire McDonough, M.S., is a doctoral student at Georgia Southern University. Currently, she is completing her pre-doctoral internship at a public psychiatric hospital in North Carolina and anticipates graduating with her Psy.D. in 2019. Claire has experience in both the outpatient community mental health setting and inpatient psychiatric hospital setting serving individuals with severe mental illness. Claire is particularly interested in working with older adults and hopes to focus her clinical work and research on helping older adults and their family members manage issues common in late adulthood.