Hi there :) My T is fully qualified and has mentioned things regarding his supervision, more specifically that he discusses our sessions in his supervision. I was under the impression that only provisional psychs had supervisors. Generally speaking, what is the purpose of supervision and what sorts of things are discussed?
Heya! I loooove this question. So settle in cause this is going to be long.
I’m licensed as well and have a number of supervisions. For me, the individual (still very helpful) and group (not helpful for me at all) supervision are required, licensed or not, because of agency policy. I also belong to a long running consult group with psychodynamic and narrative bent which isn’t exactly the same thing but it is a bunch of therapists getting together and talking cases (which we have been doing since we were out of grad school so we are very comfortable with each other). Some licensed folks pay a supervisor if they are in private practice.
Why? Because it’s helpful to have another set of proverbial eyes on the case. If you are the only one thinking about your cases, it can get a bit echo chamber-y for some. I worry that I’d been one of those people so I want to be talking to other professionals about my clients, especially if their orientation isn’t the exact same as mine. I’ve gotten great CBT advice from a therapist in my consult group I would not have necessarily explored.
It’s also because clients make you feel things and issues are confusing and you need to figure that out so you don’t have it show up in the room. It’s helpful when you are confused about what’s going on - example from this week: I met with my supervisor and described a number of session and left me feeling like wtf is happening here. She pointed out that Mother’s Day was approaching which can be a huge trigger. That is probably what was going on for some of those clients but I wouldn’t have thought about it cause I was thinking about so much else. I
It’s also helpful for me to process some of the countertransference stuff in a practical way - does this need to be managed in the room differently? How? Should we keep checking in about it? Etc. The major countertransference stuff that is brought up for me personally - well that I take to my therapist because it’s an area I need to look at. It’s also a chance to have some of the more intense stuff (sessions, crisis situations, client hospitalization, etc.) held not just by you. I get support so I can keep showing up in a good way and has been a huge factor (for me personally - I am not speaking for all) in preventing burnout. It’s also helpful to have someone see your clinical strengths and challenges and tell you about them. My individual supervision is wonderful right now and I’d see her outside the agency - in part because I can be like, “I’m so done with this [situation/case/hard thing]” and have her be like “Yup, totally. Also you can’t actually be done. It’s hard and you doing good work. You got this.” (This may not make sense without context but I hope the flavor comes through? It came from a very supportive place and I liked having both pieces acknowledged because I totally wasn’t done and she knew it. I don’t know I’m getting tired). In the agency setting, it also helps the organization understand your caseload. Do you have a low number of clients but a high number of multiple times a week clients? Do you have a high number of clients but their sessions are all about 30 minutes and they are stable? When a referral comes in, that’s helpful.
The things that get discussed - cases. Agency wise - I have a release to share information in supervision and with the rest of my team that we go over and is a requirement for our agency’s services. So the whole case is addressed, including particulars (name, age, family and abuse history) and my supervisor(s) are involved in 5150s (even though that’s on me) and calling CPS or other “risky” ethical, legal or physical situations.
In things like a consult group, no identifying information is given and what is shared is limited to the question at hand. For made up example, “I’m seeing a 62 y/o male with narcissistic personality disorder who came to because [x situation]. We’ve met [x times] and I’m just wonder how to address [x].” All kinds of stuff related to cases, transference, countertransference, ideas for treatment, getting past a stuck point in the therapy, looking for patterns, figuring out a diagnosis (especially if a lot is on the table at intake), ideas for engagement, ethical considerations (this is actually a huge piece for me - I love having people I can ask, “Is this okay? The ethical guidelines say it’s okay but I want to make sure it’s therapeutically appropriate here.”, how you are taking care of yourself, etc.
No therapist is perfect and certainly not me and I like the checks and balances of talking about cases with others. I think it provides my clients with better care than I could give them operating on my own. I want to be able to do my absolute best by them and I feel like it’s on me to do the work around that.
