Counselling - Coaching - StressManagement

Abstract
In this essay I intend to describe my developing model of supervision and how I use it in my setting, refer to the source of my model and offer theories supporting the model I use including the implications for practice. I will include a brief history of how I came to be a supervisor, how my model was developed through exploration of art work and how it represents something which is organismic and alive. I will show how it underpins my own work with my supervisee’s and reinforces the work I do with my own internal supervision, then I will look at my objectives and the difficulties that I still encounter in my work ending with my conclusion.


Introduction
The terms supervision and supervisor have crept into our vocabulary almost unnoticed even though they run counter to all our ideas of what counselling and psychotherapy are all about. It would seem useful to firstly define ‘supervision’. I particularly like the definition given by Bernard and Goodyear (1991) which I chose because some of my supervisee’s are counsellors in training and I feel this one of the most congruent with my work ethics.
They say;

“Supervision is a means of transmitting skills, knowledge and attitudes of a particular  profession to the next generation in that profession. It also is an essential means of  ensuring that clients receive a minimum quality of care while trainee’s work with  them  to gain their skills.”

The definition supplied by Inskipp and Proctor (1993) extends that definition to include a working criteria. Their definition of supervision is;

“A working alliance between a supervisor and counsellor in which the counsellor can  offer an account or recording of her work; reflect on it; receive feedback, and where  appropriate, guidance. The object of this alliance is to enable the counsellor to gain  in ethical competence, confidence and creativity so as to give her best possible service  to her clients.”

My training and experience incline me towards an ‘enabling’ role as a supervisor. This means that I have to develop a working alliance as offered above. It is dependent on what the counsellor brings with them to the supervision session. I do, however, adapt to some extent to the expressed needs of alternative approaches to learning and supervision. I am also supervising in a group setting as well as with individuals which I also find exciting. My goals though are conventional; To discuss the development of individual cases brought to the session and to enhance theoretical knowledge and the use of the self; to ensure that the basic contract is collegial; to encourage the individuality of the supervisee; to encourage the supervisee to challenge my work with them and to reinforce the core conditions which are expected in the counselling relationship and as offered by Rogers (1992) I also have to be aware of the transferential issues especially since my primary orientation is psychodynamic.


Model
My own model of supervision is based on the model I use for counselling now which is integrative yet depends very much on the person I have before me. It is one that I have developed. My theoretical background is based on the integration of psychodynamic counselling, psychotherapy and Cognitive Behavioural Therapy, which hopefully integrates successfully especially when working with supervisee’s who work with people in active addiction or recovery and with survivors of childhood sexual abuse. Boyd (1978) states that;

“it is possible to integrate several different therapeutic styles and orientations into  one’s own supervision style”.

In my case I have supervised trainee counsellors at an adult learning college on a one to one basis and, more recently in a group setting; qualified counsellors working with childhood sexual abuse also in group settings and on a one to one basis; experienced counsellors in a high security male only prison; trainee counsellors working in the field of alcoholism and addiction; and social workers who are foster carer’s working with young adults between the ages of about ten to sixteen who often exhibit behaviour conducive with that of a sexually abused survivor.

Carifo and Hess (1987) quote a variety of sources in looking at what is required of an ideal supervisor which relate closely to the core conditions required of a counsellor. They include qualities such as empathy, understanding, unconditional positive regard, congruence, genuineness Rogers (1957); warmth and self disclosure Coche (1977); flexibility, concern, attention, investment, curiosity and openness Albott (1984); Aldridge (1982) Gitterman and Miller (1977); and Hess (1980). I am therefore very much aware of what is expected of me and how many tasks I might be expected to perform to give my best to the supervisee. To do this I have developed a number of measures to ensure I do give my best while maintaining that my best is actually good enough.

I have realised that my tasks are to offer support, to encourage learning and development and to act as a buffer between the supervisee’s and their client together with the employing agency. This sometimes had implications for me and my supervisee’s as it may be that I taught one of the clients that my supervisee brought to supervision as they were also students at the college where I was a lecturer in counselling. Because of the setting I was not only seen as supervisor. Often the supervisee’s saw me in the teaching role and assessor of their work, as a counsellor, and, more difficult for me to manage, as the one with all the answers. I had some difficulty in adjusting to the new role. Hawthorne (1975) has written extensively about the power dynamics between supervisor and supervisee.

The roles that I play in supervision can be subdivided into tasks which come under three main headings, namely the normative task which deals with ethical issues, development, self-management, quality control and monitoring issues; the formative task which looks at contracting, development, teaching and education and which is more of a ‘doing’ task and works didactically through experiential self-awareness; and the restorative task where support is offered, where space to off-load and self-talk is allowed, exploration of space and expression of feelings is a function, and another task, a fourth, the creative task, where work through the use of play, artwork, play dough, shells and role play for example helps with the supervision. In my model I like to integrate the use of all these tasks as one would with a balanced diet and I feel that I dip in and out of each as the supervision session requires.

While supervising I have been afforded the opportunity to utilise some of the above skills and I remember vividly the one exercise that put me on the track to developing my own model of supervision. It was an art exercise during which I was expected to illustrate my own model of supervision. I looked at supervision as if it were the internal organs of the human body with every part having an important role and being very functioning with all parts being equally important and the body being unable to function properly without the vital organs. Interesting how my idea of supervision is seen as a dietary requirement. Interesting also to see how the journey through supervision is a little like the digestive system of the body with everything being taken in via the mouth, processed through the use of the four tasks listed above, digested and then the waste discarded. Many of my colleagues laughed as I linked it to Freud’s early stages of development, Gross (1992). I strongly believe that the supervisor and supervisee traverse these stages together and that the journey is the learning process which aids the supervisee to work effectively and safely with their client. This digestive process bears a resemblance to the model I work with, namely The Cyclical Model as illustrated by Paget and Wosket.


Supporting Theories
The Cyclical Model (Appendix 2) for me represents something alive and organic which is vital for the supervision session. Where at the beginning of the session I make a contract during which time and space is given to explore what is actually wanted from the session. I ask more practical questions about the issues involved and wanted to be brought into the session, the supervisee’s client load and time constraints. I think this reflects the way the heart is necessary and continuously pumping to stay alive. This links into the next stage which is the focus stage of Paget and Wosket’s model where everything brought to the session is broken down into segments to be dealt with, the digestive system where the food is broken down and where consideration is given to ethical issues and the interpersonal relationship between supervisee the supervisor. In order to tease out more difficult pieces for supervision I move my client into a spacial time where creative play and exploration become useful. At this juncture there are few ‘rules’ and the time is used to work together purposefully. At this point I link it to the twists and turns of the intestines, firstly the large intestine and later on the smaller one, almost fine tuning. Here we bridge the gap and look at the results of the creative space, clarify the outcome and examine how we are going to use it before moving on to reflect and review the contents looking back at the session, checking out what was most useful and discarding that which was not.

In the supervision I have become increasingly aware that what happens in the session is often a mirror of the counselling session which is a revelation to me as I actually experience it so strongly. I have used video sessions which helped me to explore where and what I needed to improve on and I am amazed at my body language, how I nod my head like a wound up toy. While linking the use of my video sessions to what I can see with the picture of my model I realise now how I can almost feel the system of the Cyclical Model working inside me. This is especially important to reflect on for me here as I recall how comfortable I was with the whole process which seemed to happen so naturally for me. As easy as breathing. It is becoming much clearer how fixed I ‘was’ in my Psychodynamic approach and my style of supervision reflected this. I am recognising how I work on my boundary setting and rigidity and how I have become more flexible. This possibly ties in with my perception of the process linking with the work of Freud.

I believe that I incorporate some of the ‘developmental model’ into my supervision sessions and refer to the work of Stoltenberg and Delworth (1987) who integrate a combined developmental model of supervision where, at Level 1;

”Workers tend to focus on specific aspects of the clients history, current situation, or  personality assessment data to the exclusion of other relevant information. Grand  conclusions may be based on rather discreet pieces of information.”

It is here that my psychodynamic background helps me to help the supervisee who, as a trainee counsellor might experience anxiety about their performance and rely on me, the one they see as professional for support and encouragement. Stoltenberg and Delworth (1987) sat that this is where;

“Balancing support and uncertainty is the major challenge to supervisors of beginning  therapists”.

As a lot of my supervisee’s work in residential settings and relate to their clients on more personal level there is sometimes a fear that, as counsellors (supervisee’s) they might over identify with their own clients. The supervisee’s are often in recovery from addiction and alcoholism themselves. This is explored more in depth in a paper, “Between Scylla and Charybdis” contained in Hawkins (1980) where discussion is about supervisee’s overcoming their initial anxieties and fluctuate between over zealous and enthusiastic to lack of confidence and feeling overwhelmed. When they lose the confidence they then become angry with me the supervisor who they then ‘knock off the pedestal’ and see as incompetent. This again ties in with my theory of the stages of development similar to the stage of adolescence. Level 2 does seem like parenting at times and trying to get it right is hard enough for parents with teenagers but with trainee counsellors it can also be difficult. The testing of authority, moodiness and need for containment is evident here and psychodynamic orientation really keeps me on the right track.

At Level 3 Stoltenberg and Delworth say;

“The Level 3 trainee shows increased professional self-confidence, with only   conditional dependency on the supervisor. He or she has greater insight and shows  more stable motivation. Supervision becomes more collegial, with sharing   exemplification augmented by professional and personal confrontation”.

I find this stage the most comfortable for me and the time when I can use the Cyclical Model to the best benefit of the client and the supervisee. The supervisee is more able here to present both the content and process of the counselling session and as laid out in Hawkins and Shohet (1989) bring to the session;

• the total process of the therapeutic relationship;
• the client’s personal history and life patterns;
• the client’s external life circumstances;
• the client’s life stage, social context and ethnic background.

At level 4, the stage Stoltenberg and Delworth refer to as ‘Level 3 integrated’, the supervisee has reached ‘master’ level. This is not somewhere I would expect any of my supervisee’s to be and is certainly not somewhere one can stay without supervision for themselves.
It is;

“characterised by personal autonomy, insightful awareness, personal security, stable  motivation and an awareness of the need to confront his or her own personal or  professional problems”. Stoltenberg and Delworth (1987)

Through the relationship which is established in this way the person being supervised can communicate not only the facts of the case but something of themselves.

Despite my discomfort with the notion that I am at Level 4 for the most part of the time I am more able to accept this as part of my own need to get it right for my supervisee’s. I have become more confident in myself though as supervisor and am surprised by my own insight and perception of the client material that I work with. Through counselling and supervision I have felt how vulnerable many clients must feel and to be more aware of the supervisee’s feelings in very difficult situations such as feeling stuck, frustrated and helpless. Those feelings which are associated with the stages of development discussed by Erikson (1968). He too was of psychodynamic background and places a lot of importance on the stages traversed through life.


Some difficulties I still encounter in supervision
I still have difficulty at times adjusting to my role as supervisor and facilitator and struggle with ways to handle my ‘authority’ connected to the issues of submission and dominance and owning my power constructively. I sometimes find difficulty handling the ‘greedy’ supervisee in and out of the group who never seems to have enough time allotted for their clients. Sometimes, although I am getting better, handling the transferential issues between the supervisee and myself in front of the group afraid of being seen as vulnerable or inadequate.

How best to use language when challenging and confronting the supervisee as many in my groups are from differing cultural, educational and religious backgrounds and a multifarious amount of settings. Working with difference. The fear that other supervisee’s may be able, A “to do ‘it’ better” than me leaving me feeling inadequate when one of them is more perceptive than me. Trying to move from supervisee to supervisor was hard for me but acknowledging that I do not have to do all the work and do not have to have all the answers has makes it easier. It is also useful for me to reengage as a client with my own supervisor which helps to ground me and give me more focus.

I feel that my role was more educational and I often flooded supervisee’s with information and pushed them mentally too hard seemingly ignoring the dynamics apparently unaware of the testing of power and authority. I was afraid of modelling my failures. I was not fully aware of what happened in the group supervision process but now recognise how it is a reflection of what happens in the counselling session and now see how this can be used constructively once understood.


My objectives
In supervision I hope to create a trusting, caring, confidential atmosphere for sharing acting as another eye giving an overview of the counselling session within the group. I hope to give respect, space and the value of contributions of the other counsellors when in the group setting giving space for the supervisee to be in touch with feelings about the counselling session. I hope to enable the supervisee to talk openly, share anxieties, emotions, doubts, hunches and anything else that was partly or wholly suppressed at the session and with these out in the light the supervisee is better informed and more able to practice effectively.

I attempt to encourage, support and affirm the supervisee acting as a helicopter between the client and the supervisee listening carefully and offering suggestions that I feel might help in a supportive and caring way. It is important for me that I am able to remember that the supervisee need not get it right all the time in the same way that I have to fight my anxieties about being the perfect supervisor. I also have to be aware of my own blind spots, bias collusion’s, projections and avoidance of involvement.

I aim to be aware of the dynamics both between myself and the supervisee in the one to one situation and within the small group setting in both of which I seem to adopt the position of supervisor in charge or am placed in that position or as the expert who joins the group at regular intervals. Any transference in the supervision session often mirrors what is happening in the counselling session and I am aware of this and learn from it. Respect for the supervisee’s skills and attempts to sharpen these by challenging in a positive and caring way where appropriate. Being aware also that I can make mistakes and get it wrong and being able to acknowledge this if it happens would be beneficial. I would attempt to encourage the supervisee to leave our session more aware, informed and empowered, skilled and encouraged than they were prior to coming to the supervision session.


Conclusion
In conclusion then my model has its background based in a cyclical model as discussed earlier. A cycle of growth, recognition and development which has evolved from my own experience and philosophy of life and from what I have learned from my counselling and supervision in practice and theory. I feel very strongly each persons’ individuality is the most precious gift they possess and therefore we each have the answers to our problems and difficulties in life. It is in counselling that we help others to discover their own answers. I also feel that many people’s self image has either never been developed or has been so severely damaged by difficulties and problems. In supervision then I try to create the trusting and caring environment as supervisor to enable my supervisee to grow and develop.

Underpinning this essay I am also aware of how my own background in psychodynamic counselling and psychotherapy affects the way I may pick up more sensitively how supervisee’s are affecting the handling of any casework. In this work with the counter transference I need to be conscious of the present network of relationships not only with the supervisee’s client but also with the place of work and employers/placements and agency, with myself, with other clients, the supervisee’s other work, family and belief system. This network includes all distortions of reality which I and everyone else concerned will bring to the situation. In the supervision on a one to one, and when in small group supervision, we are able to take the opportunity of reflecting on one another and the members of the group may also fulfil a representative function in throwing the interaction of network onto the larger screen.

In all of this we shall have the opportunity also of seeing what other changes in attitude as well as insight are possible. In the process of supervision I am also concerned with the accuracy of the presentation of the case not just in concrete detail and verbatim exchange but in particular how the supervisee experiences the client and his own feelings and reactions at important points in the counselling process.

I believe also that my style of supervision should have the effect of valuing and affirming those involved in the supervised situation remembering, of course, not to shy away from confronting the supervisee where he might be finding it difficult to grasp reality and may need to seek further individual help for himself.

I realise I made many mistakes as a supervisor. To mask my own anxiety I feel that I used, as objects , my supervisee’s to bolster up my own pseudo role of expert, namely the one who has all the answers. I wanted to be liked and accepted so I feel I colluded with the supervisee’s and did not challenge them enough or confront them. I was scared to ask the supervisee’s what they actually wanted from supervision and clearly did not define my own role, in fact I doubt I even knew at that time what my role really was. I dwelt far too much on the client and not the counsellor as supervisee and I feel that I turned my clients into quasi clients. I know that I did not have clear enough idea of what my role was nor what model, or combination of models, I was working with. Thankfully this has changed and I, like my supervisee’s, will continue to grow and develop.

I now work in private practice in Den Haag where I will continue to supervise trainee and experienced counsellors to the high level expected by such regulating bodies as The European Association for Counsellors and Psychotherapists. I facilitate training courses in counselling from Introductory level to Diploma also offering specialised workshops in subject areas such as addiction, self harm, anxiety management etc. I can be contacted on 06 - 28 34 56 17 or by e-mail at dereklainsbury@planet.nl - See also: http://www.counselling.nl/derek.html
 
 
Bibliography
Bond, Tim. Standards and Ethics for Counselling in Action, 1999, Sage Publications, London.

Dryden, Windy. Questions and answers on Counselling in Action, 1994, Sage, London.

Gross, Richard D. Psychology - The Science of Mind and Behaviour, 1992, Hodder & Stoughton.

Hawkins, P. And Shohet, R. Supervision in the Helping Professions, 1989, Open University Press

Inskipp, Francesca & Proctor, Brigid. Making the Most of Supervision, Cascade, 1993.

Martel, Sheila. Supervision and Team Support, 1987, Bedford Square Press.
 
 
References
Appendix 1 - Photograph of artwork
Appendix 2 - Diagram of Cyclical Model

BAC Code of Ethics, British Association Of Counselling, 1, Regent Place, Rugby, CV21 2PJ.