What is Therapeutic Supervision?
Child psychotherapists have a long tradition of working with birth and adoptive parents, kinship guardians and foster carers, to help them to understand the troubled children within their families, and cope with their disturbed and disturbing behaviours. Inevitably, this leads towards an exploration of emotional disturbance within the family, and traditionally child psychotherapists have then recommended that parents seek their own therapy.
However, this recommendation can only be implemented in families where it is possible to access psychotherapy - and this depends on geography and, still more crucially, on finances.
In her paper Towards an Integrated Network (Journal of Child Psychotherapy Vol. 26 no. 3 2000: pp413 - 431) Jenny Sprince describes her own evolution as a clinician towards the use of what she calls 'therapeutic supervision': that is, towards working therapeutically with foster carers and social workers to help them to process the impact that children’s disturbances have upon themselves, and upon the professional network, and to understand something of how their own internal worlds also impact on the children in their care.
In APPCIOS we believe that work of this kind is essential.
Many people working with vulnerable clients have no access to their own counselling or therapy, or to any self-reflective forums that could help them to process the impact of their clients’ emotional disturbance on their own well-being; or to explore how their own ability to provide help to their clients may be limited by traumatic experiences that they themselves have not fully processed.
Such workers may ask eagerly for supervision, but in such circumstances, traditional supervision can easily get stuck. Workers may find themselves acting out inappropriately with clients, or distressed in ways that they cannot account for, and don’t want to think about. Or they may defend themselves from emotional engagement with their clients, and consequently with their supervisors.
Traditional supervision, that is based on the assumption that personal therapeutic needs will be met elsewhere, rarely takes account of the internal world difficulties that cause these problems.
Everyone who works with the emotional disturbance of vulnerable clients - for example, school counsellors, social workers, psychiatric nurses and other health and social care professionals - is likely to require in-depth support. Traditional supervision may not meet their needs. Therapeutic supervision can deepen their understanding and enhance their professional capacities. It can prevent burn-out and secondary trauma.
However, it demands considerable skill. Supervisors must beware of inappropriate intrusiveness, and of pathologising their supervisees; they must ensure that the primary task remains that of supporting their supervisees in their work with their clients and colleagues, rather than providing them with individual psychotherapy.
Triangulation is paramount. Supervisors must give equal weight to understanding the internal worlds of their supervisees and to understanding those of the clients or colleagues that are brought for discussion. They must bring an understanding of the dynamics of groups, families and organisations, as well as of the internal dynamics of the individual, and of the interaction between each individual and the groups they belong to. These are not skills that are prioritised in most one-to-one psychotherapy trainings
As an organisation that is rooted in the therapeutic community tradition, and in the tradition of group relations, as well as in individual psychoanalytic thinking, APPCIOS is particularly well-placed to provide this form of supervision. Many APPCIOS members began their journey towards full registration with the BPC through therapeutic supervision - and many have gone on to access full individual psychotherapy in the service of better understanding themselves and their clients.
For some time now, APPCIOS has been running webinars to train its more experienced members in offering therapeutic supervision. Through this provisions we hope to make such supervision accessible to the many practitioners who feel unsupported or out of their depth, who cannot travel to the centres where further training is more easily available, and who cannot afford both supervision and individual psychotherapy.