I have wanted to write this article for a long time, but convention often prevented me from putting pen to paper. In science, understood wisdom is hard to change; any new paradigm is always greeted with skepticism and dismissive attitudes. However, I am now independent of those who might make life difficult for a lonely voice, so I think it is time to make the case against therapist supervision.
Like many therapists and psychologists, over the years I had to submit to the task of being supervised and supervising others. To clarify my objections to the process, I must first lay out the conventions and current wisdom of the last 100 years.
What is monitoring and what is it for?
Therapy is seen as an arduous task where we have to listen to problems and difficulties through the lives of other people’s stories. Difficult and stressful clients often tell us about what is happening in their lives now or in the past that is keeping them from overcoming those past traumas or present life complications. Most listening professionals can, of course, empathize with the client and, through whatever style of therapy, help the person to resolve their problems and face the future. That is the fundamental aspect of the therapeutic process.
For many less stable therapists, they face the burden of not being objective about the client’s situation and often take the burden of the client’s problems personally for themselves. After a while they face collapse and personal misery, not because of their own problems, but because they cannot mentally separate themselves from the client.
The case for supervision then is primarily one of coaching, the supervisor (usually a very experienced counselor) listening to the therapist to help that person see the client’s problems and their own in perspective. I think for a new therapist in training and a person with low self-confidence, this can help them move on and help prevent personal crises. Most organizations insist on one hour of supervision for every six hours of customer contact.
So why, having previously stated a reasonable case for oversight, am I so against the practice? Well, I will address this in the following points:
1. Most supervision is ineffective
2. Supervisors are themselves problematic
3. It is an exercise in spinning money to take advantage
4. Most famous therapists were never supervised in the modern sense.
5. It is a power game and a selfish role playing between parents and children.
6. Can be replaced easily.
Taking my first point, most supervision is ineffective; I state this from personal supervisory experience and anecdotal evidence from other therapists. When you submit to supervision, most counselors and therapists report that they feel it is a critical experience and not a supportive one. Most feel that they are being challenged to justify what they said and did in individual therapy sessions. Therefore, most are not honest or communicative in these sessions, but in fact, as any psychologist knows, they will show themselves in the best light possible. This immediately undermines the whole concept of support and guidance. If the therapist feels judged, he cannot benefit from the exercise and therefore does not feel able to grow from his current position as counselor.
The second point is the supervisors themselves. Most are not experienced supervisors but are qualified in their particular field of theory. They bear the burden of supervision because they are required to do so. However, this is not the most important aspect and I will analyze it in the next point. My own experience and that of other supervisors is that they are hearing cases secondhand, trying to judge beyond their personal experience, trying to see the mind of the therapist in front of them, and worse, putting a time limit on what they are doing. the relationship. In general, they have very little interest in the client and very little in the therapist in front of them.
My next and third point is: money! Supervisors are paid by the therapist. They know that any new counselor to become qualified needs as many client contact hours and supervision hours according to the theory requirements to qualify. This is the real crux of supervision: the money to be made from new advisors (most of whom will never qualify) is a high earning exercise. The motivation for supervision then is not a feeling of noble support but a simple commercial exercise of exploiting counselors and therapists for money. If that sounds harsh, too bad. The truth often hurts.
I guess the best way is to invent your own theory of therapy and supervise yourself as most of the famous psychologists of the past did, Freud, Jung and many other historical figures did not have to undergo supervision but in fact kept his own advice. The method they used was quite different from the onerous way we use to monitor today. If you are confident in your own ability and feel 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 is perhaps out of respect for Eric Berne, the creator of Transactional Analysis (personally, one of the best theories of psychological thought). In TA Berne enunciates the eloquent concept of the PAC model, Parent, Adult and Child as mental states. I do not want to stop here in theory and we do not have space. As a supervisor, you are acting as a Parent to the counselor’s Child ego state. This means that the supervisor is not in the position of a coach or mentor, but rather that of a superior and is often critical and fatherly in guidance. This does not matter if the supervisor assumes a role of critical parent or caring parent: the power play is the same. The counselor submits through childhood experience to a symbiosis of the parents with the supervisor. This is unhealthy and restrictive, and most counselors will take on the role of the adaptive child in that they will submit to supervision as a way of making their parent (supervisor) happy. As Berne said, we all have a little teacher inside our heads who is constantly trying to make the best of a situation and, in the case of a child, love and affection. If you can’t get love, attention will do, even critical attention.
My final point is that it can be easily replaced. Many years ago, a group of like-minded counselors decided to form a partnership away from the mainstream organizations that try to dominate the mental health regimen with rules and controlling doctrine. They met once a month as a large group, sometimes as many as 60 people. They would have a speaker on some topic of interest, who was not allowed to speak for more than 30 minutes, as most psychologists know, it is the height of our individual attention to listen and be still. Afterwards people mingled and chatted. Nothing too heavy, books read, clients seen, money talks and other general aspects of counseling. However, most importantly they formed smaller groups that lived close to each other. These groups of five or six therapists would meet once a fortnight in a person’s home and this would rotate. These meetings were relaxed and informal. You can bring medical histories or clinical problems. Each, in turn, had the opportunity to talk about what was bothering them and, in return, received advice, wisdom, or just general talk from the other members of the group. The group did not have to solve any problems and you could choose to just listen if you wanted. The idea was one of support and a feeling of a non-judgmental group. (Do not confuse this with a Group Therapy meeting). These are your peers and friends, not your supervising judge. I think the atmosphere in these groups was ten times more encouraging than any supervised session. Of course, some basic ground rules must be observed, not judge, respect other people’s theoretical point of view (everyone can be different schools of thought), this often leads to cross-fertilization of ideas. It should not be told, only discussed, this leads to an informed non-dictatorial environment. Finally, have tea and biscuits, be humorous, have fun – this is a time for you to feel good about yourself and the fact that you are part of a community of people who care about each other and fight for a better world of health. mental.
I personally have to supervise new counseling students as they see their first clients. I try to bring a supportive and coaching approach to the process. I encourage my students to form peer groups and count their hours in these groups as supervised time. I think once you’ve qualified, a peer group should be all the support you need. Current supervisors can replace their lost income by giving open lectures or group talks (30 minutes). If they really are as good as they think, then they can prove it in front of a group. Difficult decision – to be judged – isn’t it?
To reiterate that I am against supervision. It must stop except for initial training purposes. Only a therapist and her client can do the work of therapy. I know that this article will have a lot of critics and those who will make fun of my views. So be it. As I said at the beginning, any new paradigm is initially forced to move away from the convention. I just hope that over time we can realize how unhealthy the current system has become.
Professor Stephen F. Myler PhD (Psychology)