Being and Becoming a Psychotherapy Supervisor: The Crucial Triad of Learning Difficulties

Introduction

Some years back, midway through a psychotherapy supervision seminar that I was leading, an advanced doctoral student made the remark: “This is all so, so different.” She was reacting to the material that we had been covering in the seminar. At first, I did not understand her statement at all, but then it hit me: After years of having been exposed to psychotherapy theory, interventions, and research and having engaged in years of supervised psychotherapy practice, she, for the very first time, was seeing the whole venture from the other side—realizing that there was a world of supervision theory, interventions, and research about which she had had not one iota of awareness. It had never occurred to her that supervision was actually a substantive body of practice and research in its own right. In developing this awareness and being hungry to learn more, she was at the very beginning of making the vision shift that is required to be and become a supervisor.

Psychotherapy supervision has long been regarded as a crucial component (if not the crucial component) of psychotherapy education: It is a primary means by which (a) the traditions, practice, and culture of psychotherapy are taught, perpetuated, and transmitted; (b) therapist skill and competence are developed and enhanced; (c) therapist identity is nurtured, becomes solidified and established; (d) patient welfare is protected; and (e) the gate to professional practice is monitored and guarded (Bernard & Goodyear, in press [2014]; Falender & Shafranske, 2012; Hess, Hess, & Hess, 2008). In the grand scope of psychotherapy education, the place of supervision in preparing new, budding therapists seems unparalleled in its recognized importance and impact across disciplines. It may well be “the most expensive single investment of staff time in the training of the . . . [psychotherapy] practitioner, . . . [but] it [also] appears to be the single most important contributor to training effectiveness. . . . ” (Gonsalvez & Milne, 2010, p. 233). For a century the value of supervision has loomed large in the teaching and learning of psychotherapy and it seemingly continues to do so with even more acknowledged potential today (Watkins, 2011a, 2011b).

While the value of supervision is now far more readily and widely recognized, in some respects it still remains a bit of an anomaly. Perhaps the greatest irony of supervision’s first 100-plus years might best be captured in the following three statements:

Supervision history suggests that while learning psychotherapy is a laborintensive endeavor, learning to be a supervisor is considered a labor-absent one (Hoffman, 1994; Watkins, 1992; Whitman, Ryan, & Rubenstein, 2001). Some of the “credentials” that had been sufficient to qualify for supervision practice included having served as a supervisee oneself, having achieved seniority in the profession, or having had “see one, do one, teach one” experience (Alonso, 2000; Gonsalvez, 2008; Rodenhauser, 1996; Schlesinger, 1981; Whitman et al., 2001).

During the past thirty years (approximate) the sufficiency of such “credentials” has been questioned increasingly and, in turn, the need to prepare or train supervisors for supervision practice has been embraced increasingly (cf. Frayn, 1991; Riess & Fischel, 2000; Russell, Crimmings, & Lent, 1984; Watkins, 2011b). As Borders (2010) has aptly stated, “Today, the need for supervisor training is widely accepted . . . although the practice of requiring, even offering, supervisor training in academic programs continues to vary rather substantially across disciplines . . . ” (p. 130). Although “the need” is widely recognized, it has yet to translate into widely required reality. The potential importance of supervisor preparation is now (more so than at any other time in supervision’s history) prominently visible on the educational radar screens of varied mental health disciplines. Indications suggest that where supervisor training opportunities are not in place, substantive actions to remedy the absence can be expected.

In conjunction with this heightened attention for supervisor training, a parallel focus on psychotherapy supervisor development also emerged. While it has long been acknowledged that therapist trainees proceed through a developmental growth process in their journey to being and becoming psychotherapists (Ecklar-Hart, 1987; Ford, 1963; Spiegel, 1956; Tsuman-Caspi, 2012), the idea that supervisors proceed through some sort of developmental process in their journey to being and becoming supervisors did not meaningfully emerge until the mid-’80s, when supervisor development models were first proposed (Alonso, 1983, 1985; Hess, 1986; Stoltenberg & Delworth, 1987). More such models followed in the ’90s (Rodenhauser, 1994; Watkins, 1990, 1993), and we have since had a modicum of research on the topic (Watkins, 2012b). Three fundamental assumptions that either underlie or that can readily be inferred from supervisor development models are: (a) becoming a supervisor is a growth process that involves steady accretions in supervisor professional identity and skill development over time; (b) as they evolve, supervisors move from being more anxious, unconfident, less skilled, and less identified with the supervision role to becoming less anxious (more relaxed), confident, more skilled, and more identified with the supervision role; and (c) knowledge about the supervisor development process can be highly useful in facilitating understanding of supervisor trainees’ educational struggles and needs and, thereby, allow for the supervision of supervision experience to be better tailored accordingly. Understanding and using conceptualization about supervisor development tends to now be recommended practice in training new supervisors and in supervising their supervision (Borders, 2010; Watkins, 2012c).

The developmental models have been judged to be far more alike than different, and they all start and end at highly similar (if not identical) places (Russell & Petrie, 1994; Watkins, 1995). As Cohen and Lim (2008) have put it:

The models uniformly recognize the anxiety of transitioning to the new role of supervisor and through time and practice (and ideally training), acquiring the skill and comfort needed to engage in supervision practice in a more effective fashion.

While current models of supervisor development provide potentially useful frameworks for how best to train supervisors, I would like to offer a simple extrapolation from Chessick (1971) that can also be employed as conceptual complement to aid in the supervisor education process. This proposed extrapolation: (a) is consistent with and fits within existing supervisor development models; (b) focuses more on important elements (e.g., demoralization, supervision conviction) that have either gone unmentioned or have not been given proper accent in existing models; (c) captures core developmental concerns across the arc of the supervisor development process; and (d) provides a useful, usable way of thinking about supervisor training and informs it. Over 40 years ago, Chessick presented (in this journal) what I believe was a prescient publication on psychotherapy supervision, in which he emphasized the supreme value of supervision and need for supervision training, supervisor evaluation, institutional support for supervisors and supervision and, ideally, the matching of supervisors with supervisees. At that time, Chessick identified some crucial themes that would not get their due in the supervision literature until two or three decades later.

In his classic paper Richard Chessick (writing from a supervision perspective) identified the crucial triad of difficulties that students often confront in learning to be a psychotherapist: (a) dealing with the anxiety attendant to the development of psychological mindedness; (b) developing a psychotherapist identity; and (c) developing conviction about the meaningfulness of psychodynamics and psychotherapy. I propose that in slightly modified form this same triad also rears its head in training supervisors and that Chessick’s thinking can be extrapolated to that process. In supervisor training the crucial triad of learning difficulties could be postulated as: (a) dealing with the anxiety and demoralization attendant to the development of supervisory mindedness; (b) developing a supervisory identity; and (c) developing conviction about the meaningfulness of psychotherapy supervision. By extrapolating Chessick’s triad needed attention can be brought to the issues of anxiety and demoralization, supervisory mindedness, supervisory identity, and supervision conviction. In what follows, I would like to address those four elements. The specific questions that I wish to review are: How does the crucial triad of learning difficulties affect the supervisor development process? How might understanding of those difficulties be helpful to those who train new supervisors? As both potential strength and recognized limitation, this proposed conceptual/practical scheme is based on: (a) my own experience in training supervisors; and (b) my own efforts to stay abreast of developments in supervisor education.

The Crucial Triad of Learning Difficulties in Becoming a Psychotherapy Supervisor

In examining this triad of learning difficulties, I begin with the following foundational assumptions:

The words beginning supervisor, new supervisor, and supervisor trainee will be used synonymously, referring to an individual who is in the process of learning how to supervise psychotherapy trainees and is him- or herself receiving supervision training for that purpose.

Anxiety and Demoralization Attendant to the Development of Supervisory Mindedness

Models of supervisor development acknowledge that becoming a supervisor can be an experience fraught with anxiety. It is a new role for which supervisor trainees typically have no blueprint, other than having observed how their own psychotherapy supervisors operated (cf. Hess, 1986; Rodenhauser, 1997; Scechter, 1990). And as research and commentary thus far suggest, some of the past supervision experiences upon which a fair number of us have to draw are not all that favorable (Ellis, 2001, 2012; Ellis, Siembor, Swords, Morere, & Blanco, 2008; Ladany, 2004). While not eliminating trainee anxiety, supervision coursework and seminars provide a conceptual map and are means by which beginning supervisors’ anxiety can be lessened (Inman & Soheilian, 2010).

I would like to propose that beginning supervisors can also often feel the pangs of demoralization early on in their learning process. While this experience has been recognized as part of the beginning psychotherapist learning experience (Watkins, 1996, 2012a), and while self-doubt, internal conflict, and turmoil have been typically recognized as part of beginning supervisor’s early growth (e.g., Alonso, 1983, 1985), demoralization itself has not specifically been included in any supervisor development conceptualizations. Drawing on Frank and Frank (1991), supervisory demoralization can be defined as: “to deprive . . . [the beginning supervisor] of spirit, courage, to dishearten, bewilder, to throw into disorder or confusion” (p. 35). I contend demoralization can also readily emerge in the supervisor development experience and merits consideration as a normative, yet potentially problematic, aspect of that growth process.

As beginning supervisors struggle with adapting to their new role, confront the frustrations of that adaptation process and the failures that attend it, they may believe that they have failed to live up to expectations. They feel frustrated, discouraged, and at a loss about how to remedy matters and, consequently, find their sense of morale and hope diminished. Much like the learning regression through which new therapists pass (Alonso & Ruttan, 1988), beginning supervisors can also be expected to pass through their own type of learning regression. Furthermore, just as beginning therapists often agonize over the question, “Am I truly cut out to be a psychotherapist?” (Tsuman-Caspi, 2012), beginning supervisors can also wonder the same about themselves and accordingly ask: “Do I really have what it takes to be a supervisor?” Again, supervision course-work, seminars, and the supervision of the supervision provide a conceptual map, much needed support, and constructive feedback by which demoralization may be alleviated. Absent such training experiences, the beginning supervisor is left to struggle alone. Unfortunately, when that is the case, the process of becoming a supervisor can sometimes lead to such an uncomfortable emotional level that meaningful learning is compromised, growth is stunted, and potential supervisees and their patients end up suffering.

But that is a scenario that can easily be contained if not avoided altogether by means of training and supervision. From my perspective, a simple yet helpful way to begin assisting new supervisors/supervisor trainees in coping with their experience of anxiety and demoralization is to acknowledge these as a normative part of the supervisor development process itself. For example, an explanation such as the following (which can also address identity development concerns) can be used for that purpose.

Such comments, while by no means curative (and which may have to be revisited from time to time), can help to normalize, sooth, and defuse the sting of initial anxiety and demoralization, meaningfully place those experiences in developmental context, and provide beginning supervisors with the encouragement and support that they might need to ease their questioning and doubts.

As the growth process continues to unfold and (ideally) proceeds in favorable fashion, the development of supervisory mindedness is a special achievement. Just as psychotherapists are best when they possess, hone, and are able to effectively implement a high degree of psychological mindedness (cf. Chessick, 1971), supervisors are best when they develop, hone, and are able to effectively implement a high degree of supervisory mindedness. Supervisory mindedness, for our purposes, can be defined as:

Because of the complexity of the supervisory situation, which can involve top-down and bottom-up parallel processes and cross-relational identifications and disidentifications (Gediman & Wolkenfeld, 1980; Tracey, Bludworth, & Glidden-Tracey, 2012), the development of supervisory mindedness can be a particularly challenging psychological acquisition. Anxiety and demoralization, while not necessarily preventing supervisory mindedness, can prove to be potent obstacles to its development. Supervisory mindedness has a far greater chance of being cultivated in a safe, facilitative atmosphere where beginning supervisors are liberated to learn, anxiety and demoralization are minimized, and unfettered exploration and reflection on supervisory practice are encouraged.

To summarize, in extrapolating Chessick’s triad of psychotherapy learning difficulties to supervision, I propose that: (a) new supervisors, in their journey to become skilled at supervision, not only experience anxiety but also demoralization; (b) supervisory mindedness is a crucial development that supervisors must achieve to be optimally effective; (c) if anxiety and demoralization become unduly burdening, they can seriously interfere with the new supervisor’s learning process and delay or derail it; (d) undue anxiety and demoralization can prove particularly pernicious to the acquisition of supervisory mindedness; and (e) to best create a place where the development of supervisory mindedness is stimulated, a safe, open, encouraging, affirming learning atmosphere, where new supervisors’ anxiety and demoralization are minimized and opportunities for self-exploration and self-reflection are maximized is optimal.

Development of Supervisory Identity

Identity is not the easiest of terms to define (Erikson, 1968) and defining supervisory identity is no exception. From reading supervisor development theory (e.g., Hess, 1987; Rodenhauser, 1997) we are left with the crisp, clear idea that supervisory identity matters greatly and is sine qua non in the process of being and becoming a supervisor. But what is actually meant by supervisor identity has typically never been precisely defined if defined at all. Might we at least begin to define that term in such a way that it serves to better inform and instruct our efforts at supervisor education?

To begin to answer that question, let us first consider the matter of perspective shift. There now appears to be general agreement: Functioning as a supervisor requires a shift in perspective that is different from functioning as psychotherapist (Borders, 1992; Borders & Brown, 2005). This vision shift of the supervisor, as I like to think of it, has been judged to involve developmental and conceptual dimensions (e.g., conceiving in terms of supervisor role and functions; Inman & Soheilian, 2010; Ladany & Inman, 2012). Such a shift might also be thought of as being perceptual, cognitive, affective, and behavioral in scope. It involves not only coming to see oneself as a supervisor but consistently thinking, feeling, and acting in according fashion. These changes can be used to inform our thinking about supervisor identity and its definition. Perhaps we could tentatively define supervisor identity as the highly constructive, established (to varying degrees) felt sense and vision of oneself as being (or on the way to becoming) a psychotherapy supervisor. This identity is (a) adaptive and adaptable in function, (b) provides guidance and direction for supervisory action and reflection, (c) has continuity and durability across time, and (d) affects and informs cognitive, affective, and behavioral domains of supervisory practice. While that is by no means an unimpeachable definition, it provides a reasonable point for beginning to think about some of the crucial elements reflective of supervisor identity. It gives substance to the profundity of the construct, and accentuates its supervisor identity’s uniqueness and distinctiveness (cf. Bernard & Goodyear, in press [2014]; Falender & Shafranske, 2004; Hess, Hess, & Hess, 2008; Watkins, 1997).

In training and supervising new supervisors, how might we best stimulate their budding supervisor identity development? More than half a century ago, Ekstein and Wallerstein (1958) stated that professional identity originates in the training process. Supervisor identity would appear to be no different. Ideally it would entail being (a) nurtured by training that promotes learning through didactic and practical experiences and (b) facilitated through being surrounded with like-minded individuals also in the process of learning to supervise. Such training would increase the likelihood of preparing beginning supervisors for their supervision role by initiating the process of thinking like a supervisor, and instigating identity development.

If psychotherapy supervision can be characterized as a place where a space for thinking is ideally created for therapy supervisees (Mollon, 1989), then the supervision of supervision experience might be most meaningfully conceptualized as a process where we as supervisors strive to create a space for thinking about how to create a space for thinking. We wish to create for our new supervisors a place where they can freely, openly, and with impunity think about how they can create such a safe space for their own therapy supervisees. Much like the supreme importance of the alliance between therapy supervisor and supervisee (Inman & Ladany, 2008; Ladany & Inman, 2012), the development and establishment of a solid alliance between supervisor and beginning supervisor/supervisor trainee can be considered the primary means by which a constructive and productive space for thinking is actuated. Furthermore, through modeling a relationally rich, consistently liberating yet appropriately containing supervisory interaction, supervisors are able to powerfully communicate some pivotal supervision behaviors and attitudes (e.g., empathic attunement, authenticity, holding) that supervisor trainees may incorporate and then take into the psychotherapy supervision that they themselves are providing.

In supervising beginning supervisors, the interventions that can be used are basically much the same as those used in psychotherapy supervision. In addition to the alliance, some other supervisor interventions include: reviewing supervision tapes and/or process notes during supervision of supervision, engaging in Socratic dialogue, encouraging case conceptualization, asking stimulus questions, teaching skills when required, modeling desired behaviors, providing corrective feedback, remoralizing when needed, encouraging mental practice, offering tentative interpretations, and providing corrective cognitive, affective, and behavioral experiences, for example, working with beginning supervisors to remove potentially problematic cognitions about their role (cf. Bernard, 2012; Bernard & Goodyear, in press [2014]; Milne, 2010; Milne & Westerman, 2001; Neufeldt, 2007; Watkins & Scaturo, 2013). Such interventions can be quite useful in stimulating and advancing the new supervisor’s identity development and are integral to that process. Extrapolating again from Chessick (1971) with regard to learning difficulties, the supervisor might best ask:

Those questions are perpetual guides for supervisors trying to assist their supervisor trainees to navigate through the sometimes turbulent waters of the early supervisor development process.

Developing Conviction about the Meaningfulness of Psychotherapy Supervision

Just as psychotherapists must come to believe truly and deeply in the power of psychotherapy (Chessick, 1971), I contend that supervisors, to be optimally effective, must come to truly and deeply believe in the power of supervision. Achieving conviction about the meaningfulness and value of psychotherapy supervision is integral to successful supervisor development and functioning. While the development of such conviction is abetted by many possible experiences, two in my view are pivotal developmentally for beginning supervisors: (a) having ample opportunities to engage in supervision practice, ideally accompanied by supervision of supervision; and (b) having ample opportunities to learn from supervisors who are deeply convicted about the power and value of psychotherapy supervision.

In psychotherapy supervision, nothing is more deadening to new supervisee learning than being supervised by someone who has no interest in or does not like supervision (cf. Ellis, 2012; Ladany, Mori, & Mehr, 2012). In the supervision of supervision, I assert the same holds true (though admittedly no comparable research on supervision of supervision has thus far been conducted):

Beginning supervisors are most apt to learn the wonder of supervision when trained and supervised by seasoned supervisors who are imbued with the wonder of supervision. We cannot honestly transmit what we do not genuinely feel. If we are to communicate and model deep conviction about supervision to our beginning supervisor trainees, then such conviction needs to be a firmly entrenched, ineradicable part of who we are as supervisors.

The following quote from Lewis (2001), though originally focused on the psychotherapy supervisor-supervisee relationship, can be adapted to convey some of the attitude that would also seem needed in supervising beginning supervisors.

To that, I would add: Further show your passion for supervising, your deep respect for and joy in performing the activity, and your abiding belief in its power and potential. Through such “showing,” supervisors model and live out the spirit of conviction for their supervisor trainees to see and experience.

Developing conviction about the meaningfulness of supervision also results from having ample opportunities to provide supervision over time and observing the benefits that therapists accrue from having received psychotherapy supervision. While supervisor trainees can readily identify that some of their psychotherapy supervision experiences were instructive, that does not necessarily translate into their having deep conviction about supervision’s meaningfulness. Two particular practice-based experiences seem to have considerable impact on new supervisors’ process of developing conviction: (a) beginning to make the perceptual-cognitive-affective-behavioral shift to becoming a supervisor; and (b) seeing simultaneously and repeatedly how the supervision process helps one’s psychotherapy supervisees and, in turn, helps patients receiving treatment. Through repeatedly seeing the impacts of supervision and such an emerging “vision shift,” a special, deep appreciation for supervision’s promise, power, and possibility can take form, be resonantly experienced in a way not felt before, and ultimately become a vital and vitalizing part of the new supervisor’s sense of identity.

In conjunction with our own consistent modeling of the passion that we have for and abiding belief that we have in supervision, how else might we help beginning supervisors acquire supervision conviction? In supervision of supervision, I believe that it can also be quite instructive to identify for beginning supervisors the ways in which their efforts appear to be having or could have impact. For instance, some illustrative examples are:

As complement to modeling and validating practice experiences, such comments and questions can help to focus the new supervisor on the progressively unfolding trajectory of the supervisor development process, chart progress in that regard, and provide solid grounds upon which to base ever-evolving conviction about the meaningfulness of supervision.

The Developing Supervisor in Training and Supervision

Regardless of supervisor development model, these three learning challenges—managing anxiety and demoralization, establishing supervisor identity, and having conviction about supervision’s meaningfulness—have a central place in the conceptualization and facilitation of the growth and development process of the psychotherapy supervisor. While other problematic issues can emerge during the training and supervision of beginning supervisors/supervisor trainees (e.g., supervisor resistance to learning), those three challenges provide a framework within which much that arises in supervisor training is instructively located.

Conclusion

While Richard Chessick has long been (and continues to be) an esteemed contributor to the psychotherapy and psychoanalytic literature (e.g., Chessick, 1974, 1996, 2010), I have chosen to highlight here a supervision paper from the early part of his career—in which he identified three difficulties that students tend to encounter in learning to be a psychotherapist: (a) dealing with the anxiety attendant to the development of psychological mindedness; (b) developing a psychotherapist identity; and (c) developing conviction about the meaningfulness of psychodynamics and psychotherapy. By extrapolation, I have proposed that Chessick’s triad of learning difficulties can be profitably applied to the teaching and learning of supervision, whereby three learning difficulties often encountered by beginning supervisors or supervisor trainees can in turn also be identified: (a) dealing with the anxiety and demoralization attendant to the development of supervisory mindedness; (b) developing a supervisory identity; and (c) developing conviction about the meaningfulness of psychotherapy supervision. Capturing core developmental concerns that extend across the arc of the supervisor development process, this triadic conceptualization appears to provide a useful and usable way of thinking about supervisor training and potentially informing it.

More than 40 years ago Chessick (1971) stated “It is unthinkable that a good training program would not afford a regular seminar for supervisors. It is mandatory to recognize the extreme difficulty of effective supervision . . .” (p. 280). With the increasing importance of supervisor training more widely acknowledged now than ever before, his decades-old words ring ever so true today. And this extrapolation of his triad to the teaching and learning of supervision (a) bears testament to the “extreme difficulty” that can attend the developmental process of being and becoming a supervisor and (b) suggests crucial areas of concern where we as supervisor trainers can viably intervene.