Models

Examples of Supervision models (descriptions expanded):

  • Developmental: this is an approach based on the notion of levels of practitioner skill (similar to the idea of Apprentice/Novice/Tradesman/Master) with supervision appropriate to competence. However, the model does not imply that a practitioner at a given moment is entirely a novice or an expert. Supervision should have regard to a practitioner’s technical and personal position on a continuum and on multiple axes e.g. there may be expertness in one dimension (e.g. reflection on practice) alongside apprenticeship on another (e.g. technical competence). There will be many times when each learns from the other, as happens in case work.
  • Modality-specific/scope specific: the focus is on supervisee-preferred therapies and/or fields of practice. Increasingly  practitioners’ are developing their own unique, ‘eclectic’, trans-theoretical models, or relate their needs to a specific field of practice.
  • Adult-reflective: Whilst all supervision implies a reflection component, this approach views reflective practice as a skill founded on specific adult-learning theory. Freud has described therapy as including ‘hovering over’, and in supervision a focus on the adult-refective way of working encourages the use of ‘helicopter’ skills: of simultaneously working on as well as in the session with clients or patients.
  • Matrix: developed in 1985 initially by Hawkins (joined later by Shohet) as the ‘double-matrix’ model, and subsequently dubbed the ‘Seven-eyed model’ by Inskipp and Proctor in 1995 (a re-branding adopted by the Hawkins and Shohet) this approach differs in giving primary attention to the processes between supervisor and supervisee within supervision, and the processes present in the practice of the supervisee as evidenced (“reflected”) in the here-and-now supervision relationship. Thus, supervision attends to two interactive matrices: that of the supervisee with the client, and that of the supervisee and the supervisor. This model also specifically attends to transference and countertransference dynamics in these matrices.
  • 7-eyed
  • Restorative: Self-care can be over-looked for a variety of reasons, by the helping professional.
  • Risks to practitioners at the client interface include:  vicarious trauma (Pearlman and Saakvitne, 1995a; Saakvitne and Pearlman, 1995b), secondary victimization (Figley, 1982), secondary traumatic stress (Figley, 1983), compassion fatigue (Adams, Boscarino and Figley, 2005), emotional contagion (Miller, Stiff and Ellis, 1988), secondary survival and burn-out  (Schaufeli and Enzmann (1998).
  • Risks to self within the employment system include cultures typified by:
    • a hunt for ‘personal pathology’
    • a striving for bureaucratic efficiency
    • a “watch your back” mentality
    • a focus on, and driven by ‘crisis’, and
    • an ‘addictive’ or co-dependent pattern of staff relationships (Hawkins and Shohet (2006)
  • There is usually attention to ‘restorative’ needs in all of the approaches to supervision, and sometimes it may be the primary focus.
  • Restoration in this context does not imply pathologising a supervisee: rather it refers to the supervisor assisting the supervisee to recognise and manage risk pre-emptively.  A failure to do so may of course contribute to the practitioner reaching the point of needing therapy –  an outcome that has contributed to the recognition of the importance of external supervision.
  • To be clear, however: the need for therapy might be agreed in supervision, but this need is not met in supervision.
  • Group: as a ‘learning’ opportunity the group approach may well be the most effective, as it taps each individual’s expertness, capitalizing on peer strengths. It can also inhibit disclosure, however. I offer group supervision for those who also separately engage in one-on-one supervision (whether with me or some other provider) – I consider group supervision as complementary to, not a substitute for, the near absolute confidentiality present in one-on-one supervision.

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The origins of modern professional supervision:

  • So far as I can tell the modality model was ushered in from the very early years of psychoanalytic practice (Bernard and Goodyear, 1992): of the current 500-plus recognised therapies (Corey, 2009) psychoanalysis was first off the block, with supervision introduced in the 1920’s by Max Eitingon at the Berlin Institute of Psychoanalysis (Frayn, 1991)  – by 1922 the International Psychoanalytic Society mandated standardised training, performance standards, and coursework, and the treatment of patients under supervision (Caligor, 1984).
  • The term used to describe supervision back then was ‘control analysis’, delivered either as (i) a continuation of the supervisee’s own-analysis (preferred by the Budapest School), or (ii) as separated from the transference counter-transference focus of own-analysis with supervision emphasising didactic teaching (the Viennese School).
  • Present day supervision practice in psychodynamic (including psychoanalytic) contexts appears to follow the Viennese view of supervision as a teaching and learning process within a dynamic systems model, that does not include therapizing the trainee (Ekstein and Wallerstein, 1972).

I align with the Viennese approach.

  • The scopes of practice models probably have even earlier origins, and derive from the values of the emerging social reformist movements.
  • Parallel with the evolution of psychoanalysis in Europe, in England the late 1800’s saw the emergence of Charity Organization Societies whose paid “social work agents” supervised “friendly visitors” whose task in turn was to attend to the moral needs of “the poor” (Harkness and Poertner, 1989).
  • This early form of supervision was focused indirectly, on the client, not on the social worker. Zilphia Smith appears to have been first to propose in 1901 that supervision address the skill needs of the social worker (Eisenberg, 1956) – but this idea gained little traction until the Great Depression of the 1930’s, when social work expanded exponentially, and formal training for persons doing social work was introduced.
  • As Bernard and Goodyear (1998) have pointed out, the re-focus on the practitioner as supervisee, brings with it the seeds of supervisor dissonance — no longer are supervisors only allies of the supervisee, both focused on the ‘client’, but now judges also.
  • And, for supervisees, the potential for supervision to be “snooper vision” (Kadushin, 1976) has created the space for a fundamental tension in the supervision relationship, that is perhaps best reconciled in an expressive-supportive supervision relationship.
  • The nettle remains, as Bernard and Goodyear put it, for professional supervisors to “risk bruising the egos of their supervisees or, in extreme cases, even to steer a supervisee from the profession”.
  • Unavoidably, “evaluation” has the potential to be an anxiety-laden component of supervision, in a way similar to, possibly pricklier than, the cyclical ‘competence-assessment’ process necessary for professional association membership, and Registration.
  • For a much more detailed account of the development and the elements of both clinical and professional supervision, and a very full summary of the myriad philosophies and models of supervision, I recommend Janine Bernard’s and Rodney Goodyear’s the Fundamentals of Clinical Supervision first published in 1992 (by Allyn and Bacon), now in its 5th edition (2013) – it’s a great text, from the perspectives of both supervisee and supervisor, and worth every cent at between $80–$100.

The emergence of a distinction between internal and external supervision (often represented as “internal versus external”), and the development of a discipline named “professional” supervision (versus “managerial” or “administrative” or “line” supervision) are of more recent origin.

The ‘survival’ and independence of the professional form is made tenuous by ‘new managerialism’, and its reliance on a mix of employer paternalism and/or enlightenment, on various professional codes of ethics and on individual practitioner’s will and means.