I have wanted to write this paper for a long time, but convention often prevented me putting pen to paper. In science conceived wisdom is hard to change; any new paradigm is always met with scepticism and derogatory attitudes. However now I am independent of those who could make life difficult for a lone voice so I think it is time to state the case against supervision of therapists.
Like many therapists and psychologists I have over the years had to submit myself to the task of being supervised and supervising others. To make clear my objections to the process I should first state the conventions and current wisdom from the last 100 years of so.
What is supervision and what is it for?
Therapy is seen as an arduous task in that we have to listen to the woes and difficulties through the lives of other people’s stories. Often difficult and stressful clients tell us what is happening in their lives now or in the past that are preventing them from moving forward from those past traumas or the present complications in life. Most professionals listening can of course empathise with the client and through what-ever style of therapy help the person to resolve their problems and cope with 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 on the burden of the problems, personally, from the client to themselves. After a while they face breakdown and personal misery – not because of their own problems but because they cannot remove themselves mentally from the client.
The case for supervision then is mainly a coaching one, the supervisor (usually a very experienced counsellor) listens to the therapist in order to help that person get the clients problems and their own in perspective. I think for a new trainee therapist and a person with little personal confidence this may help them to carry on and assist in preventing personal breakdowns. Most organisations insist on one hour of supervision for every six hours of client contact.
So why having stated above, a reasonable case for supervision, am I so against the practice? Well I will tackle this in the following points:
1.Most supervision is ineffective
2.Supervisors are themselves problematic
3.It is a money spinning exercise for taking advantage
4.Most famous therapists were never supervised in the modern sense.
5.It is a power play and an egotistical parent-child role exercise
6.It can be easily replaced.
Taking my first point, most supervision is ineffective; I state this from personal experience of supervision and from anecdotal evidence of other therapists. When you submit yourself to supervision most counsellors and therapists report they feel it is a critical experience and not a supportive one. Most feel they are being challenged to justify what they said and did in individual therapy sessions. Therefore most are not honest and forthcoming in these sessions but in fact as any psychologist knows will display themselves in the best possible light. This immediately undermines the whole concept of support and guidance. If the therapist is feeling judged they cannot benefit from the exercise and do not feel therefore able to grow from their present position as counsellors.
The second point is the supervisors themselves. Most are not experienced supervisors but are qualified in their particular field of theory. They take on the burden of supervision because they are required to do so. However this is not the most important aspect and I will look at that in the next point. My own and others experience of supervisors is that they are hearing cases second hand, trying to judge beyond their personal experience, trying to see into the mind of the therapist in front of them and worse putting a time limit on the relationship. In all they have very little stake in the client and very little in the therapist in front of them.
My next and third point is – money! Supervisors get paid by the therapist. They know any new counsellor in order to become qualified needs so many hours of client contact and supervision hours in line with the theory’s requirements for qualifying. This is the real crux of supervision – the money to be made from new counsellors (most of which will never qualify) is a high income exercise. The motivation for supervision then is not a feeling of noble support but a simple commercial exercise of exploiting counsellors and therapists for money. If that sounds harsh – too bad. The truth often stings.
I suppose the best way is to invent your own theory of therapy and supervise yourself as most famous past psychologist actually did, Freud, Jung and many other historical figures did not have to suffer supervision but in fact kept their own council. The method they used was quite different from the burdensome way in which we use to supervise today. If you are confident in your own ability and feel you are successful with your clients (and only you and your client can judge that) then you do not need someone else to tell you that.
My fifth point is perhaps in respect for Eric Berne the creator of Transactional Analysis (personally one of the best theories in psychological thought). In T.A. Berne state the eloquent concept of the PAC model, Parent, Adult and Child as mental states. I do not wish to dwell here on the theory and we do not have space. As a supervisor you are acting as a Parent to the counsellor’s Child ego state. This stated means the supervising is not in the position of coach or mentor but in fact of superior and is often judgemental and parental in guidance. This does not matter whether the supervisor takes a critical parents role or that of a nurturing parent – the power play is the same. The counsellor is submitting through experience of childhood to a parental symbiosis with the supervisor. This is unhealthy and restrictive and most counsellors will take the Adaptive Child’s role in that they will submit to supervision as a way to make their Parent (supervisor) happy. As Berne stated we all have a Little Professor inside our head constantly trying to get the best of a situation and in a child’s case love and affection. If you cannot get love then attention will do – even critical attention.
My final point then is it can be easily replaced. Many years ago a group of like minded counsellors decided to form a society away from mainstream organisations who try to dominate the mental health regime with rules and controlling doctrine. They met once a month as a large group, sometimes up to 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, is the peak of our individual attention time for listening and keeping still. After people would mingle and chat. Nothing to heavy, books read, clients seen, money talk and other general aspects of counselling. However more important they formed smaller groups who lived near to each other. These groups of five or six therapists would meet once a fortnight at one persons home and this would be rotated. These meetings were relaxed and informal. You could bring case histories or clinical problems. Each in turn got a chance to talk about what was worrying them and in return received the advice, wisdom or just general chat 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 so wanted to. The idea was support and a feeling of a non-judgemental group. (Do not confuse this with a Group Therapy meeting). These are your peers and friends not your supervising judge. The atmosphere of these groups I think was ten fold more encouraging than any single supervised session. Some basic ground rules should of course be observed, being non-judgmental, respect for other peoples theoretical stand-point, (you could all be different schools of thought) this often leads to cross-fertilisation of ideas. You should not tell, only discuss, this leads to an informed atmosphere not a dictatorial one. Finally, have tea and biscuits, have humour, have fun – this is a time for you to feel good about yourself and the fact you are part of a community of people who care about others and strive for a better mental health world.
I personally have to supervise new counselling students while they are seeing their first clients. I try to give 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 have qualified then a peer group should be all the support you need. Present supervisors can replace their lost income by giving open lectures or talks to groups (thirty minutes). If they truly are as good as they think then they can demonstrate that in front of a group. Tough decision – to be judged – is it not?
To reiterate I am against supervision. It should be stopped except for initial training purposes. Only a therapist and their client can do the work of therapy. I know this article will have many critics and those who will deride my views. So be it. As I stated in the beginning any new paradigm is in the beginning forced away from convention. I only hope that in time we can realise how unhealthy the current system actually has become.
Professor Stephen F. Myler PhD (Psych)