So, your counselor is getting supervision? Cause for concern? (Hint: probably not!)
Any one therapist can't be all things to all people.
Every therapist has limits to their scope of practice. For one, their training can't cover everything. For another - and what I think is an even more important reason - for a therapist to decipher what's going on in a session will depend to some extent on their emotional capacity.
In other words, we all have our blind spots including therapists.
Basically, supervision is a consult with another therapist.
The idea is that the supervisor is wiser and more experienced in the area where there's a need for another set of eyes.
"Yeeks, my therapist is being supervised!"
Outsiders, non-therapists and the like, may be initially confused about the notion of supervision. In the workplace, supervision is often associated with jobs in beginner positions.
One cannot imagine for instance, a manager being "supervised". And, if a manager is being "supervised" it's often because workplace production has suffered in some fashion.
Yet in the helping professions, clinical supervision is regularly used throughout one's career - both in professional trainings as well as for one-off consults regarding specific client cases.
What is meant by clinical supervision?
Clinical supervision is a formalized process that entails sitting down with another more experienced - hopefully wiser - psychotherapist to discuss clients' issues. It's a collaborative process wherein the therapist brings her questions, comments and even possible countertransference concerns for working through.
"Is my therapy still confidential?"
It's true that aspects of your problem may be discussed with your therapist's supervisor. However, identifying details (first name, profession etc.) are disguised.
It's understanding the dynamics and making therapy more effective that's the focus of the supervision. Having two minds digest the details of your problem provides insights that may have been missed without that collaboration.
There are also times when a therapist needs to present more detailed (and disguised) information about you. In this instance, it is customary that your therapist receives your informed consent before doing so. In other words, you have a right to decline and if you agree to the sharing of personal information, you will likely benefit from your therapist's consultation.
In other words, your back-up has back-up!
Just so you know, it's been my experience that my clients are appreciative when I am getting a consult on their behalf.
By the way, there is no extra fee to you for this service. Therapists typically cover these costs as part of their practice overhead.
"Do all therapists get supervision?"
Good supervision is often sought after, especially by newbie counselors, because it's one of the best ways for deepening one's knowledge about the therapeutic process. Even seasoned therapists seek supervision when they encounter an issue that they have little experience treating.
Many feel that supervision's main role is in helping the therapist become more conscious of countertransference reactions and patterns. These implicit patterns arise naturally in connection with clients and serve as important sources of information. Indeed, for this very reason, on-going supervision is strongly encouraged by licensing or regulatory bodies.
As such, supervision for a conscientious counselor never really stops. As long as a therapist desires to grow personally, he or she will seek it out.
Not all therapists engage in this practice, however. Yet, good therapists do so on an on-going basis either through individual supervision or with colleagues.
One of the greatest challenges for any therapist is when a client presents with a problem that he or she has not fully resolved personally (a.k.a countertransference). This situation confronts a counselor in ways that other professions only come close to.
There is no simple formula for working with all clients or all presenting problems. As therapists, we are continually stretched by our own limitations and strengths in providing therapy.
My Personal Musings
As a therapist I certainly continue to be challenged by my clients. That's just life…we're all just bumping up against one another!
I also recognize that I can easily be lulled into habit patterns with my clients--I move into procedure! (Neuroscience explains that the brain is predisposed to work this way--we're "energy-efficient organisms".) So, supervision helps keep me fresh in my therapeutic approach and authentic in the way I interact with each person I work with.
Good supervision recognizes this and helps me grow as a therapist and as a caring human being. They go hand in hand as far as I am concerned.
notes
If your counselor is completing his or her internship (which is a mandatory requirement for a masters or doctorate degree), there's a good chance your therapist is bringing up your concerns with his or her supervisor (and you will be fully informed of this fact).
Supervision is also mandatory as part of educational requirements for licensing or registration in a particular locale (i.e. a province or state). After licensure, therapists remain ethically bound to seek supervision any time expertise falls short.
Supervision can also be required if a therapist has been found guilty (by their board of registration or licensing) of an ethical issue. In this case, supervision is a means for the therapist to fill in gaps in their knowledge and experience.
Reader's Comments
Craig
My ex-therapist was supervised by my new therapist
Hi, Thanks so much....found this article very interesting and helpful. I have a question id like help with please. I was seeing a therapist for around 1 year, all going ok etc...she had to quit her job for personal reasons, which hurt, but i understand it happens.
So now i see a new therapist, its going great, however we got chatting about my previous therapist and my new therapist admits she knows her and that she was her supervisor and as she put it 'brought me to supervision a couple of times' this feels ODD-my new therapist knows more about me than i first thought........AHHHHHHHHHHHHH!
what should i do? help? would she be allowed to tell me what my previous therapist told her about me/what they disscussed? please help,
Thankyou, Craig USA
Shrinklady
Oh, my goodness, I can imagine that would undoubtedly feel strange for you Craig. It'd be as if two friends of yours were speaking about you and you were not privvy to that discussion. Which of course, no doubt happens in many social circles. It would matter little of course, if you trust and love these people. It'd be another matter if you didn't trust them.
So I guess, I'd want to ask you that question...do you feel you can trust your therapist? Cause if the answer is yes, then I would think, it won't ultimately matter to you...that is, if you're able to feel resolved by how she responds to your concerns on the matter.
I certainly think it's a good idea to inquire as to the topics that were discussed. In my view, good therapy should always aim to be completely transparent. Indeed, a discussion like this could be an excellent launching off point for other aspects of your work.
Can you imagine for instance, experiencing these feelings of being "exposed" and at the same time, being comforted by her assurances (whatever you might require), how good that might feel? It could be a wonderful opportunity for working through some of your fears.
Be that as it may, I hope you keep in mind that these are two people who were vested in your best interests. That your therapist now "knows more about you" can have a positive outcome.
One thing I'd like to share with you Craig about my own personal growth as I think it might be useful. I've been doing online writing for years now and during that time, I've shared a lot about myself. I've noticed that once I become comfortable with an aspect of myself, it ceases to have a hold on me. It no longer is a concern whether someone knows that about me or not.
I can share it publically because I own it. No one can take that away from me. The happier, less judging I am of myself, the more I can accept the good and not so good, the more I can share that part of me with others without worry of being "exposed".
I hope that helps Craig,
Shrinklady
P.S. And jsut for the record, I do think it odd that identifying information was not disguised in your previous therapist's description about her work with you...unless, somehow your current therapist guessed it?
Normally, in my experience, when therapists bring client histories to a supervision hour, we use a different first name and never use a last name.
Jonathan
the notes are superb . continue with that spirit
the notes are superb . continue with that spirit
jonathan (NAIROBI, KEYA)
Marguerite
Two heads are better than one
Hello Suzanne, No comments as yet? Well you can obviously hear me breathing because I have one!
I both like and dislike the thought that anything about what I might tell my therapist is shared with any other person. I like the thought because as you say, the fact is that surely I will benefit from this. ie. two heads are better than one. I feel uncomfortable about it because I have never told anyone the things I am now just starting to tell my therapist, and it's still a difficult feeling that anyone else knows, let alone a second person.
However I have confidence in her, so I guess it has to be OK by me. And, thinking about it, ie. of the two thoughts, it really is OK after all!
Thanks for helping me work that one out by leaving a comment!!
Thanks too for a wonderful website. Marguerite
Shrinklady
Thanks for your comment Marguerite and sharing your process with us. I'd like to add an explanation on what I think just occurred for you. It might help others understand their own qualms around supervision cause I think this is a common feeling folks struggle with.
When the reptilian brain is activated (from trauma and dysregulation of the nervous system), it goes on alert to guard us from future events. It reveals itself in our awareness as a need to be "on guard".
We notice it as an alertness and being a little untrusting of others. (When the feeling is heightened it shows up in some folks up as paranoia.)
So, this feeling of being "exposed" in therapy with the thought that your therapist might seek supervision and the discomfort with it, is a natural outcome of this "on guard" state. Your nervous system was doing exactly what it needed to do to keep you safe.
And it seems that you in a place where your activation is coming down. This state is now allowing you to feel more comfort and less on guard and hence, in the perfect mind-body space to work it out as you did above.
Congrats Marguerite!
All the best,
Shrinklady
