|"Satya feels she has really benefited from therapy. Now she wants her partner to come to a therapy session. But perhaps the key question for her therapist is not whether but why?" |
|"Serena’s description of her client Alex, a new counsellor in training, as unwilling to engage with therapy, prompts supervisor Graham to question Serena’s expectations. ??Graham waits for his supervisee, Serena, to continue their dialogue" |
|"Cameron gets on well with his therapist. They have developed a quasi-supervisory relationship during his counselling training. Now he needs to find a supervisor, and thinks she might be ideal" |
|"The online supervision session has just begun and Mary is waiting for Sophia, her supervisee, to type what she wants to discuss. Mary has been offering supervision online to Sophia for a couple of years. The wait for Sophia to start seems longer than usual and Mary wonders if there’s a connection problem. Finally, words begin to appear on her screen." |
|"Donna has been working as a counsellor for five years and has recently started working at a school. This is a new field of work for her and one that she is passionate about, having wanted to work with young people for a long time. The school takes children from age 12 upwards.|
Michael has been providing her with online supervision for the past year. The session has just begun and he has just asked her where she would like to begin"
Kenneth is waiting for his online supervision session to begin with Angela. She recently started working in a prison and Kenneth is very conscious that he has never worked in a prison setting himself. Nor has he previously supervised anyone else who was working in a prison. He is wondering what issues Angela will bring to supervision and whether his lack of experience matters. When they discussed this in their last supervision session, Angela was OK about his lack of experience but Kenneth is still worried
Online supervision: competency issues
Angela: Hi, hope all is well with you.
Kenneth: Hello Angela. All well with me. And yourself?
Angela: Yes. Lots to discuss though.
Kenneth: OK, where do you want to start?
Angela: The prison really is a different world. I need to discuss some difficulties that have arisen.
He keeps his response simple so as not to direct Angela.
Angela: I guess you get used the security checks, but there are power games being played out. I mean, I've been left waiting trying to get in. My clients are referred in to see me, and that all seems fine, but then they don't arrive and you then have to find out why because it could be that there's no one to escort them over or, as I've recently discovered, they get transferred at short notice and that's it, end of therapy. It's like nothing seems certain.
Kenneth: So, what is standing out for you is the uncertainty as to whether your clients will be able to get to the sessions, or even still be in the prison? As well as some barriers you are personally experiencing?
Angela: It's the uncertainty of it all. I'm sure it's not the same everywhere, but where I'm working there are often transfers. I mean, I'm just not used to that. Working in private practice, I don't know, everything is so much more structured somehow. This is a real culture shock. I'm getting new clients but I've had two who have been transferred and I only find out when I get there. And, while my clients know that these things can happen, or that there is a transfer likely, the actual timing can be quite sudden.
Kenneth thinks for a moment. Strangely, this isn't what he was expecting. He was anticipating more challenging issues.
Kenneth: Culture shock. Something you really hadn't expected?
Angela: I knew it would be different but, I don’t know, it's like you're trying to form a therapeutic relationship with someone but it feels more tenuous, more fragile, I suppose. Like you can't rely on it. And, yes, the issues are different. I mean, in private practice I'm not working with clients who have killed someone and, strangely enough, I seem to have adapted to that.
Kenneth feels himself frowning. To which issue should he respond – the uncertainty, or Angela saying she had adapted to the background of her clients? He can feel his own uncertainty. Angela's comment about adapting to her clients seems too easy – surely it can't be as simple as that? But he isn't sure; he has no experience of this.
Kenneth: So, the uncertainty issue stands out for you?
Angela: Yes. I mean, there's not only the issue of clients making it to appointments; it feels like there is a greater issue of trust, and I feel caught. I'm there for my client but I kind of feel like I'm being related to as if I'm part of the system.
While Kenneth has responded to the uncertainty issue but he’s actually now thinking about what it must be like to counsel someone who has killed somebody. He drifts into trying to imagine how he might feel, and realises he has no idea.
Angela: Kenneth, are you there? Are we still connected?
Kenneth reads the words and they bring him back into focus. He looks back at the recent dialogue to try to pick up the thread. He feels he should be congruent and open about what he is experiencing.
Kenneth: Sorry, yes, I found myself thinking about what it must be like to work with a client who has killed someone and, well, I don't know. It just seemed quite an unknown to me.
Angela: It has been for me too but my reaction has surprised me. I don't know why. Whether it's the environment or… I don’t know.
Kenneth: Not sure why, but you seem to be adapting in some way.
Kenneth knows as he types that he somehow doesn't feel connected with the words. He is concerned.
Questions for reflection
Richard: What is your response to the supervision dialogue as it has developed so far?
Caro: Concerned about Kenneth’s abilities as a supervisor. It seems to me that he is taking a ‘deficit’ view of his role and becoming pre-occupied with what he doesn’t know about the context of his supervisee’s work rather than considering his skills as a supervisor. He contributes to this further by distracting himself by making assumptions about what Angela might find difficult. He is barely listening to her – I question whether they discussed the situation fully enough in the previous session. Kenneth is almost entirely connected with himself to the extent that Angela has to enquire as to whether he is still around.
Richard: Something is happening for Kenneth. Are we looking at a supervision issue, or therapy issue for him?
Caro: Both. It seems as if Kenneth has not given enough thought about how he might manage working in an area outside his own experience, which clearly rattles him. Nor does he seem to have reflected on what he might know about prison life in general: eg what he might read, see or hear in the media, on film, television, books and so on, or used his imagination. He was prepared to work with Angela but when the session actually takes place, his role as supervisor seems to have almost deserted him. I do wonder whether he listened to his doubts when Angela first raised the issue. If he had, he might first have considered having a session with his supervisor of supervision to explore his concerns and following this, if necessary, with an additional session in therapy. He appears to have done neither, which I would view as both negligent and ethically questionable.
Richard: What are the issues when working with a supervisee who is counselling in a setting and context that is outside the supervisor’s experience?
Caro: At base, I need to be scrupulous in considering whether I can really offer supervision or will I be too busy learning about a new setting and context at the supervisee’s expense? I need to consider whether my skills and existing experience will be sufficient to do this. There are many issues at stake here but if we have any doubts at all, I feel it is incumbent on us, as supervisors and guardians of the profession, to explore the ‘new’ and all that is thrown up for us personally and professionally.
Richard: At what point might there be a case for a supervisor needing to have some experience of the setting and context? Is this something that may only apply to certain counselling environments?
Caro: I’ve often pondered on this and the short answer is, the jury is still out. I am aware of the arguments on both sides when it comes to being a counsellor in particular settings. What I am clear about is that there is a difference between being a supervisor and a counsellor. Fundamentally, I see it as the task of supervisors to ensure that supervisees are able to be competent, humane and skilful counsellors in order to offer the best possible service to their clients, so my emphasis is on what is going on for them in their therapeutic relationship. Issues about their work will arise during this exploration. I am inclined to think that, if supervisors feel they need to know more about a particular setting and context, then they can read up and ask colleagues for further information outside the supervisory session but they do not have to have had the experience themselves. After all, as a woman, the reality of being a man is entirely outside my orbit but that doesn’t inhibit me from working with men.
Richard: ‘I don’t know’ is a phrase being used by both Kenneth and Angela. What might be the supervisory implications of Kenneth’s difficulty in empathising with Angela’s ‘I don’t know’ when he is full of his own ‘I don’t know’?
Caro: I think this just added fuel to the flames and caused Kenneth to feel even more at a loss. He started off competently enough but it became evident he did have pre-conceptions about how Angela might feel about her work in the prison. He was then confounded by her response and became caught up with his own thoughts and feelings. The supervisory implications of this were that he was distracted and could not properly supervise. What a dilemma for him! The congruent and honourable response would be for him to call a halt to their work, say he has misjudged the situation and admit that he has made a mistake in agreeing to work with Angela. He can then offer her a choice: he can agree to continue work with her once he has explored further what has arisen for him or she can find another supervisor or he too can try to find a supervisor who might be better equipped to work with her in this context. They would need to discuss this there and then and probably end the session early. As Kenneth, I would want to apologise and waive the fee.
What do you think? How would you have handled this situation? BACP members can respond to these points for reflection or join the discussions at the Therapy Today community in BACP Connect
Caro Bailey has been counselling, supervising and training for over 30 years and is a co-tutor on the CASCADE diploma in individual and group supervision.
Richard Bryant-Jefferies has written a number of books on counselling and alcohol use, in particular using fictitious dialogue to allow the reader to engage with characters and processes in the counselling room. He has been a counsellor and supervisor in the NHS and in private practice. www.richardbj.co.uk