Hypotheticals encourage proactive supervision

Using supervision to plan ahead for common and uncommon events has advantages for therapist and client. Both gain when the therapist has considered their range of responses ahead of time.

Ideally, clinical supervision is proactive. You discuss the progress of your cases and identify opportunities to be developed and pitfalls to be avoided. Inevitably, some supervision is reactive. You describe a problem or crisis and decide how such a situation can be avoided or better managed in future.

Reactive supervision can be dispiriting, even disempowering. The supervisor is given the role of dispenser of wisdom to the supplicant supervisee. A directive supervisor can leave you with the impression that you are still a novice (whatever your actual stage of training) with much to learn. Hopefully, we all still have much to learn, including our supervisors.

When cases are going well, reactive supervision seems unnecessary. Supervision sessions may be cancelled for want of any problems to discuss.

Training provides us with techniques to manage the most commonly encountered situations in practice. With practice, these become second nature. Reactive supervision provides us with approaches to improve our management of rare occurrences, but we lack practice in these situations, many of which should be handled with confidence and tact.

Practicing Therapy (Rambo, Heath & Chenail, 1993) features a number of “exercises for growing therapists” which can be used as the basis for proactive supervision, elucidating our biases and prejudices. There is another class of situations which demand planning and practice, however: those from which we cringe, those which we hope will occur rarely (if ever) and so avoid discussing.

What if my client:

  • cries?
  • starts shouting at me?
  • asks me out?
  • confesses to a crime?
  • pleads not to be discharged?

Rather than handle these situations retrospectively, we owe it to our clients and ourselves to plan for them by considering hypothetical cases in our supervision (and wherever else the opportunity presents). In the coming weeks, I’ll be presenting a series of “hypotheticals” for consideration and discussion. Some have occurred to me a number of times, others have yet to occur. My intention is not to provide supervision (this is not an agony column!) but to provide a springboard for your own supervision sessions when “everything is going well”.

One thought on “Hypotheticals encourage proactive supervision

  1. my work involves assessing people’s psychological suitability for surgery. In a recent session I was required to feedback to a client that she did not meet the criteria for a surgical procedure. During the feeback a relative of my client who attended the session became increasingly angry (raising their voice, using aggressive and confrontational language) and was waving their walking stick at me. The situation escalated very quickly and I felt physically shocked and helpless. Looking back I realised that I had not adequately thought this scenario through.

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