Episode 1: Unpacking supervision

Isabelle. 00:06

we are recording. We're recording Hi Claire, Hi Isabelle, all right, it's great to be here . Yep, pretty exciting to be starting with this podcast.

Claire. 00:20

So today we're going to be talking about supervision. What is supervision, what it looks like, what good supervision looks like, what not such good supervision looks like and what you can expect, and maybe a few tips about what I guess how you can use supervision, about what I guess how you can use supervision and how you can make the best use of your time. We all know that supervision is expensive, but you have to do it, and so let's really make it count.

IsabelleHost00:57

Sounds good. So we're going to first cover this question of what is supervision? What is it in the context of being a therapist or an emerging psychologist.

Claire 01:13

Such a good question because I think a lot of people they go into supervision quite blindly. We're told we need to do it and we turn up for it, but we don't necessarily understand exactly its purpose and what it's for. So hopefully today we can sort of unpack some of that for you.

Isabelle 01:31

Most definitely. I mean from the psychologist's perspective. You and I have both been through that very intense two or sometimes longer years of supervision. Hence two or sometimes longer years of supervision. And so when we're talking about supervision today, what we are really outlining is this mandatory process that we all go through to check that we are meeting competencies to become a professional and ethically trained person in this role. Would you agree?

Claire 02:07

Absolutely, absolutely. And even beyond the internship as well, we still need to maintain those competencies and so getting support with supervision or peer supervision or peer consultation, as it's sometimes called I see that as really a lifelong process for as long as we are in this career and something that I think is so important that we, that we engage in, which is why we need to, I think, really make it count and access supervision that works for us.

Isabelle 02:43

Yes, yes, I agree. Well, some of the nuts and bolts that you and I have kind of outlined uh around what is supervision are that. It is that quality assurance process, especially in the field of psychology. So we're wanting to really hone the, the developing therapist skills and reflective capabilities in their role.

Claire 03:10

Yeah, absolutely. And also supervision can, I think, change over the course of certainly over the course of you know, our career sort of the lifespan of our career as therapists, and at the beginning of the internship. It might look a little different towards the beginning of the internship, it might look a little different to towards the end of your internship and also once you're fully registered. So I think that's supervision can look very, very different to different people and different types of therapists too right

.

03:41

I think your style will be really influenced by your supervisor's approach and style. I certainly know that my approach to supervision is very much mirrors. Well, I hope it mirrors the supervision that I've really benefited from over the years.

Isabelle 03:58

And what's some examples of that? I'd love to hear that.

Claire 04:02

Yeah, so I had an amazing supervisor for a number of years and actually before I was, I was referred to her by somebody who I can't remember the exact way he said it, but he said you know, imagine that you're small and that she's big and you're going to be like her when you're big. And at the time I thought, wow, I'd love to be like her. But I think that I've really tried to mirror what she provided me, and for me that was a real, real balance between theory and practice, but also some really practical steps. So I would leave supervision with a clear sense of what I could do, not just what I think about and what I could read, but actually what I could actually do. And so that clear action plan for me how to tackle something in the next session or where I was going to go with something it felt quite tangible, and so I really try and provide some of that to my supervisees.

Isabelle 05:06

I love hearing you say that, Claire. I think I can relate to that experience. I had some wonderful supervision when I was developing my skills as a psychologist and it's part of what influenced me to want to become a psychologist early on in my career. Sorry, a supervisor early on in my career, psychologist as well. Yeah, I just remember thinking wow, I was so nervous and so anxious and I had no idea what I was doing. But every time I went to supervision I came away with these nuggets of gold and it shaped me and molded me and also gave me confidence like a reassurance that no, isabel, you're doing okay. It's normal to feel unsure imposter syndrome but here's some steps for you to take to help you bridge the gap that you're experiencing at the moment.

Claire 05:59

Oh, I just love that you mentioned imposter syndrome and you mentioned being nervous because of. Of course, that is mostly the case when anybody new entering supervision. It's quite terrifying Walking into somebody's room or, more recently, even in an online setting in, in really sharing those things that you don't yet know and need to know, and and that balance between you know how much do I show what I can, what I can do and what I do know, versus how am I going to get the support I need? Um, so I think that we all come into this with imposter syndrome, um and so for any new therapist listening to this, this is actually a really normal way to feel when we first start out and actually, to some extent, I still feel nervous when I go to supervision.

06:53

I still feel like, am I giving away this balance or presenting this balance of do I know enough here versus what do I need to get here? You know, can I ask these hard questions? Should I know this stuff? And over the years, I've learnt to sort of let some of that go, because ultimately, I'm going because I need it and I think, well, you know, how can I get the most out of this, and so that's what I try and encourage anybody to do is sort of go in with that. The biggest question you're going to come into the supervision is what do I need from this and how can I ask for that? Um, so I really love that you brought that up yes, yes, yes and we can.

Isabelle 07:38

I think we can all relate. Anyone who's just, you know, starting out, maybe, who's in uni thinking about going on to one of the programs to become a psychologist, or if you're a social worker, looking at doing masters in counseling, something like that, we're all going to feel so nervous and so unsure and out of our comfort zone and I love that you said that. That feeling out of our comfort zone and feeling like we don't know everything. That, for me, is an indication that we're doing really good reflective practice throughout the rest of our career. That feeling of, oh my gosh, there's still so much for me to learn. Even if you've been practicing for 20 years, we will never know everything.

Claire 08:21

Nope, I can guarantee that and you'll always, always, always need um. I think you'll always need supervision and I think you'll always need. You may look different as, as you know, you progress, but I think we always need support and, like you said, we, we're never going to know it all ever.

IsabelleHost08:40

I love that. I love that now. So, um, so we kind of touched on a few things here, haven't we around what to expect from supervision, normalising the feelings and the experiences that we have, especially when we're new to supervision and new to becoming a therapist. But we're also sort of touching on the qualities of good supervision here a little bit, don't you think?

Isabelle 09:07

What are the signs that we know we were benefiting from this right?

Claire 09:11

yeah, yeah. How do you? Yeah, how do you come out of a session? Because I think you described these nuggets of gold. You know, coming out of that session with those nuggets of gold, that that would indicate that that was a pretty good session and that you could come out with what you needed.

Isabelle 09:28

Can you think of other things that would, from your experience as a supervisor and as a supervisee, things that would tell other people listening today that they have a good supervisor or they're having a good supervision experience?

Claire 09:43

Yeah, oh, there's so many things, but I think that you know being confidence is such a big issue and you know, as we've just talked about, and I think, if we come into a session with doubts about something, I think it's so important that supervision really focuses both on the strengths and what you're actually bringing to the work, because there's so much good stuff and, yes, we want to celebrate our wins and sometimes it's really important to spend time in supervision really focusing on those wins, but ultimately, we are there to learn as well, and so, having that balance of you know, knowing what you are doing well, you've got this session that may not have gone as planned, coming away knowing actually some of that, you know I did really well, but these are things I maybe could look at doing differently and and I think that you know being I feeling more sure of ourselves and any other number of reasons why you know sessions, sessions go well, sessions don't go so well.

11:18

I think that being able to come away with a sense of what we do well versus a sense of okay, these are the I think is really important and I think to come away from supervision feeling like your supervisor sees you and sees what you know, sees where you're at and can detect what you need. That would be one really primary thing.

Isabelle 11:42

So that supervisor you're kind of describing is someone who's interested and connected and present with you in supervision. They are also not going to be inappropriately critical if you do or you're going to feel safe enough to bring an example case to supervision that you want to share because it didn't go so well and that you're comfortable enough to review that with that supervisor, knowing that you're not going to get an inappropriately negative response.

Claire 12:18

Absolutely, absolutely. Because, in the same way that we want our clients to feel safe with us, you know, I want my supervisees to feel safe enough to say you know what this seems like a silly question, but can I ask it anyway? And I'm like there are no silly questions because it's all learning and if we don't ask those questions we can easily miss things. So, yes, and we all have different blind spots and different strengths. I would want my supervisees ideally to, to feel seen and I can sort of navigate what their needs would be through the relationship and through the previous sessions that we've had, because we're going to build on that.

Isabelle 13:22

You're reminding me of a couple of things as I'm listening to you talk, Claire, a thought popped in my mind to have a little discussion around confidentiality in the supervision supervisee supervisor relationship, because that's something that maybe people who are studying psychology or wanting to become therapists they're listening to this podcast today, you know how much of my private information, or my private practice information, is kept confidential when I go into that supervision space.

Claire 13:55

Oh gosh, so important. The supervisory relationship is a contracted relationship. It's not the same as a therapeutic relationship because the dynamic is a little different. For example, as a supervisor, I'll be interested in your perspective on this, but I would probably disclose a little bit more than I would in a therapy session, because I want the client to see how I work, and and how I might respond, and also maybe some of my blind spots, because that's going to hopefully normalize some of that for them.

14:32

But there is a code of ethics and there are also ethical guidelines specifically for supervision, and these are published by the Australian Psychological Society and I share those with new supervisees because there are certain things they can expect from me and I think it's important that they know that I am actually bound and contracted by that code of ethics and so that they can expect a professional service, they can expect confidentiality, they can expect that I'm going to uphold my share of the tasks required with an internship.

15:14

Particularly, there are tasks that the supervisor for example, some of the reports supervisors need to complete those reports, not the provisional psychologist and you know there are certain components that do need to be completed by the provisional psych, but the supervisor needs to be completing their component and they need to be signing off on certain documents. It should be understood exactly what our role is and what the requirements are, but also that if there are concerns, that these be addressed in the same way that it would be in a therapeutic relationship. So if a supervisee has a concern about their supervisor, ideally they would go to the supervisor and discuss those concerns first, but that actually, we do need to adhere to that code and that any anything outside of that is is actually reportable, in the same way that unethical behavior would be reported. And so confidentiality.

16:26

I've gone a bit beyond confidentiality there but confidentiality sort of falls within that code of ethics. So what you say to your supervisor stays with you and your supervisor.

Isabelle 16:39

And it's only broken if there is a serious concern about that person's practice or a serious concern about their ability to perform their role for other reasons.

Claire 16:53

Yeah, or if there's a concern about a client. The client, therapist confidentiality and code of ethics come into play, because if there are concerns around risk of harm to self or others, then of course the supervisor is going to support the client with that information, and so you know we carry that risk with them, absolutely, absolutely.

17:25

I sometimes say to provisional psychologists I feel like sometimes we are doing this together, like when a case report gets approved, for example through ARPRA, I sort of think, well, we've passed because ultimately I've had to. I mean, it's their work, it's not my work at all, I won't take credit for that, but I have to sign off on that. And if I'd signed off on something that doesn't get approved, then I'm going to hold myself responsible for that and see that I need to brush up on something there, because it's my role to ensure that whatever goes to ARPRA is at the required standard.

Isabelle 18:06

I completely agree with you there. Every approved case report or every successful exam completed, I think, yes, you know, I got. You know, I get to share in that joy that that supervisor is experiencing. But absolutely, if they're you know, if there's a failure or if they're, sorry, that's a terrible word, but if someone doesn't pass an exam or, you know, doesn't pass the case report, yeah, most definitely, I'm straight away. I'm thinking, okay, what could have I done differently? Where did I go wrong there? We,share this responsibility for our clients, but also for the achievement of the competencies as you become a psychologist in particular.

ClaireHost18:48

Absolutely, because at the end of the day, we need to sign off as supervisors. We need to sign off that paperwork to say this competency has been met. And so you know, in some ways I'm quite, you know, quite strict, if that is the right word, about some of the requirements that I have from an ethical and legal nature, because my signature needs to go on that form. So you know, it is an ethical responsibility that we really hold and if there was to be a complaint about a provisional psychologist, the supervisor's notes would be subpoenaed, most likely, or requested, if not subpoenaed, and we would probably share in some kind of notification or investigation.

Isabelle 19:44

It's a serious responsibility that we have. Yeah, it absolutely is, and we want to share that with our supervisees. We want them to, I guess, learn to sort of navigate and be comfortable with having that responsibility on their shoulders as that professional person. So that when you know, at least if we finish the first couple of years of those mandatory supervision years, that they do emerge - I love that description you used, you know as feeling as though they have grown in their depth and breadth, but also their confidence and their comfort in being a person that has that responsibility from the guidance that they've received and the nurturing that they've received from us.

Claire 20:29

Yeah, Absolutely, and it sounds scary when we actually you know, when we think about the weight of that responsibility. But ultimately if we follow that code, then you know we can be assured that we're doing the right thing and what we need to do to share.

Isabelle 20:58

I developed this idea when I was still, I guess, receiving supervision as I was becoming a registrar, as a clinical psych, and discussion in a multidisciplinary team talking about code of ethics and things like that, and I could sense anxiety in the room. I could just sense that there was this anxiety that you know, one wrong step, that's it. You struck off. And I remember thinking to myself if I ever do something that bad, you know really really bad, that a report's made and I'm not able to practice anymore, I will accept that because that means I haven't performed to the level of the professional ability that I should be performing. And then, as soon as I thought that I didn't feel anxious anymore because I kind of just I accepted that I have this responsibility, I know the code of ethics and I follow it, and if I really stuff up that badly, man, I don't deserve to be a psychologist and that let me go on my way after that.

Claire 21:54

I love that, because we can make, we will make mistakes, you know we will all make mistakes and we will all do things,that we maybe regret or that we need to fix up later, but, like you say, if you know, if we do something really terrible, then a notification is going to be warranted.

22:19

At the same time, I have sometimes heard of some complaints that have been made that haven't really been warranted and it's a very, very stressful process. But I mean, when I have worked with people around this, you know we've always looked at, okay, well, what have we done right here, and what have we followed? And look at following the process that we've taken. And you know, in these cases, particularly the cases that I've worked with, you know they've usually been through a process and through an investigation and come through the other side and all has been well because of the breach that you're describing. So, yeah, I think it is so important. Yes, we hold it, but in some ways I think sort of just to hold it, knowing that we know what we're navigating here.

Isabelle 23:12

Wise words Hopefully those listening are feeling somewhat reassured but also helping anyone who's learning to become a psychologist or therapist now to get a rich understanding of this experience, of what it's like to be navigating these early career years and the supervision that you'll be getting. And I know sometimes we want to sort of also explore what is not so great supervision, because sometimes we don't have much choice in who our supervisor is. You know, if we're put on placements through our university or if there's just a limited availability of supervisors where you are, thinking about myself as a supervisee sometimes we can feel like we don't have much choice, even if we are experiencing a supervision relationship that's not feeling like it's useful or helpful or maybe even destructive. So I if maybe we can finish today's recording talking about maybe some of the things to consider what can you do? What can we do if we notice that we are in a supervisory arrangement that's not meeting our needs?

Claire 24:38

It's really difficult to be in that situation when we have a supervisor that's not necessarily a supervisor of our choice. I mean, my recommendation is always to think about how you can make the best of the time that you have with somebody and to think about really coming back to what your supervision needs are, and they can be so different. I think every session, every supervision session, the same way that every therapy session, is usually very different, because the needs that the person brings are going to be very, very different. So, really just thinking about you know what are the needs at the particular time of the internship Sometimes it really is. I need to tick off these competencies. I've got a set number of tasks that I need to complete.

Isabelle 25:24

And I need to record a certain number of hours on this placement.

Claire 25:28

Absolutely. Yeah, you know what are those things that are the primary importance, what needs to be, what's going to get you to your end goal, and then thinking about how we can get that from the supervision. You know, having that conversation with your supervisor around well, this is what I need to be meeting and how can you support me to do this? I think when supervisees are more sort of self-directed and self-driven, they do tend to get a little bit more out of supervision. When someone comes to me and says this is what I want from the session, I'm like okay, well, I know that you've got three or four things here and I'm keeping that in the back of my mind so that as we progress and even if we digress which is quite easy to do we can come back to what their needs are.

Isabelle 26:21

Having that agenda at the beginning of the supervision session is so great for helping both the supervisor and the supervisee to keep on track.

Claire 26:29

Absolutely, and I think the supervisee ideally would set that agenda because they are the one that has they know what they need in their practice. Is it that I've had two clients this week that I need support with? So that comes up first. I think, when the supervisor sets the agenda which I might do later on towards the internship, because you've got three case reports to write and we've got these competencies to tick off and we've got a report due next week and we need some observations, I might sort of just put that reminder and then the client says I've got a client I really, really need to speak to you about. That normally comes first for me because as a supervisor, that's, that's going to be, that's the work, that's the day-to-day work I think the person needs support with. the focus on the clinical comes first yes, as a supervisor, I would always place the focus on the clinical.

27:25

But when I see that that's then overriding all of those other factors, that's when I might start to become a little bit more directive. But coming back to that question around, well, how can the supervisee access the support that they need? Ideally they'd have that conversation with the supervisor around what those needs are and set that kind of agenda, because I think any supervisor is going to appreciate that, knowing what you're needing to achieve in the internship. Sometimes those organisational factors come into play. And then accessing support outside of the internship might also be helpful, even like accessing group supervision. You've got a primary supervisor in the workplace and that's covered financially. Group supervision is probably more cost effective to access. Also, establishing peer support groups around, maybe speaking to other supervisees around what their experience is.

Isabelle 28:30

I can relate to what we're talking about from my own experience, and I remember having an experience where I was like, oh, I'm not sure how to address this with my supervisor. So that's when I reached out. I reached out to peers who I was working with and other senior clinicians. You know, what would your suggestion be that I do in this situation? And that helped me again to bridge that gap of how to have those tricky conversations or those uncomfortable conversations.

Claire 29:03

Yeah, it's difficult. I mean I had a supervisor in the workplace for the two years of my internship, so throughout my whole internship I had the same supervisor and it was my employer.

Isabelle 29:20

You had a dual relationship.

Claire 29:22

Absolutely. I had a dual relationship. You know my supervisor was amazing at getting me through the internship, but a lot of the organisational elements had to be met through supervision and I found myself utilising supervision beyond the internship in a very different way, because I was then able to take exactly what I wanted to supervision and this is what I mean by being an ongoing relationship, sometimes for the internship, as long as you're getting the internship needs met. Now, if the supervisor's not meeting the internship needs, I think that's a different story and really around potentially then accessing a secondary supervisor whereby you can and even if you're having to fund that yourself whereby you can begin to get a sense of whether or not this really is meeting your needs, because if the supervisory relationship isn't meeting your needs, you can change to a different supervisor. But it's harder when you're in the workplace.

Isabelle 30:29

There's so many considerations here. I think I like what you said about having a secondary supervisor. I've always encouraged anyone I work with as a supervisor supervisee to think about having more than one supervisor or even changing supervisor if that's an option. I'm more than happy for someone to say if I'm doing a four plus two with them, Isabelle, I'm moving workplace, they've got a supervisor that they can you know, that they can you know they can provide me. And I always say to them please don't feel obligated to stay with me, because I'm only able to teach you and share you with my breadth of skills and knowledge. When you go in and you find another supervisor to continue your program, you're going to get all of their knowledge, all of their skills and that experience with them and I feel like that can add to your clinician's ability when you finish off whatever program it is that you're on. It just enriches you.

Claire 31:27

Absolutely absolutely, I'm exactly the same. I mean if somebody, particularly as an external supervisor where they're paying to see me, if somebody's offered a job and it involves supervision, I'm like, take it, take it and I'm here.

31:38

If you need me as a secondary, I mean I'm happy to be involved or not be involved, but I always go with the intern's needs as there are plenty of people looking for supervision and I'm wanting people to support people to access, what they what they're needing, and if I can provide that to support people to access what they're needing and if I can provide that, then I want to provide it. But if I'm not the person to provide that, or if my style of therapy or my style of supervision is not what somebody's needing, then absolutely, I wouldn't take it personally if somebody wanted to move on and I would encourage anybody who is listening and thinking about moving on to a new supervisor it's your experience, it's your supervision and you have the right to to see who you want to see. At the same time, if your supervisor is not meeting your needs, then sometimes being brave and having that conversation can also shift things in a different direction.

32:40

Because if we don't know and I've had conversations with people before and they've said I need a bit more of this, and I've said, well, I'm so glad you told me because now I can do more of that so I think that you know, as a supervisor, in the same way as we are as therapists, we ideally will be open to exploring the needs of the people that we're serving.

Isabelle 33:09

Flexibility and not taking things personally.

Claire 33:13

No, no. I mean, of course we want to be able to provide that good service, but sometimes it's the style that doesn't work, and also we have to. I think that it's important to be open to feedback as well. If what I'm providing is not of value, I actually want to know that so that I can provide something of value.

Isabelle 33:35

I love that. Yes, it's something that I can provide something of value. I love that. Yes, it's something that I try and do after or when I'm working with yeah, 4 Plus 2, every six months, when we're doing the review back to the board, I'll also sit down and say okay, it's your time to let me know how I'm going now. It can be an awkward situation, so I provide a couple of different options for how that feedback can be provided. But I do have a couple of particular questions that I like to just check and make sure that the person is feeling like I'm meeting their needs and that they're comfortable.

Claire 34:05

I love that. I love that.

Isabelle 34:09

Yeah, it's because that mutual feedback I mean, often you kind of get that as you're going along anyway, but sometimes when you don't, yeah, that can be really sometimes it's just good to do anyway. I I did some feedback informed therapy training recently as part of my job and some data was presented to us from some meta-analysis of research on the client experience of their therapists and some of the perceptions that therapists had of how well things were doing. Compared to the actual reported data from clients, we're not very good, it turns out, at perceiving whether or not things are going well and we're doing a good job for our clients, and so I could imagine that could transfer into the supervisory relationship as well.

Claire 35:00

I imagine it could, because we sort of, you know particularly and I forget about this sometimes as a supervisor, but there is that sort of sometimes that power difference. I don't like the word power, but it is that sense of, in the same way as in therapy, you know, there's a sense of seniority perhaps, and that can sometimes make it difficult for somebody coming into the profession, accessing the service, to feel comfortable enough to speak up. And that's something I think that we do begin to develop as we get older, older - that too (laugh), but as we get more experienced, I think also we often need it more in those early days because accessing that support, the internship, can be pretty tough. And so having a supervisor, I mean I would just sort of think, you know, Do you feel like your supervisor's got your back? Do you feel like your supervisor believes in you? You know? Do you feel like your supervisor is meeting your needs?

Isabelle 36:18

Are you noticing that you're growing? You know, if you compare yourself to when you first started out and the six month review comes and you think back to how you were in the beginning, to what you're doing now, is there growth there? Because, if you know, maybe that's not all up to the supervisor, that is up to you as well, but, if there has been growth and you're feeling, you know that confidence is growing, your capabilities are growing it's a good sign.

Claire 36:41

Yes, absolutely, and that's what we're hoping for, which is why it does change throughout the internship. I think it's really important that you are reflecting and I would hope that anyone listening would would be reflecting on their own supervision experience and just determining whether or not it's giving them what they're needing to complete the internship, but also, or within the work, if you progress beyond the internship, or registrar program or whatever pathway is being followed, but also that you're developing that confidence, not only taking up those skills, because we can always do another training and another webinar and you know, some learn more and read another book but you know, are we actually using that to develop confidence and beginning to feel that level of comfort?

Isabelle 37:37

in ourselves, you know, and our own identity as therapists oh, and talking about identity as a therapist, we're not going to go there today, but that is a topic that has been coming up for me a little bit in supervision and I think that could be something very cool that we could cover down the track, which I'm sure we will get to.

Claire 37:57

absolutely yes. I'm sure there's lots we could say on that.

Isabelle 37:59

Yes, all right. Well, it's been so good to share our ideas and our thoughts with our listeners today on what supervision is and what you can expect, and hopefully reflect on some of your own experiences and hopefully continue in that journey of becoming a therapist in a really supportive and helpful way.

Claire 38:22

Yes, hopefully, what you've taken away today has been helpful, or at least some of it's been helpful, and please also let us know if there are any other topics that you'd like us to cover, because, we've got a number of ideas and, some topics that we'll be covering over the coming weeks, but if there's anything, that comes to mind for you that you'd like us to discuss, then please just drop us a line and we'll be happy to include it on that list of ours. Thank you for listening.