Newsletter Spring  2008   INDEX
Foreword	Christine Driver
Articles
Supervision Research	Mary Anne Coate
My Research into Supervision	Hugh Gee
Researching Supervision	Greg Nolan
Are we academically & imaginatively under prepared for Research	Anne Bowes
What is psychotherapy Research?	Gertrud Mander
Book Reviews
Counselling & Psychotherapy Research	Jo Roscoe
What is Psychotherapeutic Research?	Gertrud Mander
Supervision in Counselling: Interdisciplinary Issues &Research.	Margaret Smith
Qualitative Research in Counselling & Psychotherapy	Anne Rogers
News and Reports

 

 

 

Chris Driver (Chair)

 

The exciting thing about our profession, whether we are working directly with clients or as supervisors is the continual discovery of something new.

 

As Eliot said:-

‘And the end of all our exploring

Will be to arrive where we started

And know the place for the first time.’

T.S. Eliot, Four Quartets. “Little Gidding”

 

This is what we constantly do in our work.  We engage with the work, explore, hypothesise, and find a new place and a new understanding.  In some respects we do research in every meeting with a client or supervisee:  we explore, hypothesise and discover.  However, we are now all being challenged to be more research minded on a broader scale and this is something we need to understand more fully as well as demonstrating to the wider world that we have the confidence to challenge, question and examine our work. 

 

The articles in this current Newsletter by Mary Anne Coate, Hugh Gee, Greg Nolan and Ann Bowes provide a fascinating base from which to consider the development of research mindedness within the supervisory field and we would like to thank the authors for their generosity in writing such interesting and informative articles.  We also have a review of the UKCP Research conference by Gertrud Mander and some interesting book reviews by Jo Roscoe, Gertrud Mander, Margaret Smith and Anne Rogers.  We are extremely grateful for their contributions and I would also like to thank Annie Power and Lynda Norton for their continued hard work in bringing the Newsletter together. 

 

At the end of this Newsletter we list details of forthcoming Newsletter themes so please consider if you could write something on either Clinical Notes and Case Reporting in Supervision or Diversity in Supervision. Ideas for themes for future Newsletters are also welcome.

 

Further articles in this Newsletter provide an update and information on various key issues such as UKCP, BAPPS West and the May BAPPS Conference.  Please book early for this exciting conference.

 

An important development in relation to previous Newsletters is that articles and book reviews from the 2006 Newsletter have been pulled together and are now on our website as the 2006 ejournal at www.supervision.org.uk.  In addition keywords have been linked to the internet so that internet searches should link to them more easily.  The articles from the 2007 journal will be in the same format soon.  A big thank you to Trevor Dawson for all the website stuff. 

 

Just one final note before you turn over to read the exciting articles.  Do think now about joining one of the BAPPS Committees.  There are a number of vacancies including the Conference and Ethics Committee and at the AGM the positions of Hon Secretary and Chair will become vacant.  Your contribution to the work of BAPPS is very important so do think about it.

 

All the best for the Spring and the coming months. 

 

Chris Driver, Chair BAPPS

 

 

 

 

Mary Anne Coate

 

In the current professional climate of counselling & psychotherapy both supervision & research have been given the status of ‘good things’.  In some professional bodies supervision is mandatory throughout a practitioner’s working life – in others regular consultative supervision is recommended. Profession-wide, & independently of theoretical orientation, I think it would be true to say that supervised practice is one of the principal tools of training.  The production of research findings – qualitative & quantitative - into counselling & psychotherapy outcomes & process is becoming increasingly important in the world of NICE where the allocation of scarce resources is linked to ‘evidence based practice.’

 

We might therefore be forgiven for thinking that the activity – research into supervision – resulting from combining these two ‘good things’ would merit the status of ‘very good thing’?!   True or not, such research is in its relative infancy.  Furthermore, the findings of two scoping searches (Wheeler 2003 & Wheeler & Richards 2007 - commissioned by BACP) of supervision literature & research studies indicate that published research has predominantly been carried out in the USA & has concentrated on supervision during training, rather than exploring the paradigm - widely found in the UK - of on-going consultative supervision for qualified & experienced practitioners.

 

It is beyond the scope of this article to review the work that has already been done. For this I would want, rather, to refer readers to the two reviews cited above.  They include details of all previous reviews, afford a good insight into the discipline & methodology of scoping reviews & provide, overall, a comprehensive & very helpful review of the literature – even though I was a bit puzzled by the omission in the overall references (2007) of one or two individual psychoanalytically-orientated texts known to me that I would have, personally, expected to find included. The 2002 review had relatively wide inclusion criteria & summarised the finding of research studies in relation to  16 identified categories e.g. models of supervision, process of supervision, characteristics of the supervisor  (Wheeler  2002 p 12). The 2007 review refined the review question to that of the impact of clinical supervision on the counsellor or therapist, their practice & their clients (Wheeler & Richards 2007 p5) & operated stricter exclusion criteria (Wheeler and Richards 2007 p10) excluding - among others -  studies using role play or simulated therapy or supervision & those studies that  did not specifically address the impact of supervision – either upon work with clients or upon the self-awareness & skills of the supervisee.  It is interesting that these strict parameters resulted in only 25 studies being included for detailed review; methodological limitations were perceived to be considerable and only one study received the reviewers’ highest rating for quality.  The infant is truly at a fairly primitive developmental stage….

 

Against this background I would like to attempt to identify some of the issues & difficulties in supervision research – though not try to solve them!  Some of them would arise in any consideration of research into counselling & psychotherapy; some appertain more specifically to supervision.

 

Why do research into supervision?

I can identify two – there may well be more – reasons for attempting to carry out research into supervision. One I would call, perhaps idealistically, the intrinsic reason. It is my submission that the development of research awareness – or the desire to evaluate what we do and try to do it more effectively is part of our duty of care and an indicator both of good practice, and the healthy curiosity of a vibrant profession. Secondly, an extrinsic pragmatic reason: do not individuals and employing organisations want to know whether supervision – in which a lot of time, money and other resources are invested – ‘works’?  And perhaps even more importantly how it works – does it address practitioners’ subjective anxieties, increase their skills, and does its impact feed through directly to client-work?

 

The complexities of doing research into supervision.

There are several issues relevant to the task of supervision research. First, the establishment of supervision as a distinctive discipline with its own literature base & discrete skills which are not those of ‘therapy writ large’ has taken time to develop, as has recognition of the need for training in supervision. In the great wide world outside & indeed even within the profession there is not, I think, universal agreement as to what supervision is or its appropriate parameters – particularly perhaps the extent to which it should or should not act as an agent of assessment or quality control. Furthermore, are there distinctive features to supervision in the different theoretical models or intrinsic differences between consultative supervision & supervision of practitioners in training? In summary are we in fact all researching the same basic product?   Are practitioners or supervisors - even when they aver that they are following the same model - actually doing the same thing? 

 

Secondly, it is arguably more difficult – though this may sound defensive - to research a sustained process such as the supervision over time of open-ended or intensive psychoanalytic psychotherapy with all the attendant postulations of the unconscious dimension & the reflection process, than a more time limited intervention which may use a different theoretical paradigm which lends itself more easily to distinct points of measurement. Though to say it is difficult does not make it impossible

 

Thirdly it is very difficult to identify specific effects of supervision and tease these out from the effect of other variables.  For example, supervision is, by definition, an activity at one remove from the actual counselling or psychotherapeutic process.  It is a bold claim that supervision has a causative and beneficial impact on client work outcome, but this is precisely the claim that people might want to make: at the least that supervision affords a measure of protection for clients, at most that it has a significant effect on the therapeutic process and outcome. But many things come between the supervision and the client; time, life events, the person of the supervisee to mention but a few. Is it in fact possible to isolate - let alone quantify - a specific effect of supervision per se? 

 

We have in the past tended to identify the contribution of supervision by relying on self-report or anecdotal evidence?  “My supervisor helped me to work differently..” How quite? In fact the traditional supervision presentation method of consecutive verbatim reports, & the systematic writing up of case histories represent ways of trying to ‘regulate’ this sort of evidence – to see what ‘working differently’ might actually involve; the problems from a research viewpoint lie in the retrospective & subjective nature of the reporting & the difficulty of generalising from findings derived from a single & unique situation.

 

To attempt to isolate a generalisable & replicable  effect due to supervision by working with a research design that compares  supervised with non-supervised practitioners – whether randomly assigned to the two conditions or not - throws up the ethical problem of control groups found in much, medical, therapeutic or educational research – that of denying a group an intervention which it is hypothesised will be beneficial & - in the case of supervision - is an actual ethical requirement for many practitioners.

 

What questions do we want to research, and how can we do it?

A problem with RCTs or Randomised Control Trials– traditionally respected as affording the most robust research evidence & which operate essentially by matching subjects as far as possible on all the variables other than that under examination - in this case the effect of supervision - & then assigning subjects randomly to one of two or more conditions of this variable, – is, in my opinion, that their result can be technically robust but not inevitably helpful to the supervisory community. This because they presuppose a ‘purity’ of environment such as is seldom found in actual practice; people do not present with the same severity of distress, in reality practitioners relate differently & phrase interventions differently with different people, & often work with people who might be excluded by the trial criteria. RCTs may be the gold standard of evidence based practice, but do they yield practice based evidence?  Do we sometimes have to refine the research question & inclusion criteria so much in order to make them amenable to RCT methodology that the question then becomes too narrow & ‘small’ to be useful or even meaningful?

 

To say this is not however to decry RCTs – they are appropriately rigorous & an antidote to fuzzy thinking and claims. Furthermore, normative results for a group of people can offer a helpful hypothesis as to what might help in work with an individual person, provided that the practitioner can hold a genuine and flexible dialogue between the more general hypotheses and the individual work. I am submitting, rather, that in research as in many other activities one size does not fit all. For example, the nature of therapeutic & supervisory tasks have leant themselves to the development of qualitative methods providing for the systematic analysis of case-history material, and to the concept of the researcher as participant observer.

 

I would however conclude by making what may seem a controversial admission. There has sometimes been a heartfelt cry that - in counselling & psychotherapy - research activity & clinical activity is antithetical to each other – that in an individual piece of work the presence of the former interrupts & indeed obstructs the latter.  In one sense this could be said to be profoundly true in that anything extrinsic to the actual psychotherapeutic relationship and dialogue impinges upon it and subtlely affects it.

 

Yet surely we never live only & completely within a process?   Does not our ability to engage yet concurrently to reflect on that engagement, lie at the heart of psychoanalytic interpretation, the reflection process in supervision and what I have called research awareness. In one sense we do research all the time; we are impinged upon all the time.  Looked at this way perhaps we can come to be more comfortable with the inevitable and sometimes more tangible impingement stemming from  actual research activity ?

 

 

References

Wheeler, S (2003) Research on supervisors of counsellors and psychotherapists: a systematic scoping search Rugby: BACP

 

Wheeler, S and Richards, K (2007) The impact of clinical supervision on counsellors and therapists and their clients: a systematic review of the literature: Lutterworth: BACP

 

Mary Anne Coate is a Chartered Clinical Psychologist & a BACP accredited Supervisor. She was a member of BACP's Supervision forum which was set up to raise the profile of supervision & supervision research pending
the establishment of a dedicated post. Formerly Head of Training at WPF
Kensington she was at one point a member of the staff team for wpf's
Diploma in Supervision, & currently still works part-time at wpf on
such projects as the co-ordination of MA programmes & the development
of the research Committee.

 

 

 

Hugh Gee

 

Most of my understanding of human psychology comes from the work of C. G. Jung especially his theories concerned with the ‘collective unconscious’ and the process of ‘individuation’. However, it was not the psychology of the individual that was the concern of my research, nor for that matter of most research that uses the case study method, but the interaction between me as the supervisor & the supervisee.  As Peter Reason (1986) says, “In essence, science is creative thinking & then careful thinking, with systematic observation and public examination of ideas & predictions against experience.  Rather than depend on method, we can return to the self-directing person as the primary source of knowing, & thus the primary ‘instrument’ of inquiry, in what we have described as experiential & cooperative inquiry.  This means research with people, rather than research on people.”  

 

It is my own view that the internal feelings of the individual are the basis of their personal authority and identity. It is the case, after all, that each individual is the world’s foremost authority on how they feel.  The individual may not always understand why s/he feels as s/he does, but s/he is the only one who knows how s/he feels.  We can guess, sometimes with a high degree of accuracy, what someone is feeling, but we can never actually ‘know’ without asking that individual.  My research, therefore, attempts to respect and exploit this psychological fact.  I respect it in so far as I involve my supervisee’s feelings about what is going on, and I exploit the fact by using my own feelings as providing a valuable source of the data to be studied.  All this accords with the views of Moustakas (1990) who says, “Heuristics is a way of engaging in scientific search through methods and processes aimed at discovery….”  Jung (1928) said something similar at the much earlier date when he stated, “The sole criterion for the validity of an hypothesis is whether or not it possesses an heuristic—i.e., explanatory—value.”  However, some writers seem to over estimate the value of the personal experience by taking it to an extreme.  For example, Maslow (1966) says, “there is no substitute for experience, none at all.  All the other paraphernalia of communication and of knowledge—words, labels, concepts, symbols, theories, formulas, sciences—all are useful only because people already knew them experientially.”  The obvious defect here is that we do not see the world as being round, we experience it as being flat.  As Moustakas says in addition to self-inquiry we must add dialogue with others.  In other words whilst the study & careful noting of our personal experiences are of importance, it is the dialogue between the inner & outer worlds that can provide the confirmation needed to value of our discoveries. Whilst it may not be the case that I have made ‘important discoveries’ as far as the rest of the world is concerned, it is certainly the case that for me I have made some important discoveries.  My views about my own supervisory approach have already been dramatically altered & I hope improved. 

Method:
 I made tape recordings of 21 individual supervision sessions; that is 7 supervision sessions with each of three supervisees.  During the sessions I noted my thoughts and feelings towards myself as the supervisor and towards the supervisee as a therapist.  I then listened to the tape recordings and made a brief summary of the sessions. In these summaries I noted my thoughts and feelings about the interviews, in particular, and also noted the nature of my interventions and the effect they seemed to have on the supervisees.  I also timed the duration of my interventions.  On listening to the tape recordings I created a category for each of my interventions and eventually found that they could all be placed under five headings. The five main categories were: 1) interpreting the patient’s material, 2) interpreting the supervisee’s countertransference in relation to the patient’s transference, 3) discussing theoretical concepts, 4) facilitating a supervisory relationship, 5) facilitating the supervisee’s analytic attitude.  It is clear that each of these functions play a part in supervision, but I would say that each supervisor is likely to be stronger in one area rather than another.  Before my research I would have said that the fifth function, facilitating the supervisee’s analytic attitude, was the most important activity and, accordingly, I would have said that it was on this area that I mostly concentrated. However, on hearing the tape recordings I found that I was spending most of the time on the first two functions: interpreting the patient’s material, and interpreting the supervisee’s countertransference.  Because I still see the fifth function as being the most important I have, since my research work, changed the emphasis of my supervisory style.

I think that it is important to quickly list the aspects of a sound analytic attitude: (a) Listening to the analysand’s material and observing their body language.  Following the feeling-tone of the material in a non-judgmental way.  Identifying the unconscious communications including enactments.  (b) Using oneself as an ‘instrument’; processing the material by ‘pondering’ as part of ‘reverie’.  Being receptive to the nature of the countertransference.  Asking oneself, ‘how does this make me feel?’ ‘What is the patient saying about me in the transference?’  Considering the ‘meaning’ and/or ‘purpose’ of the material.  Considering the material in terms of their experience and fantasies as infants.  (c)  Living with ‘not knowing’.  (d)  The nature of interpretations (mostly working within the transference); ‘here & now’ rather than ‘there & then’.  Interpretations should answer the question ‘why’ as opposed to descriptive comments which tend to be experienced as persecuting.  Does his/her interpretations come from integrated experience and not the imposition of theory.  Timing of the interpretations (which is part of being engaged with the analysand).  Hypotheses that are offered; their validation is confirmed by their being meaningful to the analysand.  ‘Ego insights’ and ‘self insights’.  (e)  Central to the Analytic Attitude is ‘benign relatedness’, i.e. valuing the therapeutic relationship: the Jungian container.  Maintaining appropriate boundaries.  Provision of a safe space, i.e. ability to hold the situation. Providing symbolic bonding, i.e. ability to meet with ‘unconscious identity’ & allow the processes of separating & defining as part of analytic engagement.   

However, in considering the above five categories I found that the supervisee will activate certain functions in me as the supervisor according to their interests, needs, & defences. Similarly, I think that I emphasised certain functions according to my interests, needs, & defences.  Thus, which functions are emphasised will depend on the complex communication system between the conscious & unconscious parts of the supervisee & supervisor.  

Conclusions:
As a result of my research I found that the most important aspect of supervision was concerned with ‘benign relatedness’ as an important part of the analytic attitude.  I also found that this was the aspect that I tended to overlook; or resist.   It became clear that insights in psychotherapy are developed out of the therapeutic relationship and that the early stages of process involve states of ‘unconscious identity’ between the therapist and their patient.  It is the process of differentiating out of these states of unconscious identity that promotes insights and individuation as described by Jung.   In contrast to valuing the therapeutic relationship, it is my experience in the field of supervision of analytic psychotherapy that there is frequently an overvaluing of the giving of insights to supervisees which may result in their being undermined.  I have also found as a supervisor that giving insights to supervisees about their patients is mostly unhelpful in that it places the focus of the supervision on the supervisor/patient relationship, whereas because of my research I found the most appropriate task is for the supervisor to focus on the supervisee/patient relationship.

My research gave rise to the important question of how can we supervise the supervisors?  What I have found of tremendous help is listening to the tape recordings of my supervision interviews.  At first I was anxious about the possibility of the recordings interfering with the comfort of the supervisee and therefore the supervisory process.  However, on asking each of the supervisees for their views on the effects of recording the interviews, they each said that they had quickly become used to the recording machine, and one of them, who had wanted to listen to the recordings, said that she had found them very useful.  I had in fact offered each supervisee the opportunity of hearing the recording of their supervision session but only one had expressed a wish to do so. What quickly became clear was that whilst the supervisees were quite comfortable with the recording machine it was I who had the most negative reaction in that at first I experienced the recordings as being some kind of superego.  Although this did not last very long it was nevertheless the case that at first I would listen to the recordings and notice all the defects in my work. This gave rise to a certain amount of looking for ‘mistakes’.  However, over the years of working as an analyst I have come to believe that the concept of ‘mistakes’ can be used in a very negative way and it was this awareness that quickly modified my attitude towards the recordings.

With the advantage of hindsight we can examine the hypothesis that we might do it differently given similar circumstances and this is the main point of supervision and the learning processes.  It may seem that I am overstating the point but I have heard the word ‘mistake’ used in the supervisory context and I do not think that learning is made easy if the atmosphere is one of blame and that is certainly what I experience when I first started listening to the recordings. Given then that the ‘blame game’ can be contained, there is no doubt in my mind that the system of recording supervision interviews provides an extremely valuable form of supervising the supervisor.  I think that this help can be enhanced by the supervisor taking issues raised by the recordings to a   discussion group of supervisors.

The original aim of my research was to discover what aspects of supervision helped to promote insights in the supervisee. However, during the process of my research I came to realise that insights could only emerge within the context of a relationship & that the involvement in a relationship was the first essential process.  I also found that it is the slow defining of the two people within the relationship that gives rise to insights.  It could be said that there is a similar process involved in carrying out research.  By that I mean it was by way of my becoming involved in the process of research that gave rise to certain differentiations which slowly resulted in the development of new insights. Continuing with the analogy, it could be argued that whilst the insights gained are of importance what is of equal importance is the process of research itself. It is the goose that can continue to lay the golden eggs, and for me even ordinary eggs have their place & more than justify the continued use of research.

References:
 Gee, Hugh (1996).  ‘Developing insight through supervision: relating, then defining’       Journal of Analytical Psychology, Vol. 41. Routledge.
 
Jung, C. G. (1928). ‘The Relations between the Ego and the Unconscious’
Col. Works Vol. 7.   Routledge & Kegan Paul.
 
Maslow, A. H. (1966). The Psychology of Science’. New York: Harper & Row.
 
Moustakas, Clark E. (1990). ‘Heuristic Research’. Sage Publications.
 
Reason, P. & Heron, J. (1986). ‘Research with People’.  Person-Centered Review, Vol. 1  Nº 4, November 1986 p. 456-476.  © 1986 Sage Publications, Inc.

 

Hugh Gee is a Training Analyst for the Society of Analytical Psychology & the British Association of Psychotherapists & member of the Severnside Institute of Psychotherapy.  He is also an ex-chair of the S.A.P. & the ex-vice chair of the B.A.P. He has written many articles and papers.  He is in private practice in Bath and London.

 

 

 

 

Greg Nolan

 

My doctoral research focussed upon: - “How do supervisors of counselling and psychotherapy manage clinical material that might challenge and transcend their prior perceptions of ‘reality’ and meaning?” I conducted open and unstructured one to one interviews with eight psychotherapy supervisors in independent practice. In re-telling the story and context of clinical case material, countertransference and parallel processes were generated. These complex dynamics at times challenged my dual role as researcher-practitioner; echoes from therapy and supervision frames were reflected in the research dyad dynamics, generating mirrored parallel processes of those relationships and a level of unexpected data.

 

I had initially set out to shed some light on events and phenomena from both life and therapeutic practice, anecdotally shared with other practitioner colleagues, that had ‘stretched’ notions from psychodynamic, spiritual, or ‘rational’ scientific knowledge, having sensed significance in personal life experiences from a young age:

 

·                      At 10, singing plainchant in the chapel choir – a sense of unity echoing in touch with ‘something’ in the chapel, from the depths of the shadows to the dissolving walls;

·                      from age 15 perceiving what seemed to be ‘auras’, or a ‘halo’ effect, around people when mentally focussed on them, visually enhancing but not colour (like the dark edges around ‘solarised’ photographic images and portraits by photographers Man Ray and Lee Miller [1930]);

·                      at 16, following a near-fatal traffic accident, the moment before regaining consciousness in a hospital ward – an out-of-body experience, vivid in its image;

·                      from a young age (pre-pubescent), and without any apparent visual or verbal clues, seeming to know beforehand what others were about to say or do, so that I remained unsurprised at unfolding events;

 

The latter of the above instances is a factor that featured early in my teaching career and later gained credence and meaning early on as a counsellor and supervisor Then, a few years into my practice as a counsellor, I began to experience some deeply impacting phenomenal events, particularly when considering existential or spiritual issues, and ‘playing’ (Winnicott 1971, Bion 1970/1983, Casement 1985) in ‘reverie’ (Ogden, 1997 & 1999) within perceptions of meaning. Some examples that I had noted:

·                      awareness opened in all directions, expanding in a vertiginous void of indescribable enormity and having a core of exquisite detail – singularity and infinity as one;

·                      on occasion, when focussed on clients’ proximal presence, the space surrounding them falls out of focus whilst their head and shoulders are visually enhanced by a ‘halo’ effect (as described above) that precedes and accompanies a therapeutically significant moment;

·                      a jointly perceived ‘whiting-out’ in an acutely felt sense of inner-peace;

·                      a feeling of dread, as if something was treading on my soul, with intent…

 

Research participants cited similar examples from personal & practice experience, their contexts & meanings jointly explored. In considering these occasions, usually occurring within deep-seated existential questioning, my literature review spanned psychoanalytic, transpersonal, spiritual/mystical & natural science perspectives on possible meanings, each of these fields presenting potential for purposefully valid, but not exclusive, constructs of meaning.

 

Whilst clients and trainees can feel cautious in attempting to describe such perceived events in therapeutic relationships (be they visual, auditory or embodied perceptions), this was as true for the participants as experienced practitioner supervisors. The process of re-storying clinical case material generated countertransference and parallel processes, complex dynamics challenging my dual / multiple roles as researcher-practitioner. Reflexively monitoring at the time, and analysis subsequently, enabled insights into supervisory processes that might otherwise have stayed hidden or unrecognised. Moments of significant insight were sometimes regarded as ‘transformational’ (Bion, 1970/1983; Milner, 1957; White, 2006; Young-Eisendrath, 2004) by the participant and, on occasion, by me as researcher. The interpretation of these ‘echoes’ from supervision and therapy frames, which I have called Meaning-Moments, was aided by the use of a schematic ‘tool’ to illustrate, identify and disentangle overlaid ‘loops’ of transference, countertransference and parallel process. A graphic representation and full description of this process is in preparation for a forthcoming paper.

 

But what is it that enables these ‘moments’ in supervision? Two strands of significant data emerged:

 

·                      ‘Enabling’ features of supervisor ‘presence’,

·                      Intersubjectivity between researcher-practitioner & participant

 

‘Enabling’ features

Patterns of supervisor ‘presence’ indicated a heightened capacity for self-reflection, self-awareness and critiquing and evident ease in working with

 

-                      a high level of therapeutic and supervisory intimacy;

-               preparedness to be surprised and to ‘not know’;

-               an intense curiosity towards existential meaning;

-               the capacity to ‘risk’ and step outside of rigid paradigms;

-               an awareness of alternative possibilities.

 

Curiosity to risk staying alongside psychological challenge (within both therapeutic and supervisory frames) indicated:

-                      an availability to ‘implicit knowing’ (Lyons-Ruth et al, 1998; Stern, 2004a, 2004b);

-                      a trusting intuition towards new insights (Castonguay & Hill, 2007; Charles, 2004; Ladany, 2007);

-                      availing moments of ‘transformational love’ (Bion, 1970/1983; Milner, 1957; White, 2006; Young-Eisendrath, 2004).

 

Researcher: participant processes

The role of ‘researcher-practitioner’ (Gabriel, 2001, 2005) generated its own dynamic in the research, particularly between mutually experienced practitioners. At times I had to handle being drawn into potential dual/multiple relationships as researcher and/or supervisor and/or therapist. Relational complexities in this ‘crisis of representation’ (McLeod & Balamoutsou’, 2001: 147-8) arose as a key issue of intersubjectivity, particularly when ‘the wounds of the healer’ (Wheeler, 2007: 255) were ‘hooked’ alongside ethical imperatives to balance the boundaries (Gabriel, 2001, 2005). I needed to respond without being dishonest or maleficent (BACP, 2002) or turning away from evident participant distress, or neglecting the care of participant / co-researcher’s well-being (Bond, 2004: 6). I sustained the research process integrity by dwelling within and tolerating this ‘chaos’, responding intuitively moment-by-moment to the overlaying paralleling of ‘frames’, described by Thomas Ogden (2005: footnote, 1268) as a ‘single set of conscious and unconscious’ object relationships. Immersion in the data and further reflection led to the construction of a Meaning-Moment schematic tool, assisting insights into the ‘populated’ dyad, these moments occurring as a ‘fourth’ element within Ogden’s ‘analytic third’ (1994, 2004, & 2005), & within which resonance was intensely perceived.

 

Reflecting on this complexity (the ‘crisis of representation’), meanings became clearer and more definable when immersed in the recorded interviews, transcripts and Literature Review ideas. I collated perceptions from the ‘Research Frame’ within Meaning-Moments, felt as an embodied phenomenon, inside of a ‘moment-of-meeting’ (Lyons-Ruth, 1998; Stern, 2004a, 2004b; Stern et al. 1998). Meaning-Moments were acknowledged by participants as emotionally significant interactions. I schematically describe the intersubjective relational process that progressively builds from the ‘Therapeutic’ and ‘Supervisory’ Frames brought by participants to the encounter in the ‘Research Interview Frame. This creates a further, and more complex, set of intersubjective dynamics, easily facilitated by practitioners curious to gain insight from material brought to the research.

 

·                      Interpreting intersubjective complexity

Deconstruction of Meaning-Moments identified serially mirrored and echoed object relationships through each of the Therapeutic, Supervisory, and Research Interview Frames. Tracking these complex dynamics illustrated moments of:

 

-                      new awareness and, on occasion, ‘transformational’ insight (Bion, 1965, 1967/1984, 1970/1983; Young-Eisendrath, 2004);

-                      vulnerability of the researcher-practitioner to neurotic or proactive countertransference (Wheeler, 2007) when dual-multiple relationships were problematic, sometimes managed by facilitative self-disclosure (Aron, 2006; Coburn, 2001; Ladany et al 1996; Ladany et al 2001, Ladany & Lehrman-Waterman 1999, Ladany & Walker 2003; Yerushalmi, 1992);

-                      parallel processes ‘echo-echoing’, and being drawn into ‘supervision’ (perhaps inevitable in the context of the research question).

 

Conclusions

The research findings indicate a number of key factors:

 

-                      As with the efficacy of the therapeutic relationship, the quality of counselling and psychotherapy supervision is clearly dependent upon a safe and intimate trusting relationship (Carroll, 1996; Gilbert & Evans, 2000; Hawkins & Shohet, 2000; Ladany, 1993; Ladany et al, 1999; Ladany et al, 2001; Ladany et al 2003; Ladany et al, 2005; Page & Wosket, 2001). 

 

-                      From within the midst of presented psyches brought to the session, supervisors need to have options to explore and inform self- and other-awareness when negotiating meanings and options (Clarkson 1997, 1998a, 1998b, 2000, 2003; Evans & Gilbert, 2005; Gilbert & Evans, 2000; Horne, 2007).

 

Circumscribed theoretical thinking was cited (by participants as supervisee) when perceptions were either negated or material was unable to be explored. Consequences for the practitioner can lead to the perpetuation of unrecognised (and therefore unaddressed) significant clinical material, perhaps through:

 

-               proactive counter-transference (the client having hooked into the therapist’s ‘pathology’), impairing the therapist’s functioning & subject to becoming ‘spellbound’ by the client’s ‘enchantment’ (Schaverien,2007:45-63);

-               remaining oblivious to manipulation by client projections, replicating relationship difficulties that might otherwise be made conscious.

 

Findings suggest that there can be worrying limitations in the depth and breadth of some clinical supervision, with the implication that lead bodies to the psychological therapies have a role in promoting the efficacy of meta-paradigmatic and pluralistic thinking across psychological constructs (Catty, 2004; Downing, 2004; Evans & Gilbert, 2005; Feixas & Botella, 2004; Hollanders, 1997, 2000, 2003, 2007; Hollanders & McLeod, 1999; Horne, 2007; Horvath, 2005; Lazar, 2002). This might be addressed by requiring prescribed standards in supervision training, as there exists for therapists, & a robust research base with which to underpin the promotion of good practice (BACP, 2005; Cooper & McLeod, 2007; Wheeler & Richards, 2007; West, 2003).

 

The small scale of this research cohort inhibits generalisations. Participants were self-selecting, all female (n8), and described their practice as Integrative (n6) or Humanistic (n2). A larger and more broadly based research programme than was possible here, systematically conducted across differing theoretical and practice paradigms, would investigate the minutiae of supervisory processes, what supervisors ‘do’ and how they do it (factors identified in West, 2004 and Wheeler & Richards, 2007). Such an investigation, with a meta-analysis linking areas of published research in the supervision field (refining the scale of Wheeler’s [2003] & Wheeler & Richard’s [2007] ‘scoping’ reviews), is particularly necessary with the arrival of statutory regulation of the psychological therapies (Aldridge & Pollard, 2007; DoH, 2003, 2007).

 

A key factor was in the management, and subsequent interpretation, of complex interview-frame dynamics. Whilst the Meaning-Moment schematic helped, an additional limitation was in the use of sound-only recording. Digital technology is beginning to make video-recording a cost-effective prospect, enhancing potential for the analysis of quantitative and qualitative approaches to research (see West’s [2004] pilot project and recommendations); the use of more than one camera would enable accurate tracking & correlation of real-time interactions, particularly with software for split-screen interlinking (Ramseyer, 2006; Ramseyer & Tsacher, 2006), & methodological triangulation (van Leeuwen, 2005; Waugh, 2004).

 

The supervisor’s capacity to monitor internal dialogue with their ‘objective’ and ‘subjective’ selves is critically important; processing intra-psychic explorations in intimate proximity with the other whilst also monitoring one’s own ‘dialectic-intrapsychic’ process (Gilbert & Evans, 2000) is a challenge for all practitioners. As researcher-practitioner, ensuring sufficiently acknowledged and recognised countertransferential elements of the ‘dialogical-interpersonal’ relationship is an ethical and professional imperative, given the inevitability of ‘mirrors’ and ‘echoes’ from re-presented supervisory and therapy relationships when researching with experienced practitioners. Such relationships, simply by their nature (Gilbert & Evans, 2000; Ogden, 2005), easily facilitate relational depth (Mearns & Cooper, 2005) and consequent complexity. If handled reflexively, insights gained are likely to be significant when each party is engaged in pushing against the limits of perception; in methodological terms, when extending the noetic horizons whilst ‘connecting a present perception with the future unfolding profiles’ (Churchill, 2006: 186), in a continual hermeneutic cycle.

 

The richness of material from this research provoked dilemmas & difficulties in unravelling what was ‘going on’. But there were also moments where there was little need for further clarifying dialogue, other than the mutual acknowledgement in the other’s eyes, witnessed in the ‘gaze’ (Fink, 1995: 91-2) of the ‘face’ (Christians, 2005: 150; Levinas 1979, 1981, & 1985; Waldenfels, 2002). Michael Balint (1968: 66) describes the intimacy & accepting ‘primary love’ within the healing relationship, re-engaging with primal need & the pre-natal awareness of ‘being’ in the amniotic fluid, in a ‘harmonious interpenetrating mix-up’; moments of intensely sensed intimacy that seem to reach back in a pre-symbolic search to re-discover womb-like thalassal tranquility (Ferenczi,1924/1938; Balint, 1968: 131).

 

In his study on psychoanalysis & spirituality, Gerald Gragiulo (2004: 32) concludes -

 ‘… in order to know anything we have to get beyond it, to experience personal meaning we have to, paradoxically, transcend it… Human subjectivity needs to be appreciated as both singular & collective, internal & simultaneously external; each individual (& culture) is a momentary concretisation within the generic background of a mist of infinite possibilities. As we create the world we live in, new worlds open up to us.’

 

©Greg Nolan 2008

 

Selected References

Ladany, N.; Friedlander, M.L. & Nelson, M.L. (2005) Critical Events in psychotherapy Supervision: An Interpersonal Approach. Washington, DC: American Psychological Association.

 

Lyons-Ruth, K. et al (CPSG) (1998) Implicit relational knowing: Its role in development

& psychoanalytic treatment. Infant Mental Health Journal 19(3): 282-289.

 

Ogden, T. (1994) The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75:3-20.

-   (2004) The analytic third: implications for psychoanalytic theory and technique. International Journal of Psycho-Analysis, 73(1): 167-195.

-  (2005) On psychoanalytic supervision. International Journal of Psycho-Analysis, 86(5): 1265-1280.

 

Stern, D.N. (2004a) The Present Moment in Psychotherapy & Everyday Life. New York: Norton.

 

White, J. (2006) Generation: Preoccupations and Conflicts in Contemporary Psychoanalysis.  Hove: Routledge.

 

Young-Eisendrath, P. (2004) Subject to Change: Jung, Gender and Subjectivity in Psychoanalysis. Hove: Brunner-Routledge.

 

A full list of references can be obtained from Greg Nolan at  g.nolan@leeds.ac.uk   and will also be available in the ejournal at   www.supervision.org.uk

 

Greg Nolan is Teaching Fellow in Counselling at the Univ. of Leeds & a BACP Senior Accredited Counsellor in private practice. He taught in secondary schools & was Counselling Co-ordinator & Programme Manager in FE.  Since 1996 has been a freelance counsellor, supervisor & trainer in FE & HE, MIND, NHS palliative care, EAPs & Voluntary Agencies across South &West Yorkshire. He has recently completed doctoral research on supervision at the Univ. of Manchester.

 

 

 

Anne Bowes

 

Where is the research to underpin our belief in psychoanalytic and psychodynamic supervision?  There was not a single response from the BAPPS’ membership to the monies that BACP offered for research in supervision.  The monies were not restricted to BACP members.  It leaves us in a very weak position when there is a need for more research papers to support our chosen approach.  At the AGM I was asked to see if there is some way to raise the profile and needs of research -. after all we conduct research on a daily basis through our work.  What is missing to enable practitioners to feel confident they can transfer an existing skill into the area of small research projects?  Do members even conceptualise that small practitioner research projects have their own validity?  Large research projects need specific funding and come under the scope of institutions but we can research in our own right through small practitioner research. 

 

 

Reflections on supervisor accreditation and training             

Sue Wheeler wrote about supervisor accreditation in CPJ, March 2001 reflecting on the low numbers of registered supervisors, only 127 at that point.  As one of those 127, I was intrigued.  Sue's article reflected on the lack of a culture that seeks out and uses accredited and qualified supervisors and the lack of supervisors seeking accreditation.  Out of my response to Sue a small qualitative research project was born.

There appeared to be two questions:  why are only a limited number of practitioners going forward to qualify as supervisors and seek accreditation?  And why don’t more counsellors and psychotherapists seek out qualified and registered supervisors?  Sue suggested that there was another question concerning supervisor training: what supervision training have practitioners had and what do they need?  As a member of BAPPS it was possible to involve other members - all trained or accredited supervisors - in a small research project, to respond via email to the questions below. There were 20 emailed responses and some verbal contributions which was an acceptable response given the smaller membership then.

 

As BAPPS’ members responded to the questions common themes emerged:

 

 

Why do so few practitioners train or seek accreditation as supervisors?

·                       These experienced and trained supervisors highlighted the truism that the limited number of practitioners coming forward to apply for supervisor accreditation reflected a commonly held view that "accreditation" does not necessarily make a good supervisor.  This lack of seeking supervisor training would seem to be at odds with a belief in the crucial importance of training in counselling and psychotherapy.

 

·                      The same supervisors had previously received good supervision from practitioners who had learned through the apprenticeship & experience model and had that experience in their mind, not formal accreditation. Apprenticeship and experience are also important with formal training and long-serving practitioners are more likely to have had good experience as they sought their supervisors on the basis of recommendation. 

 

·                      There can be burn-out (training, appraisal & writing) Even if a qualification is sought, it is yet another area to document, have CPD on etc.  No-one doubts the necessity of CPD but the formalisation of ongoing training can leave a feeling that this is bureaucratisation, not professional development, which leaves

practitioners feeling overwhelmed &resistant to 'more'.

·                      The reality of time constraints (such as a life that includes full-time practice, teaching &training commitments, a home life with a young family and a lack of easy access to further training) have to be weighed up.  There are personal & professional choices to be made. It may be that professional constraints are chosen so as to avoid inappropriate stress.  On the other hand for some practitioners time constraints are a convenient 'opt out'. 

 

Comments reflected on market forces:

·                      Enough supervisees approach and work with the untrained practitioner without their apparently needing supervisor training or accreditation.

 

·                      That the time and expense of supervision training is out of proportion to the amount of individual or groups of supervision that is done or will be done (maybe one or two supervisees or one group)

 

·                      Employers and organisations have not demanded qualified or registered supervisors.  However there are signs of change.

 

Why do more practitioners not seek trained and registered supervisors?

·                      Many of the previous responses apply to this question too.

·                      Trainees have their supervisors prescribed. 

·                      A BACP requirement for approved counselling courses is that the supervisors used by the course should reflect the core model of the course and reinforce that model in practice.  The local registered supervisors may

not reflect that model.

·                      Finding a supervisor is a very personal business.  After qualification people go to those they know and trust.  Supervisors are chosen from prior

& personal knowledge or through recommendation.

·                      Those seeking out supervisors do not see any advantage in having a qualified/ registered supervisor if their experience with a non-qualified and non-registered supervisor is good. Choosing your own supervisor is an

important act of autonomy.

·                      An unknown name out of the directory of registered supervisors is not the same as a personal recommendation.

 

·                      Geographical proximity is often important especially in the less

populated areas.

What is needed in supervision training?

·                      There is a need for a research survey of existing supervision training to examine and evaluate what consumer need is for both content and experience.

 

.   'Trainings need to work with practitioners as adults seeking further development.'  This comment is made by very experienced practitioners whose experiences of supervision training left a lot to be desired both at the lack of co-operative approach about how to fit training in, lack of explanation about the reasons for administrative requirements & training-body attitudes to the trainees. 

 

·                             Models of supervision training need to reflect 'difference', for example the difference between the supervision of trainees & of registered practitioners.  These models should include supervision training for a diversity of settings, for example EAPs, GP practice, schools, the voluntary sector, private practice & the supervision of non-counsellors. Supervisors with in-depth experience of these settings should be involved. Copeland (2002) reflects on the impact of the organisational context on counselling supervisors & its significance on how such contexts impact on the professional and ethical dilemmas of such supervisors.

 

·                             Courses should adequately cover legal & insurance supervision issues & the range of contracting issues involving supervisees & their organisations.

·                             There was also a plea that a 'training ensures that a supervisor has sufficient experience and understanding of mental illness'.

 

There are in these responses implicit assumptions about supervision training.  Those of us who are qualified or registered supervisors hope to communicate an assumption that we have had experiences through these training processes that can enrich our capacities as supervisors.

 

Exploring these supervision questions brought to light a dissonance between the public & the private language & the public & private needs of supervision. There is the public organisational statement on the role & function of a supervisor which represents an organisational, formal & 'concrete' requirement about what the expectations are around mandatory work-life-long supervision.  This has developed a certain language & mindset that is the public face of the protection of the public by the profession.

 

But behind it there is another story with a different and private language and supervisee needs, often more linked to the 'symbolic' aspects in relationships.  There are often personal, hidden and unconscious agendas that impact on supervision arrangements.  Henderson (2002) writes on choosing a new supervisor that this person needs the capacity 'to meet some personal needs as well as professional ones'.  Training courses have similar hidden agendas, for example there are issues around power.  Perhaps the way forward is to temporarily put aside the more organisational aspects of supervision and supervision training and accreditation, with its paramount emphasis on the needs of clients, to bring more into focus the hidden and private language and needs of supervision - what supervisees are seeking for themselves and not for their clients.  And this will vary. 

 

 

References

Copeland S (2002) Professional & ethical dilemmas experienced by counselling supervisors: the impact of the organisational context. CPR 2 : 231-237.

Henderson P (2002) Choosing a supervisor.  CPJ 13-12 : 22-23

Wheeler S (2001) Supervisor accreditation: it is time to apply.  CPJ,12-2 : 30-31)

 

In my role as Research Chair for the AP-PP Section of UKCP I have become profoundly aware of the lack of confidence around research, but also a longing to find some way of turning some previous work into a paper or project.  We urgently need a forum for ‘research without tears’ in BAPPS.  Research works best with a support group of some kind.  Will all those who want to take forward a small research project, or feel passionately about something & want help in taking it forward contact me? Most of you could transfer existing skills into a small project.  I will try to create a mutual support situation & seek those with existing research experience to act as a guide/s and take on board difficulties with such as ethics and confidentiality. 

 

Come on BAPPS members! If we do not demonstrate the value of our beliefs & practices in supervision then who will? Or will it have its own form of CBT for all?       ann@bowesuk.co.uk

 

 

Ann Bowes is a Psychoanalytic Psychotherapist in private practice, & is the inaugural chair of the AP-PP Section Research Committee.  She has a history of social science research in race relations & psychiatry. More recently she has undertaken research in psychoanalytic supervision & the psychoanalysis of organisations.  She has also been a Consultant in Psychotherapy in a major university with commensurate teaching experience.

 

 

 

Gertrud Mander

 

Gertrud attended the recent UKCP Research Conference. Her article introduces us to the scope & politics of psychotherapy research & shares the main points from Peter Fonagy’s presentation at the conference.

 

The title of this year’s UKCP Research Conference was From Research-Based Practice to Practice-Based Research. It urged its practitioner members to take research seriously, which makes a lot of sense as research has become essential everywhere in our society that expects its citizens to base their professional lives on ethical practice and to produce evidence of the efficacy and effectiveness of their work. In recent years it has become de rigeur for therapists and trainees to practice continuous professional development and to become accredited by their professional body, be it the UKCP or the BACP. In the wake of stringent self-regulating efforts to fully professionalize psychotherapy, to foster constant improvements in the functioning of the profession and in the maintenance of this  improvement, the UKCP has been tireless in  encouraging  the psychotherapy profession to increase research into the process, the context, the aims and the outcomes of psychotherapy  and  has been staging annual conferences, publishing an excellent journal, encouraging more trainings and networking in research. It lends its authority to the argument that all psychotherapists need to be more research-minded to support and improve their practice and to become active researchers in order to persuade the public that their work is essential to a well-functioning society and is effective in what it promises to do.

 

There are now 77 psychotherapy organisations in the UK & the media are keeping up an increasingly critical and watchful coverage of what is going on or going wrong in the field. In order to earn the confidence of the public and to demonstrate the usefulness of what the psychotherapy profession has to offer, it is necessary that all its practitioners are building and strengthening a scientific base for their diagnosis-based therapy. Back in the 1980s counselling and its professional organisation, the BACP, took the lead in developing & increasing evidence-based practitioner research, & it started a separate journal with the purpose of publishing research contributions from its members. Then the UKCP was created & also started a journal, ‘The Psychotherapist’, which promised to provide an opportunity for its registrants to share information and views on professional practice & topical issues.  Both professional organisations are putting on their separate research conferences, & all this has led to healthy competition generating an ever-growing increase in research material. As The Psychotherapist puts it, ‘We have concentrated on research that is in a form that practitioners can use to increase their effectiveness, their value to their clients & their credibility. Research is a challenging but fascinating pastime & every psychotherapist already has most of the skills needed to become an active researcher. Practitioner Research Networks provide the most practicable & effective route to meeting the research needs of psychotherapy.’

 

The UKCP Research Committee concentrates on research that practitioners can use to increase their effectiveness, their value to their clients and their credibility. It demonstrates in its journal that there is a great variety of ways in which therapists can become involved, both as users of these and as participants. The focus is on mobilising existing knowledge and co-creating new knowledge, exploring our professional identity and all the trials and tribulations experienced by therapists. That psychotherapy works has been established by decades of careful outcome research. An important early work was A Handbook of  Psychotherapy and Behaviour Change  by Bergin A & Garfield S (the most recent edition came out on 1994); this contained the first usage of the phrase ‘dose response curve’. There has also been  the substantial  book by Roth & Fonagy ‘What works for Whom’, subtitled ‘A Critical Review of Psychotherapy Research’ (1996) which the compilers of the government’s NICE guidelines for the health professions must have drawn on and which underlies the recent NHS decision to offer ‘a choice of psychological therapy for all who need it’. This has  been re-confirmed at the New Savoy Declaration Conference (30^th November 2007), when the government committed itself to implement the NICE guidelines, in order to allow G.P.s timely access to state-of-the-art evidence-based therapies for their patients. It may take 6 years to come about, but it may make all the difference.

 

The second UKCP research conference on ‘Mentalization’, entitled ‘From Research-based Practice to Practice-Based Research led by Peter Fonagy, based itself on the definition of research as ‘Studying usual care with care’ and ‘developing an overarching framework for psychological therapy using the evidence of practice’. In other words, the conference ‘carefully’ studied the problems of ‘careless’ research that does not heed Freud’s famous statement ‘because we can do good, we can also do harm’. 

 

Professor Fonagy urged the audience to keep in mind that therapists ‘tend to be poor’

 

·                      At predicting who will do badly

·                      At recognising failing therapies and at how well we are doing

·                      At developing manuals that teach how to behave & to foresee good or poor outcome

·                      At creating a sense of hopefulness

·                      At developing the  distinction between who needs  insight and who needs developmental help

·                      At understanding that clients of some therapists develop faster than those of others

 

He advised

·                      The study of practitioners  who are very effective and manualized

·                      The study of the implementation of efficacy studies

·                      That brief treatment of borderline cases makes them worse

·                      The interpretation of conflict is less helpful to borderline children than developmental help

·                      Recommended the use of simple, emotion-focused, sound-bite interventions,

·                      Praised positive mentalizing & mentalization-based research studies.

 

Emphasis was put on promoting  curiosity, the modelling of an inquisitive stance, and the offering of direct praise , but there was also the  reminder that we are all burdened by too much theory & used ‘combination treatments’ too indiscriminately. Plato was cited in support of the statement that, ‘Science is built up with facts as a house is built of stones, while a collection of facts is like a heap of stones’. Thus psychotherapy research like psychotherapy treatment should always be carefully developed in the context of practice. The final consensus emerged that the quality of social relationships has a powerful impact on everything, that there is always the search for an Other to confirm the a recalibration of practicing and care-seeking individuals. Another admonition was that psychotherapy tends often to be too general, & that a lack of specificity is the biggest challenge for it. The practitioner should constantly question himself how much positive change occurs & train other therapists to focus on key targets rather than attempt the multiplication of therapies. Apparently the increasing mountain of therapy research includes l3% of unpublished studies of clinically referred clients, & many of the others  may  claim more than they deliver. There is also no good evidence of who will benefit from inexact therapies which merely produce partial effects. Fonagy drew a poignant comparison of research with ‘the surgical image of keyhole surgery in contrast to using a scatter gun’; he also made the important statement that psychotherapy  works because it impacts on the brain. In other words, a new intellectual framework for psychotherapy is urgently needed, which identifies the underlying psychological & neural mechanisms of emotional disturbances.

 

In conclusion, the methodology of psychotherapeutic research into process, outcome, and contexts requires therapists and trainees to develop themselves and their practice, using questionnaires, interviews, measurement techniques and ongoing follow-ups. It includes statistical testing, cost-benefit analysis and a careful recognition of the problem of co-morbidity.  There are many and various schools of research, depending on the researchers’ affiliation: : the single case study , the phenomenological approach, heuristic research, post-modernist discourse analysis evolved from linguistics which questions assumptions, beliefs and the all-knowing expert, and a whole plethora of qualitative and quantitative methods.

 

I came away with the impression that we are living in a time of careful re-evaluation of what we do, of how & why we do it, & that a consensus is emerging which makes it imperative for us to root our practice firmly in the evidence-based study of clients, therapists & the contexts in which these two populations meet. All this was reflected & contained in the resolution on which the conference ended that there is an urgent need for the setting up of more Practice-Based Research Networks in the psychotherapy profession as a whole, with the help of the UKCP (& the BACP).

Later in the month, at the BACP Fellows meeting, research was also the subject under discussion and the message was again that practice-based research is necessary to establish   credibility for the profession and to generate proper understanding of what we do, why and for whom. The meeting concentrated on research as a way of justifying & demonstrating aims and goals and focused on prioritizing research topics. There was agreement that the therapeutic relationship is at the heart of our work and the vast amount of information gathered by individual practitioners from their clients needs to be pooled, classified, evaluated and written up for publication and dissemination.

 

 

References:

 

What is Psychotherapeutic Research (2006), edited on behalf of the UKCP by Del Loewenthal and David Winter, Karnac (Books) Ltd.

What Works for whom? A Critical Review of Psychotherapy Research, by Anthony Roth & Peter Fonagy (1996) Guilford Press.

A Handbook of Psychotherapy and Behaviour Change (latest edition 1994) edited by Bergin A and Garfield S, Wiley.

From Research-Based Practice to Practice-Based Research. A Conference hosted by the UKCP Research Committee and the UKCP Training Standards Committee , 21 February 2008

 

 

Gertrud Mander is a founder member of BAPPS, has worked as a supervisor/trainer for the WPF from 1983 to 2000 and has been working in private practice as a psychotherapist since 1980. She has published many articles and two books, A Psychodynamic Approach to Brief Therapy and Diversity, Discipline and Devotion in Psychoanalytic Psychotherapy.

 

 

 

Counselling and Psychotherapy Research Vol 7 Number 1 March 2007

Special Issue on Supervision; Guest Editor : Sue Wheeler

 

Reviewed by Jo Roscoe

 

In March 2007, the BACP Counselling and Psychotherapy Research Journal devoted a volume to research on supervision. It included seven new pieces of research and a systematic review of the  literature (1980 - 2006)[1]

 

For many years BACP has recommended regular supervision  as an adjunct to good practice and with a minimum number of hours of  monthly supervision as a mandatory criterion  for accreditation. Other professional associations  often encourage regular  supervision, but as yet do not require it. An exercising question within our profession is ‘ should regular supervision be a requirement; and if so, how often and how much?’  The debate is on going and is possibly  tinged with the same cynical resistance which is widely felt about regulation. None of the studies address this question directly.  Grant and Schofield [2] look at the incidence of post qualification  supervision  and conclude that participation is high, but  with a low response rate and a possibly biased  participant sample group their findings cannot be  scientific.

 

Perhaps it is the nature of research that a lot of work is often done to little effect;  or  a lot of work is done to prove something which is rather obvious - not that assumptions should not be tested - but  for example Walker, Ladany and Pate-Carolan’s [3] study found that disclosure by supervisees was more likely if the supervisor was supportive -which might have been expected. This study however, did contain a potential glimmer about the frequency  of non disclosure by supervisees.  A study of  the impact of ‘stuckness’ reported by trainees in group supervision [4] found that  the experience was associated with a sense of failure which could be alleviated by an encouraging response in supervision.  Another project explored the reactions of psychotherapists  when confronted with clients’ traumatic experiences [5].  It seemed to me that the results showed that psychotherapists may experience a shock reaction which leads them to indulge in their personal style: to offer coping strategies; do a lot of talking or attend to unburdening the client. Which would hopefully be noticed and corrected by the supervisor.

 

Kathy Crocket (New Zealand) [6] starts her study from the premise that our ideas of what we are and how we ought to be are given to us by the institutions  and disciplines  of our world; she uses a particular supervision conversation to explore the influence of supervision on the professional self we assemble for ourselves.  The supervisee speaks of her concerns about low client numbers which do not meet her or (she believes) her agency‘s expectations.  The supervisor recognises  an ‘I ought to be…’ in the material and picks her way  to uncover it.  In this instance then the supervisor is encouraging the client to adjust her self perceptions;  it follows that a different style of supervision could  add to a supervisee’s  self or mis-perceptions.

 

More interesting to me is Jacobsen’s [7] study of  the incidence & use of parallel processes. Based on videotapes of two consecutive sessions with a schizophrenic patient  interspersed by a supervision session. The study  explores the different types of parallel process presented in the material , the processes that contribute & the impact of the supervisor’s interventions. The therapist is an experienced psychoanalytic psychotherapist; the supervisor a very experienced psychoanalytic psychotherapist. The author suggests that the material is too slender a basis for drawing wide ranging conclusions about types of parallel process but contends that it provides powerful evidence of its existence & highlights its potential use for supervisors.  In this case the supervisor’s recognition and interventions empowered the therapist in his dealings with an evasive and potentially dangerous patient.  Altogether an elegant and powerful  piece of research - the first of a planned series of studies - which, in my opinion,  almost of itself justifies a call for regular supervision.

 

Worthen and Lambert’s [8] study of outcome oriented supervision will be more controversial for some of us but the findings are challenging. Drawing data from a research programme based on outcome monitoring, the study argues that supervision should include outcome monitoring and that where a client does not make progress as would normally be expected that further assessment and problem solving strategies  should be discussed and provided in supervision. Using their  own system ( a university counselling centre) to make a comparative study of outcomes from four clinical trials of treatment with feedback and monitoring and treatment without, the results showed  strongly that feedback and monitoring improved outcomes. More specifically it showed that outcomes from clients  categorised after assessment as ‘not on track’ for a good outcome improved from 25% to 49% and that ‘deterioration’ (leaving early) dropped from 19% to 8%.

 

Thus the argument is forcibly put, but throws up other questions. Are university students more accepting of (weekly) feedback forms?  Would it work in private practice or in our counselling centres? Are all supervisors equipped to provide problem solving strategies? Can a psychodynamic/psychoanalytic orientation accommodate the interventions & questionnaires? If not, then what method would?

 

The signs are that evidence of effectiveness in cost & health terms will be increasingly asked for & unless we can provide it I fear we will lose what hold we still have as psychodynamic practitioners in the NHS & the voluntary sector.

 

Wheeler & Richards’ review of the literature (1980 - 2006) as it concerned the impact of supervision on counsellors & therapists, their practice & their clients distilled some 2000 articles  down to 18 using various filters  relevant to the review. The results indicated that supervision was effective in promoting therapist self awareness & skill enhancement, thus raising the likelihood of improved client outcome - though no studies in the review offered substantial evidence of this. Moreover, most of the studies concerned trainees. Only 2 of the 18 pieces were from the UK & only 2 of the pieces met the criteria to be classified as very good.  These comments highlight the urgency of sound, focussed research relevant to supervision;  & perhaps the apparent lack of a research culture in the UK (of the two studies I expand on above, one is from Denmark & one from the US; none of the others with the exception of Wheeler & Richard’s is from the UK ).

 

So, of this issue I find most of the pieces of some interest, two worth taking careful note of and the review a good indication of the current state of supervision research. But applause for BACP for instituting a regular research journal; it should be more closely read than my own very unscientific survey amongst colleagues suggests.

 

[1]     The impact of clinical supervision on counsellors & therapists, their practice & their clients. A systematic review of the literature. Sue wheeler & Kaye Richards

[2]     Career-long supervision  : patterns and perspectives   Jan Grant & Margot Schofield

[3]     Gender - related events in psychotherapy supervision : female trainee perspectives  Jessica A walker, Nicholas Ladanay & Lia M Pate-Carolan

[4]     Trainees’ experiences of impasses in counselling & the impact of group supervision on their resolution: A pilot study  Jack De Stefano, Nadia D’Iuso,Emily Blake, Marylin Fitzpatrick, Martin Drapeau & Martha Chamodraka

[5]     Therapist reactions in self experienced difficult situations : An exploration  Annemarie J M Smith, Wim Chr. Kleun & Giel Hutschemaekers

[6]     Counselling supervision & the production of professional selves  Kathie Crocket

[7]     A Qualitative single case study of parallel processes Claus Hauggaar Jacobsen

[8]     Outcome Oriented Supervision: Advantages of adding systematic client tracking to supportive consultations. Vaughn E  Worthen & Michael J Lambert

 

Jo Roscoe is a supervisor & BACP accredited counsellor working in private practice in Hatfield & until recently in central Manchester. She has worked for a number of years as an Appraisal Visitor to the wpf affiliate network.

 

 

What is Psychotherapeutic Research?

Edited on behalf of the UKCP by Del Loewenthal & David Winter (Karnac 2006)

Reviewed by Gertrud Mander

 

This book does not initially look like an easy read, as its language is peppered with difficult concepts like ‘randomized control conditions’, ‘double blind studies’, ‘placebo control’, ‘dose response curve’, ‘combination treatment’ etc. However once the reader has decided to give it a try, the anxiety about not understanding the unfamiliar language & the new concepts is quickly overcome, as there is so much fascinating information here about what we do as psychotherapy practitioners, how we do it, & how it affects the patients.

 

The excellent Introduction by Mark Aveline, in Chapter One, takes the reader gently by the hand, explaining cogently that it is necessary to minimize bias and that every piece of psychotherapy is in itself already a form of research. The book’s authors acknowledge that the language of research may leave some therapists with ‘feelings of anxiety, confusion and ambivalence’, assuring them that the demand for evidence-based practice ‘arises as much from the needs of patients as from the demands of the market place within the health care professions’ . After voicing  these concerns, a  coherent case is made for research that is scientific, humane and relevant ( which was Plato’s description), and  the argument that ‘even experienced therapists have a relatively small pool of experience from which to draw conclusions’ will win over even the sceptical reader whose prejudice may be that most research is dryly academic. We need all the support we can get in order to do our difficult work responsibly.

 

The book is divided into five sections; the first gives an overview of different research methods, the second describes how to get started in the use of qualitative or quantitative methods of research, the third focuses on research into the process of psychotherapy. This is followed by research into the outcomes of psychotherapy & concluded by researching the therapist & the therapeutic context. Most papers are brief & accessible, & a few longer discussions are provided on the impact of researching into sensitive & distressing topics. The last section explores the therapist & the therapeutic context & concludes with researching why therapists are drawn temperamentally into different camps, such as psychodynamic therapy or cognitive-behavioural therapy, adding a cautionary note concerning the problems arising from ‘differences across philosophical positions which cannot be resolved on the level of competing facts & theories, but need an exploration of the fundamental philosophical assumptions upon which different counselling theories & approaches are based’. In other words, significant differences in personality, & particularly in ‘cognitive-epistomological styles’, may have implications for communicating, evaluating & processing therapeutic knowledge, and for the ability to consider the validity of other approaches. Therapists after all do not just differ theoretically, they also experience other personality styles differently & will now & then find dialogue with someone from a different professional persuasion difficult. A poignant example would be people drawn to behaviourism versus psychodynamically- orientated practitioners, or research enthusiasts versus practitioners who see no place for research in their work.

 

Supervision in Counselling: Interdisciplinary Issues and Research.  Lawrence Shulman and Andrew Safyer, (Eds)   The Haworth Press Inc. New York, London and Victoria (Au). (2005)

Reviewed by Margaret Smith

This book is written in the USA by American professionals who are experts in the area of clinical supervision research in their fields. It is a compilation of chapters, five of which were presented at a two day workshop in Buffalo updating each of the author’s previous research, and the other three describe the state of research into Clinical Supervision that were presented at a research conference. Two further chapters trace the history of the development of Clinical Supervision across disciplines and the development of the therapeutic alliance. Each chapter focuses on a different field and pulls together research from American Journals published in the last five years. A wealth of review literature is summarized throughout the book, making it a useful tool for those undertaking research projects in supervision in the UK, who may wish to supplement the British literature on supervision with that within the USA.

The first chapter, written by Janine Bernard, highlights the development of clinical supervision, from its practice in psychoanalysis and its spread out to other modalities and disciplines, but without training for supervisors or a real emphasis on the supervisory alliance which is core to the effectiveness of all supervision. Her paper draws attention to some of the key differences in practice today, from when she started working 25 years ago. She notes that outside of Social Work Supervision, little attention has been paid to the infrastructure of supervision, which has focused more on “...paradigms, techniques and relationship ...” Bernard (2005 p10). More recently, a driver for change has come from new technologies; allowing recording of material has required more attention to the infrastructure, along with a move towards accreditation, regulation and the development of academic standards. Along with this, an increasing aspect of supervision is attention to legal ethical issues and boundary issues. With respect to dual relationships for example within training, she suggests that boundaries, between student and supervisor, have sometimes become too rigid. However, a positive is the change in the location of the “problem” from the supervisee to the recognition that the supervisor is not a blank screen and that differences have to be accommodated.

The chapter on The Clinical Supervisor-Practitioner Alliance: a parallel process, by Lawrence Shulman, was the one to which I warmed the most. The content is rooted in his research & his illustrations are most pertinent to new supervisors, & those working with inexperienced counsellors & therapists. He illustrates the fundamental role of trust, rapport & caring within the supervisory relationship, giving brief illustrative vignettes, both from his research & his experience in supervision. He shows the importance of allowing the space to tune in to the meaning of what a client may say, & not just the content. For example with a personal question such as, “Are you married?”, he helps supervisees to avoid defensive responses such as, “why do you ask?”, & encourages them to respond genuinely & professionally & to find their own authentic voice rather than responding prescriptively. One case of a counsellor working with a young native Canadian mother, who had been reported as neglecting her children, highlights the importance, of the supervisor being aware of who each of them was identifying with & the impact that this was having on their perspective on the situation. Shulman also emphasises the importance of the supervisor modeling with the counsellor the non-judgmental response that would encompass both acknowledging the real concerns about the mother’s behaviour towards her children but also helping them to hold in mind & respond to the needs of a mother of three children forced to leave her support network & finding herself isolated & in one room. Shulman also lays emphasis, through description & vignette, on the importance of the supervisor being aware of parallel process & the likelihood of acting out in the supervision, the dynamics which in turn will mirror the process present in the therapy. I liked the idea he puts forward that development in supervision is partly about shortening the time between making a mistake & spotting that this has happened. He also suggests that therapists, & by implication supervisors, move from making simple mistakes to more complex ones!

Borders presents an overview of the research published over the five previous years and offers an account of this, presented as themes and trends, in counselling supervision and supervision in counsellor education. Information about the type of research, e.g. qualitative or quantitative, areas covered by Journal and the research focus, e.g. the supervisory relationship and multicultural supervision is presented in tabular form. Following on from this are a series of sections which paint a picture of the key findings and make suggestions about useful future research areas for developing our understanding about what makes supervision effective. One example of this is the section on papers researching the effectiveness of group supervision. Starting with a review, (Holloway and Johnston 1985) which described group supervision as, “widely practiced but poorly understood ...” (1985, p332). They then summarised the findings from the four papers: participants found group supervision highly effective, especially in promoting counsellor autonomy in their work in spite of the marked preference for individual supervision. Borders then highlights the lack of research in this area. Other areas reviewed in this way include supervisory dynamics, multicultural issues, supervisor training and competence.

Goodyear, Bunch & Caiborn reviewed the 49 papers published in Psychology Journals on any aspect of supervision between 1999 & 2004. They then presented in tabular form, the focus of the article into nine categories, e.g. alliance, countertransference & competancy & the type of article, e.g. review, qualitative, quantitative or narrative. The paper then briefly discusses the findings & calls for more research into supervision by psychologists.

The final chapter by Marion Bogo is on the place of clinical supervision within Social Work Education. Drawing on 40 articles she looks at the importance of the student’s host organization in engaging with supervision and the benefits of learning from the experience of experienced practitioners. She also highlights the importance of preparing students to use supervision to the best effect and some of the safeguards that could usefully be put in place, for example to deal with the issue of student suitability. She also covers supervisor competence and group supervision.  

Although only the first two chapters of this book are written form a psychodynamic perspective, it covers a wide range of supervisory themes relevant to all modalities such as the therapeutic alliance, legal and ethical issues and equality and diversity. 

The book would also be of particular interest to those psychodynamic supervisors who offer supervision to nurses, social workers & psychologists working in other fields. It is packed with references & useful in reminding us as supervisors of the importance of research in our field as a way to improve practice and to give supervision the research grounding it needs in today’s climate of evidence based practice.

Margaret Smith is a supervisor, psychodynamic psychotherapist and a group analyst working with health service staff in Liverpool.  She is a visiting lecturer for the Tavistock Institute and teaches on the Liverpool block training ‘Consultation and the Organisation’.

 

Qualitative Research in Counselling and Psychotherapy

John McLeod   (Sage publications 2007)

 

Reviewed by Anne Rogers

 

This was my introduction to the work of John McLeod, Professor of Counselling at Dundee University, although he has written a number of books & papers on the subject of research in Counselling & Psychotherapy. As I believe quite strongly in the need for more research in psychotherapy I welcomed the opportunity of reviewing the book.

 

There has been relatively little analytic psychotherapy research. We are all familiar with case studies, there has recently been some quantative research, particularly in regard to outcome, & while qualitative research has been used for some time in the health & social sciences it has not been much used in the field of psychotherapy.

 

The given aim of this book was to introduce & describe the methods of research available for use; to summarise & discuss research examples & to review the issues & controversies associated with this area of work. This is a massive undertaking & there were many times while reading the book I questioned for whom he was writing. The reality is that most research is carried out within institutions & Universities, students there have access to ‘research subjects’ & the means of publication. It is also true that students tend to follow similar methods to that of the department or supervisor.

 

However given those restrictions there is much that could be of interest in the book for counsellors & psychotherapists, even if they do not intend to do research themselves it is important to know what is or is not being done in their name. All research & research funding is political, this is particularly true at the present time when much research and money is being used to advocate particular types of therapy.

 

McLeod takes us through several methods of research. The Hermeneutic approach is an understanding framed by ‘historical consciousness’, cultural concepts embodied in language. This method is much used in the social sciences. The Phenomenological approach aims to produce an exhaustive description of everyday experience, and thus to arrive at an understanding of ‘the thing itself’; this method is very dependent on the personal qualities and experience of the researcher. He argues that a combination of both these approaches is necessary in qualitative research and he goes on to detail different ways that this can be done, while all the time relating methods and ideas back to the underlying philosophical principles, particularly to those of Edmund Husserl and Martin Heidegger. Husserl in his search for ‘radical certitude’ and Heidegger fiercely committed to the integration of hermeutics and phenomenology.

 

In subsequent chapters McLeod goes on to detail the different ways these approaches can be combined and different methods that can be used. Approaches might include interviews, questionnaires, discourse and conversation analysis. There is a rather long chapter in which he gives details of these different approaches. These were mostly quite interesting but seemed to me somewhat too detailed for the initial enquirer into qualitative research while probably not detailed enough for the researcher wanting to know ‘how to do it’.

 

McLeod makes the point throughout the book that the good qualitative researcher needs to be familiar with many approaches before being able to make a choice & to find his/her own way of working. A blurring of genres can be important allowing research to move between science & art, thereby transcending the confines of any one particular method. The researcher also needs to be aware of the development & complexity of these perspectives. Qualitative research must keep changing in response to both individual & social circumstances. Researchers must struggle with the task of knowing. The qualities of a ‘good researcher’ he says, are ‘imagination, creativity, courage, personal integrity & commitment’. But these are also the qualities of the ‘good’ psychotherapist.

 

McLeod makes a comparison between a piece of qualitative research with a work of art. Both are constructed & are a representation of the world. One fundamental difference between art & qualitative research however is that the latter does not have any equivalent to the many art critics & historians writing books & articles in newspapers & journals for the general public. However I think this situation is slowly changing, counselling is more talked about, prospective clients are more questioning if not yet well informed.

 

McLeod’s main plea in the book is for more qualitative Outcome Research. Until now outcome studies have been mostly the preserve of quantative analysis with randomised controlled trails and rather constraining questionnaires in which too often neither the voice of the client nor therapist is heard. If counselling and psychotherapy are to be taken seriously, and to attract funding, it must address the problem of investigating outcome.

 

One of the most interesting chapters was the one in which he addresses some of the critical and complex issues around qualitative inquiry.  What is at stake, he says is validity and truth and critical reflexivity.  How are we to judge the quality of a piece of research? He has argued throughout the book that qualitative research is a personal activity and that if the ‘findings’ of a qualitative study are generated through the active personal engagement of the investigator then what is produced will almost inevitably reflect his approach. What will be said in an interview is influenced by the presence and skill of the interviewer. How can we judge whether the research is reliable if reliability is judged by the possibility of getting the same results whoever the researcher? McLeod argues that reflexivity is central to any qualitative research. It implies awareness of the moral dimension of the work; it invites consideration of the processes through which the text is co-constructed and it opens up a necessity for new approaches to writing and communicating research findings. Moral considerations, he argues, go beyond inscribed ethical codes. They cover concerns about the impact of the research interview on the informant. In the presence of a skilled interviewer new issues may be opened up but often with no opportunity to continue the conversation after the interview. The ethics of reporting clinical material has been discussed by a number of people including Barbara Wharton  in the Ethical Attitude in Analytic Practice. McLeod is arguing that moral issues go beyond the question of ethics and simple consent to publication, which do not take into account the possible consequences of the participant seeing their story in print. What also, he asks, of the ‘dread, guilt, shame evoked in the researcher when writing about others’. McLeod does not however address the many deep anxieties for practitioners as to how any such research would effect themselves, their relationship with their patients and the therapy, particularly if it is still ongoing. Until these issues are opened up and discussed it seems difficult to see how there can be any significant development in outcome research, especially in psychoanalytic psychotherapy.

 

Anne Rogers is in private practice. Formerly she was Clinical Manager and Treasurer in her own Training Organisation. She has been supervisor, seminar and group leader in a Wpf affliliate where she continues as an academic tutor to individual students.

 

 

Penny Wise & Geri Dogmetchi

UKCP ICO

 

Complaints Organization (ICO)  It has finally accepted that with Government Registration by the Health Professions Council (HPC) which really does look inevitable complaints will be dealt with by that body.  Meantime the UKCP has reverted to hearing complaints appeals, as it always has. It is unclear whether it will be able to take over the complaints process from Member Organisations in the interim before HPC registration comes into effect. BAPPS Members might like to know that BAPPS has attempted to have some input with the DOH and HPC with regard to supervision, standards and complaints.

 

Section: Council for Psychoanalysis & Jungian Analysis (CPJA)

Whilst a lot of time &money seems to have been wasted on the ICO, our section particularly has done a lot of thinking about the complaints process, government registration & about our analytic practice and this has been very fruitful & creative.  The section agrees there are differences between us but we are all in agreement with regard to our concerns about the lack of understanding about psychoanalytic processes by HPC & none of us are keen about HPC registration. It was agreed at the Section meeting that we would try to hold some meetings & a conference between the various Member Organisations so that we can share ideas with grass roots members and publicize our work. There is now a CPJA website which will represent our ideas, publish research and hopefully have a register which we hope in future, will include information about BAPPS and supervisors. There is dissatisfaction from our Section regarding UKCP (in what respect?) and also because we appear to hear rumour rather than fact about the HPC. The website indicates our desire for more independence. 

 

Section BAPPS input

BAPPS Ethics Committee has worked on the CPJA Ethical document for them. As yet there has been no decision by CPJA Ethics Committee. Both Geri & Penny have had to spend considerable time performing quinquennial reviews of training & listing bodies within the Section as part of our role as delegates. We shall not be attending theUKCP AGM this March because of the prohibitive cost.

 

HPC Skills for Health

At present the Skills for Health body is setting up a consultation process with representatives from all psychoanalytical organisations. Peter Fonagy and Anthony Bateman, who you will be familiar with, appear to be chairing these meetings. It is unclear how much, or the timing of, consultation since representatives have not been chosen yet and June seems to be the closing date with Autumn as the final decision time. We were hoping that we would follow the BPS into registration but it appears that the HPC is under pressure from the Government to ensure registration of all of us is in place by end of 2009. It is presently unclear what categories and standards will apply to entry on to HPC register.

 

 

BAPPS West continues to offer support to a supervision course under the
aegis of STPN commencing this September.  We also are pleased to run two clinical supervision seminars in Bristol.  The first is with Jean Knox on
26 April when she is in dialogue with Francis Hauxwell concerning the
supervision of borderline patients.  The second seminar is with Joy
Schaverien on 11 October when the topic will encompass the erotic
transference & counter transference in supervision.  All enquiries
concerning these events should be addressed to me at ann@bowesuk.co.uk or on 0117 9735844.

 

 

 

 

David Hewison

David Hewison will present a paper which addresses pressures on us as supervisors to fall into rigid states of mind in the presence of particular emotional constellations in the supervisory setting, in ways that we may not initially notice.  In particular it explores the impact of typical difficulties around our abilities to think clearly or freely, to avoid knowing too much or too soon, & to restrain our actions (interpretations, instructions etc) before we have had a chance to reflect on what it is we are doing.  It uses Sophocles' three Theban plays: Oedipus Rex, Oedipus at Colonus, & Antigone as exemplars of these troubling states, showing the emotional pressures behind our 'blind spots' as supervisors, & it illustrates them with examples from the supervision of individual & couple psychotherapy.  The aim of the paper is to 'triangulate' theory & practice with the work of one of the greatest ancient dramatists, showing us that these emotional complications are nothing new, but that they are particularly hard to avoid. 

Dr David Hewison is Reader in Couple Psychoanalytic Psychotherapy at the Tavistock Centre for Couple Relations & a Jungian Analyst.  He is a Full Member of the Society of Couple Psychoanalytic Psychotherapists & a Professional Member of the Society of Analytical Psychology.  He teaches & supervises widely in this country & abroad, & he is involved in the TCCR's' Effective Staff Supervision' programme which applies psychoanalytic thinking to supervision in the caring professions & organisations as well as in the SAP's Certificate in Supervision course.  He has a practice of individual analysis, supervision & couple psychotherapy in North London.

 

Supervisors’ Conference

Saturday 10^th May 2008

 

WHEN THINKING, KNOWING, & ACTING

GET IN THE WAY OF SUPERVISION

REFLECTIONS ON OEDIPUS AND HIS CHILDREN

 

DAVID HEWISON

 

             9.30           Registration

             10.00         Welcome and Speaker

             11.15         Coffee

             11.45         Discussion groups

                1.00        Lunch

                2.00        Plenary

                3.00        End

There will be a book stall

The Tavistock Centre
120 Belsize Lane
London  NW3 5BA

Nearest tubes:    Finchley Road;  Swiss Cottage

Cost:   £75.00 by 5^th May 2008                     Cheques payable to  BAPPS
Carolyn Couchman, Dept C4,The Old School,  Halstead,  Sevenoaks,   Kent T14 7HF

 

Cancellations policy:  1 month = full refund.  2 weeks = 50% refund.  1 week = no refund

 

 

Anna Bravesmith will speak at the autumn conference, following the AGM on 8^th November, at the Tavistock

 

 

 

The newsletter committee would like to convey warm thanks to all members who have contributed to recent editions. The size of this newsletter demonstrates that BAPPS is generating an impressive level of thoughtful reflection & writing.  Whereas there are a number of books of the "How to ......" genre regarding supervision, the BAPPS newsletter provides a forum for development & exchange regarding the ongoing development of supervision practice. In order to achieve this level of debate we rely upon BAPPS members, as experienced supervisors to share "nuggets" of their experiences & observations, as well as more extended pieces of writing on a topic. In addition, book reviews, course & conference reports etc. are also welcomed.

 

Please do consider joining in & contributing to future editions; our articles are usually between one & two thousand words, book reviews are 500 to 1,000., but "nuggets" can be a few paragraphs.  The following themes are in the pipeline:

 

 

Summer 08- Notes in supervision:  How do we (supervisees & supervisors) use them? What are the possible uses, abuses or other pitfalls? Any novel approaches, insights or frustrations? The deadline for copy is the end of May.

 

 

Autumn 08 – Diversity in Supervision: we welcome papers looking at how difference within the triangle may impact and how it is managed.  Have you encountered an issue with difference in individual or group supervision which has given you especial pause for thought  e.g. pregnancy, class, illness, theoretical orientation, gender, race, stage of training, age .........?

 

 

Spring 09- theme to be decided – ideas welcomed:

 

Please contact     Annie Power – anne.power@gmail.com

or            Lynda Norton - lynda.norton@ntlworld.com

 

 

Aggie Moorman

      2 Cranedown Lewes SUSSEX BN7 3NA

      01273 47024       agasw@yahoo.co.uk                                         [ BACP ]

 

Janette Gale

      26 Harnham Rd Salisbury  SP2 8JJ

      01722 502789     janette.gale@ntlworld.com                   [ BACP UKRC]

 

Susanna Alward

       27 Shooters Hill Red Lion Lane  LONDON  SE18 4LG

      020 8856 6666    anna.alward@lineone.net                               [ UKCP ]

 

Raphael Lopez de Soto

      Holistic Health Centre 3 Chobham Rd Woking  SURREY  GU21 6HX

      01483 724300     r.lopezdesoto@btinternet.com                         [ UKCP ]

 

Richard Nash Nehrebecki 

      The Brompton Therapy Centre  5-6 Roxby Place   Rickett St

                                      LONDON  SW6 1RU

      0786 759 1840

      The Psychotherapy Practice  2 University Rd

                                      Southampton SO17 1TJ

                                      Nehrebecki@aol.com            [ UKCP  BACP  UKRC ]

 

Frances Bower

      12 Lawley Street  LONDON E5 ORJ

      07956 563422     frances@fbower.orangehome.co.uk [BPC BACP UKRC]

 

 

 

 

The Newsletter is prepared by the Publications Committee

Chris Driver, Lynda Norton and Annie Power.